Dual-Market States Are Neglecting Medical Cannabis—and It’s Fixable

Across the country, dual-market states are running the same experiment—and getting the same result: adult-use expands, and medical cannabis quietly declines.This is not because patients stopped needing medical cannabis. It’s because state policy frameworks often treat medical like a legacy program, while adult-use becomes the growth engine.The duplex problem: one foundation, two realitiesThe simplest way to explain what’s happening is to imagine a duplex.Two homes share a foundation and structure. But one side gets the upgrades: new windows, a new furnace, new shingles, regular maintenance. The other side becomes rundown—still operating like it’s 1955.That’s the medical vs adult-use pattern we keep seeing:* adult-use gets modernized systems, better access, more investment* medical gets treated as “still there,” but not prioritized* eventually, patients and consumers choose the side that feels supportedThen policymakers ask: “How do we reinvigorate the medical program?”The answer isn’t branding. It’s value.If a state wants medical cannabis to stand up in a dual market, the solution is not a new slogan or a minor rule tweak. The solution is building medical value that adult-use cannot replace.That means real clinical and observational research tied to:* product development,* measurable health outcomes,* and evidence that can inform physicians and patients.M4MM’s recommendation: build clinical research capacity and partnershipsFor New Jersey and other dual-market states, M4MM recommends a clear, proactive strategy:* Operationalize medical cannabis researchMany states have “research language” in statute, but it sits underused. This is the moment to build a real research pipeline.* Create a clinical research licensing pathwayStates can establish a clinical research license category (or a functional equivalent) that supports structured partnerships and studies.* Fund and facilitate partnershipsAlign in-state resources so research universities, hospital systems, and licensees can run pilots and studies that document outcomes.* Prioritize health equityMedical cannabis research should include conditions that disproportionately impact minority communities and other underserved populations—so medical programs serve real needs with real evidence.Medical should function like prescription careMedical cannabis should operate like prescription medications: targeted, outcome-based, evidence-informed care.Adult-use is closer to over-the-counter access.A strong dual market requires both—but it only works when medical is treated as a medical system worth investing in.Call to actionIf your state wants a robust medical program that survives alongside adult-use, the time to rebuild is now—before medical becomes permanently irrelevant.M4MM is available to partner with policymakers, regulators, researchers, licensees, and advocates to structure real-world solutions.Partner with M4MM: minorities4medicalmarijuana.orgFor additional information, please contact:By Eric FosterNational Policy Director for Cannabis & HempMinorities for Medical MarijuanaEmail: [email protected] Common Sense by Eric Foster is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber.Thanks for reading Common Sense by Eric Foster! This post is public so feel free to share it. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit ericfoster52.substack.com/subscribe