Evaluating the Ohio Medical Marijuana Control Program: Satisfaction and Perception

Since the inception of the Ohio Medical Marijuana Control Program (OMMCP) in 2019, the Drug Enforcement and Policy Center (DEPC) has surveyed medical marijuana patients and potential patients to evaluate their experiences and satisfaction. These surveys aim to fill in a critical gap in our understanding of the medical marijuana program in Ohio and to find out how the people being served by OMMCP evaluate its performance.

In November 2023, Ohio voters approved a ballot initiative to join 23 other states in legalizing cannabis for recreational use. The initiative went into effect on December 7, 2023, legalizing possession of marijuana for personal use of up to 2.5 oz and allowing for home cultivation. Following a licensing process, official recreational sales in Ohio dispensaries started on August 6, 2024, leaving the medical marijuana program largely unaffected in fiscal year 2024. This sixth annual report thus provides a unique snapshot of a medical marijuana program on the brink of recreational sales and provides insights into patients’ opinions about the medical program and its future.

NOTE: This page does not incorporate citations. Download the report to find the full list of sources and references used.

Our 2024 survey of over 5,000 medical marijuana patients and prospective patients and state data from the Ohio Division of Cannabis Control and Department of Taxation reveal the following key findings:

1. Increased patient satisfaction

Our survey recorded a considerable increase of patients reporting being extremely satisfied with the Ohio medical marijuana program, increasing by 12 percentage points from 19% in 2023 to 31% in 2024. A total of 74% of respondents reported that they were either extremely or somewhat satisfied with OMMCP, and only 20% reported being either somewhat or extremely dissatisfied. While 20% dissatisfaction is not to be disregarded, these numbers represent an almost complete reversal from results in our first survey in 2019, when only 16% of respondents reported being satisfied and 67% reported being dissatisfied with OMMCP.

Satisfaction levels among Ohio medical marijuana patients

2. Falling participation for both patients and physicians

Despite high levels of patient satisfaction, this year was the first year that OMMCP recorded a decline in the number of active patients (patients with active recommendation and registration), decreasing by 10% from its peak in October 2023 (184,958) to 165,746 in June 2024. The most recent OMMCP report for the month of September 2024 shows further decline to 159,997 active patients. This is not surprising given similar experiences of all other states that have transitioned to adult-use market. Their experience also shows that the extent of the decline will depend on the degree to which regulators and policymakers are willing to make changes to policies that affect patients’ access to marijuana products and their satisfaction levels.

During the same time period we have also seen the number of physicians with certificates to recommend drop from 648 in June 2023 to 605 in June 2024. This represents an average of approximately 5.1 physicians with ability to recommend medical marijuana per 100,000 Ohio residents and 264 active patients per one licensed physician as of September 2024.

OMMCP Medical marijuana patients with active registration and recommendation

3. Flat sales receipts and tax revenue despite increases in sales

In a year-to-year comparison, Ohio medical marijuana market continued to experience a robust growth in the number and weight of product sold. In FY24, sales of plant product increased by 30% compared to the previous fiscal year, going from 71,506 pounds sold in FY23 to 92,979 pounds sold in FY24. Sales of manufactured products also recorded solid growth of 20%, going from 6,794,542 units sold in FY23 to 8,182,377 units sold in FY24. While the recorded growth continues to be robust, it nonetheless shows signs of slowdown when compared to the rate of growth from FY22 to FY23, which was 39.6% for plant products and 33.9% for manufactured products.

Despite the robust growth in total sales, sales receipts remained largely flat due to declining prices, increasing only by 2% from $478,067,435 in FY23 to $487,589,380 in FY24. This is significantly lower growth rate than the 10% recorded from FY22 to FY23. Since its inception in January 2019, the Ohio medical marijuana program recorded over $1.88 billion in sales.

According to the Ohio Department of Taxation, as of March 31, 2024, the state of Ohio collected $95,875,003 of total marijuana tax revenue from the 5.75% state sales tax. Municipalities, counties, and other regional entities have collected an additional $24,889,170 from local sales taxes ranging between 0.5 – 2.25%. Tax revenue collections in Ohio follow a similar pattern seen in other states, with an initial rapid growth of 168.5% in its third year of operations, followed by 39% and 10.9% in its fourth and fifth year, and finally plateauing in its sixth year with virtually flat tax revenue collection.

4. Falling prices with a summer 2024 spike

The average price of one gram of marijuana plant product decreased by 19.8% from FY23 ($7.67) to FY24 ($6.15). The price of manufactured product unit has fallen similarly by 18.5% from FY23 to FY24 ($34.35 and $28.00 respectively). However, June and July of 2024 recorded the highest average plant prices ($7.28 and $7.83 respectively) since January 2023 and November 2022, which could be an indication that dispensary pricing is likely to be negatively affected at least initially by the beginning of recreational marijuana sales, which commenced in August 2024.

5. Michigan dispensary prices continue to be significantly lower than prices in Ohio dispensaries

While the average monthly price in Ohio dispensaries has gone down by nearly 20% from FY23 to FY24, the state of Michigan registered a small increase in price from $3.52 in FY23 to $3.61 in FY24. The average monthly differential between Michigan and Ohio dispensaries is significantly lower, decreasing from $4.15 in FY23 to $2.55 in FY24. Nevertheless, prices in Ohio dispensaries continue to be approximately 70% higher than in Michigan dispensaries.

6. High levels of dispensary utilization

Eighty-one percent of survey participants indicated that they always obtained their product from a licensed Ohio medical dispensary, while only 3% of respondents did not use Ohio medical dispensaries at all. The second most frequented source for medical marijuana were licensed dispensaries in another state, with 9% of respondents always obtaining their product from this source and additional 34% sometimes utilizing them. The survey also revealed that 2% of respondents always and 15% sometimes purchase marijuana from the illicit market. When asked to about the reasons why survey participants did not use Ohio dispensaries, the leading factor, selected by 27% of respondents, was the high cost of product, followed by the cost of obtaining and maintaining a patient card being too high (11%) and lack of diverse products available in medical dispensaries (8%).

7. Cost of marijuana product, cost of annual registration and lack of legal protections continue to drive dissatisfaction

Even though the level of dissatisfaction has decreased significantly over time, the survey asked about which factors were driving patients’ dissatisfaction. Factors driving patient dissatisfaction stayed consistent with 2023, with 70% of respondents reporting that their dissatisfaction is driven by the high prices in Ohio dispensaries, 56% citing the high cost of annual fees and doctor recommendation, and 47% citing lack of legal protections for employment.

8. Provision of legal protections most important policy change to improving patient satisfaction

Four policy changes would have significant positive impact on patients’ satisfaction: 80% of respondents stated that providing legal protections for patients would significantly increase their satisfaction, as well as allowing home delivery (73%), not requiring annual doctor recommendations (71%), and not requiring annual registration (66%). On the other hand, two policy changes would have significant negative repercussions for patients’ satisfaction – not allowing virtual medical appointments to obtain a recommendation (76.2%) and not allowing online ordering of medical marijuana (66%).

1. Preserve supply of reasonably priced marijuana products for medical patients

The question of reasonably priced marijuana products for medical patients becomes especially important given the summer 2024 spike in marijuana product prices. While the beginning of recreational sales is often accompanied by some price fluctuation as markets need time to adjust to increase in demand, it is important that Ohio regulators and policymakers ensure that patients’ access to reasonably priced marijuana products is safeguarded. While recreational users can simply forego purchasing marijuana if prices are too high, medical patients do not have such luxury. We recommend that regulators and policymakers pay close attention to ensuring that there is a sufficient supply of marijuana product by monitoring growth rate in cultivation areas of approved licensees and considering adoption of official policies that would prioritize supplying medical patients over recreational users similarly to what has been done in the state of Illinois.

2. Enhance access to medical marijuana for patients in need

In addition to ensuring reasonably priced supply, legislators and regulators could adopt further measures that would make accessing medical marijuana easier for patients in need. Specifically, Ohio General Assembly should consider allowing home delivery of medical marijuana product to registered patients, relaxing the requirement for annual registration and doctor recommendation, especially for patients with chronic conditions, and revising allowable purchase limits for medical patients to align them with the significantly higher limits under the adult-use statute.

3. Ensure needed potency is available for patients

The increasing potency of marijuana products available in licensed marijuana dispensaries and the potential harms associated with high potency products has long been the subject of medical studies, some of which have noted correlation between adverse outcomes for certain type of users and prolonged cannabis use. Given the public health concerns and expressed opposition by some state leaders to legalization of marijuana in connection to the high potency of today’s product, it is possible that the Ohio General Assembly may explore further limiting the potency of marijuana products in Ohio dispensaries. In any future reforms, policymakers should make a distinction between recreational and medical users, as these two groups might have different needs in respect to marijuana potency. Notably, our survey respondents mentioned the lack of low-THC products in Ohio dispensaries, which suggests that legislators may need to address both ends of the potency spectrum to help advance patient needs.