Serving as Education Chairman for Maryland's Medical Cannabis Commission for over three years gave me a front-row seat to one of healthcare's most complex regulatory evolutions. We built frameworks from scratch — education standards, provider guidelines, patient safety protocols — in a space where the clinical evidence was still catching up to patient demand.
Now, several years later, the landscape has matured significantly, but the fundamental challenge remains: medical cannabis still lacks the clinical standardization that every other therapeutic modality in medicine takes for granted.
The standardization gap
We can prescribe opioids with precise dosing protocols and well-understood pharmacokinetics. We can titrate anticonvulsants for neuropathic pain with established guidelines. But when it comes to cannabis-based therapies for chronic pain, we're still operating with too much variability — in formulation, dosing, delivery mechanisms, and outcome measurement.
This isn't an argument against medical cannabis. It's an argument for elevating it to the same evidentiary standard we apply to everything else in our toolkit. Patients deserve that rigor.
Where I see opportunity
The states that invested early in robust education and regulatory infrastructure are now best positioned for the next wave: clinical research partnerships, pharmaceutical-grade product development, and integration into multimodal pain management protocols. For physician-entrepreneurs with regulatory experience, the advisory and consulting opportunities in this space are substantial and growing.