Creating the ‘Maryland Model’ for Cannabis Regulation

Will Tilburg

“It’s a really unique space and opportunity,” he said. “Cannabis law and policy is at the nexus of constitutional issues and federalism, health care and medicine, as well as business regulation, agriculture, manufacturing and retail. And it’s also a social justice issue.”

He started developing his expertise in the field as an attorney at the University of Maryland School of Law, where he advised local governments and health departments on issues they were facing. Around 2016, as states started passing ballot referendums on cannabis, he recalled, “Health departments were like, ‘What the heck are we supposed to do with this drug? How do we regulate it?’” I drew the short straw in the office and started working on it.”

Tilburg soon joined, then led the Maryland Medical Cannabis Commission before becoming the inaugural head of the new agency. Today, the state has one of the most racially diverse industries in the country, thanks to MCA’s focus on social equity. Since marijuana was legalized last year, three-fourths of new licenses have been awarded to minority-owned firms, and agency has launched a new workforce development initiative, prioritizing people with non-violent cannabis-related offenses, to train and place them in every segment of the industry.

“I am grateful to Will … for making Maryland a national model to show how states can transition into an adult-use cannabis market in an efficient and equitable way,” said Gov. Wes Moore in a statement.

Tilburg, also an adjunct lecturer at UMD’s School of Public Health, looks back at the crisis he tackled early on, what he’s tried to emulate and avoid from other states’ cannabis experiences, and what the future of cannabis regulation looks like as the federal government considers changes.

At the Maryland Medical Cannabis Commission, you were in charge of rolling out the state’s medical program. What were your biggest challenges in that role?
It was rocky. There was litigation around who won licenses, a political scandal related to the legislators involved, so it was having trouble getting off the ground. I joined in 2017 as the director of policy, and became executive director in 2019. During my first week as executive director, there was a public health crisis. About 70 people across the country died from e-cigarette or vaping use-associated lung injury, which we later found out was from the illicit market. But we had to pull all vape products off the shelves and have them retested to make sure they were safe.

How was the transition from medical to recreational cannabis in the state?
The referendum passed overwhelmingly in November 2022, then the legislature passed comprehensive legislation that the governor signed on May 3, 2023. We had less than two months to stand up a new industry and create a new state agency by July 1. The average turnaround time is 18 months.

What states did you look to as models? What pitfalls did you want to avoid?
Maryland wants to be a model for how to do it in a safe and equitable way. Cannabis overall is an experiment. For other industries, the federal government provides standards and a backstop: The FDA determines nutrition labels of the food we eat, and the EPA determines what pesticides are safe. But states have been left to their own devices.

We looked to Massachusetts as a good example on the East Coast, surrounded by states without legal adult use, with a similar population to Maryland. We wanted to avoid what happened in New York City, where there was a massive influx of illegal businesses that started selling the first day that recreational cannabis became legal because they hadn’t licensed enough retail outlets to sell it. Once you cede market share, it’s hard for legal businesses to compete.

We also wanted to make sure vulnerable populations who need cannabis as medicine were able to access it. In some markets, there have been product shortages, prices skyrocketing. We allowed businesses to ramp up production, and put protections in place for patients so they had priority, with separate lines and operating hours.

Why did you focus on social equity in cannabis licensing?
A lot of individuals have been harmed by (criminal) cannabis charges. We wanted to make sure those people benefitted when we were licensing, focusing on certain jurisdictions with the highest numbers of cannabis charges, because we know that wasn’t equitably enforced across the state.

Our first round of licensing for growers, processers and dispensaries was only for social equity applicants. We created a portal to verify people and make sure they were eligible to apply, then created an $80 million business assistance fund to help licensees with grants and loans, because large banks can’t lend to cannabis businesses. We’ve also created an Office of Social Equity to provide applicants and licensees with technical and business support to get to the finish line. Out of the 205 licenses awarded, 75% went to minority-owned businesses.

How is the state managing the health risks of cannabis legalization?
We set really strict manufacturing, labeling and packaging to restrict youth use. You have to be 21 or older to buy cannabis, and ID is scanned and checked twice at every dispensary. The packaging and labeling can’t appeal to kids or resemble commercially available food products. And for advertising, you have to demonstrate at least 85% of the audience is over the age of 21.

In partnership with the Maryland Department of Public Health, we developed an extensive public education campaign about the impacts of impairment on driving and how to safely store cannabis. At the point of sale in all dispensaries, there’s information about responsible use: Start low, go slow. We conducted a baseline study in spring 2023 on use by age group, hospitalizations and poison control calls, and will update that every two years. DPH now has a dashboard to track public health impacts of cannabis.

One of the biggest challenges is that there is an unregulated market of cannabis sativa plants because of the 2018 federal farm bill. Those products are considered hemp, but they can contain a large amount of THC. This is a national problem—it’s estimated to be a $30 billion industry.

What’s the future for cannabis in the state?
During my tenure, we’ve tried to get cannabis treated like any other medicine, instead of a stigma-plagued drug. We tried to get insurers to cover it, unsuccessfully, but it can be covered by worker’s comp now. People can still get fired for cannabis use by employers, so there are challenges to making it on par with other age-restricted products like alcohol.

Cannabis laws continue to evolve. For 20 years, it’s been states, states, states. Now, the federal government may have a greater role to play. For first time in 50 years, the federal government is proposing to change cannabis from Schedule 1 to Schedule 3, where it could be a prescription drug. That could have significant impacts. There’s also talk of legalizing at national level, although there’s uncertainty around the new administration.