With retail marijuana shops set to open next year in Massachusetts, supporters are worried that medical marijuana patients could be forced to pay inflated prices for the drug, possibly lose access to specialized preparations, or simply end up marginalized among the coming flood of recreational users.

To ensure medical marijuana lasts, proponents are lobbying for changes that include making it easier and cheaper to register as a patient, guaranteeing a steady supply of marijuana just for patients, and encouraging investment by allowing nonprofit medical dispensaries to convert to for-profit businesses.

A few even want the state to handicap the recreational pot sector with high taxes and tight local controls. That would make it tougher for dispensaries to convert en masse to recreational operations, as has happened in some other states that legalized marijuana.

“The idea is to change the cost-benefit analysis so folks with capital to invest will find medical viable,” said Daniel Delaney, a lobbyist for some of the state’s existing medical dispensaries. “If you make the recreational market wide open, people will go straight into that business and they won’t do the medical work. That will leave patients in a lurch.”

Delaney — whose opposition to the ballot initiative legalizing recreational pot made him highly controversial among advocates — wants taxes on marijuana sales increased to 25 percent, from the current maximum of 12 percent. Medical marijuana is currently not taxed. He also wants to make it easier for municipalities to ban recreational shops by allowing local elected officials to decide instead of putting the question to a communitywide vote.

Jim Borghesani, a leader of the 2016 legalization ballot initiative, said those proposals are nonstarters.

“We don’t want to see any patients find it more difficult to obtain medical marijuana,” Borghesani said. But high taxes and numerous local bans on recreational shops would “defeat the purpose of the initiative in the first place, which was to eliminate the illicit market.”

Though they expect some to migrate to recreational shops, advocates say there will remain many patients who require specialized marijuana treatments. Some — such as those with seizure disorders — consume “noneuphoric” strains or preparations of cannabis that have low levels of psychoactive THC. These products contain other cannabanoid compounds that may bring health benefits but don’t produce the sensation of being high.

Patients and their physicians are worried that shops oriented to recreational marijuana, where most customers are looking for a strong high, won’t bother with such products.

“I don’t really care where my patients get their medicine as long as it’s safe,” said Dr. Jordan Tishler, a Massachusetts physician who prescribes marijuana. “But in practicality, the problem is that they may go to a [recreational] store and simply not be able to find any products that fit the bill for them.”


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