Missouri's rural areas voted big for medical marijuana. Could they help legalize weed in November?
In 2019, Brooke Foster learned her son was changing his undergraduate major and abandoning his pre-medicine track.
His new plan: cannabis.
Foster, who owned and operated her family’s chain of local grocery stores in rural, northern Missouri, was shocked.
She knew little about medical marijuana and, as many do, thought it was just a way for people to get high.
Fast forward three years and Foster, who recently sold the grocery business, and her son have three dispensaries, a manufacturing and lab facility and are developing a cultivation site. The company, COCO, serves and employs northern Missourians, who have been surprisingly supportive of the introduction of legal weed.
Rural Missourians voted heavily in support of medical marijuana legalization in 2018 and seem to have welcomed it readily into their communities.
Some folks still have reservations about recreational legalization – they want a program that will be safe for their communities. But come November, Missourians will have to vote yea or nay on an adult-use marijuana legalization amendment.
According to a recent poll by SurveyUSA, 62% of 1,782 registered voters in Missouri responded that recreational marijuana should be legalized. Among other respondents, 25% were against legalization and 13% were not sure.
Notably, support for recreational marijuana didn’t vary much across the state. Although support for legalization stood at 67% in urban areas, according to the SurveyUSA poll, 60% percent of registered voters in rural areas also supported legalization.
All for medical
Foster was worried about the community’s reaction before COCO opened, but it turned out that folks were supportive of it.
“If this can help somebody and they don’t have to get on narcotics or any sort of prescription drugs like that, and it is all natural, and it helps somebody, they’re all for it,” Foster said. “I am being dead truthful, I bet really we’ve only heard one negative comment.”
In 2018 Missouri passed Amendment 2, to legalize medical marijuana, with almost 66% approval. While voters in Kansas City and St. Louis overwhelmingly supported the amendment, many rural communities also supported the change.
Livingston County, where COCO has one of its three dispensaries, had 54% of its population vote in support of medical marijuana. Shelby County, the location of COCO’s lab and cultivation site, had over 46% voting in favor.
Lyndall Fraker, director of the medical marijuana section at the Missouri Department of Health and Senior Services, said his home county of Webster, east of Springfield, passed the medical program with almost 60% of the vote. Fraker said this reflected how most rural counties voted.
Leading up to the vote in 2018 and since its passage, Fraker said Missourians were exposed to information and testimonies on the benefits of marijuana for treatment of chronic pain, PTSD, epilepsy and other qualifying conditions.
“I think that message traveled quite well in the last five years or so, and it’s really reduced the stigma that’s always been with marijuana in general,” Fraker said.
He also believes that support for medical marijuana has grown across the state because of the professionalism and appearance of the licensed operators in the state.
“When you drive down the street and you see a medical marijuana facility, it doesn’t look like a head shop,” Fraker said. “Most of them look like a drive-in bank or a boutique.”
Many Missourians like the medical program because it’s well regulated. The strongest opponents to the program are those who believe in marijuana legalization, but who oppose regulation of the plant.
“People that don’t appreciate our program are those that quite frankly just want marijuana to be free range, do whatever you want, (with) very little regulation,” Fraker said. “And that’s not what we believe the voters in Missouri want.”
The same arguments exist for adult-use legalization and surround constitutional Amendment 3 on this November’s ballot.
After the 2018 election, many rural Missourians were eager to enroll in the medical marijuana program.
Missouri Marijuana Card first opened offices in Kansas City and St. Louis. The company, which helps potential, and current, medical marijuana patients to get their medical cards, kept fielding calls asking for physicians in rural areas of the state.
After realizing that folks outside of the major metro areas needed medical cards, Missouri Marijuana Card changed its approach. Cassandra Brooks, the company’s president, said through telemedicine it’s now able to reach every corner of the state.
“We pivoted over to telemedicine and we found that it just opened the floodgates for so many other patients,” Brooks said. “Telemedicine just provides so much more access for these patients, and we’re helping so many more patients because of it too.”
Missouri’s medical marijuana amendment also stipulated that dispensary licenses be distributed throughout the congressional districts to ensure access across the state.
Dan Viets, who serves as secretary on the board of directors for the National Organization for the Reform of Marijuana Laws (NORML) and worked on Missouri’s medical legalization, estimates most Missourians are within 50 miles of a medical dispensary.
Patients who can’t drive that far, or who just want to save a buck, can participate in the state’s home-grow program.
Foster’s brand, COCO, has dispensaries in Chillicothe, Moberly and Hannibal, Missouri. In conversations she’s had around town, Foster said enthusiasm is not quite as high when the conversation turns from medical marijuana to adult-use legalization. But the latter is still widely approved.
“You’re probably going to find very similar opinions as you do with liquor,” Foster said. “Even though liquor is fully legal, there are some folks that aren’t believers in having a drink. And that’s fine, that’s America.”
Opposition to legalization
Adam Warren, the Livingston County prosecutor, said the general population in the area around Chillicothe leans more towards legalization than not.
“I think that people are a little more liberal, in the classical sense, out here, where, as long as you’re not gonna hurt someone else, we don’t mind you doing it,” Warren said.
But, that doesn’t necessarily mean they will vote in the affirmative come November. Warren said he’s not sure his community feels Amendment 3 is restrictive enough, and may worry about the immutability of a constitutional amendment.
“I don’t know if my community will go for that,” he said. “They’re giving it a better treatment than alcohol if it goes through this ballot initiative.”
Specifically, Warren feels the amendment could have a chilling effect on some cases he might prosecute. He fears the protections for marijuana consumers would restrict his ability to pursue certain cases where marijuana is involved.
“It’s restrictive to the government and permissive to the individual,” Warren said. “We should be able to say, ‘Take a step away from (marijuana), and get your life back on track.’”
Some folks are also concerned that recreational legalization will mean greater exposure to kids and teens.
This is of utmost concern for Jennifer Rhoad, who works in youth drug prevention for Smithville Community In Action.
The organization works with funding through the federal Drug Free Communities program, which places marijuana as a high priority substance.
“I don’t think marijuana being bad for youth is necessarily a controversial topic,” Rhoad said, noting that all of the states that have legalized adult-use programs have set an age minimum of 21.
Consumption under the age of 21 would not be legal if Amendment 3 passed, but Rhoad said legalization typically leads to increased access, and therefore consumption, by teenagers.
According to a publication by the National Institute on Drug Abuse, high school-aged consumers of marijuana are more likely than adults to become addicted to marijuana. Rhoad said this is due to the still developing brains of young folks.
The effect of marijuana legalization on youth consumption rates is unclear as advocates for and against marijuana cite research on either side. And a 2020 study by the American Academy of Pediatrics found that there was a national increase in the percentage of adolescents consuming marijuana, but the connection to state legalization policies was “not clear.”
Rhoad cited Missouri statistics that show an increase (less than 5%) in youth consumption since the start of its medical program.
Amendment 3 seems likely to pass, Rhoad said. That means her job is to get on top of educating teens and parents about the dangers of marijuana exposure to young folks.
Practically, she aims to implement prevention education in her community and also education to adult consumers around safe storage of the drug.
“Prevention is really everyone’s job,” Rhoad said.
Rhoad worked with the dispensaries in her region to promote safe storage practices and youth prevention when medical marijuana first passed in 2018. Regardless of their stance on marijuana legalization or consumption, most folks generally agree with her from a youth perspective.
She encourages Missourians to visit the Department of Health and Senior Services comment form on Amendment 3, and advocate for the addition of youth prevention and addiction education.
Viets believes that rural Missourians will support the proposed adult-use program. But notably, the Legal Missouri proposal has a provision which allows a city to exclude non-medical dispensaries by a citywide, popular vote.
Viets explained that the decision is really up to the people, not their elected officials, and because of that, he believes few communities will opt to exclude recreational facilities.
“Our experience has been, and in other states, that the people generally are more accepting than their representatives are,” Viets said. “I’m not sure why this is, but the people that are elected to represent the voters often are far more conservative than the voters themselves are.”
Cash is the other crop when it comes to cannabis.
“What we have right now, marijuana prohibition, is a price support system for illegal drug dealers,” Viets explained. “It keeps the price and the profit of marijuana artificially high, and at the same time, those who engage in that illegal business do not pay one cent in taxes.”
If marijuana is going to be part of a community, Viets said, the community might as well benefit from it.
Amendment 3, if passed, would stipulate a 6% state sales tax on the sale of adult-use marijuana. Local governments would have the option to impose an additional 3% sales tax that would stay within that community.
According to Viets, the local tax is estimated to generate over $13 million in revenue. More than just a drop in the bucket for smaller cities.
“I think that’s another reason why rural communities will be receptive to adult-use marijuana taking place in their communities, sales and cultivation and manufacturing, because of the additional tax revenue,” Viets said.
In addition to promoting education around marijuana, Rhoad said Missourians should take advantage of this portion of the proposed amendment.
“Advocating for the local tax in your community would be a great thing for people to do because there will be a cost to local communities, so you need to get that passed as soon as possible,” Rhoad said.
Cannabis also creates jobs.
According to an economic impact report by Missouri Medical Cannabis Trade Association (MoCannTrade), since licenses were first awarded in 2020, almost 10,000 jobs have been created in the state related to cannabis. The same study estimated $501 million in income from those jobs.
“That’s a lot of jobs, and it’s something to sit up and take notice of for sure,” Foster said. “Even in the tiny little town of Clarence, Missouri, where our lab is … the folks have been so receptive and eager to help, and they’re appreciative that we’ve brought some jobs to the area.”
COCO is currently developing a cultivation site in Clarence which will bring more jobs to the town of just over 1,000 people.
It can also draw younger people back to rural areas, which keeps a town from dying out.
“Folks like my son, my nephew … they would not be living here if it weren’t for cannabis,” Foster said. “They’d be going to St. Louis or Kansas City, just like everybody else does.
“I tell people, even if you aren’t on board, politically or whatever your beliefs are, I respect that and I completely understand,” Foster said. “But surely you’re on board with what it’s done economically.”
Since medical dispensary sales began in October of 2020, Missouri has seen over $470 million in transactions, according to the Department of Health and Senior Services. Sale totals equate to over $26 million in tax revenue to the Missouri Veterans Commission.
Foster believes strongly in the medical benefits of cannabis, which is why she helped found COCO. But, if the recreational marijuana amendment passes in November, COCO plans to apply for a comprehensive license to sell adult-use and medical products.
“We want to help the patients, that is our number one priority… But we also want to create better jobs …(and) you still have to be able to pay your light bill,” Foster said. “To do that you’ve got to make money. That’s no different than the restaurant business or a furniture store, grocery store.”
It’s simply a way to easily expand her market.
“It’s not my job to judge someone, nor was it my job in the grocery store to judge if somebody’s buying Twinkies,” Foster said. “You can buy whatever you want, but it will be a good thing for us to be able to sustain in business and to be able to create higher paying jobs and better jobs for people.”
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