By Patrick Camp
pcamp@cullmantimes.com

After experiencing a dramatic turnaround in her health by treating multiple issues and medical conditions with medical cannabis in Arizona, Amanda Taylor returned home to Alabama to advocate for patients such as herself. But, she said a proposed local tax increase set to appear on the ballot during the Nov. 5 election would put a barrier between some of the area’s sickest individuals and the medication they need.

“To me, this is a direct attack on people who are sick, suffering and dying,” Taylor said.

Describing herself as a “medical refugee,” Taylor said medical cannabis provided a relief that enabled her to discover what she believes to be her purpose in life … helping others find similar help dealing with their own medical conditions.

Taylor’s health issues are numerous: 45 lesions on her brain and spine, Multiple Sclerosis, Post Traumatic Stress Disorder and Gastroparesis — a chronic nerve condition which slows the stomach’s ability to empty food into the small intestine — among others.

She said her body had been resistant to most medications prescribed by her doctors, but had found temporary relief from the drug Marinol — a synthesized form of THC typically used to control nausea, vomiting and loss of appetite in people with HIV/AIDS or who are receiving chemotherapy treatment. However, the drug’s high cost and the severe side effects from its long-term usage made it an unfeasible option.

“At that time, with insurance, it was costing me over $2,500 each month and it started giving me bad side effects because it is not meant to be used long-term,” Taylor said.

At one point, after her weight had fallen to about 90 pounds, Taylor said she could “literally feel the life leaving her body,” as she laid on the concrete floor of her home pleading with God to spare her.

“I said ‘Lord, I’ve always served you. Please, don’t let my story end this way.’ I said I would serve him in a new way, in anyway that he said. Wherever he said to go, I would follow without question,” Taylor said.

Taylor said she was found by a friend and rushed to Cullman Regional Medical Center for emergency treatment.

She said she had always ignored the pleadings from her friends and family members to treat her symptoms with marijuana until she was hospitalized on a different occasion and was visited by a friend, who had advocated for the legalization of marijuana in Colorado. At the time, she said she had experienced violent dry heaving episodes that they had pulled muscles and even cracked ribs. “It looked like something out of ‘The Exorcist.’ It was the most awful thing to endure. I thought I was dreaming or something because she walked into my room and I couldn’t believe she was there. She waited for the nurses to walk out and she said, ‘Do you want to live?’ I told her I did and she got this little tube out and squirted this sticky oil under my tongue. In no time I could just feel the difference,” Taylor said.

Taylor had been given a full spectrum cannabis extract known for its higher than average levels of THC. While that extract gained notoriety from its inventors’ claims that it cleared cancer spots on his skin within days, a 2022 study published in the National Library of Medicine produced found there was insufficient data to support the claim it was an anti-cancer agent. Still, Taylor said, she was unable to deny the dramatic turnaround she had experienced.

“I knew I had to leave. I would have died here, so I fled. I became a medical refugee,” Taylor said.

Although she admits that she was “horrified” at the idea of using cannabis as medicine initially, she remembered her near-death conversation with God and believed that she had found the direction her life was supposed to take when she landed a job working in a medical cannabis dispensary.

During the job interview for that position, Taylor told her future manager that she intended to learn as much as possible about the medical cannabis industry.

“I told her that if I can assist someone else to get the help that I am receiving, then I feel like I am fulfilling something of high spiritual importance,” Taylor said. “I felt as though I was on a mission from God to learn as much as I could about cannabis.”

Taylor said she absorbed information and built as many connections as possible during this time. As her health began to improve, she began hiking in the mountains where she would pray, reflect on her journey and document the things she had been learning in her journal. It was on one of these excursions that she said she had a vision of herself in a medical cannabis facility back in Alabama, speaking to group of individuals she described as “the suits,” who she understood to be Alabama lawmakers.

“God was calling me home. He was telling me that I have to come home and fight for Alabamians to have safe access to medical cannabis,” Taylor said.

Taylor packed up her life and returned to Alabama and she’s since become an advocate for medical cannabis, starting at Wagon Trail Hemp Farm in southwest Cullman County — one of five facilities in the state to receive an integrated medical cannabis facility license.

Taylor worked part-time at Wagon Trail until she was diagnosed with MS in 2020. In 2021, as a result of her advocacy work, Taylor was invited to attend the signing of the Darren Hall Compassion Act, which legalized medical cannabis in Alabama. The bill’s sponsor, Sen. Tim Melson, a Republican representing Limestone County, presented her with an autographed copy of the bill and Gov. Kay Ivey personally thanked her for the amount of hard work and dedication Taylor had shown in advocating for the bill.

“When she said that, it was, to me, affirmation that I was on the track that God has intended for me,” Taylor said.

Local Amendment 1
In the years since Taylor watched Ivey sign the bill legalizing medical cannabis, civil disputes have delayed Alabama’s rollout.

Taylor said the wait is “heartbreaking.” Now there’s a possibility of another potential roadblock for patients seeking relief.

Local Amendment 1, if approved by Cullman County voters, would add an additional 15 percent tax on medical cannabis.

“To me it’s almost like they are crippling [medical cannabis] to keep it from happening,” Taylor said.

The ballot referendum to decide whether the tax should be implemented was created by a bill carried through the Alabama Legislature in 2023 by the Cullman County Delegation — representatives Corey Harbison, Randall Shedd Tim Wadsworth and Senator Garlan Gudger. While Wadsworth cosponsored the bill in the House, he said he was not present when the bill was first discussed. None of the other delegates were able to recall which specific member pitched the idea to tax medical cannabis, only that it came up during an informal meeting with District Attorney Champ Crocker who had been seeking funding sources which would allow his office to hire additional personnel.

“The DA had been seeking ways to possibly get additional funding for his office to help hire more staff,” Harbison told The Times in 2023. “At one point, they got a lot from the worthless check unit, but that really isn’t producing much at all, at this point. We agreed as a delegation to let citizens vote for a tax on it, and it is earmarked for the DA’s office and for mental health. It’s pretty cut and dried. The citizens can decide if they want it or not, and our delegation is good with whatever voters decide.”

According to budget reports provided by the Cullman County Commission, the Worthless Check Fee fund has decreased by 37 percent since 2018, when it generated $66,876. The most recently approved budget accounted for $25,000.

An audit report from the Alabama Department of Examiners of Public Accounts showed that between Dec. 1, 2016 and Aug. 31, 2022, the Worthless Check Fund accounted for roughly 10.5 percent of the DA’s total receipts.

The bill divides revenue generated from the tax, and would give 33 percent to the Cullman County Delegation “to be used at their discretion on mental health issues,” and 67 percent to the DA’s office “for personnel purposes.”

Crocker said he has tried to be responsible with public funds during his time in office by eliminating positions which he felt were no longer needed, and shifted two of the office’s assistant district attorneys to a part-time schedule when he took office in January 2023. Both ADA’s have now been reinstated as full-time employees.

“We have to be good stewards of taxpayer dollars,” Crocker said.

Speaking to The Times Wednesday, Oct. 23, Crocker said he was prohibited from endorsing the ballot referendum, but was able to shed some light on how his office would use the additional funds the tax would generate. He said more personnel is needed in order to help work through the current backlog of criminal cases in the district court system.

“We’ve got the same number of ADA’s that were here 20 or 30 years ago. So, we would hire more prosecutors. That would be the priority because we inherited a backlog of cases,” Crocker said. “I don’t think it’s fair or just for victims or their families to wait five, six or seven years to get a case resolved, and I don’t think it’s fair to someone who is accused of crime to wait that long. If you have more prosecutors to move the cases, that time should be reduced.”

Crocker said that after the immediate needs of the DA’s office had been met, he was open to the possibility of renegotiating the revenue split in order to drive more of the generated revenues to mental health initiatives.

“I would say that if this passes and our staffing needs are met, I would certainly be open to adjusting that split in the future,” Crocker said. “We’re really all in this together, and if we get to a point that we are in a position to revisit this in the future then we certainly will.”

The DA’s office receives funding from several sources including court-ordered fines and fees. The FY25 County Commission budget allocated $77,755 to the DA’s office to provide the salaries for two assistants which included employee benefits.

The Alabama Department of Finance’s website shows a total of $1,143,061 spent for personnel costs in the Cullman County DA’s office between November 2023 and October 2024. An additional $157,422 was spent on employee benefits during the same time period.

Cullman County Commission Chairman Jeff Clemmons said $150,000 of the county’s opioid settlement funds had been approved to go towards the DA’s drug court program during the course of three years. This, Clemmons said, had been Crocker’s only request for additional funding to the commission.

Chris Van Dyke, the Chief Operating Officer for Cullman’s largest mental health service provider, Wellstone, said he had been unaware of the proposed tax until he learned it would appear on the ballot and would also not offer an official endorsement for the tax increase. While the bill does not designate specific funds to Wellstone, he said the costs to provide residential care for mental health patients had become an increasing financial burden.

“We know homelessness is an issue and there are very few affordable apartments now, so residential care is definitely needed,” Van Dyke told The Times.

Van Dyke said Wellstone’s goal was to eventually open a smaller version of its recently completed pediatric crisis care center in Madison, Alabama.

What does Alabama’s medical cannabis program allow?
Alabama law exempts medicine from being taxed when it is prescribed by a physician and filled by a licensed pharmacist. However, federal laws designating marijuana as an illegal schedule 1 controlled substance — defined as having a high potential for abuse and no currently accepted medical use — prevent medical cannabis from being labelled as a prescription medication.

Instead, the law allows physicians approved by the Alabama Medical Cannabis Commission to write “recommendations” to patients to be filled at a licensed dispensary and leaves room for sales to be taxed.

The law includes a built-in 9 percent excise tax which is earmarked to fund future medical cannabis research in addition to any relevant local or state sales taxes. If approved, the proposed local tax would increase the cost of medical cannabis sales between 33 and 34 percent more than the gross sales total, nearly three times the amount of local taxes on hard liquor sales.

The United States Department of Justice has recently moved to reclassify marijuana as a Schedule III drug in recognition of its medical uses and has concluded that it has comparatively lower risk of abuse that other substances. Alabama Medical Cannabis Commission member Sam Blakemore said that while the degree to which the rescheduling would affect Alabama laws was unclear, it could be a signal of changes in the future.

“Who knows what’s going to happen when it is rescheduled,” Blakemore said.

In order to qualify for medical cannabis patients must be diagnosed with at least one of the following 15 medical conditions which Blakemore said typically leave them disabled and living on fixed incomes.

— Autism Spectrum Disorder.

— Cancer related cachexia, nausea or vomiting, weight loss, chronic pain.

— Crohn’s disease.

— Depression.

— Epilepsy or other conditions which cause seizures.

— HIV/AIDS related nausea or weight loss.

— Panic Disorder.

— Parkinson’s Disease.

— Persistent nausea.

— Post-Traumatic Stress Disorder.

— Sickle Cell Anemia.

— Spasticity associated with Multiple Sclerosis or a spinal cord injury.

— A terminal illness.

— Tourette’s Syndrome.

— Condition causing chronic or intractable pain.

“I grew up in the Baptist Church and they used to call it ‘helping the sick and the shut in.’ That’s what I sit and think about, the people who are needing this medicine the most with this initial roll out, are people who are having hundreds of seizures, cancer or MS. We are talking about some of the sickest people in the state,” Blakemore said. “As a healthcare provider, it’s easy to see that. It’s your duty. But, a lot of it has to do with your day-in and day-out reality. If you aren’t around people who are sick everyday, you might not think it’s a big deal.”

Blakemore said Minnesota offered a comparable market to Alabama’s medical cannabis program and used its price study report to predict the estimated monthly cost for patients once products become available. During the program’s initial rollout, costs averaged about $362 per month for patients. Adding the 33 percent local tax, which would be assigned to those sales in Cullman County, would increase those costs by roughly $119 to a total of $481.

The price study showed monthly costs increased for patients suffering from multiple conditions, which Taylor said has been the case for many patients she has interacted with.

“You’re already dealing with someone who is having a difficult time surviving in the world we have found ourselves in,” Taylor said. “This is really going to hurt the patients. That’s going to make some people get far less medicine than they need and some won’t be able to get it at all.”

Data from Ohio State University’s Moritz College of Law showed that these prices were likely to decrease over time. However, it also highlighted the price sensitivity which Blakemore worried could direct patients to utilizing the black market.

“I’m a pharmacist and I take care of a lot of people. I’m very aware of what happens with drugs. We are always going to be competing against the Black Market. Price sensitivity is real. Inflation is real. People not being able to get their medications because they are too expensive is very real,” Blakemore said.

Unintended consequences for local revenue
While less than 1 percent of the state’s population is projected to qualify for medical cannabis, Blakemore said the industry is primed to be a highly competitive one.

The law allows for a total of 37 dispensing sites throughout the state. Each of the four dispensary license holders are allowed to operate three sites and the five integrated facility holders to operate five. Legislation introduced earlier this year which would have increased the number of licenses was unsuccessful. Based on the most recent round of licenses awarded — which is currently being challenged by Alabama Always, a denied applicant for an integrated license — Cullman County would have two dispensaries.

Blakemore also said he felt that an unintended consequence of the tax would be that rather than generating revenue in Cullman County, it would, instead, incentivize patients to visit other dispensing sites and drive what local taxes would otherwise be collected to surrounding counties.

“When this finally rolls out to folks there’s going to be a lot of competition amongst the dispensaries. [Cullman] is close enough to Huntsville, Alabama that it wouldn’t surprise me at all if people just drove there or to Birmingham,” Blakemore said.

Joey Robertson, head of operations and public relations for Wagon Trail Hemp Farm, said the company’s primary goal would be to offer products at an affordable price point for their patients. He hoped that their ability to cultivate, produce and distribute products would allow them to offset any additional taxes which may be implemented, but maintained that after experiencing the benefit medical cannabis has had for those who need it, his first priority would be to the patients.

“Now that we’ve been doing this for a few years and we’ve heard the testimonials of the people that we’ve helped, with little to zero negative repercussions, I can’t unseen what I’ve seen. I know that there is a true medicinal benefit to these products. That is what drives us now. I’ve seen patients with cancer have reduced symptoms and lead a better quality of life. I’ve seen people overcome opioid addiction and use these products which aren’t going to be addictive. I’ve seen veterans with PTSD walk back from the edge and live a better quality of life. I can’t unsee those things,” Robertson said.

Robertson said the primary goal when Wagon Trail first began was to create a supplemental revenue stream for the farm’s other operations. Now, it has invested roughly $6 million in preparation for Alabama’s medical cannabis rollout and expects an additional $4 million will be required to finalize the license process and to kick-start operations once the current legal challenges have been resolved. He did say that, like most businesses, they had anticipated to operate at a loss for the first several years. Also, he said, no additional taxes would be placed on the companies’ distribution sales to other facilities and, if needed, Wagon Trail could refer patients to the dispensary it plans to open in Decatur, Alabama.

Robertson said his primary issue with the proposal was that it would taxing what is likely to be some of the sickest individuals within the community to purchase what the state has already determined to be medicine, but which will not be covered by their healthcare insurance.

“I understand taxes. I understand that if our local government needs revenue, they have to find way to come up with those finances to operate. I get that. My issue is that they are taxing medicine that is going to be out-of-pocket for these patients. It is making it look like they are putting a ‘sin tax’ on something that is strictly medicinal,” Robertson said. “If this was covered by insurance and somebody is just going to fill their $5 opioid prescription it would be a big difference — but it’s not.”

Crocker said he would be open to alternative funding solutions, but that his ultimate goal was to solve the immediate needs of the DA’s office and would let Cullman County voters decide how those needs should be funded.

“I am certainly open to solutions, but there are taxes on lots of things in our society and voters will ultimately have that decision on whether to support this or not,” Crocker said. “I’m trying to solve a problem and get the staff we need to address the backlog, help our victims and achieve justice. That’s really the bottom line. As for [whether it is morally wrong to tax medication] … I believe we do have a moral citizenry in this county and that they are capable of making a decision.”

Erasing a stigma
Taylor said despite the challenges she and others have faced in their campaign to see the promise of medical cannabis realized in Alabama, she was thankful for the opportunities she has been presented to speak up for others like her who may be unable to do so themselves. She hoped that as time went on that the stigma she had seen associated with cannabis would eventually fade away but until then, she would continue to educate those around her and fight for their right to have access to the medicine they needed for as long as God allowed her to do so.

“Honestly, if I didn’t have my faith I think this would have been the end of me. There are days where I would get 45 phone calls and when you are talking to that many hurting people and they look to you — it is heartbreaking and it is gut wrenching. I have to hold on to my faith because I think this would have totally done me in if I did not know that He put this here. We are all going to die, but you can help yourself to not suffer or even heal some things — but people die from a lack of knowledge and that weighs on my soul everyday. I have to give it back to the Lord everyday because it is so overwhelming and heartbreaking, and just continue to ask for guidance and to continue being a voice for the people,” Taylor said.

 

Wallace State Community College will host a town hall meeting Tuesday, Oct. 29 at 2 p.m., in the auditorium of the James C. Bailey Center on Local Amendment 1. The discussion will be led by Crocker, Van Dyke, Robertson and Victim Services Captain with the Cullman County Sheriff’s Office Ed Potter.