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A total of 69,787 Massachusetts residents are now enrolled in the medical marijuana program as active patients, under which sales began in 2015, up from 63,720 at the end of March.

“The increase doesn’t surprise me — we’ve always believed that more than a majority of [recreational] customers are using cannabis for medical needs such as anxiety, pain relief, and sleep disorders,” said David Torrisi, the president of the Commonwealth Dispensary Association. “There’s a direct relation to the recreational shutdown.”

However, Torrisi added, hybrid recreational-medical retailers typically derive 80 percent to 85 percent of their revenue from recreational sales. With that market closed, even record increases in the number of medical marijuana patients are merely a “drop in the bucket,” and won’t come close to offsetting the lost sales.

Torrisi said he fears many of the remaining displaced recreational consumers are simply turning to the illicit market, where products are not tested.

Unlike recreational consumers, medical marijuana patients pay no tax on cannabis purchases, and are permitted to order delivery, purchase more potent products, and take advantage of discounts and loyalty programs.

The commission assumed oversight of the program from the state Department of Public Health in 2018. Since then, the agency has moved to ease access, including by eliminating patient fees and automatically issuing temporary medical marijuana cards immediately upon a doctor’s recommendation.

More recently, in response to the pandemic, commission officials waived the requirement for patients to see a doctor in person, allowing them to consult a physician by phone or internet video instead.

Appointments typically cost $150 to $250; some doctors hand out stacks of recommendations, while other physicians provide more serious, personalized care for those with complex medical situations or who are new to marijuana. State law allows physicians and nurse practitioners to issue medical cannabis recommendations for any condition they believe the drug could help manage or treat.

Baker ordered licensed recreational marijuana businesses to close by noon on March 24, saying it was necessary to prevent out-of-staters from flocking to the shops and possibly spreading COVID-19. He has allowed medical dispensaries and their suppliers to continue operating. Baker’s office did not immediately respond to a request for comment on the surge in medical marijuana registrations.

No other state in which marijuana is legal has completely shuttered recreational sales because of the COVID-19 outbreak; cannabis officials elsewhere have acknowledged many recreational consumers use the drug for medical reasons, and are instead requiring operators to use order-ahead and curbside-pickup systems.

In addition to the spike in the number of new patients, the past month also saw a substantial increase in the number of patients submitting annual renewals of their medical marijuana cards. From March 23 to April 21, 4,700 patients renewed their cards, up from 3,921 between February 23 and March 22.

Nichole Snow, the president of the Massachusetts Patient Advocacy Alliance, praised the commission for taking steps to bolster the state’s medical marijuana program. Without the recent changes to the registration process that eliminated most manual review, she said, the agency would have been completely inundated by the recent spike in new registrations.

“The process has been a lot simpler and easier to understand — it’s very quick and expedient now,” Snow said.

Snow called on the commission to allow phone and video appointments permanently, saying it extends access to vulnerable people without the means or ability to visit a doctor’s office.

“A lot of patients were being kept out of the program because they couldn’t easily get to a doctor’s appointment, whether it was because of financial or geographic barriers or because they’re bed-bound,” she said. “Allowing telemedicine has really changed that.”

A group of recreational marijuana companies has sued Baker over the shutdown, arguing the policy is unfair when liquor stores remain open and that they could operate safely by banning out-of-state residents and using curbside pickup and other measures. The companies were joined in the lawsuit by military veteran Stephen Mandile, who said he relies on cannabis to treat serious injuries he sustained in the Iraq War but fears losing his federal benefits if his name appears in a database of medical marijuana patients.

A state judge last week denied a request by the plaintiffs to immediately lift the ban while the lawsuit plays out, saying it was unlikely they will prove Baker had no rational basis for the move. However, the judge wrote in his ruling that the businesses made a convincing policy case for reopening, and that the state could allow them to do so without compromising safety.


Dan Adams can be reached at daniel.adams@globe.com. Follow him on Twitter @Dan_Adams86.

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