In this episode of Listen, Ladies, host Maryalice Aymong talks to Hillary Peckham, co-founder and chief officer of Etain Health, the first and only women-owned medical marijuana business in New York State. When Etain was awarded the license in 2015, Hillary became the youngest person to ever receive a competitive marijuana license in the United States.

Below is an excerpt from her interview. To listen to the whole episode, download Listen, Ladies in iTunes.

Listen, Ladies (LL): This podcast is very much about highlighting women breaking new ground in their fields. You are at the forefront of that with Etain. First, I would love to have you tell us a little about yourself and your background.

Hillary Peckham (HP): Etain is the only weman- and family-owned medical marijuana company in New York. It was founded by me, my mother, and my sister. We got interested in it thanks to my mother, Amy, our CEO. She was the caretaker for my grandmother, who was diagnosed with ALS. We were watching how end-of-life care could be really mismanaged in a lot of situations.  For instance, oftentimes doctors prescribe more and more medication for a terminally ill patient whom they know they cannot really help, but they prescribe the drugs anyway. This happened to my grandmother.  By the end of her life she was on about 20 different medications. All of them had reactions with each other, and she had to be quarantined because of them. It was difficult to watch. At one point a physician did recommend medical marijuana, but at that time it was illegal in New York, and neither my mother nor my grandmother were comfortable with that. But that got my mom thinking.  She spoke to my sister and me about it, and that spurred us to look at the research on medical marijuana to see whether it could, in fact, help my grandmother. Ultimately, we researched the industry as prospective entrepreneurs. We started hearing about all these patients across the country who were having a lot of success getting off of traditional pharmaceuticals by replacing some or even all of them with marijuana. We were taken with the plant’s impact on patients. And for me it was personal. Prior to going to college I had had hip surgery and lost the use of my right leg for about two years. I couldn’t walk because the surgery failed. I saw how pain could be mismanaged. Throughout college the only thing that physicians could give me was Percocet for pain and Adderall for staying awake during class. I resented that that was how I was expected to function. Right now the majority of our patients have some sort of pain that they are seeking relief for, and I really see how marijuana can be used to treat it and to improve the quality of their lives.

Hillary Peckham

LL: It sounds like this whole issue is very personal for you. Before we talk about the basics of medical marijuana, may I ask how you decided to take your own experience and start a business to help others?

HP: We kind of got really involved. As I was graduating from college, where I’d studied music and minored in biology, I thought I was going to go into music therapy. My sister is a certified therapist, so we both were interested in alternative therapies. We started reading about it, and right as I was graduating, The Compassionate Care Act was passed. I am one of four kids in my family.  My youngest sibling was about to go to college, so my mom was a free lady. I got home, and she said, “I want to start my own business,” and I told her, “If you mean it, let’s do it.” It was really just my mon and I researching, travelling to places that have a lot of legal medical marijuana businesses already up and running, like Colorado, and talking to a lot of people. We were really taken by the industry and the impact it can have. But I noticed how competitive and male dominated the industry was (and always had been), so my mom said we needed to find a women’s group for cannabis! I said, “Mom, its a free world, everything is equal, there is no problem doing it,” but she turned out to be right.  From there we met the founder of a networking group called “Women Burrow,” and she introduced us to still other women in the industry.  This was probably the most important thing we did for our business: building a really high-quality team. Once word of our efforts spread, we drew a ton of support. From then on we were up and running in a year.

LL: Let’s talk about the types of people and patients who find that medical marijuana can be beneficial to them. What kind of conditions are we talking about, and what have you seen that medical marijuana can do for them?

HP: In New York it is very regulated: Not just anyone can get access to medical marijuana. You have to see a physician who’s been certified to recommend it, and that physician has to recommend you and say that you have one of the qualifying conditions. Some of these conditions are chronic pain, spinal cord injury, HIV, ALS, MS, Huntington’s, Parkinson’s, epilepsy, and cancer.  You also have to have a symptom associated with one of these conditions. But it is being regulated in a way so that not everyone has access to treatment.  And this is not California. There is a lot of stigma. In California if you say you have a headache, you can go and buy medical marijuana. In New York, you really need to have proof. We’ve seen life-changing results in a lot of patients. One of the impactful moments was after we got up and running, which was difficult because we were under a lot of time constraints. Within a couple months, we saw a ten-year-old non-verbal girl. She was having over 100 seizures a day. Her mother could not go to work because she had to take care of her child, so finances were a struggle. Within two days she said her first word, and within a couple weeks her school was like, what are you doing? How is this happening? Within a couple months, her daughter was able to go to after-school activities, and now her mother has a job. The change in life that it can bring to not just the individual but the whole family is touching to me and makes it all worthwhile. The most classic cases are always the ones that touch your heart and make everyone start crying. Or take people who take really high doses of opioids and have been doing that for ten years. This helps them get off of that, so they are more clear headed. Marijuana doesn’t have the same impact on their bodies and their organs that an opioid might. You know you are helping to give them a longer life and a more sustained quality of life.

LL: What strikes me about a story like that, the ten-year-old that had to go through her whole life without having this incredible moment where she was able to do all these things she hadn’t done before, is why do you think it is still a last-resort option? Somebody has to have tried everything else before she can try that, and go through all these hurdles. Does that resonate with you at all?

HP: I think that a huge part of our business is education. It is difficult for parents to understand that this is a medication, something that is regulated as such. There are still people I talk to every day in New York who don’t know that medical marijuana is an option. I know there is a lack of research because it is federally illegal. You can’t get federal funding for the research, and there are no FDA guidelines on the dosages and whatnot. So a lot of doctors feel uncomfortable prescribing it.

There is also a misconception that you are going to get high. The reality is that CBD (Cannabidiol), which is what medical marijuana is, has no psychoactive components. So you’re not getting the patient high. Yes, you are giving him or her cannabis, but it’s a different strain. It has different ratios. There is nothing to be afraid of:  Patients are given very small doses to start and receive higher doses only gradually upon showing they can tolerate the levels they are already on. The whole process is incremental and has only positive effects. Unfortunately, many people don’t know these things, so the stigma associated with non-medical marijuana gets transferred to medical marijuana.  It’s such a shame because it’s keeping people from getting help.

From left to right: Hillary Peckham, Amy Peckham (CEO and Hillary’s mother), and Keeley Peckham (Chief Horticultural Officer, Hillary’s Sister).

LL: I am also curious about the legal landscape in terms of running a business. In some states, medical marijuana is legal, but it’s still federally illegal. What kind of challenges does that present to you?

HP: At this point, I don’t even think it’s weird, I think it’s funny. But the legal landscape you mentioned does make running a medical marijuana business very complicated.  You cannot get traditional funding like you could with a normal business. Most banks can’t give you a loan or anything like that. They won’t even accept your money because of insurance. They would be in jeopardy of losing it if they kept on deposit funds from a marijuana company. You have to find credit unions or local banks across the nation that might be able to take your money.

Most transactions for patients are in cash. We can accept debit cards, but there are limited options when it comes to the credit card industry. Managing cash is a big issue for everyone in the industry because it’s a security risk, and it makes it very difficult. We’re lucky to have a bank account now, but we’ve been kicked out of banks before.  It’s almost a rite of passage! And when you do get kicked out, you have to scramble. For instance, I had an online payroll system, so what was I supposed to do? There are a lot of challenges that way. You have to do everything by the book or you will risk flouting not just state law but federal law. We make sure all of our employees are very well trained not just on what our operations are but on why we have the procedures that we do. We want our staff to understand all the legalities so they can make sure themselves that they are always compliant.

On another note, you find a whole bunch of different quirks where people expect that you are making millions of dollars. The reality is, we have pharmacists in the dispensary, we have overhead, we have a whole manufacturing facility that we have to pay for. It’s not a black-market operation where you don’t even need a storefront, it’s a real business!

The other aspect of it is taxes. Marijuana companies that have a retail store are subject to a tax code called 280E. That means you cannot deduct any expenses except your cost of goods sold. If you do, you pay a tax penalty. As an example, an employee who works out of the dispensary making 100,000 a year really costs a marijuana company 200,000 dollars because of the penalty. You pay double. This can be really challenging particularly when you cannot get a loan. So we try to stay very lean and do what we can. But it is definitely challenging.