How the HIV/AIDS Epidemic Gave Rise to Today’s Medical Marijuana Markets

Learn how LGBT activists played a critical role in the rise of state-legal marijuana markets in the United States.

by Cyrus Dioun, Assistant Professor of Management

From New York to Denver to San Francisco, hundreds of cities just celebrated Pride in June and July. These festivities highlighted the political and cultural impact of the LGBT community since the Stonewall riots of 1969. Many are already aware of how LGBT activists fought for the right to love. But did you know that they also played a critical role in the rise of state-legal marijuana markets in the United States?

I recently explored this in “Making the Medical Marijuana Market,” my published article in the Architecture of Illegal Markets (Oxford University Press 2016). Through my research, I found that gay rights activists and entrepreneurs were essential in the development of today’s state-legal medical and recreational marijuana markets. How did this happen?

During the late 1980s and early 1990s, the HIV/AIDS epidemic ravaged American cities. At the time, gay men were disproportionately affected by the disease. Many of those affected also suffered from wasting syndrome, or extreme nausea that causes rapid weight loss. The inability to eat and keep on weight accelerated the progression of the disease and increased the likelihood of death.

HIV/AIDS patients who smoked marijuana found that it gave them the munchies, or a powerful surge in appetite. The munchies had a valuable antiemetic effect that counteracted the nausea and enabled those with HIV/AIDS to eat, maintain weight, and live longer.

Yet most individuals dying of HIV/AIDS did not have access to marijuana — which was illegal at the local, state, and federal levels — because they did not have connections to those in the illegal market. In order to provide access to HIV/AIDS patients, activists and entrepreneurs at the intersection of the gay rights movement and the illegal marijuana market formed organizations to give access to the sick and dying. They created the first marijuana “buyers clubs,” where individuals with a doctor’s note were able to buy marijuana. These clubs took their inspiration from the pharmaceutical buyers clubs — made famous in the Academy Award winning movie, Dallas Buyers Club — and would become the early model for medical marijuana dispensaries in the state of California.

In addition to developing an interface between the legitimate needs of dying HIV/AIDS patients and the illegal market for marijuana, activists helped reframe marijuana, justifying its legalization as an act of compassion for the dying. They used this new understanding of marijuana to develop support for ballot initiatives legalizing medical marijuana markets, passing statutes in San Francisco in 1991 and California in 1996.

More than two decades later, advances in anti-retrovirals have helped transform HIV/AIDS from a death sentence into a manageable disease. Moreover, wasting syndrome is no longer a common symptom of HIV/AIDS in the U.S. Nonetheless, the compassionate framing of the disease and the use of marijuana to treat it dramatically accelerated the rise of both medical and recreational marijuana markets. New medical marijuana laws typical use similar framing, describing marijuana in terms of compassion. Look around today, and you’ll see that many modern dispensaries are modeled on these original buyers clubs from the early 1990s. The movement created a legacy that carries on.

Interested in this topic and others like it around enterprises and strategic development? Check out my entrepreneurship course, ENTP 6030 Entrepreneurship in Emerging Industries, offered in Spring 2020.


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