Vermont is preparing to embark on a major overhaul of its struggling medical cannabis program, which has steadily lost registered patients since the state made it legal for people to grow weed at home in 2018. The decrease has accelerated since late 2022, when stores selling cannabis legally to all adults began to open in Vermont. The medical program now counts 2,700 patients, down from a high of about 5,700. Patients who live with one or more of about a dozen conditions recognized by the state can pay $50 for a medical card that's good for three years. They do not pay taxes on cannabis products, have access to higher-potency concentrates and other specialized items, and are allowed to exceed the one-ounce limit on a single purchase that applies to recreational buyers in Vermont. Medical cannabis dispensaries can also deliver their merchandise and bring it curbside to patients' vehicles, unlike shops in the recreational, or adult-use, market. But there will be just two medical-only dispensaries left in the state — in Brandon and Montpelier — after a South Burlington dispensary, Ceres Collaborative, closes soon. A new law scheduled to take effect on July 1 would allow any of the 100-plus shops in the recreational market to apply for a "medical use endorsement." With that permission, a shop could also operate as a medical dispensary and thus sell and deliver high-potency, tax-free weed to registered patients. The control board has published proposed rules to carry out the new law, subject to a review this winter and spring that includes a public hearing and comment period. "This, to me, is not about injecting new life into the program," said James Pepper, chair of the Vermont Cannabis Control Board, which regulates the industry. "It's about making sure that the existing patients and the people that the legislature has deemed are qualified to access medical cannabis still have that access." It's unclear how many of the dozens of licensed recreational shops will participate. Given the small number of registered patients, people in the industry say selling medical cannabis will not be a moneymaker. The endorsement costs $250 each year, on top of the $10,000 annual retailer license fee, and budtenders would have to complete training on how to serve this new clientele. Shops would have to provide patients a private space for confidential consultations, if asked, and must keep medical products "physically…