In 2016, surgeons opened up a 70-year-old retired UC Berkeley lecturer named Jim, found his aggressive stage four bladder cancer had spread beyond what they could remove, closed him back up, and sent him home with a one-year prognosis.
That was nearly 10 years ago. Jim is 79 now. He hikes daily in the Bay Area with his golden retriever and hosts a monthly reading group on social theory and philosophy. He gets CT scans every three months, and they keep coming back the same way, no cancer progression.
RELATED: An industry built by showing up—and why we can’t stop now
His oncologist credits immunotherapy, which Jim started after the FDA approved it for bladder cancer right around the time of his diagnosis and told him to “keep doing whatever he was doing.” That included cannabis. Jim has used cannabis daily since 2016 to manage his symptoms, free of charge through a compassionate cannabis program called the Shelter Project. As a retiree with mounting medical bills, the program has mattered as much to him financially as it has medically, so he can continue doing exactly what he’s been doing.
Jim is one of more than 1,320 members who have received free cannabis through the Shelter Project since Jetty founded it in 2014. The program has donated more than $1.2 million in product across California, Colorado, and New York. Jim’s story is also a window into something the cannabis industry doesn’t talk about enough, and that’s how adult-use legalization, for all its hard-won victories, quietly abandoned some of the very medical users who made it possible.
The Cannabis Industry was Built on the Backs of Patients
Compassionate cannabis began in the AIDS wards of 1980s San Francisco, where activist Mary Jane Rathbun, also known as “Brownie Mary,” smuggled homemade cannabis brownies to dying patients. It was carried forward by Dennis Peron, who lost his partner to AIDS and channeled his grief into the grassroots movement that produced California’s Proposition 215, the first statewide medical cannabis law in the country, in 1996, when I was still in high school in Buffalo.
From children with epilepsy whose seizures stopped responding to every pharmaceutical but cannabis, to Veterans with PTSD who found relief when nothing else worked, to cancer patients managing the brutal side effects of chemotherapy, the moral case for legalization was built patient by patient from that point on. Patients fighting for access to cannabis fueled the next two decades of legalization across the country.
RELATED: Seniors are already using cannabis – policy needs to catch up
In late 2013, when we were just starting Jetty, my co-founder, Ron Gershoni, had a college friend, Alex, who had just been diagnosed with a brain tumor and was going through chemotherapy and radiation. Ron started showing up at Alex’s apartment in San Francisco with mason jars full of cannabis oil. Alex said it gave him instant relief from the side effects of chemo, and he effectively became “patient zero” for Jetty’s compassionate cannabis program. That informal act of care formally became the Shelter Project in 2014.
When Adult-Use Arrived, the Safety Net Collapsed
When California legalized adult-use in 2016, an unintended consequence quietly devastated the compassionate care network that had grown up around Proposition 215. Donated cannabis was taxed the same as sold cannabis, at rates exceeding 38 percent. For most brands and dispensaries, giving product away to sick people in need became economically impossible. Programs that had operated for years shut down almost overnight.
We spent years lobbying for a fix, and California eventually passed SB 34, the Dennis Peron and Brownie Mary Act, in 2019, exempting donated cannabis from state excise taxes. But the damage to the compassionate care network was already done, and it hasn’t recovered.
Additionally, nearly every state that made a transition from medical to adult-use has seen medical program enrollment decline and compassionate care programs close down as access barriers like no insurance coverage, registration fees, and physician costs remained, making it harder to be a cannabis patient versus an adult-use consumer.
But the Patients Didn’t Just Disappear
Ezekiel, a former concrete engineer from Fresno, spent his career building hospitals, prisons, and government facilities across California. In 2014, a concrete truck pinned him against a wall at a job site, leaving him paralyzed for three months. During treatment for his injuries, doctors discovered he had right kidney carcinoma. His kidney had swollen to nearly the size of a basketball; emergency surgery to remove it saved his life. He has been in remission ever since.
At the time of his diagnosis, Ezekiel had three children, a newborn on the way, depleting savings, and medical bills that workers’ comp wasn’t covering.
“I was depressed and scared,” he said. “I didn’t want to leave my children behind. They’re my everything.”
RELATED: More states push to let terminally ill patients use cannabis in hospitals
Ezekial found the Shelter Project through a law school instructor while retraining for a new career. He now has five children and drives nearly 90 miles each way from Fresno to pick up his products at a dispensary in Patterson.
He has become an informal ambassador, passing Shelter Project information on to fellow patients in the waiting room at his cancer care facility.
“I used to go in nervous,” he said. “But now with the cannabis, I’m going in with a smile. Some of the older patients ask me, ‘Why are you happy? You’re young, and you’ve got cancer. What are you happy about?’ And I tell them I found medication that helped me out.”
Ezekiel is particularly clear-eyed about what distinguished the Shelter Project from the medical system that nearly failed him. “Even my insurance was trying to tell me I didn’t have enough money to get my kidney removed,” he said. “They were basically telling me I was on a waiting list and I was going to have to die. And you guys aren’t like that. You don’t care if people don’t have the money, you still help.”
The Private Sector Has to Do More
Today’s regulated cannabis industry was built on the backs of patients, and too many of them are getting left behind. Insurance doesn’t cover cannabis, and most states don’t protect compassionate care programs from taxation. In New York, where Jetty expanded the Shelter Project in 2025, there is still no regulatory framework protecting or incentivizing these programs at all, meaning that we absorb the excise tax on every product we donate in the state. It’s a cost we accept, but it is also a barrier that keeps other companies from doing the same. New York needs a version of SB 34.
For patients in the greatest need, the safety net is almost entirely dependent on the private sector, and very few brands are stepping up. That’s not a criticism I make lightly. Running a cannabis business is hard. Margins are thin. Regulatory environments are brutal. But this industry did not arrive at legalization through lobbying alone. It got here because patients, advocates, and caregivers put their names, their bodies, and sometimes their freedom on the line to prove that cannabis was medicine. We owe them something.
RELATED: A weed bust led to my dream job – I know it isn’t fair
The Shelter Project isn’t a marketing program. It isn’t a tax strategy. It’s a line item in our budget that we treat as non-negotiable the same way we treat product quality. When we expanded to Colorado in 2024 and to New York in 2025, the Shelter Project came with us.
We are also not the only answer. There are other companies and organizations like Emerald Bay Extracts, Cornerstone Wellness, Weed for Warriors, and more that provide compassionate care programs. But more can be done.
We’re hoping other brands, other operators, other dispensaries will look at what we’ve built over the past decade and decide they can do something similar. You don’t need our infrastructure. You need a willingness to put patients ahead of margin.
The Shelter Project Accepts Applications Year-Round
The Shelter Project accepts applications all year with open enrollment, where we select program participants twice a year, from May through June, and again in October and November. Enrollment is open now through June 30 for cancer patients in California, Colorado, and New York. Accepted applicants receive free cannabis products curated to support their needs, distributed through a network of dispensary partners in each market.
For dispensaries, there is no cap on partners. We want to expand into more of California’s Central Valley, where Ezekiel still drives 90 miles each way because there is no closer pickup location; into more of the Bay Area; into New York City and upstate. If you share this ethos, reach out. The more depots we can open, the more people we can reach together.
Compassionate care programs like the Shelter Project give patients like Jim and Ezekiel one less thing to worry about while they battle cancer. The industry that patients built owes them the chance to keep feeling that way.
*This article was submitted by an unpaid guest contributor. The opinions or statements within do not necessarily reflect those of GreenState or HNP. The author is solely responsible for the content.
