Trulieve is the anomaly of the US cannabis industry: a multi-state operator that has managed to remain profitable for years, in a sector where almost all players were burning cash. Founded in Florida in 2015, led from day one by a woman lawyer turned entrepreneur, Trulieve has built its dominance of a state medical market by cultivating patient loyalty rather than expansion at any cost before striking the biggest blow in US cannabis history in 2021.
The Trulieve story began with three Florida horticulturists: George Hackney Sr., Thad Beshears of Simpson Nurseries and Richard May of May Nursery. These professional growers, with decades of experience in greenhouse agriculture, saw the legalization of medical cannabis in Florida as a natural opportunity to apply their know-how to a new crop.
In 2015, Florida authorized the medical use of cannabis via the Right to Try Act, paving the way for the first vertically integrated production and distribution licenses. The three horticulturists form a team and write a 2,000-page application to obtain one of the five licenses issued by the state. They know how to grow, but they need a profile to navigate the complex regulations and structure the business.
Ben Atkins, investor and owner of eleven dispensaries in California, introduces the team to Kim Rivers. An M&A and securities lawyer, Rivers left the practice of law to become an entrepreneur. She has been managing Inkbridge LLC, an investment company, since 2011, and had just completed a successful exit when she was approached by the Trulieve team.
Her initial reaction was cautious. She studies the dossier, analyzes the Florida market and sees a unique window of opportunity: a market at the dawn of its development, competition limited to five initial operators, and an integrated model from cultivation to sale that would allow full control of the value chain. She joined Trulieve as CEO and co-founder in 2015.
The team submits its application and is awarded one of five licenses. The cultivation facilities are up and running in just 70 days. In July 2016, Trulieve opens the very first legal medical cannabis dispensary in Florida history, in Tallahassee.
Where its U.S. competitors scattered across numerous states in their early years, Trulieve is adopting the opposite strategy: dominate Florida absolutely before considering any expansion. Florida is a huge market, the third most populous state in the US, with an aging demographic particularly receptive to medical cannabis as an alternative to opioids and painkillers.
Trulieve is building a dense network of dispensaries throughout the state, with the explicit goal that no Floridian will be more than an hour's drive from a Trulieve dispensary. It is developing a home delivery program and an online service with in-store pick-up. It cultivates patient loyalty through a policy of medical training for prescribing doctors - Ben Atkins personally supervises relations with healthcare professionals.
The result is clear: Trulieve captures a dominant market share in Florida, reaching almost 900,000 registered patients in the state at its peak. The company remains profitable quarter after quarter - a rare performance in the sector. It goes public on the Canadian Stock Exchange (CSE) under the symbol TRUL and trades on the U.S. OTCQX market under TCNNF.
In May 2021, Trulieve announces the acquisition of Arizona-based multi-state operator Harvest Health & Recreation for $2.1 billion in stock - the largest transaction in U.S. cannabis history at that time.
The deal, finalized on October 1, 2021, propels Trulieve to the rank of largest U.S. cannabis operator: 126 dispensaries in 11 states, 22 cultivation and production sites totaling 3.1 million square feet of space, 7,600 employees. Combined adjusted EBITDA for 2020 reached $266 million.
Trulieve operates mainly in Florida, Arizona and Pennsylvania. It is one of the few U.S. MSOs to have maintained consistent operating profitability despite the industry's headwinds: tax pressure from Section 280E of the U.S. tax code, which prohibits cannabis companies from deducting their expenses, difficulties in accessing bank financing, and volatility in the OTC stock markets.
The major issue for Trulieve remains Florida. In 2024, Amendment 3, a citizens' initiative to legalize recreational cannabis in Florida, supported financially by Trulieve, is up for a vote. Its eventual adoption would open up the largest potential recreational market in the United States.
Kim Rivers has been personally involved in the campaign, while developing social equity initiatives such as criminal records expungement clinics and partnerships with brands owned by entrepreneurs from communities affected by the war on drugs.
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