Andrea Karam, Co-Founder of Ratio Cannabis – Interview Series

As more people across the country turn to medical cannabis and find relief in many different ways, it makes sense that patients would benefit from business owners and advocates who come from medical or pharmacy backgrounds. Fortunately for Ohio patients seeking medical cannabis, one such professional not only exists but also co-founded her own dispensary. To better explore the similarities between pharmacy operations and the cannabis industry—as well as gain insight into Ohio’s medical cannabis landscape—MyCannabis.com had the opportunity to speak with Andrea Karam, Co-Founder of Ratio Cannabis.

What did you study in college, and how has that academic foundation influenced your professional decision-making?

My academic background was centered on pre-law studies, which gave me a strong foundation in analytical thinking, structured problem-solving, and objective decision-making. The most impactful coursework challenged me to evaluate issues from multiple perspectives, anticipate consequences, and understand how legal frameworks translate into real-world outcomes.

That foundation was further reinforced through my mediation licensure, which emphasized neutrality, active listening, and resolution-based thinking. Mediation trained me to navigate competing interests, de-escalate complex situations, and arrive at outcomes that are both practical and sustainable—skills that have carried directly into my professional leadership.

Together, these experiences shaped how I approach decision-making today. I lead with a balance of compliance, empathy, and strategic foresight, always mindful that policies, regulations, and business decisions ultimately affect people and communities. That mindset has guided every stage of my career and continues to inform how I evaluate opportunities, build teams, and step confidently into this next chapter.

How did your background as a pharmacy technician prepare you for working in medical cannabis and supporting patients?

My experience as a pharmacy technician provided a natural bridge into medical cannabis, because at its core, the industry operates much like a traditional pharmacy. I was already fluent in the importance of accuracy, inventory controls, backend reporting systems, and strict adherence to state-mandated compliance programs.

Equally important, that environment instilled a deep respect for compassionate, patient-centered care. Pharmacy work reinforced the significance of confidentiality, HIPAA protections, and trust; principles that directly shaped how we structured dispensary operations, staff training, and patient interactions.

When I entered the medical cannabis industry, it was governed under the Board of Pharmacy, which made the transition seamless. I was already familiar with regulatory expectations and became even more immersed as they applied to cannabis specifically. That continuity allowed me to operate confidently within a highly regulated framework while thoughtfully adapting standards to meet the unique needs of medical cannabis patients.

What drew you not just to working in cannabis, but to co-founding a dispensary?

My path into cannabis and ultimately co-founding a dispensary was rooted in a genuine appreciation for plant-based medicine shaped by personal experience. My father passed away from multiple sclerosis, and witnessing the limitations and side effects of conventional pharmaceutical treatments sparked a lasting interest in alternative and integrative approaches to care.

That conviction was further reinforced when my mother later suffered a severe stroke that led to dementia. Once again, I found myself exploring plant-based alternatives where traditional treatments struggled to deliver meaningful relief. Co-founding a dispensary allowed me to align professional expertise with personal values and to help create responsible, compliant access to plant-based medicine for others navigating complex health journeys of their own.

Years later, that interest aligned organically with opportunity. A close friend of more than three decades had secured a medical cannabis dispensary license, and my background in pharmacy operations, regulatory compliance, and legal advocacy paired naturally with Ohio’s highly structured cannabis market. In many ways, it felt like a role I had unknowingly been preparing for throughout my career.
What legal or regulatory challenges did you face when creating Ratio Cannabis?

Establishing a medical cannabis dispensary in a region operating under a local moratorium required precision, persistence, and a deep understanding of regulatory frameworks. Navigating zoning constraints and identifying a legally viable location was the first major milestone and laid the foundation for everything that followed.

While there was early local resistance driven largely by misinformation, progress ultimately came through patience, transparency, and unwavering adherence to the law. At the state level, the experience was notably collaborative. I personally authored all required compliance documentation, each of which was approved, allowing the business to obtain its certificate of operation.

The process reinforced an important lesson: in highly regulated industries, success is built on preparation, credibility, and consistency.

What accomplishments are you most proud of since Ratio Cannabis opened?

Successfully creating a compliant dispensary in a region under a local moratorium was a foundational achievement. Beyond simply opening the doors, we intentionally designed a culture and customer experience centered on genuine care.

Rather than prioritizing transactions, we focused on relationships. Our team was trained to step out from behind the point of sale, engage patients personally, and treat each individual as more than a number. That philosophy translated into tangible results, including an employee retention rate of approximately 82 percent and deep patient loyalty.

The most defining accomplishment was transitioning the business through a strategic acquisition within roughly two years of operation. That outcome validated the strength of our systems, culture, compliance posture, and scalability, and demonstrated that a people-first model can succeed at an enterprise level.

Why is access to medical cannabis in smaller, rural communities so important?

Access to medical cannabis in rural communities is critical because many patients face real physical, medical, and socioeconomic barriers to care. For individuals managing chronic conditions, long-distance travel is often unrealistic due to health limitations, mobility challenges, or financial constraints.

When we opened, patients were frequently traveling 50 miles or more just to access their medication. Reducing that distance was not a matter of convenience; it was a matter of continuity of care. Access to therapeutic, plant-based medicine should not be determined by geography, income, or physical ability.

Supporting the community meant meeting patients where they were and designing systems that removed barriers rather than creating them.

How would you describe the acquisition process, and what made Ratio Cannabis attractive for acquisition?

The acquisition process was both challenging and instructive, requiring extensive preparation before formal discussions began and sustained focus throughout. It was not confined to leadership alone; it touched employees, customers, and daily operations, requiring stability and clear communication at every level.

What made the business attractive was a combination of people, performance, and positioning. Strong employee retention, loyal patient relationships, and geographic placement in a region where regulatory barriers had already been navigated all played meaningful roles.

Together, those factors demonstrated that the organization was not simply operating successfully; it was built to scale.

What advantages does Ohio’s cannabis industry offer compared to neighboring markets?

Ohio’s cannabis program benefits from an intentionally structured, capped market that emphasizes stability, oversight, and long-term sustainability. While the framework continues to evolve, regulators have maintained open lines of communication, allowing operators to address challenges proactively.

By preserving guardrails around licensure and compliance, Ohio has avoided many of the pitfalls seen in neighboring states that expanded too quickly. This measured approach has positioned Ohio as a durable, credible market built for longevity rather than volatility.

What are the objectives of Karam’s Kids Center, and why did you decide to start it?

Karam’s Kids Center grew organically from my family’s martial arts business, founded in 1973 by my father, Harvey J. Karam. From the beginning, the program emphasized leadership, discipline, and transferable life skills through a structured curriculum built around twelve core principles.

Over time, it became clear that many children lacked consistent mentorship or access to leadership development. In response, I founded

Karam’s Kids Center as a nonprofit in 2013 to operate alongside the family business and ensure at-risk youth could participate at no cost.

Through grants and partnerships with local agencies, including schools, counselors, courts, and organizations such as Big Brothers Big

Sisters, the program provides structure, confidence, and values-based guidance. The mission is to help shape stronger futures by giving kids tools they may not otherwise receive.

What are your exciting future plans, and how do you see federal rescheduling impacting the industry?

I am excited about what is next for myself and for an industry transitioning from proving legitimacy to building longevity. Being part of that next phase, where thoughtful regulation, strong systems, and purposeful design converge, is where I see the greatest opportunity. I am ready to take on the next challenge of building and scaling organizations that value discipline, creativity, and long-term impact.

Within Ohio’s highly regulated market, I have designed unconventional, design-forward merchandising and marketing experiences that stand apart from anything else currently in the state. Translating brand stories into physical space, executing them at a high level, and seeing measurable ROI has been especially rewarding. That work has organically attracted vendor interest from partners seeking to be featured in differentiated, elevated environments.

In parallel, I am focused on developing regulatory and compliance frameworks intended to operate congruently with Ohio’s existing oversight structure. As cannabis programs mature, the complexity of compliance inevitably increases, and gaps can emerge that create risk for both operators and regulators, not due to negligence, but due to the pace and intricacy of evolving requirements. I am particularly interested in how structured education, standardized compliance practices, and clearer operational guardrails could support greater consistency, accountability, and confidence across the ecosystem, benefiting both operators and the Division of Cannabis Control as the market continues to grow.

Federal rescheduling has the potential to eliminate Internal Revenue Code Section 280E, which places an outsized tax burden on cannabis operators by prohibiting standard business deductions. Removing that constraint would allow reinvestment in staff, infrastructure, and consumer experience, while also opening the door to more modernized, education-forward marketing frameworks.

Beyond economics, rescheduling should catalyze meaningful criminal justice reform. Individuals should not continue to face criminal penalties for conduct that is increasingly recognized as therapeutic, regulated, and medically beneficial. Aligning policy with science, compassion, and fairness is a necessary step forward.

I am eager to take on the next challenge towards contributing to growth and scale were long-term impact and disciplined execution matter most. As Ohio’s cannabis industry grows beyond its early chapters, I’m optimistic about what’s next and motivated by the work it will take to help write what comes after.

Thank you for joining us, Andrea! For more information on Ratio Cannabis, please visit its website.