I didn’t go to medical school to decide who can be certified to have medical marijuana. Yet every Thursday morning, I see patients in a rented space because if I don’t provide this service, these patients will have few other options.
In January of 2016 when medical marijuana first became available, I completed the four-hour, online course because I knew my home bound, end-of-life patients could benefit. These were patients with end-stage cancer, multiple sclerosis and Parkinson’s and most had never tried marijuana in their life. Initially, I restricted my certifying to my established patients, but soon I was receiving calls from patients in the Hudson Valley area who were desperate to have someone certify them. There was a lot of secrecy in the beginning of the program about which doctors were able to certify. Only other doctors had access to the list. Eventually, that information was made available to the public, as long as the provider agreed.
After hearing a chorus of pleas from patients, I realized I could not hope to visit all of these people’s homes and instead, I rented a space a half day in downtown New Paltz. These new patients shared reports of people traveling hours to see a doctor and being asked for $300 to $500 per visit. Most doctors were also insisting patients needed to come in regularly to maintain their certification. With less than 1% of health care providers in New York able to certify, these doctors were in demand and were using the program to profit. There is nothing new about the health-care industry taking advantage of the sick, but it still appalls anyone with a conscience. Soon I was getting calls from different organizations about how they could grow my “marijuana practice” and bring more patients to my doors. They seemed unable to understand why I would accept insurance and why I wasn’t looking to expand.
What these organizations were ready to capitalize on is this truth: medical marijuana works. I have seen many people who were reliant on opiates for their chronic pain drastically scale back their use of prescription medications and in many situations stop them all together. I have seen patients with cancer suddenly have an appetite again and gain weight as well as energy. My Parkinson’s patients whose tremor was almost unbearable found a new steadiness. MS patients find new fluidity to their movements. It isn’t a miracle, and it doesn’t work for everyone, but it does help many severely ill people who have not been able to find relief from traditional pharmaceuticals or can’t tolerate the side effects from mainstream drugs.
The most mindboggling aspect to this issue is how onerous the process of obtaining marijuana is for both patients and providers. It takes me minutes to send a prescription for opiates, substances that are killing more than 100 Americans a day, but for a severely ill person to get marijuana, it takes weeks. Furthermore, that opiate prescription will be covered by their insurance along with a small co-pay, while the marijuana itself will cost hundreds of dollars a month depending on the product, dose and frequency.
So if you are suffering from “cancer, HIV infection or AIDS, amyotrophic lateral sclerosis (ALS), Parkinson’s disease, multiple sclerosis, spinal cord injury with objective neurological indication of intractable spasticity, epilepsy, inflammatory bowel disease, neuropathy, chronic pain or Huntington’s disease” and hoping to use medical marijuana to ease your symptoms, good luck with finding a doctor to certify you, paying their fees, navigating the website, waiting for your card and finally affording the marijuana itself.
I do not think this bureaucratic mess was what was intended when lawmakers in Albany passed the legalization of marijuana for medical purposes in 2014. Currently, 29 states have legalized marijuana for medical purposes and New York has some of the most restrictive rules. Reviewing systems from other states does provide simpler alternatives, primarily doctors filling out a simple one-page form recommending marijuana for their patients based on their knowledge of the patient and their diagnosis.
It is also crucial to change federal legislation as many physicians are hesitant to be involved in recommending a schedule I drug, a designation that currently includes heroin and LSD. New bills with bipartisan support are currently making their way through congress. Simplification and clarification of marijuana regulation is essential to providing access for thousands of severely ill patients.
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