In 2014, New York became the 23rd state to legalize marijuana use for a handful of specific medical conditions. But New York State’s medical marijuana program is the most restrictive program in the country. The product is only available in Cannabis oil via several delivery methods including capsules, vapor, tincture and spray. Governor Andrew Cuomo’s program does not allow the use of the whole plant or edibles — “prohibiting smokable marijuana will keep the drug out of the wrong hands,” says Cuomo.
This presents a small problem, according to Gene P. Epstein, FNP, one of New York’s growing list of individuals that can certify you for a medical marijuana card. “The products offered in NY State are purified marijuana. They are separated by extraction — the CBD and THC, which leave out a whole lot of other things that are in the whole Cannabis plant — THCA, CBN, CBC, terpenes, lactones, etc. Whole plant marijuana is much better than the pharmaceutical products and they are growing strains now which contain high contents of both CBDs and THC,” says Epstein. Right now, marijuana, as you may know it, is not legal in the state.
Epstein, a psychology major and paramedic in New York City for over ten years, has over 20 years EMS experience dealing with chronic pain including assisting in countless opioid overdoses. “Back then I dealt with a lot of pain issues and they used a lot of opioids. Many people got into trouble with that. Opioids are still used for acute pain and effective.”
Though opioids work quite well for chronic pain, they are highly addictive and carry many unwanted side effects. “Cannabis works very well on pain. However there were not any studies performed in this country due to Cannabis being a schedule one drug, the same class as heroin and cocaine,” says Epstein. “The initial Cannabis studies began in Israel and Europe by combining Cannabis CBD and THC mixtures. The body has this benzoxazinoid system. THC can lock into the brain and interfere with pain receptors and help with that, so the THC is really good for pain but for some people the problem is that it’s very psychoactive. CBD is not all psychoactive, however it’s a very strong anti-inflammatory. In England they have had much success with a 1 to 1 mixture by adding CBD’s to THC it enhances [them] which is called the entourage effect. It mitigates the psychoactive effects of the THC so it’s not as strong but you still get the anti-inflammatory effects of the CBD, which is very good for neuropathy, peripheral nerve pain, anxiety, PTSD, IBS, MS, Parkinson’s Disease, damage, pain and adding a little THC to it helps with the pain.
The most popular product we use is the 1:1 formula until recently they came out with 2:1, two times the amount of CBD to one part of THC. CBD and THC both seem to be very effective with very few side effects.” Working with patients experiencing chronic pain for a life time, Gene states, “Little did I know that the answer was right under our noses for thousands of years, Cannabis.”
Right now, there are 1,332 registered practitioners in New York State who can evaluate and prescribe a medical marijuana card for you and more are being added daily. There are currently 36,053 certified medical marijuana users in New York State. I am one of them. Suffering from chronic pain from several abdominal surgeries, I wanted to see if these products work well on pain. It turns out that they work extremely well if used properly.
In order to obtain a medical marijuana card, you need a referral from your primary care doctor for a doctor or LPN who can certify you. Once certified, the card usually comes in anywhere from three to ten days in the mail. Your medical marijuana practitioner will prescribe what would be best for you to start. In my case I had to experiment with a few products to find one that works best on pain and not offering any psychoactive effects. I find the 1:1 product, Balance, to work the best for me. The products are pricey; however, the prices will most likely come down with more and more dispensaries added every week.
According to New York State’s Medical Marijuana website the following conditions are accepted for a medical marijuana card. “You are potentially eligible for medical marijuana if you have been diagnosed with one or more of the following severe debilitating or life-threatening conditions: cancer, HIV infection or AIDS, amyotrophic lateral sclerosis (ALS), Parkinson’s disease, multiple sclerosis, spinal cord injury with spasticity, epilepsy, inflammatory bowel disease, neuropathy, Huntington’s disease, post-traumatic stress disorder or chronic pain (as defined by 10 NYCRR §1004.2(a)(8)(xi)). The severe debilitating or life-threatening condition must also be accompanied by one or more of the following associated or complicating conditions: cachexia or wasting syndrome, severe or chronic pain, severe nausea, seizures, or severe or persistent muscle spasms.” On Veteran’s Day this year, Governor Mario Cuomo approved medical marijuana to the list for PTSD which will help many veterans and other people suffering from this incapacitating disease.
If you are driving on Route 28, headed towards Woodstock, you’ll see an unremarkable building on the right side of the road with the words “Etain” written on a tiny sign by their driveway. You can pass by this building countless times over the past few years and not have any idea of what it is, even though you may have heard of a Medical Marijuana Dispensary right on Route 28.
“We are limited in our marketing and advertising. We chose the name Etain because it has meaning to us and it wasn’t a very obvious name like you might see in Colorado like “Green Leaf”,” Cannabis Rush” or Canna something. We didn’t want to have Cannabis in our name, we wanted something unique and different. We chose Etain because it’s kind of nondescript,” says Hillary Peckham, one of the founders and CEO for Etain explains.
Etain is a family run, woman-owned business established and run by Amy Peckham and her two daughters, Hillary and Keeley. “My grandmother, Francis Keefe, was diagnosed with ALS and my mother was her care taker, so we saw how her end of life care was mismanaged. My grandmother was put on over 20 different medications and a lot of them had different reactions. Her passing was not very comfortable, I think she could have had a better quality of life. A doctor had recommended medical marijuana for her and at this point it wasn’t legal in New York State, so we did not have this as an option. So we started looking at it,” says Hillary.
Etain was one of the first five dispensaries to be granted a medical marijuana license in New York State in 2015. With a staff of over 45 people, Etain runs a clean, streamlined operation. “We have chemists, horticulturists, pharmacists, everybody sort of contributes towards the products that we make and the formulations,” Hillary says. She and her laboratory manager, Sarah Collins, created the original formulations used today by Etain.
The company has four main products, each offered in different delivery methods. Dolce, which is high in CBD’s and low in THC. Balance, which is one-part CBD to one-part THC. Forte, which has the highest content of THC, usually for cancer patients and usually works better with experienced marijuana users. Etain’s newest product, Mezzo, which is two parts CBD to one-part THC is quite promising for pain without the feeling of being “high.” This product has less of a psychoactive effect and works well for pain and people that work and want to function daily.
“New regulations are coming through and we are waiting to see if they pass and in what version. In New York, we are held to pharmaceutical standards and it is very difficult to insure the effective dosing with edibles, meaning that each edible is consistent in the entire batch,” says Hillary. Having their products held to pharmaceutical standards gives Etain more credibility in the medical community by using capsules and tinctures, things that doctors are familiar with. “It will be a slower move [than] you see in other states that offer whole plant and edibles. More control over the dosage. Everything you put in an edible is food grade so it does not meet the high standards of pharmaceutical products in New York State” Hillary says.
In the lobby of the offices in Kingston sits a testimonial book with the experiences of the people using Etain products. All of the reviews are encouraging and people from all walks of life with all kinds of ailments say they are feeling better, without pharmaceutical drugs. Patients with MS, ALS and several kinds of cancer all write astounding reviews for the product. Medical marijuana seems to work as a means to get off opioids when one is addicted. “We have had a tremendous success with many people who are on large doses of opioids, and they are coming off these narcotics. In terms of managing their pain, many of them are able to stop using opioids after a few months of treatment with medical marijuana…this could be a really useful tool in fighting the opioid epidemic,” Hillary says.
She is no stranger to pain herself. “For me I had a failed hip surgery and was not able to walk for two years. I saw how pain can be mismanaged, it was difficult for me to get through my day on different pain killers. I was worried about the addictive qualities of the opioids. Medical marijuana was again recommended to me for my pain, however again it was still illegal in NY State. So, we started to seriously look at the industry and right around the time of my grandmothers passing is when they were talking about the Compassionate Care Act of 2014, which my mother and I are very passionate about. That’s when we decided to apply in New York State for a medical marijuana license.”
This is what is available in New York State. The product is priced higher when compared to “street prices” of marijuana, though testimonies appear to show it effective if one is experiencing chronic pain or any of the listed ailments.
“It’s a hugely rewarding industry to be a part of and I am really grateful for the opportunity it is bringing a new quality of life to so many people,” says Hillary. “This is why we became involved and what we are so passionate about,”.
See www.health.ny.gov/regulations/medical_marijuana/about.htm for more information.
Etain is at 445 NY State Route 28, Kingston, NY 12401. To reach them, call 914-437-7898 or e-mail email@example.com.
To reach Gene Epstein, FNP, Medical Marijuana Certification and Consulting, call 845-430-4239 or e-mail: firstname.lastname@example.org.