The Week In Review-The Weekend Ahead

Medical Marijuana, What You Need to Know and Can it Help End the Opioid Crisis?

By Edie Johnson

Medical Marijuana is being touted as a new healing and chronic pain relief alternative. But before you decide to make the trip to the north end of Newburgh for some, there is a lot you need to know.

Firstly, as of now you need not only a prescription, but a special authorization card from the State of New York. And there are only certain doctors that are certified to help you to obtain such a card. To find out who is certified, you can pull up a list, by county, at the New York State Department of Health. There presently 17 certified physicians in the county of Orange.

What diseases are now permitted to be treated with medical marijuana?
At present about 10 approved conditions may qualify a person. They with include: Cancer, HIV/AIDS, ALS, Parkinsons Disease, chemotherapy, MS Spinal Cord Injuries, neuropathies, Huntingtons Disease, inflammatory bowel disease and chronic pain syndrome. Recently added are PTSD and opioid use. Addition of temporary use for acute pain (broken bones, etc.) is waiting for the governor’s signature.

There is a wealth of other information at the state site including press releases about newly approved coverages.

Curaleaf, the first and only dispensary site in Orange County, has counselors to assist people through the process as well as counseling as to the best product for a given condition and particular person. Their highly trained staff have been reported to be extremely helpful and friendly. They operate in 9 states and a pharmacist is present for consults.

However, you should be prepared that selecting a doctor from a state list may not be as easy as one might think. Some of the doctors listed are certified, but do not presently use their certification. Others may have moved their practice to a new location and are with a group or with an immediate care group that doesn’t allow certification at the site. Still others, because of a growing list of patients are seeking this alternative, are booked solid for up to 5 or 6 months. In fact, available certified doctors are so busy that a new alternative has popped up of doctors who will evaluate patients via New York skype.

Why is this new alternative becoming more accepted?
A main reason is providing it as an alternative to highly addictive opioids. There are few other remedies on the market for severe and/or chronic pain that don’t include a frightening list of possible long term side effects, and some that can cause fatal diseases. A growing elderly population is bringing more and more severe aches and pains into the diagnostic picture. Medical marijuana has potential side effects as well, but researchers point out that to their knowledge no one has ever died from it.

Over the past several years one crisis, that of overuse and over-prescription of opiate pain medications has led to severe restrictions on how and when doctors are able to prescribe them without fear of repercussion from both the medical and government authorities. As a result, many people were left without effective alternatives. Others turned to overuse of over-the-counter medications that can cause long term organ damage. Still others turn to the street markets and perpetuate the cycle of drug and gang violence. Given the time lag during which pharmaceutical companies have promised to make efforts to develop other alternatives, the pressure for the medical marijuana alternative, along with numerous new studies that validate its effectiveness, prompted many states, and now New York , to relax its laws, especially with renown and respected physicians coming onboard with cautious praise.

The most common forms of administration are pills (regular and extra strength), tinctures (added to juice, water or tea), or a “vape pen” that is inhaled. The vape pen product is absorbed the most quickly. The pills act more slowly but last much longer. A new transdermal patch is also under review.
Each product contains THC and CBD. The CBD portion is a potent anti-inflammatory, and has a calming effect. The THC is the “feel good” component and helps activate dopamine, a natural anti-pain and mood elevator that can “restore synergy” if used in small amounts. It is also located in the brain near receptors for the immune system and may actually boost health. A higher proportion of THC can cause anxiety. CBD as it may restore synergy of the patient’s system is also believed to help regulate disordered thinking as in psychoses.

Interview by Orange County Post with a Patient
Michael, a middle-aged gentleman with a full productive life in his past became sidelined and out of work almost ten years ago due to debilitating pain from ulcerative colitis and Crohn’s Disease. He lost 40 lbs, tried to work through it but was in so much pain that he could not go to work, had restless sleep with night sweats, and too tired to accomplish much during the day. In an interview with the Orange County Post, Michael said that after years of trying to deal with the pain through opioid use, last Spring he went to an open house at Curaleaf. He said that for many, the opportunity to arrange for treatment locally, without having to travel to Albany, Westchester or New York City with a small child who has epilepsy and seizures when under stress, is life changing. After getting instructions, Michael was able to consult with a certified practitioner online and signed up for a skype appointment with a doctor the next day. After taking an online selfie he filled out his portion of the forms online. Within a day he was able to print out his certification form. The entire process took 3 days. With his New York State authorized card he was able to return to Curaleaf to have product counseling. Because his pain is acute, he said he prefers the vape pen, but he says he has met quite a few people who prefer lozenges. He said the pain relief was nearly immediate. The application procedure cost $150. Product cost varies widely.

Michael said he is now back to full time work, and in his spare time he goes to Albany and advocates for fair laws regulating supervised use.

Why is Medical Supervision Necessary
Medical marijuana is grown under laboratory conditions and with strict oversight that assures accuracy of the product’s potency down to a milligram. Varieties of marijuana, for instance, that are grown in California ocean waters have been found to be many times more potent than is standard. How would a user know what variety/potency they are getting? Even more concerning is that marijuana, which needs to be heated to release the effective ingredients, can be condensed during the process, altering its potency (sic) and increasing its effect many times. Add to that the likelihood that street providers may lace their product with additions like fentanyl, which can be lethal in even low doses, and possible legalization for recreational use (which would have potentially different products, legal and not legal, all over the state), and you have a nightmare of policing for law enforcement.

These complications of questionable product, inexact dosages, individual reaction and changing health conditions , as unintended consequences, can result in a new world of helpful medicinal products that facilitate a full and happier life, or it can be a recipe for tragedy. Hence the reluctance of state authorities to make the jump from closely monitored supervision to recreational use, which will require a vast new system of education and oversight.

One more important cautionary about this and any other pain relief options is that while pain killers may help the underlying condition by decreasing inflammation, if the underlying condition includes broken bones, infection, or serious disease, it can mislead a patient into not seeking other necessary resources to help or cure the underlying cause.

Caption: The Curaleaf dispensary on North Plank Rd. in Newburgh is currently the only medical marijuana dispensary in Orange County and has received many positive reviews. As of June they had given consultations to over 1,000 customers.

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