Returning to Washington: State of Cannabis in Flux

Quite a while ago, I realized I would be visiting Washington State in July 2016, just soon after the changes that Washington's legislature was enacting in regards to cannabis. These changes were the very reason that many medical marijuana activists voted against recreational cannabis. 

Back in 1998, Washington voters legalized cannabis for medical use. However, there were no "dispensaries" or "safe access points" that I knew about. Some farms were cultivating and supplying patients, but only on a small-scale and it was difficult to understand the system.

In 2011-2012 a plethora of "safe access points" using a law that allowed "collective gardens" began appearing in many communities and cities especially on the west side of the Cascade mountains. The Eastern side being a bit more conservative, and slower to recognize the changing laws.

I had become a legal patient for the first time in 2008, and I have had a front-row seat to all of the changes. I even voted "no" on I-502 which ended up passing, legalizing the sale of cannabis for recreational purposes. 

I have been with my husband in Arizona during much of the enacting of I-502 for the past 9 months, and I was anxious to see the changes that would come about with the forced closure of the collective garden "safe access points" and the virtual elimination of all medical access points for cannabis all together.

I will insert a few disclaimers here: The few shops that I have visited so far have also had flower of several types, but on these trips I have not been looking for flower, only concentrates. Also, I have only visited a handful of shops in some rural areas so far. I will be continuing to write about my experiences in Washington as they occur.

Vancouver

Soon after I entered Washington, I pulled over looking for a gas station. After getting gas, I happen to see a vape store and thought I'd attempt to get a replacement battery for my vape pen which hadn't worked since Arizona due to my failure to charge the batteries.

After purchasing a pre-charged replacement battery, I struck up a conversation with the cashier and older male customer in a wheelchair about the current state of cannabis in Washington. The gentleman was quick to let me know he had a buddy who was selling solventless dab oil that had essential oils added for taste, for only $20 per gram.

I was quick to let the gentleman know that I had no time or money to purchase medicine from this particular source and I had granddaughters waiting for me, then I left.

Tenino

After my visit with my granddaughters, I decided to check out what the recreational shop in Tenino was offering. There were many bright packages, but most of the "dabable" oil that would work in my vape pen (my only current personal medication device) was priced far out of my price range. There were 3 different types, sourced from one particular breed of plant each. They were all priced between $35-$50 per gram. 

There were also 2 different types of "RSO-type oil" for sale at the Tenino shop. These were $45-55 per gram. 

Centralia

When my needs were not met in Tenino, I decided that my former favorite safe access point just north of the Lewis/Thurston county line was close enough to check out. I didn't know if they had turned "recreational" or not, but I figured it was worth a check.

The company that currently is housed in the building took it over after the people who I was working for were evicted by the owner. It is the closest safe access point to Centralia, and is in a high-traffic area.

When I approached the building, I wasn't sure they were even open. All the signage had been removed, the "green cross" that had always been out at the road was gone, and the "open" sign was off. There was a "no trespassing " sign in the window regarding law enforcement. 

But, the door was open. So, I went in. 

There was a gentleman at the reception desk who asked me if I was in their patient database, I said that they did have my paperwork from last October and it was still valid. He informed me that they had transitioned into a "private club" and only saw patients that had previously registered their paperwork with them. 

When he brought me back, I saw that the only thing that had changed was the absence of "name brand" edibles. There were still multiple jars of flower in both Sativas and Indicas. And there were a generous shelf of concentrates below.

The "crumble" from a Cherry Kush was my choice. Since it was Monday, the special was 5 dollars off any "dab oil," so my selection was $20. There were also platinum selections of different types of C02 oil and other methods of extraction, like Rosin, for $35-60 per gram.

I wasn't satisfied completely with the dab oil, however. I happen to see that they had some Pre-98 Bubba Kush flower, and treated myself to a gram of that (at $10) just to smell (and eat). 

Shelton

The Cherry Kush Crumble was quite effective medicine for my needs. I still had capsules of hemp oil and RSO for the rest of the month, but needed something to vape to stave off my nausea, PTSD and anxiety. When I realized that the Crumble was going to get low before the end of the month, I figured I needed to find out what I could purchase more local to where I was staying.

I came across a recreational store that just happened to be affiliated with a previous Safe Access Point that I had known about. I was familiar with the family and have respected them for some time for their work with patients through the years. It was a "rec shop" that I wasn't too offended to spend my money at, to be frank.

As I entered BatStone Buds, I noticed that they were a very classy looking shop, with a clearly marked "medical" counter. When I asked about concentrates, and medical cannabis, the young cashier lead me over to tinctures. 

After clarifying that I wanted to see what they had in "dabable" concentrates (she did also show me several syringes of RSO-type oil for sale, but I didn't inquire about the cost at that time), she lead me back to the recreational counter and directed my attention to a case with 4-5 different brands, each having several types.

I chose the "Uncle Rudi's" frankly due to the price. There were two strains available, "Afgooy" and "Indica hybrid." I chose the Indica hybrid for personal reasons. The young lady said it was "$20 per gram," and gladly took my $20 bill. 

When I got the reciept out, I did notice that it wasn't, in fact, $20 per gram, but instead it was listed as $13.72 per gram with $5.08 state tax and another $1.20 going to the local government.

As for the medicinal product bought at a recreational outlet, I found it comparable to the "shatter" medicine that I had procured in Arizona frequently. And also, equivalent to the Crumble I had purchased at the access point turned "private" club. 

Going Forward

I have plans to spend the next few months up here in my home state before returning to Arizona. During this time it will be interesting to observe how the state of cannabis evolves in Washington State. For now, the biggest loss appears to be the Cannabis Farmer's Markets which were an opportunity for the patients to meet the farmers and to purchase medicine frequently at a much discounted price. 

Currently, any discounts or "farmer's markets" will be strictly black market with the Washington State Liquor and Cannabis Board in control.

Cannabis is the Answer to a Painful Question

The following is a research paper that I wrote for an English class at Southern New Hampshire University. I am publishing just as I turned it in, complete with references. 
However, I am editing in some photos to break it up a bit. Perhaps later I will hyperlink the references, and remove the parenthetical citations, but for now I will leave it as is.

Cannabis is the Answer to a Painful Question

There are many types of pain, but pain is the primary reason people seek care from physicians (Blesching 404). Opioid-based medications like Fentanyl (duragesic), oxycodone (Oxycontin, Percocet), morphine, Dilaudid and methadone are currently the primary treatments prescribed by physicians for severe chronic pain. Deaths from opioid pain medications are at a catastrophic level in the United States, the United Kingdom, Australia and Canada (“Opioids”). However, in areas where cannabis has been legalized for the treatment of chronic pain, those deaths have fallen by over 25% (Young). If cannabis was legalized universally for the treatment of chronic pain, fewer people would overdose while attempting to find

relief from this symptom.

In December 2015, CNN headlines screamed, “Drug overdose deaths reach all-time high,” when reporter Nadia Nounang announced opioid based drugs (including prescription medication) were responsible for 61% of those deaths. Ms. Kounang followed up three months later in the same publication with the Federal Drug Administration’s answer, “FDA requires ‘black box’ warning on painkillers” in which they finally warned consumers about addiction, physical dependence, the possibility of overdose, and death. These were similar to the warnings the FDA issued in 2013, intending to educate physician and patient alike.

The suicide rate among patients who suffer from chronic pain is double the rate in the rest of the population. Some would say chronic pain is a disease in its own right. More than 20 percent of Americans report from suffering some degree of chronic pain. It is connected with the absolute worst quality of life (MacCallum). More people die from opiate pain medication than any other medical treatment for a non-life threatening conditions.

Although opioid-based medications are the most common treatment for pain; recent studies indicate opiates are not effective for treating chronic pain. According to the the Centers for Disease Control and Prevention (CDC) when it recently announced it does not recommend physicians prescribe opiates for chronic pain, one reason stated was the risks of using this drug class for this symptom outweigh the benefits. According to United States 2014 statistics, 52 people died each day from prescription pain medication ("An important shift on opioids").

Five and a half years before writing "Doctors told not to prescribe opiates for chronic pain" for USA Today, Liz Szabo published an extensive viewpoint titled, “Treatments for Chronic Pain Can Lead to Prescription Drug Abuse,” in the same publication. In the 2010 piece, Ms. Szabo delineated the extensive problem prescription pain medication has become in our society; in the follow-up this March, she reported the CDC’s eventual response: Opiates are now considered to be only a very short term treatment at as low a dose as possible. A handful of exceptions were made, particularly in end-of-life circumstances (2010; 2016).

When the CDC announced in March 2016 they no longer recommended opioid pain medication for patients with chronic pain, they did not give clear alternatives. In the past five years, when attempting to avoid the temptation of taking opioids due to addiction, even patients who identify themselves as addicts or as allergic to opiate-based medications are being pushed those same pain relievers at every emergency room or physician’s office visit (Koons; Slighte). The CDC did not indicate how physicians should treat chronic pain without prescribing their favorite medications (Szabo “Doctors”).

Cannabis has been used to relieve pain and spasticity since ancient times (Mathre 112).
When using cannabis for chronic pain, many patients report they are able to reduce, then eliminate, not only narcotic pain relievers, but also antidepressants, benzodiazepines and anticonvulsants (Floyd; Mathre 121-123; Slighte).

In the United States, the first law in relation to cannabis came into effect before the states were united. The 1619 law ordered farmers to grow “Indian hemp” in Jamestown Colony, Virginia (Ditchfield & Thomas x). In spite of overwhelming evidence to the contrary, the United States federal government currently contends the cannabis plant is dangerous and has no medicinal value (Ditchfield & Thomas xvi).

In 1996, California and Arizona were the first two states to vote into law medical marijuana (Mathre 51). Since then, 22 other states and the District of Columbia have voted into law various cannabis products for assorted conditions. The following states list “chronic pain,” “intractable pain,” or “other debilitating conditions defined by physician” in regards to treating chronic pain with cannabis:
         Alaska, Arizona, California, Colorado, District of Columbia, Hawaii, Maine, Maryland, Massachusetts, Michigan, Minnesota, Montana, Nevada, New Hampshire, New Mexico, Oregon, Pennsylvania, Rhode Island, Vermont & Washington (Rahn).
However, cannabis remains illegal on a federal basis and this is enforced through raids carried out by federal authorities on a weekly basis on medical establishments (Wattles).

In spite of its opposition to the concept of cannabis having medicinal value, the United States government has issued several patents for the use of cannabis in medicine. At least two of these are specifically related to how cannabis helps patients who are experiencing pain (Eckroate 23).

Studies examining opioid overdose deaths in this country from 1999 to 2010 have shown in areas where medical cannabis has been legalized, significantly fewer people are dying from opiates. In fact, the longer there has been a medical cannabis law in place, the fewer deaths there appear to be. During the first year, deaths dropped about 20%, but by the sixth year of medical cannabis legality, there were more than one third less deaths from opiate-based pain medication than were anticipated (Bakalar).

Rather than being a gateway drug TO opioid addiction, cannabis appears to help patients recover from opiate addictions and treat their pain in an alternative manner. There is also evidence to suggest cannabis may help assist in general abuse recovery (Ditchfield & Thomas 49). Other studies show cannabinoids (active components of cannabis) have the ability to work together with opioids so the pain medication is more effective and the patient can reduce their tolerance to the opiate, causing the patient to require less medication for the same relief (Mathre 121-123).

There are many people who do not understand the methods employed by medical cannabis users in the treatment of disease. To much of the world, rooms full of acrid smoke and teenagers "couch locked" from popular movies are what they picture when you say the word "marijuana". "Cannabis" is a less known, but a preferred term among patients who are very serious about this botanical medicine. The current cannabis treatment preparations in tinctures, capsules and cooked into meals would not be recognizable to the marijuana user of the 1960s and 70s. Cannabis can be consumed as a topical, vaped in a e-cig, taken as a capsule or inserted as a suppository (Backes 101-105). Contrary to popular opinion, the stereotypical "lazy stoner" does not represent the modern medical marijuana patient who by and large reports he is able to "get on with his life" as it was before pain became a daily issue.

Pharmaceutical companies are not ignorant to the possibilities created by cannabis. A cannabis-based medication named “Sativex,” developed by G.W. Pharmaceuticals, has shown great promise relieving pain and spasticity in controlled studies since 2014. It has not yet been FDA approved for widespread use (Cervantes). As with any other pharmaceutical product, Sativex is priced to cover the years of research required to bring it to market, making it more expensive than most could afford--much more expensive than growing an herb in your backyard.

Opponents to medical cannabis programs often ignorantly use potential for addiction as an argument against marijuana. What they fail to understand is the slight capability for cannabis to cause dependence is much different than addiction drug-seeking behavior commonly found with opiate, tobacco and alcohol addictions (Bultman and Kingsley 98; Eckroate 135-137). The small percentage of marijuana users who do display a dependency may exhibit irritability and difficulty sleeping as well as some nausea upon quitting use (Bultman and Kingsley 97). The symptoms the patient was relying on the cannabis to treat will also return upon ceasing consumption of the herb.

There are other clinicians who are developing their own methods for managing or alleviating chronic pain. One is Pete Egoscue. He has written books about the exercises he employs to rid people of their chronic pain forever (“Pain Free”). Unfortunately, most people are lazy when it comes to their health. If there is a pill to pop, a suppository to push, a joint to smoke or a tea or tonic to drink they will do it much faster than they will ever pick up a book and read it, much less actually learn exercises and do them repeatedly enough to be effective (Whiteman).

More than 1.5 billion people suffer from chronic pain worldwide. That includes over 100 million Americans. Deaths from opioid pain medications exceed all of those from illegal drugs for ALL age groups, from 15 to over 65. The largest group dying are those from 45-54 (“Deaths”). The numbers are staggering. What is just as shocking is that NO ONE is dying from cannabis. In fact, in areas that have legalized medical marijuana, significantly fewer people are dying from opioid pain medications.

When evaluating cannabis versus opioids for chronic pain, there are two simple but profound facts must be acknowledged above all others:

1. Prescription opiates kill more people than any other type of medication (Kounang “Drug”).
2. Cannabis has never killed anyone (Carter; 'It's zero!').

The Chief of the CDC was quoted on March 16, 2016 stating, "We know of no other medication routinely used for a non-fatal condition that kills patients so frequently," when speaking about doctors prescribing opioid pain medications (Szabo “Doctors”). When researching possible deaths from cannabis, Rep. Blumenauer from Oregon stated it perfectly in November of 2014 when he said, "it's zero!" ('It's zero!').

It is not enough to take away the source of the fatalities without providing a safe and effective replacement for pain control. Cannabis is a treatment that provides relief without the fear of accidental death via overdose. If physicians want to “FIRST DO NO HARM,” they should recommend medical cannabis for chronic pain FIRST. 

Works Cited

"An important shift on opioids." Washington Post 6 May 2016. Opposing Viewpoints in Context. Web. 12 May 2016.

Bachhuber, Marcus, and Colleen Barry. "Of Pot and Percocet." New York Times 31 Aug. 2014: 12(L). Opposing Viewpoints in Context. Web. 9 May 2016.

Backes, Michael. Cannabis Pharmacy: The Practical Guide to Medical Marijuana. New York. Black Dog & Leventhal Publishing. 2014. Print.

Bakalar, Nicholas. "Patterns: A Benefit of Legal Marijuana." New York Times 1 Sept. 2014: D4(L). Opposing Viewpoints in Context. Web. 9 May 2016.

Blesching, Uwe, PhD. The Cannabis Health Index. Berkeley, California. North Atlantic Books. 2013. Print.

Bultman, Laura, M.D. & Kingsley, Kyle, M.D. Medical Cannabis Primer: For Healthcare Professionals. Minnesota. Minnesota Medical Solutions. 2014. Print.

Carter, Gregory T., et al. "Re-Branding Cannabis: The Next Generation of Chronic Pain Medicine?" Pain Management 5.1 (2015): 13-21.ProQuest. Web. 20 April 2016.

Cervantes, Jorge. The Cannabis Encyclopedia. China. Homestead Book Company. 2015. Print.

Corderoy, Amy. "Chronic pain sufferers gain relief from cannabis - study." Sydney Morning Herald [Sydney, Australia] 27 Jan. 2015: 10. Opposing Viewpoints in Context. Web. 30 May 2016.

"Deaths from Opioid Pain Relievers Exceed Those from All Illegal Drugs." Prescription Drug Abuse. Ed. Margaret Haerens and Lynn M. Zott. Detroit: Greenhaven Press, 2013. Opposing Viewpoints. Opposing Viewpoints in Context. Web. 27 Apr. 2016.

Ditchfield, Jeff and Thomas, Mel. Medical Cannabis Guidebook: The Definitive Guide to Using and Growing Medicinal Marijuana. China. Green Candy Press, Oceanic Graphic International. 2014. Print.

Eckroate, Norma. The Medical Marijuana Handbook: A Patient’s Guide to Holistic Healing With Cannabis. Bradenton, Florida, USA BookLocker. Com Inc. 2016. Print.

Egoscue, Pete. Pain Free: A Revolutionary Method for Stopping Chronic Pain. New York. Bantam. 1998. Print.

Floyd, Keith. Personal Interview. 26 May 2016.

"'It's zero!' Rep. Blumenauer on number of marijuana deaths." CNN Wire. 13 Nov. 2014. Opposing Viewpoints in Context. Web. 9 May 2016.

Koons, Anne M. Personal Interview. 29 May 2016

Kounang, Nadia. "Drug overdose deaths reach all-time high." CNN Wire. 18 Dec. 2015. Opposing Viewpoints in Context. Web. 22 May 2016.

Kounang, Nadia. "FDA requires 'black box' warning on painkillers." CNN Wire. 24 Mar. 2016. Opposing Viewpoints in Context. Web. 12 May 2016.

Armentano, Paul. Letter. "Marijuana and Opioids." New York Times 29 Apr. 2016: A20(L). Opposing Viewpoints in Context. Web. 12 May 2016.

Mathre, Mary Lynn, ED. Cannabis in Medical Practice. Jefferson, North Carolina. McFarland and Company, Inc Publishers. 1997. Print.

MacCallum, Elizabeth. "Strict Regulation of Prescription Drugs Harms Patients Suffering from Chronic Pain." Prescription Drug Abuse. Ed. Margaret Haerens and Lynn M. Zott. Detroit: Greenhaven Press, 2013. Opposing Viewpoints. Rpt. from "Sufferers of Chronic Pain and the Government's War on OxyContin." Maclean's Magazine (15 Mar. 2012). Opposing Viewpoints in Context. Web. 27 Apr. 2016.

Nohlgren, Stephen. "STUDY POSES NEW POT BENEFIT; States with medical marijuana are seeing lower than expected opiate overdoses." Tampa Bay Times [St. Petersburg, FL] 27 Aug. 2014: 1A. Opposing Viewpoints in Context. Web. 9 May 2016.

"Opioids: A national crisis needs a federal response." Globe & Mail [Toronto, Canada] 11 Apr. 2016: A11. Opposing Viewpoints in Context. Web. 27 Apr. 2016.

Rahn, Baily. Qualifying Conditions For Medical Marijuana by State. Leafly. May 3, 2016. Web. May 22, 2016. https://www.leafly.com/news/health/qualifying-conditions-for-medical-marijuana-by-state

Slighte, Jason, Sr.. Personal Interview. July 29, 2015.

Schneider, Jennifer P., M.D., Ph.D. Living With Chronic Pain: The Complete Health Guide to the Causes and Treatment of Chronic Pain. Long Island City, New York. Hatherleigh Press. 2009. Print.

Szabo, Liz. "Doctors told not to prescribe opiates for chronic pain." USA Today 16 Mar. 2016: 01A. Opposing Viewpoints in Context. Web. 27 Apr. 2016.

Szabo, Liz. "Treatments for Chronic Pain Can Lead to Prescription Drug Abuse." Prescription Drug Abuse. Ed. Margaret Haerens and Lynn M. Zott. Detroit: Greenhaven Press, 2013. Opposing Viewpoints. Rpt. from "Prescriptions Now Biggest Cause of Fatal Drug Overdoses." USA Today 10 Aug. 2010. Opposing Viewpoints in Context. Web. 27 Apr. 2016.

Wattles, Jackie. "Medical marijuana now legal in 24 states." CNN Wire 17 Apr. 2016. Opposing Viewpoints in Context. Web. 30 May 2016.

Whiteman, Honor. “Have We Become Too Dependent on Medication?” Medical News Today. January 29, 2015. Web. 20 April 2016.

Young, Saundra. "Medical marijuana laws may reduce painkiller overdoses." CNN Wire 25 Aug. 2014. Opposing Viewpoints in Context. Web. 28 Apr. 2016.

Cannabis Caregiving

Being a Cannabis Caregiver can mean many different things.

Some caregivers are growers, who carefully select and breed and cultivate personalized strains for their patients.

Other caregivers research and develop recipes for medications that are not only effective, but taste palatable or perhaps even with a gourmet flair.

There are also cannabis caregivers work in dispensaries or "collective gardens" in positions we refer to as "bud tenders" but perhaps are better described as pharmacists or better yet, farm-assists.

Being a responsible caretaker of a cannabis patient, no matter the role, involves research, and very active patient communication.

Cannabis Caregiving with Hillbilly Rick

Many people have acted as my cannabis caregivers.

When my own edible education began, my friend Rick introduced me to "cannabutter" and showed me the process to extract cannabiniods into fat. He also helped me learn about dosages and strains that were helpful for my health conditions and how to grow.
My lessons included cloning as well as law enforcement officers tours of a legal garden.
The entire experience was quite eye-opening.  This was in 2010.

In the years between 2010 and 2013, I had travelled the country learning what I could from patients and caregivers living in the trenches of psuedo-cannabis medical "legality" and some just illegally healing. I had acquired knowledge about topicals and tinctures, about making cannacaps and eating more than just

cannabutter.

I also have a medical background. In my early twenties I worked as a back-office nurse before my disabilities necessitated me retraining outside of the medical field.

In 2013, I had the opportunity to re-visit cannabis caretaking with Hillbilly Rick. Only this time, the tables were turned. My friend was being quite honest when he confided in me that he knew I would be offended if he had asked anyone else to care for him after major intestinal surgery. I probably would have been.

Rick, as with all other patients whom I have provided care for, was recommended cannabis by his doctor.  The cannabis preparations that I prepared for him were purchased at his local collective garden. He also received a small donation from his collective garden during his after-care.

I prepared with topicals and tinctures, capsules full of a sticky blackish green goo

known as "RSO" for the man (Rick Simpson) who came up with the widest known method of extracting the concentrated cannabis oil. Also known as Full Extract Cannabis Oil (FECO) or Hash Oil; it is a substance highly concentrated in cannibinoids, and fairly easy to dose in capsules or a rice-grain portion eaten on top of a slice of banana or cracker.

Rick's recovery from surgery was fairly uneventful, once he left the opioid pain relievers in the hospital. Out of the hospital only a couple of days, I accompanied him and his granddaughter to church.
Two years later, Rick is the healthiest I have ever seen him. Oh, did I mention, he has stage IV kidney cancer; a diagnosis he has lived with for over 20 years now. (To read more about Rick and my friendship, please read: My Best Friend).

My Farm-Assist

Tables were turned once again, less than a year later, when my newlywed husband became my cannabis caregiver.

He already had partially assumed that role, when we began gardening together. You see, I married Floyd's Farm-Assist.
As much as I thought knew, he had more to teach me about gardening and the cannabis plant in general. Keith had been around cannabis for most of his life. When he took on the moniker "Floyd's Farm-Assist" it was because he had been helping others farm their cannabis for decades. He had also been researching the most effective strains for his own health conditions

On May 24th, I fell ten feet, backwards, suffering a compression fracture to my

T-11. I broke my back.
After the doctors assessed that I was correct in not wanting any opioids to treat the incredibly intense back pain I was having, and I learned how to walk again in the four excruciating days in the hospital; I was discharged into Keith's care.

The day after I came home, another caregiver delivered donated infused coconut oil and tincture. Keith carefully filled capsules full of coconut oil, and I took tincture by the tablespoon, and my pain was finally under control.

While being both a patient and a caregiver, I have learned many different aspects of using cannabis as a medication.  I found that using infused coconut oil worked better than using butter. Then came the addition of lecithin to the recipe, enhancing the absorbability of the cannaibiniods in the human cannaibinoid receptors.

My back healed faster than my physicians thought possible.
Compression fractures, due to their nature, don't heal completely. However, except for a need to understand my limits at times, I find that a year and 3 months after my fall, my health is very close to what it was before the fall.

A Post-Surgical Cannabis Caregiving Summer

This summer provided me two more opportunities to revisit post-surgical

caannabis caregiving.
My husband Keith, had arthroscopic knee surgery on his meniscus and a cartilage band. Then my brother was inspired by Keith and desired to go through back surgery (a laminectomy) without any opioids.

Keith's surgery was a fairly minor procedure. It was preformed in a out-patient surgery center. Afterwords he was sent home. Keith used many different cannabis preparations.

Knowing his sweet-tooth, and his disdain for pills (he had survived multiple pharmacological dependencies after several back surgeries, including one that left his leg paralyzed), I made him a variety of different high-protein but sweet granola bars.

They proved to be a bit too sweet, as well as a bit too highly medicated for his needs, so I soon cut them into multiple servings and dusted them with unsweetened cocoa, tempering the sweetness a bit.

Keith used a combination of full plant concentrate, inhaled and vaporized cured flowers & concentrates, tinctures and "RSO" as a topical on the incisions themselves. He also ate fresh and dried whole plant, including hemp seeds.

Keith's Medicine & Recovery

Keith's recovery was extremely fast. Within two weeks he was feeling better than before the surgery. He had full range of motion plus some and was released for full physical therapy with a brace that prevented him from hyper-extending his weaker knee until the leg strengthened.

In August came my biggest challenge thus far as a cannabis caregiver. My only sibling, my baby brother, was inspired by Keith's rapid surgical recovery and was impressed by the effect that cannabis had on his own pain; so he decided to go through his laminectomy without any opioid pain medication.

To avoid using opioids during the surgery, his physician used Ketamine. This caused him neuropathic hypersensitivity as well as memory loss after surgery.
I was at his bedside as soon as he was offered pain medication. Having made his choices clear pre-surgery, he became angered and frustrated when the nurses pushed him to change his mind about opioid medication. After some miscommunications were cleared up, Jason proceeded with his intended cannabis treatment.

It is against all hospital policies to bring in medication with which they are unfamiliar. From a medical standpoint, I understand this.
Jason made the decision the day after surgery, to transfer his care from the hospital to my personal care near the hospital. We spent several days in the shadow of the hospital, their resources available if he needed them, as he recovered from his back surgery.

Jason's treatment included topical RSO on the incision, high-cbd cream in the surrounding tissues, capsules of RSO, infused coconut oil and lecithin, as well as vaporizing cannabis concentrates. Jason also had the opportunity to try a new transdermal patch that was offered at our collective garden (however, he did not find that the patch met his medication needs.)

At his two-week post-surgical check-up, Jason's physician was extremely happy with his recovery and the look of the incision site. Although he was anxious to exercise more than just walk (for the second week of recovery, he had worked his way up to walking over a mile every day), she cautioned him to restrain himself from over-doing.

Feeling accomplished, I released him from my care. In spite of the title, I didn't and don't currently have a garden. My supplies are purchased or donated. I had run out of medication even for myself, I had none to give. Jason's medication was purchased with the limited resources that he had, and those resources had been exhausted.

Three days later, I heard my baby brother describe pain as a "new definition of a level '10'" ... only a week after we had him down to a "1 or 2".

This is the only reason I never wanted him to depend on cannabis.

His insurance would have paid for multiple medications to control the pain. His insurance company doesn't care that those prescription drugs are addicting and harmful to his surgical recovery and his recovery status.

Jason remains resolved not to use opioids.  In spite of medication shortages due to low financial resources, he is continuing to heal and amaze his physicians and his family. He remains in recovery.

The Price of Being a Patient

The Economics of Medical Marijuana and Disability

Background

In the past five years, I have had the incredible opportunity to travel the country and visit friends across the USA. Many of the friends I have visited, have been cannabis patients. Most of my friends are disabled, and/or caring for a disabled family member or dear friend.

I have witnessed many paradigms across the country, but for the purposes of this piece, I will limit my observations to the states where cannabis has been made legal for medical use.

Recently, a few more states have been added to the quazi-legal paradigm of "recreational cannabis" that I witnessed in Washington this past year and their attempt to implement it.

I had voted against I-502 for a number of reasons (for a full explanation, please read my blog piece, "This Woman and Her Vote"), but it passed regardless. The push for taxable marijuana was too big of a carrot to pass up for Washington State voters.

I also understand, and empathize with those people who need cannabis for medical purposes, but who can not afford the required doctor paperwork which is not covered by any insurance. This is largely due to the fact that the federal government has issued threats to licensed physicians that they will prohibit them from practicing if they do get themselves involved with medical cannabis.

In spite of this fact, the New England Journal of Medicine in May of 2013, reported that 76% of physicians agreed with medicinal cannabis use.

PATIENT ACCESS

When "recreational marijuana" was legalized in Washington State, it took over 18 months to implement the legal state-taxed store sales. The law had created a grey market. It was legal to possess, but not buy or sell or cultivate. However, it was and still is, legal to cultivate up to 15 plants if you are a legal patient.

Thus spurned the grey market of Washington. Patients who could grow, who had the means and opportunity, found that they could pass on products to friends as long as they didn't get caught.

A sign in a Olympia, Washington
Collective Garden

With the popularity of BHO (Butane Hash Oil) exploding, patients also found themselves in a predicament where collective gardens would pay them money for the trim off of their plants. Trim that was in many instances, previously donated for the purpose of making FECO (full extract cannabis oil), one form of which is often referred to as RSO (Rick Simpson Oil).
It is THIS oil, this plant concentrate which has been credited by many ad hoc studies as well as personal testimonies, as having cured cancers.

Patient Income

I haven't found any formal statistics in regards to the proportion of medical marijuana patients on disability income. From personal experience including my experience volunteering at a Collective Garden in Washington, I would venture an educated guess at 60-75% of all medical cannabis users (with a valid recommendation, or not) are on disability income from either Social Security, or a private source.

Let's look at the numbers, JUST for Social Security. There are two programs. One serves the people who are too disabled to have supported themselves for any period of time by employment, that is called Supplemental Security Income (SSI). As of 2013, 4.92 MILLION US citizens were on this program, receiving an average payment per month of $550.

The second program is known as "Disabled Workers" or Social Security Disability Insurance (SSDI). During the same time frame 8.96 million US citizens were drawing their Social Security through this program at an average payment of $1145/month.

When one averages the two classes of disabled Social Security recipients together, the average monthly income for 14 million people is less than $850 per month.

Medication Expense

From personal experience and observation, as well as physician recommendation and referral, the average cannabis patient with life threatening or chronic conditions requires between 1 and 3 grams

of dry, cured cannabis on a daily basis.

Prices for cannabis, per gram, can vary widely. The average up in Washington for medical is currently $10/gram. Washington is a state that also allows patients to grow up to 15 plants for their usage no matter their proximity to any organized & taxed grow or sales operation.

Arizona has a different paradigm. They enacted a "25-mile Rule" in regards to cultivating rights of patients. (A topic that will be covered in detail soon in a separate article). This means that if a patient lives within 25 miles (NOT driving distance, but as a "crow flies" which can be several hundred miles different) of a dispensary; they are not permitted to grow their own medication.

Arizona's state-taxed dispensaries charge upwards of $20/gram of dry medication. Then they add city, county and state taxes to the price.

A quick price comparison of the most popular concentrate, BHO, finds that Washington averages $30-50/gram; while Arizona charges $60-80/gram.

The cost of arguably the most beneficial concentrate of cannabis, full extract oil, is also the most expensive. FECO, RSO, Phoenix Tears, Raw Hash Oil are all names for a black-looking substance sold in capsules and syringes. It it dark green or dark amber depending on the method and solvent used. When an edible solvent (grain alcohol) is used, it is so green it looks black.

Washington Collective Gardens generally sell one gram of FECO for between $30 and $90.

The costs associated in making FECO for one's self to cure cancer is astronomical without growing one's own plants.

THE MATH BEHIND THE "CANNABIS CANCER CURE" 

It takes APPROXIMATELY one pound, sometimes more, of raw bud material of the cannabis plant, to process 60 grams, known as a 90 day treatment to begin a cancer cure.

Patients who have metastasized, are recommended to keep taking one gram of FECO every day for the rest of their lives as a maintenance dose.

FECO is not just recommended for cancers. Many studies have recommended that FECO is the ideal treatment and possibly cure for many types of neurological disorders as well as cancer. This raises the stakes when looking at the numbers of people with said conditions.

Back to the Math

If the average disabled patient makes less than $850/month, and uses only 1 gram of cannabis per day, in Washington state, purchased at a collective garden, that comes to $300/month medication cost. Leaving less than $550 to live on.

If that same person wants to heal themselves from cancer, and needs a 60 gram supply of FECO to do so, as well as dry medication to control symptoms like nausea which are not well controlled from the FECO, the numbers get CRAZY.

One pound of cannabis can not be purchased either in Arizona or Washington or any of the other medical states, legally.

One pound of cannabis can only be grown, then processed immediately. A pound of cannabis is approximately 453 grams.

If it were to be purchased, it would range from $4,530 in Washington prices or $9,000 in Arizona prices.

Then comes the price of the solvent and the physical ability to do the job of extracting it.

I do not personally know of any disabled patients who could afford to stay alive at these prices.

The Future

I don't know what the future holds. I can hope and pray that our federal government will see it's way to legalizing the safest medication that seems to grow on this earth.

I do know that the math doesn't make sense. I constantly wonder why are we extorting our meekest of meek and our sickest of sick to make money?

I hope that soon relief can be found for all of those in search of it....at a reasonable cost or with the unlimited ability to cultivate this plant.

Zuki Saved My Life

With cheesecake brownies
She saved me from violence
when a flat tire in the sun
Wasn't very fun.

Hip Happy Brownies
helped us see blessings
Instead of grumble
at the work to be done.

As we traveled
on a rickety spare;
A major wrong turn
Normally would have
caused me to pull out my hair....
Instead, due to a friend
We smiled and explored
Learning about the land
God brought us to  once more.

Angel, not Ange,
is how I see-
This person who's given
my life back to me!

With gummies and yummies
She rescued me from thirst;
Soothing butter and honey
Saved me from my worst.

The headaches of altitude sickness
and drought
Lead me to worry, frightened
...in doubt.
Through candies and cookies
in flavors galore--
She saved me from illness,
my spirits did soar!

Thank you my Sister,
I can't say enough.
Please believe me,
It got mighty rough!
The clouds of my mind,
my body broken in half;
To say you saved my life,
Isn't to laugh.

Then there's the life
of my husband and mate,
Without your candy,
I may doubt our fate!

Thank you again,
for being a sister and friend;
We thank you so much,
Gratitude without end.


(written 7 Oct 2014)

Cannabis and Me: My Testimony of a Plant Christ Created

Before I go any further with my tales of volunteering at a collective garden, I thought I would write a bit of a testimonial. 

Even if readers know why I use this plant medically, sometimes even I need a refresher. When I am out of my medicine, these reasons become crystal clear.

Physicians & Pharmacists: Diagnosis & Treatment

The first diagnosis that is listed on my medical records pertaining to the use of cannabis is intractable pain caused by damaged nerves during my last pelvic reconstructive surgery (the initial injuries happened when I was an infant then complicated with motherhood & several unsuccessful surgeries).

From 2002-2009, I was prescribed Fenantyl via a Duragesic patch. Fenatnyl is an opioid pain medication that is about 75-100% stronger than morphine.
My physicians repeatedly informed me that due to my pain levels, I would never be able to live off of a morphine-strength pain medication. I am allergic to morphine. Fentanyl with vicodin and percocet was how I survived for 7 years.

During my time on opioid pain medications, I soon learned that any exertion brought nausea, as well as irritation of the initial pain. The side effects of opioids caused me to loose my teeth, and my life. I spent most of my days in a dark bedroom watching DVDs, curled up in a fetal position.

In 2008, when my daughter graduated from high school, I was barely functioning on 19 pills a day. All prescribed by the same physician. Most were for side-effects of other medications.  During the time I was on these medications I developed other physical issues. Some where profound, like the hiatal hernia I developed during a violent vomiting episode. This has left me with chronic nausea.

The other diagnosis that I use medical cannabis for also stems from the abuse I sustained as a small child by my father, then step-father.  PTSD and depression with anxiety are some of the major reasons that cannabis is my medication of choice.

I have a family history that is frightening for depression. My father and grandfather both committed suicide. My aunt and I both have had several unsuccessful attempts at the same action. Major Depressive Disorder is so much more than "the blues."

An ironic experience I have had is one of friends getting tired of my acting out during a major depressive episode and tell me to "go take a Prozac." The reason I find this ironic is that during the time I was being treated by physicians for my depression through pharmaceuticals (1982-2009), I exhausted every formulary; up to, and including ALL SSRIs (of which class Prozac is in). The only medication for depression that I have not been suicidal on, is Cannabis.

For my anxiety issues, I have been prescribed at least five different medications. Some two at a time. Couch-lock has nothing on the zombifying experience of prescription anxiety medications. At least I didn't drool much. But I was not "with-it" enough on them to live.

When a friend suggested that instead of using vicodin or percocet for my "break-through pain" that I use cannabis (or as she so eloquently put it "smoke a bowl!"), I was leery. When I suspected that it would just get me intoxicated and waste more of my life, she pointed out that my life currently consisted of being in bed 24/7, how much more could I loose? I acquiesced and tried it.

During the years I used cannabis as a supplement to my prescription medications, I began to live again.
I found that if I smoked about 2-3 hits off of a pipe or joint, I had the energy to push past the pain. Then the pain began getting less. 

The End of Prescriptions - An Alternative Presented

When I was discharged without notice from the physician prescribing the pain medications in August 2009, it was cannabis that relieved some of the symptoms of withdrawal from the Fentanyl and Percocet. It was the only reason I was able to get through the hell of withdrawals without becoming suicidal.

Months after I was off of all prescription medications, still exhibiting several symptoms of withdrawals as well as my primary issues of anxiety and depression as well as nausea and anorexia; I tried my first edible cannabis products. I was absolutely amazed at the results.

The more cannabis products that I consumed, the better I felt. I began to feel HEALTHY!
I began to be able to do so much more. I began to regain my life.

Last year, cannabis ended up leading me to become a Latter-Day Saint. I joined The Church of Jesus Christ of Latter-Day Saints when God answered my prayers with this plant. But that's another story for another time (feel free to follow my spiritual journey at SlightelyMormon.org).

In the fall of 2013, at a sister-friend's urging; I tried an experiment. I began taking a full-plant extract oil (FEO) on a daily basis. There are many names for this type of oil and many ways to process it. Some of the most common names are Rick Simpson Oil (RSO) or Phoenix Tears. My husband calls his version, without the decarboxylation step (I will post about his oil soon), "Jesus Oil."
No matter the name it goes by, it is an extract of the oils of the cannabis plant. I prefer the "full-plant" with the cannabinoids that are only found in the leaves and other non-bud parts of the plant included.

Here is a link to the best explanation I have found for the processing of small batches of this type of oil, by a dear friend, Breezy Keifair: How to Make Cannabis Oil Without Alerting the Neighbors.

As the rice-grain sized bit of oil began to be absorbed into my system, I didn't become intoxicated nor did I feel any euphoria. In fact, as the days progressed to weeks into this experiment of daily oil, I found I was feeling less euphoria from cannabis, but more happiness over-all. My body began to feel "able". My mind was clear. I could think, and I had energy. I didn't hurt and my legs worked. My brain looked towards the Gospel and furthering my fores into genealogy. I could think and feel clearly.

Thirty days into using cannabis oil daily, I felt like a new woman.

As I have experimented with the use of cannabis for my health, it has been with the guidance of my health care providers and my "cannafamily" - an intentional family of friends.

As I have learned about the cannabis plant, I have attempted to share this knowledge with others.

For seven years, prescription medications took my life away from me. Several years ago, while I was in a puddle of vomit and tears, I prayed to my Heavenly Father to save me. It is He who held the branch of the cannabis plant to me. It is He that saved me, through a plant.

County Line Alternative Medicine: First Morning as a Volunteer

Day 2, morning one. It was my first Monday morning in a very long time. My disabilities took my freedom from me. My freedom to work. On this Monday morning, I walked about a quarter mile on the way to work, before hitchhiking for a ride.

Today was more than my first day volunteering for this Collective Garden. It was also the 4 year anniversary of the day my physician had discharged me without notice; putting me involuntarily into withdrawals from the fentanyl and percocet he had been prescribing for five years. For the two years before that, it had been my general physician. But strangely enough, she was no longer in practice.

This Monday morning felt triumphant. I had begun to take my life back with my baptism in the spring, now perhaps I could at least have the opportunity to help others at the same time as ease the incredible strain on my pocket book that my medical costs were, as they are to anyone on disability.

The day started off wonderfully. I began to learn my way around the front desk procedures; as I had been trained on the bud-tending bar the previous Saturday night shift.

I was given passwords and asked to update the web menu on many sites. I began to become acquainted with the other volunteers and their stories.

County Line was owned and operated by a woman on disability who got tired of her husband sitting around smoking pot all day and doing nothing. So, they started a Collective Garden with a grow and a lounge in the back where he could still, in fact, sit around and smoke weed all day. Only now, they could make money off of it. That was my observation on first glance. I saw a family with two disabled parents attempting to get by and looking at what they knew and making the best of it.

Jim (all of the names have been changed) was the official owner of the business with their adult son as a partner, as not to get his wife in trouble with Social Security; but he was quick to point out that his wife, Betty, was the true boss. She was, in fact, the one who did the books....and the one to whom the boys on night-shift were answerable for their shenanigans.


Betty and I got along quite well. In fact, I still miss her and keep her in my prayers.


Another volunteer I had the opportunity to meet was Jill. She was the "cleaning lady." In fact, she was a very disabled woman. A patient who lived on a meager fixed income who had trouble affording her medicine. So, she offered to do anything for the Collective Garden. They made her the cleaning lady, and gave her one gram for every 6 hours of work.


For those of us who are disabled, every hour we work is worth so many more "able-bodied" hours. It takes us so much to be able to push past the pain coma of a pain level that sometimes reaches 9.5+ upon awakening without any cannabis in our system. 

To procure a lowly $10 worth of medicine for 6 hours of bending, twisting, and lifting...doing all of those things that our physicians have warned us against, is something that too many of us would do in a heartbeat.


That was the remuneration that we all received. All of the volunteers were patients. We all received one gram of dry, cured, medicine for every 6 hours of work that we provided. As "volunteers", it was a paradigm that was not uncommon, as testified by the volunteers who came from other places. Jim and Betty tried to "sweeten the deal" by promising a dream trip to all the volunteers and calling them "family".  Meanwhile, many were in the negative by the time they came to work that day.


On the shiny side of the cloud that first day, were the patients that I was able to meet and help. While riding a line, not attempting to give out medical advice, as none of us want to be practicing medicine without a license; I was able to share my personal experience with this plant in it's topical, edible and combustible forms with a patient who was in severe pain. Within minutes after using a topical spray, she experienced relief. As a caregiver, it was enough to make me want to come back the next day to help again.

There are many stories that remain to be told. Many yet to write. County Line Alternative Medicine was north of an unfriendly county border and I lived south of that line. Living in unfriendly territory towards a medicine I have come to know is God's was, and is, a challenge. Just because cannabis is legal in Washington does not mean it is liked. Many counties, even west of the Cascades, are very unfriendly to cannabis and anyone who uses it for any reason.

We must continue to spread education and understanding. Erase fear with education. Learn, teach, and grow. Overgrow with the Love and Lighte of Christ. And Cannabis.