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.

Hippocracy of the Alternative

In these days when the Hippocratic oath is more than a little hypocritical, we need our alternative medical care more than ever before.

In today's world, those who have gone about getting their education in the prescribed manner have incurred so much debt, that entire professions worth of employees, be they physicians, pharmacists or licensed nurses and massage therapists; they are trained very well: You do what we say, or you loose your license. You must not use or do what you know is right, even though it is the compassionate thing to do, you will loose your way to earn money if you do it.

It is a simple as that. It all boils down to the almighty dollar. Non-maleficence, first doing no harm; has gone the way of family doctor who performs house calls. First, they harm your wallet, which effects your general well-being; then what they do causes more harm than good. Thus, ensuring your return and another procedure and visit that they can bill you for. Upfront payment accepted only. Medical ethics?!

When those with the initials after their names; when THOSE who have done the education the prescripted way, when THEY FAIL to act in a caring manner, when they FAIL to act with compassion and care CHOOSING the lure of Satan in the guise of the almighty dollar, those of us who DO CARE about our brother are forced to become "front line medics" using the tools that GOD Himself gave us to treat and attempt to cure what ails each other.

The next line of treatment, in a "compassionate state" is to go to the alternative care providers. Those with no medical degrees, relying on self-directed studies of the studies performed by distant scientists as well as anecdotal evidence of friends.

But what do we get, when we place our trust and health care needs in the hands of people we will actually call "family," a "canna-family;" solely because they partake of the same alternative treatment that we have chosen?

Under RCW 69.51a, the medical cannabis in Washington is governed. A new set of rules and laws were added when Washington State voters approved I-502 against the objections of many medical cannabis patients.

The fight for and against I-502 split the cannabis community in more than two pieces. A community that refers to itself as a family; now cannibalizing each other for the cash that they can procure. 


After traveling the country for the past 3 years, meeting a lot of people in a lot of different circumstances, most of them revolving around a plant, I decided to take up an invitation to "volunteer" at a local "collective garden" in Washington State for a few months. What I observed while there made me sicker than even "big pharma" has for a long time.

I will be posting stories from the Collective Garden I was volunteering at. It is and was the norm. I had the opportunity, while there and at other times, to interview and get to know as true friends, a large variety of people, all patients, who have volunteered in these "Gardens". Their, and my experience is typical of what a small town "Safe Access Point" is in Washington State.

I believe in a better paradigm. I aim to create a situation for myself, my husband and as many of our friends as possible in a community that is about caring. Cannabis is a part of it, but currency will not be.

My heart has been hurt tremendously by the people who call patients "family" only to be close to them when they receive their pittance of a decreasing valued limited income. It is time for all to grow their own. It is time for people to step up and help their neighbor if he CAN'T grow. It is time to be our brother's keeper. It is TIME to Overgrow the World with compassion. With the love and lighte of Christ. And with Cannabis.