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 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.