Tuesday, February 26, 2013

My Medical Marijuana Experience- a lupus patient comes clean about going green

As a sufferer of a chronic ailment - Systemic Lupus Erythematosus - I've had medical professionals unofficially recommend cannabis for years. This week I decided to get assessed to see if I was eligible for an authorization to use medical marijuana in Washington State.


'Green Wellness' Medical Authorization Clinic had an established online presence in addition to offering 24 hour a day, 7 day a week phone verification service. In order for a patient to visit a medical cannabis provider, the provider needs to verify the medical recommendation.  A specialty clinic that offers easy verification is desirable because a medical marijuana patient can spontaneously visit any medical cannabis provider (including farmer's markets) without having to wait two days for a doctor's office to return the phone call.

The Green Wellness online intake form was straightforward. After submitting it, they called me within an hour and sent a confirmation email saying I was 'pre-qualified' and offered me a variety of appointment times. I scheduled my appointment for the following afternoon. I did not have a copy of my medical records, so I was told my fee would be $178 ($20 less if you have your records). Although they did not take health insurance, they accepted cash, debit and major credit cards.

Their Seattle location is on the ground floor of a high rise at the foot of Capitol hill tucked by the freeway. Their lobby was a standard higher-end medical practice waiting room with leather couches and a pod style coffee maker. The office demeanor was professional, and I was given seven pages of paperwork to complete along with an authorization to release my medical records from my doctor (in my case, my rheumatologist).

The paperwork asked about the condition I was seeking to use cannabis for, along with questions about if I had tried cannabis for the condition. They were particularly interested in conditions where I could reduce my use of other drugs by using cannabis. Ironically, I had to add a section to their form because I find that using cannabis can help me stay compliant with one of the medications I take (Methotrexate) which is effective but has unacceptable side effects.

Medical Authorization to Use Cannabis in Washington State
Dr. Z came out and invited me back to the consultation room. We discussed my lupus: the onset of symptoms in 2004, the difficulty of getting diagnosed (common with autoimmune diseases) and the impact of my symptoms on my quality of life. My biggest complaints are joint pain (particularly in hands and wrists, but the hips, knees and feet too) along with appetite loss and fatigue. I explained the symptoms that came on in 2004 - a rash on my face I mistook for adult acne that wouldn't go away, fingers turning blue (a condition I would learn is called Raynaud's phenomena) and debilitating arthritis which developed primarily in my hands. I had always been healthy and strong, a bit of a tomboy and the one time recipient of a perfect attendance award at school. The formal diagnosis of lupus came in 2005 after my  blood chemistry showed a variety of antibody markers typically used to diagnose lupus.

Lupus is incurarable, and there hadn't been a new treatment approved for lupus in 50 years until Benlysta was released last year. Many of the medicines used to treat lupus (like Methotrexate) are off-label uses doctors have found to be effective. Methotrexate is prescribed for rheumatoid arthritis - a condition related to lupus. Methotrexate is a chemotherapy drug,  I take it orally once per week (in doses about 1/100th of the dosage used when give for leukemia). Although it helps reduce my inflammatory arthritis and some of the skin issues; the nausea, appetite loss and patchy hair loss are unpleasant. To reduce these side effects, my rheumatologist has also prescribed a drug called 'leucovorin' which I take 5 hours after taking my weekly methotrexate dose. The leucovorin hasn't been particularly helpful. Other suggestions to deal with side effects weren't viable (like taking it on Sunday so I could feel terrible on my day off instead of on a work day) or learning to inject it ('you'd only have to do it once a week!'). Benlysta, the new lupus drug, is an 'infusion' drug which is delivered through a multiple hour intravenous infusion every month along with an annual price tag approaching 30k.

I have a prescription for opiate pain medication, Vicodin, which I take for major flare-ups. But narcotics are habit forming and constipating and something I would like to use with moderation. I explained that cannabis seemed to make the vicodin more effective and that the marijuana was oddly effective in its own right. I don't think it actually quells the pain, but it makes me not care about the pain either.

Over the years I've learned to cope with pain, but appetite and related issues had taken the greatest toll on my overall well being and quality of life. Over the years my appetite faded and eventually disappeared; at the same time, horrible sores in my mouth made it excruciating to eat. I lived on coffee, instant breakfast and gelato. Food had once been the central theme of my life - I am a food scientist by vocation - and now I would forget to eat for hours at a time. I stopped making plans to eat meals with others because I couldn't eat.

Marijuana absolutely, unequivocally improves my appetite. Not every type of marijuana out there, but most of them. Now that I am eating again, I realize what a significant effect the lack of eating was having on my life. From a mood perspective, I imagine I was a beast to be around. With lupus, I am accustomed to aches and pains, so perhaps I just lumped the bad feeling from not eating into lupus  malaise. I had forgotten the joy of a delicious meal enjoyed with family and friends.

Routes of Administration for Medial Cannabis

Dr. Z recommended medical cannabis to me and provided some advice about how to use it. As a past cigarette smoker, he suggested I might consider a vaporizer to spare my lungs further damage. He also said that while he could not recommend a dispensary directly, that I should check out reviews online from other medical patients (there are a number of sites like leafly.com had such information available). He said there were a wide range of levels of quality in the dispensaries out there, but that at a good one the 'budtender' would be able to recommend ideal strains or products for my specific complaints.

I got an extra certified copy of my medical recommendation (a total of 3). I will keep one copy in my wallet, one at home and one will go to a care provider if I find someone willing to grow plants for me. A certified copy of my recommendation letter and my WA state identification is all I need  to begin exploring the dispensaries and farmer's markets sprouting up all over town.

Next Article: My first dispensary visit

------------------------(c) 2013 Stoner Living Blog

Thursday, February 14, 2013

Stoner Living Space Alert - Asteroid Passing between Earth and Moon

Hey Stoners - stay out of the stratosphere - a big space rock might hit you if you get too high! An asteroid is going to pass between the earth and the moon on Friday February 15, 2013. It will be closest to earth around 11:30 AM (PDT). The big (150 feet across) old hunk of iron and ice will be closer than the satellites above us. And we haven't had anything of this size pass this close in the past 40 years or so since we've had satellites integrated into our daily lives -  in terms of relying on them for communication, navigation and even weather reporting. Let's hope for the best.

Moon Rocket Vintage Toy from Stoner Living
Our Sources Inform Us The Moon is Safe from 2012-DA14
Asteroid 2012-DA14's orbit will send it below the Clarke Belt - an elevation popular for communications satellites because objects there appear motionless in a fixed position above earth in what is called a "geostationary orbit". This special spot, 22,000 miles above earth, has become crowded with lots of communications and security equipment - making it entirely possible that the asteroid could collide with navigation (GPS), weather or communication equipment. But NASA assures the public that there is no chance of a collision with earth.

We are huge space nerds here at Stoner Living and so we were sad to hear that the best viewing with binoculars will be from Eastern Europe, Asia and Australia. But on the bright side, the satellites above Seattle should be safely out of asteroid 2012-DA14's path of destruction.

Viewing will be streamed online and you can watch it live right HERE.

---------------(C) 2013 Stoner Living Blog

Saturday, February 9, 2013

Consistency, Cannabis and Keeping it Cottage

The legalization of marijuana will change a lot of things, and one concern of cannabis connoisseurs is what I'll call the 'Budweiser effect': the standardization and homogenization which could come as large players enter the market and displace the current cottage industry. At public comment meetings related to the implementation of I-502 in Washington State, the fear of losing the boutique nature of the marijuana industry is often expressed with the analogy of microbrewed beer versus Budweiser. Given the immense popularity of marijuana, it seems likely that small, medium sized and large companies will all have a place in the emerging industry. There's a place for our beloved microbrews, but there is plenty of room for Budweiser too.

fresh hops in hands of Oregon brewmaster from Stoner Living blog
Fresh Hops in the Hands of a Brewmaster
Big brands like Budweiser deliver their product with consistency, reliability and accessibility - very comforting attributes to a consumer. You may think what you will about the flavor (or lack thereof) of the King of Beers, but you can order a Budweiser in Milwaukee, Seattle or Sioux City and it's going to deliver the same product experience every time. Familiarity instills a sense of comfort, it's a fact of human nature leveraged by marketeers every day, and is part of the reason Budweiser, McDonalds and  franchises in general are successful.

hop pellets
Hop Pellets offer Consistency
Hops are closely related to marijuana and are also members of the botanical family Cannabaceae. Consider the differences in how microbreweries typically use hops versus how hops are incorporated by large, corporate breweries. Hop pellets and fresh hops can both make beer, but hop pellets look like gerbil food.

As marijuana becomes commercially available, it is inevitable that product lines will develop to meet consumer expectations in terms of consistency and reliability. The existing tobacco smoking products industry (cigarettes, cigars and pipe tobacco) does a remarkable job offering consistent products to their consumers. Tobacco is an agricultural product, subject to effects of differing crop years and an ever increasing international market for raw materials. But the industry has developed technologies to ensure the consistency their consumers expect.

A Cigarette Sacrificed for Educational Purposes
Blending is the tobacco industry's strategy for delivering consistency to their smokers. Different varieties of leaf including Bright, Burley and Oriental (in the case of cigarettes), along with other components are mixed together to create a final blend. Within a single type of tobacco - say 'Bright' - a blend may have a mix of different crop years, and leaf from different continents. Rather than patenting formulas and having the details become public, most blend recipes are closely guarded trade secrets.

Blunt wrapper
A Wet Mango Blunt Wrap from Royal Blunts
One dirty little secret in the art of tobacco blending is the inclusion of reconstituted or 'sheet' tobacco. Tobacco scraps and dust are ground into a slurry and turned into sheets in a process akin to paper making. This 'sheet' product can be produced very consistently, making it a great tool for a leaf blender trying to create a consistent smoking product. A robust industry exists supporting such technologies. Blunt wrappers are just squares of flavored sheet tobacco.

The future of the cannabis industry is history in the making, and much will depend on how the foundations are laid in Washington and Colorado. The cottage industry nature of NW cannabis culture can be preserved if the community demands it. The marijuana industry is destined for greatness, and there is room for players of all sizes.


The Author with Wild Hemp (2010)
Article by Heather Hjorth. Heather is the Principal Consultant at Hjorth Product Research - the world's first consumer and product research consulting firm dedicated to serving the legal cannabis industry.
Disclaimer: This article references Budweiser only as a reference for our audience. The author is not affiliated with Budweiser in any way; this article does not imply any knowledge of past, present or future business or marketing plans of Budweiser or Anheuser Bush.

--------------(C) 2013 Stoner Living