Ask Me About My Therapeutic Cannabis Recommendation
I was thrust into the medical marijuana debate more than three years ago when an MCD opened two doors down from my house and our residential street filled up with mostly mid-twenties "patients" looking to buy "medicine". While no one disputes that some patients who are legitimately can legitimately use marijuana to treat their symptoms, what concerns me is that "medical" marijuana seems to be a mostly transparent smokescreen for recreational use. "Medical" cannabis is sold without the standardization and certification which is not necessary for recreational use and would drive up costs.
Is "medical" marijuana being dispensed exclusively for "medical" purposes, or can someone who exhibits no symptoms apart from drug-seeking behavior obtain a prescription? I decided to find out.
I started by consulting the back pages of those respected medical journals, the SF Weekly and the SF Guardian, which feature advertisements for numerous MCDs and a few "physician evaluation" clinics. I found one and made an appointment by logging onto the clinic web page, creating an account, and booking a reservation online. Same-day service, nice. I printed out the PDF forms which I printed and filled out before arriving, both to save time and to get my story straight. Consulting various pages about medical marijuana I found two symptoms that I thought I could pass - back pain and insomnia.
The outside of the clinic was visibly distressed to the point of appearing abandoned, with a broken sign out front saying simply "MacDonald". The interior is a sparse but clean open room, with couches at one end for waiting patients, two desks in the middle for clerical staff and two small offices at the back for consultations. I handed the secretary my forms, she took my height, weight, pulse, and blood pressure, paid the secretary $135 cash, and took my place on the couches next to three other men.
The doctor's office was decorated with various certifications and a diploma, from Italy, bearing the name of another doctor. The doctor himself was a good-humored, older man - a decade or so older than my father and possibly nearing retirement. The kind of doctor whose life wouldn't be ruined if he lost his medical license for writing medical marijuana prescriptions. He used a stethoscope to check my heart and lungs and then reviewed my forms. We discussed my supposed health issues and he told me that it wasn't sufficient to just be able to claim that I had "back pain" since "anyone can claim that they have back pain and everyone has back pain". Did I know what was causing my back pain? I said it was probably my bad posture and desk job. Have I raised these issues with my primary care provider? I told him that the last time I'd seen a doctor was for travel vaccinations and that I hadn't brought up these concerns this or any other time. He told me that my claim alone wouldn't be sufficient to allow me regular marijuana use; I would have to document my condition with records from another doctor. He suggested that I could either make an appointment with my primary care physician or with a free clinic. I would need to return sometime within the next two months after seeing another doctor so that my symptoms could be documented. He asked me how much I'd been self-medicating prior to his visit; I told him that I'd never used marijuana to treat my symptoms, that I'd used marijuana recreationally on a few occasions, but that I had very little experience as a regular user either therapeutically or recreationally. The actual question that ought to be at the heart of the consultation - the condition which was causing my symptoms - was addressed superficially. The question of what medication would be the best treatment for that condition or its symptoms was simply assumed and never discussed - I was there to obtain marijuana and he was there to certify my objective pro forma. By the end of the appointment I was assuming that the lack of documentation would mean that he would wait for more information and a return visit, but he still gave me a two-month recommendation with instructions to return after documenting my condition to get a recommendation dated for a full year.
One hour after leaving my house, as a patient without any documentation of symptoms or illness, as an inexperienced user without any recommendations of dosage size, without any discussion of mainstream alternatives, I was holding my own "Therapeutic Cannabis Recommendation" written to me by a doctor I'd never met before. Mission accomplished.
I have no doubt that the quasi-legal nature of medical marijuana and the federal harassment of the state distribution system has something to do with some aspects of the care I received. The shabby office with no outside markings, the unfamiliar near-retirement-age doctor taking in $135 cash for every 10 minute consultation - legitimate patients wouldn't need to resort to seeking treatment from these sources if medical marijuana were more broadly accepted. But drug-seeking patients would be seeking these out when their doctors balk, and our state sanctioned system would still allow this. I see very little difference between the care I received and a system where medical clinics advertise Ritalin or OxyContin "consultations" in the backs of free newspapers, run clinics out of unmarked offices, and write prescriptions allowing patients to buy many times the amount of "medicine" they can be reasonably expected to use and self-medicate unsupervised and unmonitored for a period of months to one year before their health and treatment is re-evaluated. I see very little difference between San Francisco potheads looking for doctors willing to write them a recommendation for what they unconvincingly describe as medical use and Rush Limbaugh shopping for doctors willing to write him a prescription for what he unconvincingly describes as medical use. The difference, I suppose, is that Rush can't buy a month's worth of medicine every time he visits any pharmacy without surrendering his prescription to prevent re-use. Rush has to visit several doctors and obtain several prescriptions before he can receive "more of the drug than intended by any single physician". I can obtain a ridiculous amount of potentially recreational and abuse-prone "medicine" for the next two months, legally, without any further difficulty.
Update: NPR catches on to the fact that 'medical' cannabis is not just for sick people.
Is "medical" marijuana being dispensed exclusively for "medical" purposes, or can someone who exhibits no symptoms apart from drug-seeking behavior obtain a prescription? I decided to find out.
I started by consulting the back pages of those respected medical journals, the SF Weekly and the SF Guardian, which feature advertisements for numerous MCDs and a few "physician evaluation" clinics. I found one and made an appointment by logging onto the clinic web page, creating an account, and booking a reservation online. Same-day service, nice. I printed out the PDF forms which I printed and filled out before arriving, both to save time and to get my story straight. Consulting various pages about medical marijuana I found two symptoms that I thought I could pass - back pain and insomnia.
The outside of the clinic was visibly distressed to the point of appearing abandoned, with a broken sign out front saying simply "MacDonald". The interior is a sparse but clean open room, with couches at one end for waiting patients, two desks in the middle for clerical staff and two small offices at the back for consultations. I handed the secretary my forms, she took my height, weight, pulse, and blood pressure, paid the secretary $135 cash, and took my place on the couches next to three other men.
The doctor's office was decorated with various certifications and a diploma, from Italy, bearing the name of another doctor. The doctor himself was a good-humored, older man - a decade or so older than my father and possibly nearing retirement. The kind of doctor whose life wouldn't be ruined if he lost his medical license for writing medical marijuana prescriptions. He used a stethoscope to check my heart and lungs and then reviewed my forms. We discussed my supposed health issues and he told me that it wasn't sufficient to just be able to claim that I had "back pain" since "anyone can claim that they have back pain and everyone has back pain". Did I know what was causing my back pain? I said it was probably my bad posture and desk job. Have I raised these issues with my primary care provider? I told him that the last time I'd seen a doctor was for travel vaccinations and that I hadn't brought up these concerns this or any other time. He told me that my claim alone wouldn't be sufficient to allow me regular marijuana use; I would have to document my condition with records from another doctor. He suggested that I could either make an appointment with my primary care physician or with a free clinic. I would need to return sometime within the next two months after seeing another doctor so that my symptoms could be documented. He asked me how much I'd been self-medicating prior to his visit; I told him that I'd never used marijuana to treat my symptoms, that I'd used marijuana recreationally on a few occasions, but that I had very little experience as a regular user either therapeutically or recreationally. The actual question that ought to be at the heart of the consultation - the condition which was causing my symptoms - was addressed superficially. The question of what medication would be the best treatment for that condition or its symptoms was simply assumed and never discussed - I was there to obtain marijuana and he was there to certify my objective pro forma. By the end of the appointment I was assuming that the lack of documentation would mean that he would wait for more information and a return visit, but he still gave me a two-month recommendation with instructions to return after documenting my condition to get a recommendation dated for a full year.
One hour after leaving my house, as a patient without any documentation of symptoms or illness, as an inexperienced user without any recommendations of dosage size, without any discussion of mainstream alternatives, I was holding my own "Therapeutic Cannabis Recommendation" written to me by a doctor I'd never met before. Mission accomplished.
I have no doubt that the quasi-legal nature of medical marijuana and the federal harassment of the state distribution system has something to do with some aspects of the care I received. The shabby office with no outside markings, the unfamiliar near-retirement-age doctor taking in $135 cash for every 10 minute consultation - legitimate patients wouldn't need to resort to seeking treatment from these sources if medical marijuana were more broadly accepted. But drug-seeking patients would be seeking these out when their doctors balk, and our state sanctioned system would still allow this. I see very little difference between the care I received and a system where medical clinics advertise Ritalin or OxyContin "consultations" in the backs of free newspapers, run clinics out of unmarked offices, and write prescriptions allowing patients to buy many times the amount of "medicine" they can be reasonably expected to use and self-medicate unsupervised and unmonitored for a period of months to one year before their health and treatment is re-evaluated. I see very little difference between San Francisco potheads looking for doctors willing to write them a recommendation for what they unconvincingly describe as medical use and Rush Limbaugh shopping for doctors willing to write him a prescription for what he unconvincingly describes as medical use. The difference, I suppose, is that Rush can't buy a month's worth of medicine every time he visits any pharmacy without surrendering his prescription to prevent re-use. Rush has to visit several doctors and obtain several prescriptions before he can receive "more of the drug than intended by any single physician". I can obtain a ridiculous amount of potentially recreational and abuse-prone "medicine" for the next two months, legally, without any further difficulty.
Update: NPR catches on to the fact that 'medical' cannabis is not just for sick people.