In November 2012, Massachusetts became one of eighteen states in the U.S. to pass a law regulating access to medical marijuana. The state has been extremely thorough and cautious in determining how to successfully implement the law, especially when it comes to the rigorous application process for those who wanted to open dispensaries in the Commonwealth. Late last month, the Department of Public Health finally awarded the first 20 licenses for medical marijuana dispensaries in 19 communities across Massachusetts. These dispensaries will be allowed to grow and sell marijuana for patients with certain debilitating medical conditions like amyotrophic lateral sclerosis (ALS), Parkinson’s disease and cancer. Many dispensaries are slated to open their doors to patients come summer.
While Question 3 passed with a landslide 63 percent of votes, many do not believe marijuana should be grouped in with more conventional treatments. In a statement from the Massachusetts Medical Society, President Ronald Dunlap, M.D., wrote, “As the state opens this new chapter in public health, the Massachusetts Medical Society must remind patients of the Commonwealth that there is insufficient scientific information about the safety of marijuana when used for ‘medicinal’ purposes. Patients should remember that marijuana lacks the rigorous testing of drugs approved by the Food and Drug Administration; that claims for its effectiveness have not been scientifically proven; and, that it poses health risks of toxins and cognitive impairment, the last condition being especially risky for young patients.”
Even though it may not have FDA approval, some studies suggest that medical marijuana can be highly effective for patients who suffer from chronic pain or cannot tolerate more traditional prescription painkillers. However, alternative medicines still carry a stigma—especially cannabis. Patients with real, debilitating conditions often have to constantly risk their safety to procure it through illegal channels.
Matthew Allen, executive director of the Massachusetts Patient Advocacy Alliance (MPAA), believes that one of the most beneficial parts of this law is the safety it provides to patients and medical professionals.
“The law will protect patients who already use medical marijuana from the dangers of the black market. Patients will no longer have to go to back alleys to access their medicine, and they will know that it has been tested to be free of contaminants,” Allen said.
Many people are hesitation about medical cannabis because they find it difficult to see past the way popular culture depicts marijuana and its users. Even the most progressive thinkers have trouble shaking the stereotypical image of a college-aged stoner plopped in front of the television munching on junk food.
Unfortunately, many people group medical marijuana patients in with recreational drug users. Even though medical cannabis is not a new concept, many people still find it hard to envision a marijuana patient like a middle-aged mother of two with breast cancer who can barely keep water down after rounds of harsh chemotherapy.
Allen said that he was initially attracted to the issue because he first thought of “penalties for medical marijuana use as an example of policy based on ideology, not science and fact.” After years of working with patients and their families, he said that he can “now understand that this is an issue that impacts individuals and whole communities on a deeply personal level, since it directly impacts [one’s] quality of life.”
“I have met so many people with debilitating conditions whose lives have been turned around by medical marijuana,” Allen explained, “that working on this issue is more important to me than ever before.”
Tommy Dawson is an example of the type of people Allen advocates for, and who has felt the impact of medical marijuana legislation. He has suffered from a degenerative disorder called Neurofibromatosis, Type 1 throughout his life, and he depends on medical marijuana to relieve his pain. His wife, Nichole Snow Dawson, is a telecommunications technician and advocate for medical marijuana patients who has spoken at State House hearings. After losing her beloved grandfather to cancer in 2000, she now advocates primarily on behalf of her husband.
“It’s a genetic neurodegenerative disorder that promotes growth of tumors on nerve endings instead of fighting them,” Nichole explained. “Tommy has had several surgeries to remove tumors throughout his life, and being unable to take opiates for pain relief leaves him with very few options.”
Dawson and her husband have struggled with procuring medical marijuana on numerous occasions, and it is a gamble every time.
“Buying medical cannabis on the black market is a frustrating process,” Dawson said.
“You aren’t walking into a store front or calling an 800 number for a refill. You seek medicine through friends’ word of mouth, and if you get to the end of the process with a bud that will help you at the time you need it, you’re lucky.”
Nichole recalls a particularly tough experience that captures the unpredictability of the black market. After undergoing a painful surgery to remove a tumor from his left heel bone, Tommy desperately needed marijuana. At the hospital, Tommy was prescribed Vicodin for his foot. Eventually, said Nichole, “Tommy’s stomach couldn’t handle the Vicodin anymore. It was making him sicker than the wound on his foot.”
With no other options in sight, “he decided it was best to push through the pain without the help of medication unless we could get him some bud,” Nichole recalled.
The waiting game for medical marijuana patients can be a harrowing experience, especially when it is a time-sensitive case like Tommy’s. They attempted to procure marijuana through a contact they thought was understanding of Tommy’s condition, but in the end their contact did not follow through. Nichole said that the dealer treated them “as a major inconvenience,” but admits that they got lucky again when she “eventually managed to contact someone that could help.”
The legalization of medical marijuana is important not just for quick and safe access, but also for patients’ humane treatment. Nichole lamented, “Not having safe access makes you feel helpless at the worst times. It’s undignified. It’s hurtful and depressing.”
“The black market doesn’t care if you are a patient,” Nichole explained. “Unless you have really awesome friends pointing you in a good direction, you can be treated as an inconvenience, overcharged or taken advantage of by folks that know you will wait because you can’t get medicine anywhere else.”
Nichole is grateful for the steps officials are taking to better accommodate patients like her husband, and the people who care for and about them.
“I don’t wish that kind of experience on anyone. If we can change things for patients, we should without hesitation,” she said.
Mike Cann, a marijuana reform expert who writes the weekly column “Blunt Truth” in DigBoston, is fortunate to be a well-connected patient. Since he devotes a lot of his time advocating for medical marijuana, he knows many illegal growers in the area for when he needs to find cannabis to ease the chronic pain he still experiences from a serious back injury during his time as an athlete. A wrestler in high school and college, he also coached wrestling after graduating. And while access and quality are not looming problems for him, money definitely is.
“The biggest issue for me is the high cost,” Cann explained. “Ideally, I’d love to have a half ounce a week for my condition, but often I have to go without because of that high price. An ounce of good medicine can typically cost between $200 to 400 a week. That’s a lot of money to cover every week.”
Nichole Snow Dawson also lamented the unnecessarily high prices of medical marijuana. She explained that her husband’s pain is so grave that when she says he needs “medicine” she means “concentrated cannabis oil taken in capsules, and raw bud to vaporize to relieve his pain and nausea.”
“From the generic black market dealer you can get one-eighth of raw bud for $60. It’s not a good deal,” she said. Since extracting THC to make this type of concentrated oil requires quite a lot of marijuana, it is sometimes just too costly, especially when patients are paying completely out of pocket.
As a former two-term president and a ten-year board director with MassCann/NORML, Mike Cann is pleased that patients in the Commonwealth will soon be able to buy safe and unadulterated cannabis from dispensaries. But even though the Commonwealth will closely control access, safety and quality, he said that the prices will stay prohibitive.
“It’s planned that Mass. dispensaries will charge comparable to the black market,” Cann said. This includes “charging patients for annual renewals of $250 a year, $200 cash to the doctor and $50 to the Massachusetts Department of Public Health.” Cann feels that it is unfair that patients have to pay “street-level prices for cannabis.”
However disappointed Cann might be with the Department of Public Health, he is confident a 2016 ballot initiative is very likely to follow in the footsteps of states like Colorado by legalizing recreational marijuana in the Commonwealth. Cann said that the state’s “medical marijuana program is great for moving cannabis reform along for patients, but it’s truly not enough.”
According to Cann, the Department of Public Health’s program keeps prices up for patients, and the only thing that will change that is for the cost of recreational cannabis to come crashing down. He explained that this can only be done with full legalization.
“It seems they are most interested in creating more state DPH jobs for their department than anything else,” Cann said. “Their jobs first, dispensary owners second and then the patients last. Seems that’s the order of priorities with DPH.”
How this situation plays out over the next few years will rely on how dispensaries operate in the coming months. But one thing is for certain: There is no stereotypical cannabis patient.