Tricky Science, Poor Access, and High Prices: The Parallel Medical World of Medical Marijuana in America

Lack of knowledge takes its toll on patients. In accordance with CDC, a fatal marijuana overdose is unlikely, although people have died doing something dangerous while under the influence of cannabis. But patients have had negative reactions after they tried cannabis to treat the symptoms of an illness they happened to hear could help.

Ann Hassel originally believed in the healing properties of marijuana. She pushed for legalization in her home state of Massachusetts and even served time in prison on marijuana-related charges. After weed was legalized for medical use in 2014, Hassel, now 55, quit her job as a physical therapist and went to work at a dispensary.

She used marijuana because she “thought it helped … physically and mentally” but stopped using after she was diagnosed with heavy metal poisoning and developed suicidal thoughts. In both cases, she blames poorly tested high-potency concentrates that have become more widely available since legalization.

“That’s what burns me; that the most susceptible people, who may have lung and other problems, use this substance,” Hassel said.

Arnsten says she checks family or personal history of mental health or heart disease issues before recommending cannabis, and recommends that patients not choose smoking or vaping as their consumption method. Other doctors, however, simply make recommendations without much discussion—and many patients try medical marijuana without even consulting a doctor like Arnsten.

Some states, cities, and even hospitals have come up with creative ways to fill in the gaps left by the lack of regulation or formal connection to the medical system. A bill in New York would require state insurance agencies to cover patients’ medical marijuana costs. Meanwhile, patients and a medical marijuana company in New Mexico have filed a class action lawsuit against some of the state’s largest insurance companies with the intention of forcing them to cover the cost of medical marijuana.

Universities have emerged with study programs for the medical cannabis industry, such as the graduate program in Medical Cannabis Science and Therapeutics now available at the University of Maryland School of Pharmacy. The program aims to ensure that people working in the cannabis industry, including pharmacy workers who make recommendations from behind the counter, know how to read and contextualize scientific research, as well as how to guide new users in a healthy way. Other states, such as Utah and Pennsylvania, require a pharmacist to be present at the pharmacy. But most states still don’t require any credentials or training for medical professionals.

“The states are like a patchwork of regulation and, frankly, they are doing a really crappy job,” Hassel said. “You’ve got cracks and people take advantage of that and [others are] harm.”

Meanwhile, patients who get their medical marijuana card through the Montefiore Health System in the Bronx don’t pay per visit, saving them about $200.

“The way we do it is safer. We have access to a person’s entire medical record, we get results, we talk to a psychiatrist or other attending physicians,” said Arnsten.

However, even this solution is only sorting. Of the thousands of people certified by Montefiore to use medical marijuana, only a quarter buy medical marijuana more than once.

“Most people said, ‘I can’t afford it,'” Arnsten said. “We removed it [cost] barrier, but we have not been able to change this barrier to the cost of products in pharmacies.”

Most Mondays Amy Carter frequents a small bar in Flint that has a giant red chili hanging over the door. She meets up with friends to drink beer and play pool.

“My therapy [is] shooting pool and darts,” Amy explained, describing her escape from the daily stress of full-time nursing. “I listen to loud music. I don’t have to think about what’s going on. And all I have to focus on is to take that shot.”

Between shots, she chats with friends, holding a pool stick in one hand and a Budweiser in the other. Chilly’s Bar is another extension of the world of medical marijuana that Amy has built around herself and other patients in Michigan. The bartender, none other than Ashley Morello, a mum caring for medical marijuana, comes over to see if anyone needs another glass.

Every parent or grandparent Amy knows has their own experience of cannabis for pain relief, seizure reduction, or autism treatment. If you are part of this community, you are likely to find someone who has done hundreds of hours of research on the use of cannabis to treat a specific disease and gives detailed advice on how to try different strains, doses, and products until you find the right product.

Amy has pamphlets she leaves at the doctor’s office offering counseling services to help patients get the right marijuana products. She has taught other parents how to make cannabis oil capsules at home and how to give liquid cannabis to children who cannot swallow pills.

Amy and her community have developed their own solution to Swiss medical marijuana laws applied to cheese, and fear a major federal overhaul of state medical programs could jeopardize this.

“Leave the patient care system alone. We can get our clubs and we can really help people who really need it,” she said.

Amy’s network, however, has one big catch: it’s completely separate from the traditional medical system that most Americans still work with, and no brochures, Facebook groups, or local events will find every potential patient or parent and make sure they all receive accurate medical information and advice.

“I don’t blame anyone for not wanting to get into this arena who practices traditional medicine because there is so much that is unclear,” Arnsten said. “On the other hand, I feel that our patients – especially those with chronic pain – are using these products or want to consider using them. … And we should be able to answer these questions for them.”

Erin Smith contributed to this report.