Is medical marijuana right for you?

By Mitch Allen

There is so much new research on the benefits of medical cannabis, from slowing the progression of Alzheimer’s to shrinking malignant tumors, that state after state is going full throttle to bring those health benefits to its citizens.

On September 8, 2016, the State of Ohio took action with the passage of House Bill 523, which legalized medical marijuana under the strict guidelines of the Ohio Medical Marijuana Control Program. The program is complex and as yet incomplete, but one local clinic is helping patients make sense of the regulations and prepare them right now for the full rollout which is due to happen any day now.

“The state was unable to meet its initial goal of September 8, 2018, but all indications are that they are getting close,” says Erin Lesueur, Executive Administrator of Lakewood Medical Clinic.

So what’s taking so long? The answer: enormous complexity. There are three different government agencies responsible for the operation of the program which includes growing the cannabis, processing it into effective forms, testing it, creating retail dispensaries, registering patients and licensing certified physicians.

According to the state:

“The Ohio Department of Commerce is responsible for overseeing cultivators, processors and testing laboratories. The State of Ohio Board of Pharmacy is responsible for overseeing retail dispensaries, and the registration of patients and caregivers. The State Medical Board of Ohio is responsible for certifying physicians to recommend medical marijuana.”

Add to this the fact that federal law has not caught up with state law and you have a lot of members of the medical community walking on eggshells and choosing their words carefully. For example, the term “prescription” has a formal federal nuance, so—if you qualify—a physician certified in Ohio will give you an “affirmative defense” which you can use to secure a “recommendation” once the program officially begins. With your recommendation in hand, you can secure your medical marijuana from one of 56 certified dispensaries now being established around the state.

Once available, your recommendation will be good for one year, but you will be allowed to purchase only one 90-day supply at a time.

Do You Qualify for Medical Marijuana?
In order to qualify for medical marijuana, you must be diagnosed with one or more of 21 qualifying medical conditions, but that’s not all.

“Our goal is not to encourage patients who are seeing positive results from traditional treatment to change what they’re doing,” Erin says. “Our certified physicians will recommend cannabis only if you aren’t getting proper symptom relief from your current treatment or if the side effects of your current treatment are too severe. In many cases, cannabis can improve symptoms with minimal side effects.”

There are many different strains of cannabis and various delivery methods based on your individual case, including your lifestyle.

“If you work during the day, then you likely do not want a strain or dosage that causes a psychoactive effect,” Erin adds.

“There are plenty of medical marijuana options that can give you relief without making you ‘high.’ On the other hand, if the goal is to reduce night terrors associated with post-traumatic stress syndrome—PTSD—then your physician may give you a recommendation that offers psychoactive effects at night but not during the day. With the variability of strains and dosage, there are literally thousands of options.”

According to Erin, the right combination of options is called “the Entourage Effect,” that is, various aspects of cannabis in the right combination to create a synergistic effect appropriate for each patient.

For a complete list of all current qualifying medical conditions, see the sidebar accompanying this story. Some of the more common conditions include multiple sclerosis, Parkinson’s disease, ALS, certain cancers, and inflammatory bowel diseases such as ulcerative colitis and Crohn’s disease.

Not surprisingly, the fastest growing demographic group relying on medical marijuana is patients aged 54 and older because many of the qualifying conditions are symptomatic of aging.

Types of Administration
If your current idea of medical marijuana involves “firing up a joint,” forget about it.

“Smoking any form of cannabis is—and under current law will remain—illegal in the state of Ohio,” Erin explains. “Marijuana smoke, like tobacco smoke, contains carbon monoxide, tar and other toxins that you do not want to introduce into your body.”

The types of cannabis administration approved by the state of Ohio include oils, tinctures, plant material, edibles, patches and vaporization. Your Lakewood Medical Clinic affiliated physician will make a recommendation based on your condition, symptoms and lifestyle.

“We don’t work in a vacuum,” Erin adds. “We’ll also work with your existing hematologist, oncologist or primary care physician. Medical marijuana is not a replacement; it’s adjunctive and should be considered along with your other medications and your overall health goals.”

How Does it Work?
The effects of medical cannabis vary depending on the strain and the synergistic Entourage Effect mentioned above. Different strains feature—among other things—different “terpenes,” the unsaturated hydrocarbons found in the essential oils of plants that also create fragrance such as pine, lavender and citrus.

For example, the terpene “myrcene” is found in mangoes, hops, bay laurel leaves, thyme, lemongrass, and basil, but when it acts synergistically with other chemicals in cannabis, it can produce a sedative effect which means your physician likely would not recommend that particular terpene for use during the day.

In addition, cannabis contains phytocannabinoids that act on our own endocannabinoid receptors to improve neurological function.

“Everyone sees the neurological system as the brain sending out signals,” Erin says.

“But now we know that it’s a two-way street. Neurotransmitters also work in the opposite direction, sending signals back to the brain. This is new science, but we know already that phytocannabinoids help the entire system, which may explain why cannabis helps prevent the progression of neurological disorders like Alzheimer’s disease and chronic traumatic encephalopathy (CTE).”

Qualifying Conditions
Certified physicians may recommend medical marijuana only for the treatment of a qualifying medical condition. Under Ohio law, all of the following are qualifying medical conditions:

• AIDS
• amyotrophic lateral sclerosis
• Alzheimer’s disease
• cancer
• chronic traumatic encephalopathy
• Crohn’s disease
• epilepsy or another seizure disorder
• fibromyalgia
• glaucoma
• hepatitis C
• inflammatory bowel disease
• multiple sclerosis
• pain that is either chronic and severe or intractable
• Parkinson’s disease
• positive status for HIV
• post-traumatic stress disorder
• sickle cell anemia
• spinal cord disease or injury
• Tourette’s syndrome
• traumatic brain injury
• ulcerative colitis

To find out if you qualify for medical cannabis, contact Lakewood Medical Clinic for an appointment and secure your affirmative defense if you do. Although medical cannabis is not currently covered by insurance, it is an affordable alternative for many patients.

Lakewood Medical Clinic is located at 11906 Madison Avenue in Lakewood, Ohio. For more information or to schedule an appointment, call 440-809-8450. The website is LakewoodMedicalClinic.com.