Just What the Doctor Ordered

Even legitimate patients with one of 21 qualifying conditions—including cancer, post-traumatic stress disorder and chronic pain—can have a difficult time getting clinicians to sign off on their state health department paperwork.

Since 2007, more than 13,300 patients have received their "green" cards, but fewer than 900 health care workers in New Mexico have certified patients in the program.

Cannabis, it seems, remains a political football, with patients stuck in the middle.

Patient advocates say that's because medical schools are not teaching students about the human body's endocannabinoid system, and medical residents finish their rounds without understanding the medicinal value of marijuana.

Tim Scott, the founder and president of the New Mexico Cannabis Patients Alliance, thinks doctors believe their patients "just want to get high."

Scott isn't just an organizer, he's a patient too.

Diagnosed with painful peripheral neuropathy brought on by irreversible diabetes, Scott says when he got tired of having needles injected into his spine, his doctor refused to help him get legal pot.

"A lot of hospitals and medical groups refuse to allow their doctors to participate because they get federal funding," says Scott. "What's worse, if they find out you're using medical cannabis, they won't treat you anymore."

That may be true at some clinics and hospital around the state and at the Veterans Administration hospital in Albuquerque, but doctors at Christus St. Vincent Regional Medical Center in Santa Fe are allowed to use their judgment and recommend patients use cannabis.

Mandi Kane, a hospital spokeswoman, says the hospital doesn't turn away its patients who use pot and says the hospital's doctors have an "obligation to provide care under independent discretion."

Dr. Steve Jenison, who was just reappointed to the Medical Advisory Board by state Health Secretary Retta Ward, thinks the situation with clinicians is improving. Jenison says he personally wishes that more health care workers were aware of a court decision that affirmed a physician's right to recommend medical marijuana without government in terference.

But those opinions, he tells SFR, are his own, and he's "not speaking as a board member."

He'd like to see the state health department, which has produced five community outreach programs to inform both patients and clinicians about program regulations since last August, provide more training. Jenison says that could give doctors more confidence to certify their patients.

"As long as medical providers are conscientious about spending time with their patients, perform relevant physical exams, review a patient's complete medical record and establish a physician-patient relationship, they probably won't have a problem," he says.

Most Active Qualifying Medical Conditions

Jenison, who served as medical director for the state's cannabis program, tells SFR he plans to discuss some lingering issues at the advisory board's next meeting on May 1 in Santa Fe, including a rule that requires chronic pain patients to be certified by a pain specialist or a clinician with expertise in the disease that's causing the pain.

Jenison also wants a discussion about whether patients should have to undergo traditional treatment and drug regimens before being allowed to use cannabis, especially if a practitioner determines those treatments, which can lead to opiate pill addiction or overdose death, could be harmful to a patient's health.

Scott says he hopes the health department listens to the board and considers public comments. When he decided to register for the program, he relied on word-of-mouth recommendations to find a compassionate doctor.

It's not impossible to find someone to certify new patients. You can even find providers and patient consultants online. But be warned: Some of those services, Scott says, have a shady reputation.

"I wouldn't call them card farms, but some are more professional than others," he notes, adding some groups charge patients steep fees to refer them to a doctor.

SFR discovered that a few of the state's 23 licensed producers are willing to help out. Len Goodman's family-run NewMexiCann Natural Medicine has partnered with two providers who visit with patients at their dispensaries.

Nurse practitioner Lori Frohe, who owns Mindful Medicine Behavioral Health Care, just started seeing patients at Goodman's new location in Taos, where patients she met earlier this month expressed frustration that their own providers wouldn't certify them.

"Many patients have been using marijuana illegally for years to treat their PTSD symptoms," says Frohe, adding her patients simply want the health benefits from legal cannabis.

Even when you find a provider, don't expect your certification to be cheap or quick. Expect to pay $180 to $300 for your initial registration plus perhaps another $100 every year for renewal forms. That amount doesn't include any medical tests, which can often cost more than $1,000. Oh, and insurance companies don't cover this cost or reimburse for cannabis the way they do for prescription drugs.

Once you're enrolled in the program, the "high" life doesn't get much easier.

A medical card doesn't give patients carte blanche to smoke wherever they want. You could be arrested if you spark a joint or bowl in public. That's why many patients purchase edible candy and snacks. The cannabis-infused products provide relief and can be consumed almost anywhere. It's still risky for patients to fly with their medications or cross state lines. If you want to purchase legal weed in other states, the health department tells SFR it's not sure which states, if any, recognize New Mexico's patient cards.

While state law provides some civil and some criminal immunity, your landlord can still kick you out of your apartment, especially on properties that participate in Section 8 housing programs, since they're funded by the federal government. Even your boss can fire you if you test positive for cannabis or catches you coming back from lunch medicated. Medical cannabis may be authorized by statute, but the State Personnel Office fired one of its government employees after she disclosed her use of cannabis, and other workers have met similar fate.

FOR MORE INFO, visit nmhealth.org/about/mcp

Santa Fe Reporter