Walk into the Department of Health’s rented office spaces on Rodeo Road and you’ll see not one, but three signs with large print instructing visitors to head to suite 200 on the second floor for the Medical Cannabis Program. Upstairs, a receptionist accepting applications makes friendly small talk with prospective patients who’ve formed a line.
That line is getting longer. New Mexico's medical cannabis program recorded 44,403 active patients in June, up from 40,432 in April. And as the state appears reluctant to discuss the trajectory of its program, physicians and dispensaries are finding each other to form an improvised, pro-pot healthcare network that is helping mint new cards at a quickening pace.
In the last two weeks, SFR submitted at least nine requests for an interview with Kenny Vigil, the division director for the medical cannabis program and a former department spokesman and television producer. Vigil refused to answer questions.
The silence is one reason why Dr. Benson Daitz, a family medicine physician and a professor emeritus at the University of New Mexico, is working on a documentary that explores the impact of medical cannabis on patients in the state. The filmmakers are speaking with medical professionals, patients and cannabis producers to shine a light on a subject obscured by decades of federal prohibition on scientific research into marijuana.
"The idea of it really has more to do with what my own experience has been as a physician working in a pain clinic and seeing folks who've benefitted," Daitz tells SFR.
For now, doctors and nurse practitioners have to seek out patients to refer to the program, and patients have to seek out cannabis-friendly docs to fill out state paperwork that says they qualify with one or more of 21 recognized conditions. Participating is Dr. Florian Birkmayer, an Albuquerque-based physician featured in Daitz' film who specializes in holistic care tailored to individual patients. He acknowledges there aren't many doctors in New Mexico who do what he does.
On the phone, Birkmayer is quick to say that he got his medical degree from an Ivy League university (Columbia University; his undergrad was Princeton). He eventually began treating people with substance abuse issues, at which point he became "frustrated with modern psychiatry and its over-reliance on prescription psychiatric medicines, because it just didn't work well and caused horrible side effects." A student of Carl Jung's theory of the collective unconscious, he's also administered equestrian therapy and believes he's helping people on their journey to self-discovery.
"If I have something with firsthand experience that I can see is better, and not have to prescribe something with horrible side effects, I'm morally obliged to do that," Birkmayer says of writing cannabis recommendations.
He is well-known among the cannabis dispensaries in Santa Fe. He drops into New Mexicann Natural Medicine, Fruit of the Earth Organics and Ultra Health several times a month to consult with prospective patients experiencing symptoms of post-traumatic stress. (Full disclosure: Dr. Birkmayer filled out my referral for a medical cannabis card.) Shift Cannabis, the newest dispensary in Santa Fe, also refers most of its potential customers to him.
Yet most of the time patients visit dispensaries, they're consulting with budtenders. Budtenders aren't doctors, but their jobs call for recommending particular strains or products. They're a hybrid between a barista, a checkout clerk and, yes, a pharmacist. When you buy from them for the first time, your guess about what would work best for you might be just as good as theirs.
Demand for cannabis cards is so high that some businesses are based solely on arranging short appointments between doctors and patients. Elora McMinn, office manager at the Albuquerque-based Peace Cannabis Cards, which she describes a for-profit "medical marijuana card clinic," has a rotating list of nurse practitioners, family practitioners and psychiatrists who come to the clinic every few weeks.
"We do come across a lot of people who come in and say, 'My doctor won't let me do any of this, they won't agree with it, how do I proceed?'" McMinn says. "We're for those people who don't have [pro-cannabis] doctors."
Many dispensaries maintain relationships with licensed caregivers. Abby Rodriguez, a family nurse practitioner, says she recently started pitching her services to dispensaries around town. New Mexicann allowed her to leave a pile of cards for patients to call, and the dispensary now lists her as one of the 13 medical providers it works with across the state.
"For cannabis, I try to bring awareness to other providers that maybe don't know much about it, or that maybe have a stigma around it," says Rodriguez, whose practice integrates both Western and alternative medical approaches. In her experience, providers are open to learning more about the plant, but less willing to recommend it.
Others are recommenders and evangelists. The Verdes Foundation, a dispensary in Albuquerque, sends at least one of its two staff nurses to speak with groups curious about cannabis an average of once a month. The foundation produces cannabis and has a dispensary, but also considers community outreach to be a core part of its mission.
"By talking with the business community, we can showcase that we are a legitimate business in the state of New Mexico," says Community Relations Manager Shawna Brown. She cites an upcoming presentation in September that the organization's director of operations, a registered nurse named Rachael Speegle, will give in Santa Fe to the New Mexico Association of Health Underwriters on the ethics of recommending medical cannabis.
When it comes to matters like insurance, the law can be tricky for caregivers to navigate. For example, if a primary doctor fills out a card recommendation for a patient who is charging the doctor visit to their insurance, the doctor might be running afoul of federal law, which states that doctors cannot prescribe anything listed as a Schedule I narcotic by the Drug Enforcement Agency.
One of the biggest question marks is whether US Attorney General Jeff Sessions will follow through on his threat to crack down on state medical marijuana programs. Most people who spoke with SFR say they're skeptical that the feds could stymie a program with such momentum (New Mexico's program, which started in 2007, has seen a 67 percent increase in the number of active patients just in the last year), let alone prosecute providers.
That possibility is "definitely something that would be a fear of mine," says New Mexicann dispensary manager Josh Alderete. He continues, "but I'm not really following it too much. Still gotta come to work, you know?"