What Maine Doctors Should Know About Medical Marijuana

Medical marijuana has been legal in Maine since 1999. In 2009 and 2011 laws were expanded and clarified giving Mainers the right to assign caregivers, buy medicine from dispensaries, or cultivate their own crop. Although the medical marijuana culture is changing, many Maine doctors are still fearful of the law, ignorant of the benefits, and judgmental of patients seeking a recommendation. Any physician or surgeon licensed to prescribe drugs may recommend cannabis treatment to a patient with a qualifying condition, but patients throughout the state are having a difficult time finding doctors willing to discuss medical marijuana.

• You will not risk your medical license by recommending medical marijuana to a qualified patient. Maine has strong laws to protect physicians included in the 'Rules Governing the Maine Medical Use of Marijuana Program'. On April 8, 2002 the U.S. Supreme Court upheld the first amendment right of physicians to discuss medical marijuana with patients, as originally ruled by the ninth circuit U.S. Court of Appeals in San Francisco Conant v. Walters CA: No.00-17222 D.C. No.CV-97-00139-WHA OPINION.

• Marijuana is a viable treatment option for many of your patients. The industry of medicine would not exist today if humans hadn't noticed the incredible power of plants to heal the body. Cannabis is in its infancy of modern medical research and has been proven an effect pain reliever, appetite stimulant, and anti-inflammatory. Studies have confirmed marijuana's ability to fight neurodegenerative diseases, prevent diabetic retinopathy, relieve the symptoms of gastrointestinal disorders, and reduce seizures, tics, and muscle spasms. Cannabinoids have shown potential to inhibit cancer cells, inhibit the HIV virus, and combat the resistant bacteria M.R.S.A. Anecdotal evidence suggests those with autism, post-traumatic stress disorder, and hypertension may benefit from the medical use of marijuana.

• Marijuana does have negative side-effects for some patients, just like pharmaceutical options. Adverse effects may be alleviated by changing the method of ingestion. Patients may wish to smoke, use a vaporizer or water bong, eat cannabinoid-based foods (commonly called edibles), or use a tincture. All marijuana is not alike and patients may have to experiment with various strains to find the right treatment option for their medical condition. Depending on their symptoms, patients may prefer a strain high in either THC or CBD cannabinoids. Caregivers and dispensaries can provide strain recommendations.

• You will not get a 'Doctor Feelgood' reputation by recommending cannabis to qualified patients meeting state standards. The same rules that apply to prescribing opiates in the Code of Maine Rules 'Use Of Controlled Substances In Treatment Of Pain' apply to medical marijuana recommendations. Marijuana is often a safer and more effective treatment than pharmaceuticals or surgery, but also works well alongside today's medicines to relieve unwanted side-effects.

• You may lose patients by refusing to discuss medical marijuana. Patients on MaineCare (Medicaid) are having an especially difficult time finding doctors open to the discussion. Physician offices and community healthcare centers associated with hospitals seem especially resistant to medical marijuana. One patient with Crohn's disease said his specialist "flat-out refused to talk about it" and a woman with debilitating back pain said her long-term primary physician "actually laughed in my face". Both of these patients were so offended, they immediately began searching for new doctors. Physicians should not allow personal opinion to interfere with patient care. Maine citizens have the right to expect doctors to perform their jobs without judgment, ignorance, or discrimination.

Maine doctors should read the research studies concerning the 85 discovered cannabinoids, weigh the benefits and risks, openly discuss marijuana when asked about treatment options, and then make an educated decision to recommend or not recommend marijuana based on each individual patient's needs.

Choosing a Cannabis Caregiver in Maine

If you are a qualified medical marijuana patient with a valid physician recommendation certificate you can choose a caregiver to grow your medicine by completing a Designation Form.

Caregivers can provide quality medicine at a fraction of the $400+ price per ounce you will find at marijuana dispensaries. Most caregivers charge between $150-$350 per ounce, but you should shop around to find the right cannabis caregiver for you.

Always ask these six questions when speaking to potential caregivers:

1. Do you use chemical, organic, or natural growing techniques?
If the grower uses chemicals, consider the risks. Most organic growers use prepackaged soil, nutrients, insecticides, and fungicides. Natural growers tend to use materials from nature including local forest humus and composts. All plants should be flushed two weeks before harvest to ensure the safety of the medicine you will be ingesting.

2. Where is the marijuana grown: indoor, greenhouse, or outdoor?
Indoor and greenhouse marijuana is usually more potent because the trichomes (crystals) are not washed away by rain, but many long-time marijuana users prefer the flavor of outdoor plants.

3. Which strains do you currently grow and can I request particular strains?
Depending upon your illness, you may benefit from differing amounts of THC, CBD, or other cannabinoids. Your caregiver should be able to provide a strain to meet your medical needs.

4. Do you deliver?
Some caregivers are willing to deliver marijuana to your home for free or for a reasonable fee.

5. How much marijuana can you provide on a weekly or monthly basis?
Your caregiver needs to provide enough medicine for you. Currently patients can possess up to 2.5 ounces. Your caregiver should be able to provide you a perpetual harvest so there will not be a 'dry spell'. You may also wish to ask if prepared tinctures or edibles are available.

6. May I see where the cannabis is grown?
Most caregivers grow from home so be mindful of their privacy. A caregiver may wish to meet in a public place to see your valid physician certification and discuss your needs before showing you the grow area. You have every right to view the grow room or outdoor space where your medicine will be grown to be sure conditions are clean and sanitary. If plants are crowded, pests and fungus may be a problem. If light is inadequate, plants may not be potent or may not yield enough for your needs. Each caregiver can grow for up to a maximum of 5 patients so if there are hundreds of plants, the caregiver is breaking state law.

Medical Marijuana for Asperger’s Syndrome

Can cannabis help those with high-functioning autism?

Asperger's Syndrome (AS) is considered a form of autism, rating high on the autistic spectrum. AS is exhibited in childhood and throughout life. Symptoms include social awkwardness, loud vocalizations, atypical speech, emotional detachment or over-attachment, anger management issues, and narrow interests that may become obsessive. Those with AS usually feel like they don't "fit in" with society. They're often smarter, more creative, or more observant than their peers and can excel in life when given a chance. Marijuana can be used to alleviate the negative symptoms and accentuate the positive aspects of Asperger's Syndrome.

How to Use: Tetrahydrocannabinol (THC) and Cannabidiol (CBD) are the two main cannabinoids found in marijuana. THC is psychoactive, causing the "high" associated with marijuana use. CBD is non-psychoactive and has a calming effect. Aspies should choose high quality medical marijuana that has a high CBD to THC ratio. Use tinctures and edibles for long-lasting effects. Smoke or vaporize marijuana for a quick fix. Try mixing buds and leaves together to get more CBD's in your medicine.

Anxiety: Anxiety issues can make it impossible to lead a productive life. CBD's calm the body and mind to relieve stress. but beware of high THC concentrations that can cause severe anxiety and panic attacks.

Anger and Rage: Aspies are often ruled by their emotions and can have temper-tantrums well into adulthood. Smoke or vaporize marijuana as soon as you feel the anger rising and you should be able to calm down enough to talk about your feelings.

Gastrointestinal Disorders: Sufferers of AS can have stress management issues due to their inability to control emotions. This can lead to disorders of the gastrointestinal system, such as ulcerative colitis, inflammatory bowel disease, and Crohn's Disease. Marijuana has pain-relieving and anti-inflammatory properties that can ease discomfort. If you are malnourished, use marijuana to stimulate your appetite.

Insomnia: Stress and depression can make it impossible to get a good night's sleep. Marijuana can help you fall asleep and stay asleep.

Racing Brain: Aspie brains can race out of control making it difficult to concentrate and communicate. Marijuana slows down your thought processes, enabling you to think clearly and focus on one subject at a time.

Socialization: Marijuana can alleviate social phobias, allowing you to leave the house and interact with the world without worrying about feeling different.

Medical marijuana may not work for everyone diagnosed with Asperger's Syndrome. You may have to experiment with THC to CBD ratios and methods of ingestion to find a treatment plan that works for you.

Medical Marijuana for Kids: Seizures and Epilepsy

Should parents ever consider giving marijuana to a sick child?

Scientific research and anecdotal evidence suggests those with seizure disorders can benefit from the use of medical marijuana, but would you give marijuana to your child? Many parents are facing that difficult decision and some are saying "yes".

Discovery Channel's Weed Wars documented a California father as he made the difficult decision to buy medical marijuana for his 5 year old son. Jason's son, Jayden, has been diagnosed with Dravet's Syndrome, a rare and deadly form of epilepsy. He suffers from severe seizures almost every day of his young life. After trying numerous pharmaceutical drugs with no success, Jason visited a marijuana dispensary. An employee suggested a glycerin-based tincture. Jayden took his first dose - just one drop of the sweet liquid - without complaint. Four days later, Jason said his son had not had a seizure since beginning marijuana treatment and never appeared intoxicated.

Marijuana has 85 known cannabinoids with Tetrahydrocannabinol (THC) and Cannabidiol (CBD) being the main focus of research. THC is psychoactive and causes the "high" associated with marijuana. CBD is believed to have more medicinal qualities. A University of Saskatchewan study indicated the THC in marijuana may intensify epileptic seizures while a University of Reading study showed anti-convulsive properties in CBD. Anyone choosing medical marijuana to control seizures should seek strains that have a high CBD to THC ratio. The tincture given to Jayden's dad was high in CBD and low in THC to maximize medicinal qualities and minimize psychoactivity.

Giving your child medical marijuana doesn't mean handing him a joint and a lighter. Today there are many options for ingestion including vaporizers, tinctures, extracts, teas, and edibles. Edibles can be purchased or made at home by infusing butter with a cannabis oil extract and then using the butter to make cookies or treats. A dose of CBD marijuana will not get a kid high and does not have the dangerous side-effects associated with pharmaceutical drugs. Some parents are making the choice give marijuana to children despite the controversy.

Sources:
Weed Wars on YouTube
"Marijuana Compound May Intensify Epileptic Seizures - Research at the University of Saskatchewan" University of Saskatchewan, News Release, August 10, 2004
"Cannibidiol exerts anti-convulsant effects in animal models of temporal lobe and partial seizures" University of Reading, December 3, 2010

How to Find a Marijuana Caregiver in Maine

1. Decide what is important to you.

• Do you prefer organic or natural methods? Most organic growers use prepackaged soil, nutrients, insecticides, and fungicides. Natural growers tend to use materials from nature including local forest humus and composts.
• Where do you want your medicine to be grown: indoor, greenhouse, outdoor? Indoor and greenhouse marijuana is usually more potent because the trichomes (a.k.a. crystals) are not washed away by rain, but many long-time marijuana users prefer the flavor of outdoor plants.
• Do you need your medicine to be delivered? Some caregivers are willing to deliver marijuana to your home for free or for a reasonable fee.
• How much marijuana do you use? You caregiver needs to provide enough medicine for your needs. Currently, patients can possess up to 2.5 ounces. Your caregiver should be able to provide you with a perpetual harvest, so there will not be a 'dry spell'.

2.  Gather a list of local caregivers.

• Medical Marijuana Caregivers of Maine (MMCM) is a non-profit trade association that connects patients and caregivers throughout the state. MMCM services are free for patients (caregivers pay $30 a month). MMCM can be contacted by calling 207-699-4217.
• Compassionate Caregivers of Maine (CCM) is another non-profit organization. Call 1-866-327-5449 to find a local caregiver.
• You can search online for a caregiver in your area or contact patient advocates. Also try calling marijuana dispensaries. Although dispensaries and caregivers are competitors in the pot business, some dispensaries will give you information about local caregivers.

3.  Call or email caregivers.

• Caregivers can only grow for 5 patients, so you may have difficulty finding a caregiver that is accepting new patients. Speak to as many caregivers as you can and be sure to ask lots of questions about things that are important to you.

4. Meet the caregiver.

• Most caregivers grow from home, so be mindful of their privacy. A caregiver may wish to meet in a public place to see your valid physician certification and discuss your needs. Caregivers are able to employee one assistant, so you may meet the assistant first.

5. Ask to see the grow area.

• You have every right to inspect the grow room or outdoor space where your medicine will be grown to be sure conditions are clean and sanitary. If plants are crowded, pests and fungus may be a problem. If light is inadequate, plants may not be potent or may not yield enough for your needs.

6. Officially designate your caregiver.

You will need to fill out the Designation Form. Both you and your new caregiver must sign the form. You must know how many plants your caregiver will grow and if you will be picking up your marijuana or having it delivered. This designation is valid for one year, but can be changed at any time.