Focus on the Forgotten Medical Marijuana Patients

This is the 4th annual Dr. Bob’s Call to Action- A summary of my thoughts on goals we, as a community, should try to accomplish in 2014. Previous years focused on talking to your doctor, expanding the program by encouraging a friend ‘on the fence’ about registering, etc. This year I want to focus on the forgotten Michigan medical marijuana patients.

Since the start of the program, the detractors of the MMMA have constantly harped about how those that voted for medical were ‘duped’ into thinking that medical marijuana was to be used for ‘seriously ill if not terminal patients’ only, and that the backers of the Act were using it to effectively legalize drug use. The report of the program seems to bear that out at first glance, but on deeper reflection they give us a clear direction for the coming year.

Analyzing The Numbers

Forgotten Medical Marijuana Patients

According to the ‘Michigan Medical Marihuana Act Statistical Report for Fiscal Year 2013’ published Dec 4th, 2013 there are approximately 118,000 active patients in the state. There are problems with this report. First, HIV and AIDS are listed as two categories, yet they are the same. So are Cachexia and Wasting Syndrome, and the totals of all the conditions come to 103%.  My own experience shows that most patients have several qualifying conditions, yet the report seems to say otherwise as the total of all is close to 100% rather than 120 or 130% as one would expect if many had pain and spasm, or cancer and nausea, as one would expect. But let’s assume the numbers are correct. What do they tell us?

The Conditions Voters ‘had in mind’ When They Voted:

No one would disagree these are serious and potentially terminal conditions. Those that suffer from them are clearly ill and deserve our vote for compassionate use of medical marijuana.  They account for approximately 9,504 patients or about 7.9% of all medical marijuana patients in the state.

 ‘Orphan Conditions’ Not Generally Considered

The ‘orphan conditions’ with very low incidence.  ALS and Nail Patella account for a total of 36 and 24 patients in the ENTIRE program.  Add to that Alzheimer’s and you have another 36 patients for a total of 96 patients in the entire state using the certification program for these conditions.

Other Conditions Patients are Certified Under

These conditions account for 113,796 patients or just shy of 95% of the program. This is a staggering number, and clearly patients are seeking an alternative to the typical prescription drug therapy that has been so accepted and over prescribed in the past for these conditions.

If we are to believe the numbers, then it would seem the ‘backaches’ outnumber the ‘real patients’ by more than 10 to 1, and confirm the detractors’ assertion that the ‘compassion of the voters’ for very sick or terminal patients is being turned into an excuse for getting high by folks with minor problems. IF the numbers are to be believed, I see some trends here. Medical marijuana is becoming a ‘one trick pony’ for chronic pain.  Much as AIDS was initially viewed as only being a problem of gay men. The importance of medical marijuana is being diminished by further characterizing this ‘chronic pain’ as being ‘minor’ and not ‘worthy’ of special permission to use a schedule 1 controlled substance.

Chronic Pain is a Real Problem

This needs to be countered by the fact that chronic pain is life limiting, that 1 in 5 visits to primary care doctors are for complaints of chronic pain, and chronic pain, treated with 4 time a day narcotic such as Vicodin, accounts for over 13,000 doses of narcotic per month per physician in primary care (120 doses per monthly prescription x 5 patients per day x 22 working days per month). If the use of marijuana can reduce that by 1/2, that will reduce the total number of doses per year by nearly 80,000 doses of narcotic per physician. So chronic pain is a good use for medical marijuana and exactly what the voters envisioned.

There are only 3156 certified for cancer, 312 AIDS patients, and 1236 with Glaucoma in the ENTIRE PROGRAM. How many cancer patients are there in Michigan? According to this report issued by the State of Michigan there were about 19,000 active cases of AIDS in Michigan in 2012, yet we have 312 AIDS patients in the medical marijuana program? Why is this?  What are we going to do about it? Why do I call these patients the ‘forgotten medical marijuana patients’?

The Many Uses for Medical Marijuana

In order to gain acceptance by the medical community, medical marijuana cannot just be a ‘one trick pony’. It is approved for many conditions.  It is effective for many conditions. WE MUST USE IT FOR MANY CONDITIONS! We must make sure that those conditions the ‘average man’ on the street thinks should be treated with medical marijuana are in fact treated with medical marijuana. It is far to easy to minimize chronic pain as justification for special permission to use a schedule 1 controlled substance, yet a ‘real’ condition like cancer only accounts for a tiny percentage of the total.  We need to increase that percentage, we need to remember the forgotten patients. Cancer and HIV both have very active community support groups. Can we get the discussion of Medical Marijuana started in these groups?

I am going to make it a point to reach out to these groups in 2014, to explain how and why marijuana can help their conditions and improve the quality of their lives, and to encourage participation in the program. I ask that every Michigan medical marijuana patient look for these groups, find a glaucoma patient to encourage, or support a relative with cancer and GET THEM INVOLVED with the program. The pain patients come on their own, if for no other reason that chronic narcotics are not helping them. Michigan Attorney General Bill Schuette is constantly on the news talking about medical marijuana patients and their ‘backaches and sore shoulders’ in a manner that portrays marijuana as a drug that has no ‘healing powers’.

Patients Are Being Left Out

Cancer patients are under the care of oncologists in hospital cancer centers. They are not, in many cases, allowed to offer marijuana as a matter of hospital policy. HIV patients are in federally funded programs as well. They are not being educated about medical marijuana. Similar situations apply to Crohn’s, Glaucoma, and Seizure patients. They are NOT getting the information from their clinics. We need to step up and help them learn about cannabis.

You could say it is up to us- the medical professionals in cannabis medicine. to educate them. But only 1500 doctors out of more than 30,000 primary care doctors wrote even ONE certification in 2013. There are simply not enough of us, and we are too busy trying to meet the need to educate the sheer numbers of groups and individuals that need to get the message. So my call to action is to you, the 118,000 patients in Michigan. Find a glaucoma or cancer patient. Educate them. Encourage them to research on their own and ask questions. There are many hospice patients in Michigan, if you know one, educate them on the quality of life issues with medical marijuana. Educate their hospice nurse. Get these people involved in the program. Medical Marijuana is not just for pain. Let’s prove that in 2014.

Legislation May Change for the Better

Due to a change in attitude in Lansing, we may have legislation that makes dispensaries legal soon. Many seriously ill patients are not physically capable of growing their own marijuana, and don’t have the first clue how to find a caregiver. With dispensaries, these barriers of access to Medical Marijuana may be lifted. It is time for them to use that access and participate in the program to make their lives better. Let’s get the focus on the forgotten medical marijuana patients and bring them in.

Dr. Bob Townsend

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