Massachusetts’ recent ballot measure to legalize recreational (“adult use”) Cannabis theoretically makes marijuana available to most residents age 21 or older. However, if you have a serious medical condition, there are still advantages to going through the process of becoming physician-certified and registering for a medical cannabis card. For one, recreational cannabis will not be widely available in Massachusetts until, at the earliest, July 2018. More critically, recreational retailers lack the necessary framework to provide reliable, patient-specific guidance on dosing, methods of administration, frequency of use, common side effects, rare (but important) risk factors for adverse effects, and other health considerations. For these reasons, it is worth talking to a doctor about a medical marijuana prescription. The question is, where should you turn to for help? If you want to register for a medical marijuana card in Massachusetts, what’s the first step you should take? Continue reading to find the answers.
Why Get A Prescription For Medical Marijuana When You Could Simply Buy Recreational Cannabis?
First, let’s begin with a quick overview of the recent history of medical marijuana in Massachusetts. In November 2008, Massachusetts voted to decriminalize (but not legalize) the possession of small amounts of personal-use marijuana, meaning individuals in possession of less than one ounce could be fined but not incarcerated. In November 2012, Massachusetts voted to legalize medical marijuana, initiating the Medical Use of Marijuana Program, which is overseen by the Massachusetts Department of Public Health system. Most recently, in November 2016, Massachusetts voted to legalize recreational Cannabis, which had previously been decriminalized but not legal.
In light of the pro-legalization vote, any resident 21 or older will generally be able to purchase adult use cannabis beginning this summer, provided he or she presents appropriate ID and obeys dispensary policies. But while this sort of consumer-driven model, in which buyers are given minimal science-based guidance, is likely adequate (if imperfect) for recreational users, individuals with medical conditions are strongly urged to consider finding a licensed physician.
The reason is simple: like any medication, cannabis is safest, most cost-efficient, and most medically effective when properly dosed. However, in order for dosage to be properly calibrated, the patient must be medically evaluated, which a dispensary worker is simply not qualified to do, for two reasons:
A dispensary salesperson lacks the necessary medical training. In fact, it is not uncommon for salespeople to push medically inappropriate novelty products, such as “marijuana pizza,” simply to hit quotas. These products are often highly potent, delivering a stronger dose (at a higher price) than the patient actually needs to feel relief. Not only is this a waste of the patient’s time and money – it also increases the risk of needlessly experiencing intense anxiety or paranoia, which is more likely at higher doses.
There is no ongoing patient-doctor relationship. The salesperson cannot “check in” or “follow up” with the individual to find out what’s working, find out what isn’t working, or identify any problem areas, such as a family history of addiction, schizophrenia, or cardiovascular disease.
We’ve established that individuals who have medical conditions should seek a doctor’s guidance prior to exploring cannabis therapies. But where to turn? Who to ask? And how to get started?
The first step is to familiarize yourself with Massachusetts qualifying conditions. As of 2018, these conditions include:
- Amyotrophic Lateral Sclerosis (ALS, Lou Gehrig’s Disease)
- Crohn’s Disease
- Hepatitis C
- Multiple Sclerosis (MS)
- Parkinson’s Disease
If you don’t see your condition on this list, don’t panic: state law also permits “other conditions as determined in writing by a qualifying patient’s physician,” which brings us to the next step: talking to your doctor about medical marijuana. Your primary care provider (PCP) is unlikely to have extensive experience in this field of medicine, and you may initially feel a little awkward or nervous about asking questions about cannabis. You should also know that you won’t be leaving your doctor’s office with a “prescription” for cannabis, which is still a Schedule I controlled substance prohibited under federal law.
Nonetheless, talking to your doctor is still an important step, because your physician – or a second doctor, if your PCP turns out to be flatly anti-cannabis – can do three critical things for you:
- Answer basic questions about medical cannabis – for example, is it safe to use marijuana while pregnant? – or at least point you toward helpful informational resources.
- Provide you with copies of your medical records.
- Refer you to a specialist or clinic that does focus on cannabis therapy, such as Inhale MD. Just as you would see a dermatologist about a skin problem, or an ophthalmologist about an eye problem, you should specifically look for a cannabis specialist or medical marijuana doctor – not any other type of healthcare provider.
Once you have access to your medical records, which must date back at least 12 months, you can contact your doctor. They will ask you to complete an intake questionnaire and fax us your medical records, which will need to include both of the following:
- A diagnosis of cancer, Parkinson’s disease, Crohn’s disease, or other debilitating conditions. Some examples of the “other conditions” commonly allowed by state law include depression, anxiety, anorexia, and rheumatoid arthritis (RA).
- Either medical tests or a physician’s expert opinion supporting the diagnosis.
If we determine that medical cannabis would be suitable for your condition, taking into consideration your medical history, current medications/counseling, and other factors, we will schedule you for an appointment, provide you with a confidential consultation, and provide you with an online certificate through the Massachusetts Department of Public Health.
Once you are have obtained electronic certification (which superseded paper certification in 2015), you can begin the process of registering for a Massachusetts medical marijuana card. (Note that in the future, you will need to renew your medical marijuana card, just as you would need to renew your passport or driver’s license.) Equipped with your patient certification and medical marijuana card, you will be able to purchase medical cannabis within the supply restrictions set by state law: currently 10 ounces (280 grams) per every 60-day period.
By: Dr Jordan Tishler, The Fresh Toast