Post-Traumatic Stress Disorder Approved as New Condition for MMJ

 

PTSD Added as a Qualifying Condition

 

 

 

Michigan has added the first new condition for medical marijuana since the Act went into effect in April 2009.  After being passed by new conditions panel it was officially approved by LARA on 3-14-14.  This is the result of more than a year of work on the part of two panels, scores of live and written testimonies, and countless hours of work by many individuals.

What is PTSD?

There are Six Diagnostic Criteria for PTSD:

symptoms of ptsd

The Symptoms of PTSD

  1. The person has been exposed to a traumatic event involving death, bodily injury and experienced feelings of fear or helplessness.
  2. The event is relived again and again.
  3. The person seeks to avoid things that remind them of the event or withdraws.
  4. The person is hyper-vigilant, angry, or has exaggerated startle responses
  5. The symptoms continue longer than one month after the event.
  6. The symptoms impair the patient socially or interfere with normal function.
  7. Acute PSTD has a symptom duration of less than 3 months, Chronic PTSD is more than 3 months.

How Can Cannabis Help PTSD?

Most treatments for PTSD currently revolve around what is called ‘cognitive therapy’- Basically patients are led on exercises and discussions to ‘think through the problem’ in the individual and group setting.  Part of the treatment involves sharing experiences with others with similar experiences and working towards replacing the exaggerated fear responses with more healthy coping mechanisms.  Therapy can last for years and involve medication to help with depression.

Medical marijuana can interfere to some extent with cognitive therapy and provides an escape from the distressing thoughts.  While it may prolong the treatment duration, it can in many cases provide a needed break in the stress, improve the quality of the patient’s life in the short term, and may prevent catastrophic complications such as suicide, violent behavior and relationship problems.

Denali Healthcare is taking the position that the patient should have input into their therapy for PTSD.  In some cases, patients can tolerate intense cognitive and other traditional therapies, in others the patient may require immediate relief of symptoms.  We feel this is best determined on a case by case basis and the patient should have a say rather than be ‘told’ they must limit themselves to specific treatments.

While PTSD is traditional viewed as a disorder of combat veterans, any traumatic experience- exposure violent death in an automobile accident, loss of a child, assault/rape, and physical/psychological abuse are examples of civilian cases of PTSD. The photo for this article depicts the 1982 drowning death of a child that affected the 19 year old EMT at the left of the image to this day.

What is the Denali Healthcare Standard for Certification for PTSD?

The diagnosis of PTSD is serious and life altering.  It may affect the insurability and employability of the patient for life.  It may result in disability determinations. It cannot and should not be diagnosed by non-mental health professionals, and certainly should not be diagnosed based on a single meeting in a hotel or dispensary clinic for the purposes of obtaining a medical marijuana card.  It MUST involve follow up to protect the patient from potentially life threatening complications- To give someone a diagnosis of PTSD and walk away is akin to telling them they just had a heart attack and wishing them luck as you walk out of the room.

Accordingly, the Denali Healthcare Standard for the Certification of Patients with PSTD is as follows:

  1. The diagnosis MUST be formally made by a mental health professional according to the standard of care- by appropriate criteria and over a series of evaluations.  The mental health professional making the diagnosis must have arranged for follow up with a treatment plan and appropriate safety measures.
  2. Patients MUST have documentation of the diagnosis IN HAND when requesting certification.  We will not request records or in any way make the diagnosis ourselves.  Appropriate records include, but are not limited, letters from their therapist, medical records supporting the diagnosis, and/or a disability determination of any percentage for PTSD.
  3. Denali Healthcare will administer a standardized screening test for PTSD as part of the patient record (if PTSD is the only qualifying condition claimed).

Our Concerns about PTSD as the sole criteria for a certification.

The use of PTSD as the sole criteria for certification carries with it the risk the ‘low standard’ clinics will attempt to use a single evaluation by a ‘checklist’ of some sort to make the diagnosis (especially by non-mental health providers) simply to qualify the patient to pay for a certification.  This carries with it several risks.

  1. PTSD could become viewed as a ‘sham’ condition simply used to qualify the patient for a card.  This disrespects those that truly suffer from the condition and decreases the seriousness of the disorder.
  2. If PTSD is diagnosed and not properly followed up, people could die.  There are 18 suicides a day on average in veterans due to complications of PTSD, not to mention broken homes and lives.  If it is identified, it must be followed up.
  3. Once ‘labeled’ with the diagnosis of PTSD, patients face lifelong problems obtaining life insurance and possibly health insurance.  If they can, it may be at a higher premium than their demographic peers.  It may limit their employability, ability to own firearms, and a host of other issues.
  4. In the event a patient applies for disability, the discovery by the hearing officer that the diagnosis was made by a non-mental health professional to obtain a medical marijuana card may not turn out well for an otherwise deserving patient.

The addition of PTSD to the qualifying condition list is a huge advance for medical marijuana patients, and it may save lives.  It carries with it a high potential for abuse and must be applied carefully by qualified providers and certification physicians.  Denali Healthcare is more interested in the safety and well-being of our patients than their certification fees, so we will adopt a conservative and well documented approach to the use of PTSD as the sole criteria for medical marijuana certification.

We encourage all high standard clinics to adopt and publish similar criteria.

 

6 Things I would do if I Owned a Dispensary!

dispensary5

First off, if I was to open a dispensary, there are some obvious things I would do, such as installing a very high tech security system, with 10 Pit Bulls, 8 Doberman Pinschers, and 20 Ninjas guarding the door…wink, wink*! But seriously, if I was to open a dispensary, I would really want it to be unique and tailored for the patient. The patient is the most important aspect of a dispensary.

In many states, including my state of Michigan, we are not allowed to have legal dispensaries. Patients have to have a caregiver to acquire their meds or grow their own.

[When referring to the word “meds”, this can be marijuana flowers, oils, and or medibles]

So as I contemplate how unfair it is for us law-abiding citizens to not have credible access to our meds, I begin to think about how cool it would be to own my own dispensary and what things would I do to make my dispensary the best.

Well, after further contemplation, I compiled a list of 6 things I would do if I owned a dispensary. This list is from my own personal perspective, but feel free to make up your own list of things you would do or you can think of ways to improve my dispensary!

  1. $20 a gram limits- Our prices of meds will range from $5 to $20 a gram. No meds will cost you more than $20 a gram no matter how good it is. We will also sell meds for $5 a gram, this will be our low end, and affordable for the low-income patients. Patients must qualify as low income in order to purchase meds for this price. All meds and price ranges will be first come, first serve basis. We will post messages on Facebook or Twitter letting our patients know what strains are available each day.
  2. Dab Bar- Inside my dispensary, there will be a Dab Bar. This Dab Bar will be an elaborate set-up put together like a real bar, where patients can step –up and order one of our many selections of dabs from some of the most potent strains available. Our set-up will allow patients to take a dab on sight, as there will be a variety of vaporizers to use, the Dab Bar would be similar to a Hookah Bar!
  3. Weekly Grow Classes and Informational Sessions- Every week, we will offer “Grow Classes” and “Informational Sessions” teaching patients how to grow top shelf buds, make Rick Simpson and hash oil, bubble hash, etc. During the informational sessions, we will discuss all the current affairs with Medical Marijuana, and what we as a people can do to improve this law, and how to stay in compliance with our current medical marijuana laws.
  4. Free Med Day- Once a month, my dispensary along with my growers will donate meds to the low-income and less fortunate patients. On this day, qualified patients will have access to free meds, as we will give away free meds for a whole day.
  5. Create Jobs- One of the most important things a community needs to survive is the availability of employment. As my dispensary thrives, I will put an emphasis on creating employment for the community. Whether it’s bud trimmers, growers, teachers, drivers, customer service, etc., my dispensary will create jobs for the community, and we will take pride in putting income into households and adding tax money to the local economy.
  6. Home Delivery Service- The home delivery service will mostly be offered to the elderly, disabled, and severely ill patients. There is no way this group of patients should have to go to a dispensary and stand in line for their meds. Instead we will personally and gladly deliver meds to these patients’ door steps.

This concludes my list of things I would do if I owned a dispensary. And although, I am sure there is a lot more to it when owning a dispensary, and there are many things I left out, I feel if I was to implement these 6 things, I would have a very successful dispensary.

My mission would be to serve the patients in the highest capacity, and to spread love, joy, and meds through-out my community. Join me in this thought process and think of some things you would do if you owned a dispensary.

Owning a dispensary may be a little far-fetched at this moment and time, but you have to admit that it would be very awesome to own a dispensary!

Dell J.

a.k.a “Yung Kushy”

This email address is being protected from spambots. You need JavaScript enabled to view it.

https://www.facebook.com/yung.kushy.31

Response to Editorial Written by a Drug Task Force Officer

A Physician Response to the Dangers of Decriminalizing Marijuana 

I am Dr. Robert Townsend, President of Denali Healthcare, a Mt. Pleasant Pain Management office.  I read with some interest the ‘Guest Voice’ Article on the ‘Dangers of decriminalizing marijuana’ by Michael Covarrubias.  Despite my concern about retribution I felt the need to respond to the outrageous claims made in the article.

It seems that drug enforcement officers such as Mr. Covarrubias seem to have an outline for these articles.  I’d like to respond to several of their ‘talking points’ about the evils of medical marijuana.

Big Cannabis has duped the voters

A common theme used by those with a vested interest in the ‘War on Drugs’ is that there is a hidden hand at work- Big Cannabis.  Big Cannabis is a ‘tool’ of the drug cartels and a danger to truth, justice and the American Way.  They talk about the ‘intent’ of the voters to help terminal patients.  They talk about marijuana financing heroin and cocaine.

The truth of the matter is the voters are not as stupid as they would like us to believe.  They knew EXACTLY what they were voting for.  My 75 year old mother wanted to help cancer patients AND those with chronic pain when she voted for the Act.  I suspect many others did as well.  As for financing drug cartels, marijuana does not do that.  The fact that marijuana is illegal and people are forced to buy it from criminals does.  Fortunately, we have medical marijuana in this state, so people can grow it themselves or buy it from their licensed caregivers.

Marijuana Patients are Poor Parents

All this nonsense about children being kicked out of their bedrooms so people can grow marijuana is designed not to show the danger to children, but to show their marijuana smoking parents are incapable of caring for them properly.  Good parents would never do such a thing, so ‘weed’ smoking parents must by definition be bad.  We see this angle constantly being exploited by CPS, vindictive ex-spouses, and the courts, despite the protections built right into the Act to prevent such assumptions.  Sen Rick Jones is even attempting to ram through a bill forcing parents to choose between children and medicine to formalize the mindset.

Children and College Kids

A common theme is to associate marijuana use with children.  Actual state statistics show that of 130,000 medical marijuana patients in this state, only 44 are minors.  Having certified about 1/3 of them, I can assure you that most will not live long enough to be majors and all are gravely ill.  They are exactly the ‘terminally ill’ patients the voters were ‘duped’ by ‘Big Cannabis’ about, yet because the image of a toddler with a bong is what you are trying to project, you conveniently leave out the ‘duped voter’ angle.  In my practice the average age is 51 with well documented medical conditions.  Fewer than 17% are under the age of 30.

Cannabis is different now… and dangerous

Your study suggests that there is THC on the surfaces of homes of medical marijuana patients, and that somehow this is so dangerous that you need to wear protective gear as if you were cleaning up a meth lab (note the association of cannabis with meth to control the mindset of the reader).  Yet THC is harmless, and in fact there are literally thousands of studies showing medical benefit.  Meth is not.  Unlike cannabis, cocaine is legal, far more dangerous and addictive, and is schedule 2 and available for medical use. I wonder what the risk of even nanogram levels of marijuana on a coffee table will have any adverse effect with transdermal absorption.  But if you are worried, please feel free to wear your bunny suit.

Cannabis hurts performance and makes you stupid

Last I checked, cannabis was not used as a performance enhancing drug.  We all know how it hurts athletic performance in people like Michael Phelps.  You would be amazed at how many very smart people at companies like Microsoft or Google actually use cannabis yet still manage to muddle along and turn their companies into Fortune 500 operations.

Cannabis is a Gateway Drug

Mr. Covarrubias discussed his interviews with college students and how they claimed cannabis was the cause of their woes.  Let’s get this clear.  He wasn’t interviewing them for a term paper, or a newspaper story.  He was ARRESTING them.  They were sitting there, in handcuffs, facing a charge that likely would ruin their lives- impacting their employment, student loans, even military service.  I am sure they told the authority figure with the badge anything he wanted to hear.

The gateway drug for heroin is prescription pain killers- more than 51% started their habit at the doctor’s office.  The vast majority of people get their first exposure to ‘illegal’ drugs with alcohol and underage drinking.

In closing, as a citizen, a voter and a member of the medical community, I wish to personally thank Mr. Covarrubias and his brother law-enforcement officers for the job they do keeping us safe from dangerous drugs.  I just want to very clearly tell him that Marijuana is NOT one of them.  The major adverse side effect of marijuana is exposure to the criminal justice system.

Dr. Robert Townsend is President of Denali Healthcare in Mt. Pleasant, a pain management clinic.  He uses cannabis certifications as a tool to reduce the use of more dangerous narcotic pain medicine.  He is not a card holder and has never personally used marijuana.

Denali to Offer On Line Follow Up

 

Denali Healthcare offers On Line Follow Up

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Follow up is essential for a bonafide doctor/patient relationship

At Denali Healthcare we are constantly working to protect patients based on the latest court decisions- Most recently concerning the need for follow up after the certification as a measurement of the bonafide dr/pt relationship. We have always offered free, in person follow up with the doctor.  Now patients can complete the requirement for follow up ON LINE and help us with some research into the demographics of medical marijuana in the process.

Follow up provides us with:

  1. Feedback on the effectiveness of our recommended treatment
  2. Useful demographic data for studies on the use of Medical Marijuana in Michigan
  3. Essential records for you medical chart that will be needed in a Section 8 Defense
  4. Makes sure our records are up to date

If you don’t have time to schedule a formal follow up appointment with us, all you need to do is click this button and we can update your chart…

Submit your follow up to us by clicking this button SUBMIT YOUR UPDATE

Follow Up Couldn’t be Easier!

We are currently working on a study of the demographics of Michigan Medical Marijuana Patients- Recently the state put out some misleading statistics concerning the distribution of conditions, we want to find the true numbers of patients certified for each of the approved conditions.  We believe that the state only counted one condition per patient- a card holder with cancer and nausea would be counted as ‘nausea’, we want to count both and need data to do it.

Based on recent court decisions, we at Denali Healthcare feel there will be a large number of Section 8 cases in the coming year.  Not only will the data we are collecting help patients, but the charted follow ups from the on line forms will be critical in the defenses of individual patients.

After you complete the form, it will be added to your chart.  Thank you for your help!

 

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