7 Rules You Must Know About Michigan Medical Marijuana!

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For all of you who have some interest in Michigan’s Medical Marijuana Program, whether a doctor, patient, caregiver, etc., here are some rules you must know and follow.

“Bona fide physician-patient relationship”

The physician has reviewed the patient’s relevant medical records and completed a full assessment of the patient’s medical history and current medical condition, including a relevant, in-person, medical evaluation of the patient. The physician has created and maintained records of the patient’s condition in accord with medically accepted standards.

The physician has a reasonable expectation that he or she will provide follow-up care to the patient to monitor the efficacy of the use of medical marihuana as a treatment of the patient’s debilitating medical condition. If the patient has given permission, the physician has notified the patient’s primary care physician of the patient’s debilitating medical condition and certification for the use of medical marihuana to treat that condition.

“Get Registered and Grow Your Own”

A qualifying patient who has been issued and possesses a registry identification card shall not be subject to arrest, prosecution, or penalty in any manner, or denied any right or privilege, including but not limited to civil penalty or disciplinary action by a business or occupational or professional licensing board or bureau, for the medical use of marihuana in accordance with the act, if the qualifying patient possesses no more than two and one-half (2.5) ounces of usable marihuana.

If the qualifying patient has not specified a primary caregiver he/she will be allowed under state law to cultivate marihuana for their own medical purposes. Each patient is allowed to grow 12 marihuana plants kept in an enclosed, locked facility.

“Enclosed Locked Facility”

All marijuana plants must be grown in an “enclosed, locked facility", which means a closet, room, or other comparable, stationary, and fully enclosed area equipped with secured locks or other functioning security devices that permit access only by a registered primary caregiver or registered qualifying patient.

Marihuana plants grown outdoors are considered to be in an enclosed, locked facility if they are not visible to the unaided eye from an adjacent property when viewed by an individual at ground level or from a permanent structure and are grown within a stationary structure that is enclosed on all sides, except for the base, by chain-link fencing, wooden slats, or a similar material that prevents access by the general public.

The facility is also anchored, attached, or affixed to the ground; located on land that is owned, leased, or rented by either the registered qualifying patient or a person designated through the departmental registration process as the primary caregiver for the registered qualifying patient or patients for whom the marihuana plants are grown; and equipped with functioning locks or other security devices that restrict access to only the registered qualifying patient or the registered primary caregiver who owns, leases, or rents the property on which the structure is located. Enclosed, locked facility includes a motor vehicle if both of the following conditions are met.

“Designate a Primary Caregiver”

A primary caregiver who has been issued and possesses a registry identification card shall not be subject to arrest, prosecution, or penalty in any manner, or denied any right or privilege, including but not limited to civil penalty or disciplinary action by a business or occupational or professional licensing board or bureau, for assisting a qualifying patient to whom he or she is connected through the department's registration process with the medical use of marihuana in accordance with the Act.

The primary caregiver can possess two and one-half (2.5) ounces of usable marihuana for each registered qualifying patient to whom he or she is connected through the department's registration process. For each registered qualifying patient who has specified that the primary caregiver will be allowed under state law to cultivate marihuana for the qualifying patient, 12 marijuana plants kept in an enclosed, locked facility.

A registered qualifying patient or registered primary caregiver who has been convicted of selling marihuana to someone who is not allowed to use marihuana for medical purposes under the act, shall have his or her registry identification card revoked and may be found guilty of a felony punishable by imprisonment for not more than 2 years or a fine of not more than $2,000.00, or both, in addition to any other penalties for the distribution of marihuana.

“Felonies and Caregivers”

A primary caregiver will not be registered by the State to grow medical marijuana for any patient if he or she has been convicted of the following:

(A) Any felony within the past 10 years.

(B) A felony involving illegal drugs or violent crimes.

“Affirmative Defense for arrest for Medical Marihuana”

A patient and a patient’s primary caregiver, if any, may assert the medical purpose for using marihuana as a defense to any prosecution involving marihuana, and this defense shall be presumed valid where the evidence shows that: the medical use of marihuana to treat or alleviate the patient’s serious or debilitating medical condition or symptoms of the patient’s serious or debilitating medical condition;

(2) The patient and the patient’s primary caregiver, if any, were collectively in possession of a quantity of marihuana that was not more than was reasonably necessary to ensure the uninterrupted availability of marihuana for the purpose of treating or alleviating the patient’s serious or debilitating medical condition or symptoms of the patient’s serious or debilitating medical condition; and

(3) The patient and the patient’s primary caregiver, if any, were engaged in the acquisition, possession, cultivation, manufacture, use, delivery, transfer, or transportation of marihuana or paraphernalia relating to the use of marihuana to treat or alleviate the patient’s serious or debilitating medical condition or symptoms of the patient’s serious or debilitating medical condition.

(1) A physician has stated that, in the physician’s professional opinion, after having completed a full assessment of the patient’s medical history and current medical condition made in the course of a bona fide physician-patient relationship, the patient is likely to receive therapeutic or palliative benefit from

“Petition to add qualifying diseases or medical conditions”

The department shall accept a written petition from any person requesting that a particular medical condition or treatment be included in the list of debilitating medical conditions under R 333.101.The department shall submit the written petition to the review panel. Within 60 days of receipt of the petition, the panel shall make a recommendation to the department regarding approval or denial of the petition.

Upon receipt of a recommendation from the review panel, the department shall do all of the following:

(a) Post the panel's recommendations on the department's website for public comment for a period of 60 days.

(b) Give notice of a public hearing not less than 10 days before the date of the hearing.

 

“Kushy” Dell J. is a blogger and teacher for Dell’s Classroom found on the website for Dr. Bob and the Certification Crew.

Caregiver Responsibilities under Hartwick

 

Caregiver Responsibilities under Hartwick

In response to our request, Attorney Randall Collins of Grand Haven addresses the Hartwick CoA Decision

Law Office

of

Attorney Randall L. Collins

_________________________________________________

        P.O. Box 231

Grand Haven, MI  49417

(616) 844-5446

(616) 825-6275 fax

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

TO:              Medical Marijuana Community

FROM:         Attorney Randall Collins

DATE: January 17, 2014

RE:              Caregiver Responsibilities

If you are a Caregiver you must read the Appellant Court decision on People of the State of Michigan v. Richard Lee Hartwick.  Richard attempted to do everything by the book but did not understand the meaning of being a caregiver.  He did not know the illnesses of his patients, he did not know what strains or strengths of meds or THC/CBD was working and did not have a paper trail of what he tried for each patient.

If you are growing a strain of high THC, you do not want a patient with pain issues.  Most patients have pain issues and yet there is hardly anyone growing high CBD medicine.  Do you still not get it?  Sativa gets you high, works as an anti-inflammatory in a limited capacity.  Indica helps with pain.  Indica has a high CBD.  Sativa is high THC.  What are you growing?

YOU HAVE TO DECIDE:

A) Do I continue to grow my meds as they stand and find patients who will get the maximum benefits from it, or

B) Do I change my operation, to grow the meds for the current patients I have.

Track what is working for your patients and what is not working.  When did you talk to your patient last, did you sit and have a beer with them or did you actually have a heart-to-heart about their health and what you can do to better the patient?  When push comes to shove if the patients feels no relief from your meds and is just getting a buzz to forget the pain, game over.  You failed.  Medicine is suppose to aid in the relief of the illness.

So what do you need to do to learn more about this?  Test your grow each and every time.  Track how you are performing as a grower and log how the test results show how palliative relief will be maintained for you patient.  The true medical marijuana certification doctors will spot a bad caregiver when asking certain questions of the patient.  The doctor must document their findings every year.  These records of your work will be admissible in court.

I am available for consultation and grow room inspections in an attempt to point you in the right direction.  (616) 844-5446  or on Facebook as Grand Haven Legal

Editor's Note- In addition to knowing your patient's condition and selecting a specific strain for them based on the condition, caregivers are being held responsible for the validity of the doctor/patient relationship between the doctor and their patient.  If the physician is not known to the caregiver, it is wise (and may be legally essential) that the caregiver confirm that the physician will require and retain medical records of the visit, meet personally with the patient, and arrange for follow up with the patient.

 for full article and decision see 'caregiver responsibilities'

I'm a Good Mother- Why is CPS Investigating ME??

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Why is CPS Investigating Me?

By Attorney Jennifer P. Bukovinszky

Bringing a child into this world is hard enough but when the new mother is a marijuana user and has used marijuana during pregnancy, she is faced with so much more.

The Child Protection Law (CPL), requires certain people (mandated reporters), to make a complaint of child abuse to Child Protective Services (CPS) if the mandated reporter suspects that the newborn infant has been exposed to any amount of a controlled substance or if a controlled substance is found to be present in the newborn infant’s body. MCL 722.623a. It is important to note, that the mandated reporter will not be required to make a complaint if it is known that the exposure to a controlled substance was the result of medical treatment administered to the mother or the newborn infant.

But…it is likely that the hospital staff will err on the side of caution when deciding to initiate a complaint to CPS if it is suspected that the mother’s use of a controlled substance has transferred to the newborn infant while in utero.

Once a report has been made, a CPS worker will automatically investigate the complaint to determine if the newborn infant was in fact exposed to a controlled substance and the circumstances surrounding that exposure.

 

Read more...

The Real Truth about Cannabis… and why Marijuana is not a drug!

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Cannabis has been cultivated throughout the world’s history as a source of industrial fiber, seed, oil, food, recreation, religious, spiritual enlightenment, and medicine. Each part of the plant is harvested differently, depending on the purpose of its use.

Cannabis is a flowering plant that includes three known varieties, Cannabis Indica, Cannabis Sativa, and Cannabis Ruderalis. These three grow naturally in Central Asia and South Asia with no human intervention. The flowers (and to a lesser extent the leaves, stems, and seeds) contain psychoactive and normal active chemical compounds known as cannabinoids.

Cannabinoids are a class of diverse chemical compounds that activate receptors on cells that block neurotransmitter release in the brain. These receptors include the cannabinoids found in cannabis and some other plants. Cannabis can be used for pain management by altering transmitter release on nerve cells that carry signals from sensory organs toward the body’s control system to remove the pain.

The most notable cannabinoid is tetrahydrocannabinol (THC), the primary psychoactive compound of cannabis. Cannabidol (CBD) is another major constituent of the plant, representing up to 40% of its substance. Cannabinol (CBN) is the primary product of THC degradation and there is usually little of it in a fresh plant and is only mildly psychoactive. Currently, there are at least 85 cannabinoids in cannabis, with THC, CBD, and CBN consisting of the top three.

As mentioned earlier, THC is the primary psychoactive compound of the cannabis plant. This is what causes you to have the high feeling or the feeling of euphoria. CBD (Cannabidiol) shares a precursor with THC and is also psychoactive, but considered to have a wider scope of medical applications than THC, including treating epilepsy, multiple sclerosis, spasms, anxiety disorders, schizophrenia, nausea, convulsion and inflammation, as well as inhibiting cancer cell growth. Cannabinoids can also be put into cakes, cookies, brownies, or other foods, and can be consumed for recreation or medicinal purposes.

Is Marijuana the same as Cannabis?

Marijuana consists of the dried flowers of Cannabis plants selectively bred to produce high levels of THC and other psychoactive cannabinoids, such as CBD. These cannabinoids are concentrated in a viscous resin produced in structures known as trichomes. Trichomes are the fine outgrowths or the hairs on cannabis flowers. The resin produced from trichomes is a viscous liquid, composed mainly of volatile fluid terpenes, which make resin thick and sticky.

Cannabis plants consisting of dried flowers, i.e., Marijuana can exhibit many variations in the quantity and type of cannabinoids they produce. Selective breeding has been used to control the genetics of plants and modify the cannabinoids. This is the reason why you have such a variety of marijuana strains with distinct taste, smell, and potency. And this is also why certain strains bred from Cannabis plants are better for certain illnesses.

The two main Cannabis plants are Cannabis Sativa and Cannabis Indica. Cannabis Sativa are long lanky plants that can take up to ten weeks to harvest during flowering. They tend to have a more grassy type odor to the buds providing an uplifting, energetic and “cerebral” high that is best suited for daytime smoking.

A sativa high is one filled with energy and can easily entice creativity for new ideas. Sativa plants are dominated by high THC levels and low or no CBD levels. These cannabinoid levels are why cannabis sativa plants are known to be good for alleviating pain.  

Sativa seeds are chiefly used to make hempseed oil which can be used for cooking, lamps, lacquers, or paints. They are also used as caged-bird feed, for it is a moderate source of nutrients for most birds.

Benefits of Sativa:

  • Feelings of well-being and at-ease
  • Up-lifting and cerebral thoughts
  • Stimulates and energizes
  • Increases focus and creativity
  • Fights depression
  • Relieves headaches and migraines
  • Relaxes muscles, relieves pain

Common Sativa Strains:

  • Silver Haze
  • Jack Herer
  • Maui Waui
  • Sour Diesel
  • Skunk #1
  • Trainwreck

Cannabis Indica are short and stocky and can take up to eight weeks to harvest during flowering. . They have a heavy, stony high that is relaxing and can help different medical problems such as treating insomnia. Indica plants have moderate THC levels and higher levels of CBD than Sativa plants.

Indica buds are most commonly smoked by medical marijuana patients in the late evening or even right before bed due to how sleepy and tired you become when high from an indica strain.

Cannabis Indica originally come from the hash producing countries of the world like Afghanistan, Morocco, and Pakistan.

Benefits of Indica:

  • Relieves body pain
  • Relaxes muscles
  • Relieves spasms, reduces seizures
  • Relieves headaches and migraines
  • Relieves anxiety or stress
  • reduces inflammation
  • stimulates appetite

Common Indica Strains:

  • Kush
  • Chemdog
  • God Bud
  • Northern Lights
  • Blueberry

A cancer patient hoping to relieve the pain from chemotherapy would benefit greatly from the effects of an Indica plant, whereas an individual dealing with depression would better benefit from a Sativa plant. Combining different Indica strains, different Sativa strains or a combination thereof creates hybrids. The resulting hybrid strains will grow, mature and smoke in relationship to the Indica/Sativa percentages they end up containing."

Common Hybrid Strains:

  • AK 47
  • Black Jack
  • Blueberry
  • Super Skunk
  • White Widow

Due to the crossbreeding, some strains may have higher THC OR CBD, and the terpenes dictate the smell and flavor.

Terpenes are the primary constituents of the essential oils of cannabis flowers. An “essential oil" carries a distinctive scent, or essence, of the plant. Essential oils are widely used as natural flavor additives for food, as fragrances in perfumery, and in traditional and alternative medicines such as aromatherapy.

THC and the other cannabinoids have no odor, so marijuana’s compelling fragrance depends on which terpenes predominate. It’s the combination of terpenoids and THC that endows each strain with a specific psychoactive flavor. The resinous trichromes of the cannabis plant contain both the cannabinoids as well as the terpenes, which are constantly being replaced as they evaporate from the resin.

There have been over 200 terpenes found in cannabis. However, only a few of these oily substances have large enough amounts to impact the bud. The amount and type of Terpenes can vary with each strain of marijuana, which is the reason for all the different smells and flavors from all the strains. Studies have also shown that the full range of psychoactive and medical effects of Cannabis resin cannot be re-created simply with the use of pure cannabinoid type drugs like THC.

Hmmm...This is an interesting plant, but how is it consumed?

There are a variety of ways to consume Cannabis; however the most prominent way is by some form of smoking or oral consumption. Each way of consumption has benefits and some may have drawbacks to consider. The intensity of your high or the level of the psychoactive effects can differ depending on your method of cannabis consumption. For this discussion, we will focus on smoking with a paper or cigar wrap, pipe or bong, vaporizer, and medibles.

Smoking (paper or cigar wrap):

Smoking is the most expedient method of consumption, with almost immediate effect and dosage controlled by the patient. A rolled paper filled with marijuana is called a joint, while a cigar wrap filled with marijuana is called a blunt. Both methods are definitely reliable for you getting a full blast of THC. A blunt seems to hit harder and get you higher than a conventional joint, but both are very highly effective.

The controversial downside to smoking marijuana is that it can damage the lungs and cause respiratory problems. Although results from clinical trials have been contradictory, many researchers believe herbal marijuana contains toxins and carcinogens that lead to increased risk of respiratory diseases and cancer and therefore recommend other methods of consumption of medical marijuana besides smoking.

However real studies of populations of cannabis users have failed to show the lung damage everyone expected to see and as the NHS report  accepted in 2011 there is "no conclusive evidence that cannabis causes cancer". THC - one of the main chemicals in cannabis seems to have anti-cancer properties which may account for this unexpected finding.

According to reports, if you do choose to smoke, here are some helpful tips to minimize the risk due to toxins and tars contained in the marijuana:

  • Use more potent, higher THC cannabis so less inhalation is necessary to acquire an effective dose.
  • Use a filter and non-chemical rolling paper if smoking a marijuana cigarette (joint) or cigar wrap (blunt).
  • Exhale immediately      after inhaling deeply to avoid the tars in the marijuana from coating your lungs. It is a myth that holding your breath will create a stronger dosage or enable more THC to be absorbed.

Pipe or Bong:

Essentially, a pipe is a bowl to hold the hash or marijuana with a tube to suck on. The smoke goes right from the stem of the bowl into your lungs. The longer the stem the better, as this allows the smoke to cool and the heavy tars to condense out before you breathe them in. The pipe may have a little hole on the side of it, which you cover while you are inhaling the marijuana smoke while holding the whole pipe and smoking. A pipe which has been in use for a few weeks will soon become full of thick sticky tar and will need cleaning out.

A bong can be many different styles but it’s all basically the same thing. The smoke is pulled through some water which gets rid of some carcinogens and makes for a much smoother hit. The chamber is a lot bigger than a bowl so you can clear it which may increase your high. Some studies have reported that bongs are a very safe way to consume marijuana because the water filters out the smoke, thus making them healthier to use.

Bongs get you stoned much quicker than joints particularly if there aren't many people sharing the hits. Bongs also deliver much more smoke in one hit than a pipe or water pipe so inexperienced smokers might find they get too stoned too quickly.

Such as the case with all things, patients must consume their medicine in moderation and always pay attention to how you and your body react to your medicine. If something doesn’t feel quite right with you after medicating, don’t hesitate to seek some help by telling your doctor, family, friends, or be sure to go visit the nearest ER!

Vaporizer

A vaporizer is a small to large size device that heats herbal cannabis to a desired temperature which causes the active ingredients to evaporate into a gas without burning any plant material. You will heat marijuana's active ingredients in the plant to a point where it produces a vapor (a fine mist), then inhale the vapor into the lungs. The correct vaporization temperature is around 320o Fahrenheit.

Hot air vaporization releases about five compounds, with THC being in the highest concentration, whereas smoking marijuana releases about 111 compounds. This is the non-smoked method most often recommended as an alternative to smoking. Patients can utilize it for most of the symptoms/conditions for which marijuana is recommended.

There are many vaporizers on the market, use due diligence when choosing the one for you. Prices can vary, and they are usually in the $200 - $500 range for a good reliable vaporizer. So although vaporizing may be the safest way to consume marijuana, it is also the most expensive. However, there are many new vaporizers on the market, and the open competition seems to be lowering prices. So you should take your time and do some research on the internet or visit your local smoking post or Head Shop.

Medibles (oral consumption):

Medibles are what we call cannabis that is infused in different foods for our consumption. Cannabis flowered tops and leaves are simmered in butter (or vegetable oil) for several hours, transferring the THC and other cannabinoids to the butter. The solid plant material is then discarded. The butter, now a dark shade of green, is then used in baking such items as brownies and cakes, or added to such foods as spaghetti sauce or soup. The oily base of the butter is needed for the cannabinoids to properly adhere.

This method is utilized by many patients suffering from pain and spasticity, and sometimes sleeps disorders. Although not the preferred method for patients suffering from nausea, vomiting or loss of appetite, it is sometimes used to supplement other delivery methods, or used by those unable or unwilling to smoke or use a vaporizer.

By consuming your medicine with medibles, patients have to realize that once the marijuana is consumed, it goes directly into your blood stream, which can get you very stoned and takes effect very quickly.

**Smoking cannabis results in a significant loss of THC and other cannabinoids through exhaled or non-inhaled smoke. In contrast, all of the active constituents enter the body when cannabis is consumed orally.

A warning for those choosing to medicate with edible marijuana – unlike with smoking and vaporizing, it is much easier to over-consume and therefore over-medicate with ingestion. Because it can take longer to feel the effect and/or because the edibles taste good, patients are warned to start with a small amount, wait an hour or two before ingesting more, and be extra careful in consumption so as not to exceed recommended dosage.

No Drugs Involved!

In summary, what we have in cannabis is a wonderful plant that can be used for a variety of things. This one plant can build cities or countries and at the same time feed and heal the people. There is no other plant in the world naturally grown with the capabilities of the cannabis plant. To be considered a drug and illegal, is the greatest folly the world has ever known. Hopefully as time goes on, more studies will show how this plant can help make the world a better place.

Everyone should take some time to read and learn about the cannabis plant and how it has played a major part in our world’s history!

Dell J.

http://www.leafly.com/hybrid

http://en.wikipedia.org/wiki/Cannabis_indica

http://www.thcdigest.com/indica-vs-sativa/

http://en.wikipedia.org/wiki/Cannabis_consumption

http://www.nhs.uk/news/2012/06june/Pages/cannabis-lung-health-risks-underestimated.aspx

http://www.theweedblog.com/smoking-marijuana-vs-vaporizing-marijuana-infographic/

http://www.thestonerscookbook.com/how_to_cook_with_weed.php

http://www.naturalnews.com/cannabis.html

http://www.hightimes.com/read/talking-terpenes

http://www.denalihealthcaremi.com

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