Focus on the Forgotten Medical Marijuana Patient.

Focus on the Forgotten Medical Marijuana Patient

This is the 4th annual Dr. Bob’s Call to Action- A summary of my thoughts on goals we should, as a community, 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 medical marijuana patient.

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.

Let’s look at some numbers…. 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? Let’s do some simple math with the percentages listed. First let’s divide the conditions into three categories:

Those conditions the voters clearly ‘had in mind’ when they voted for the Act- Seizures, Cancer, Glaucoma, HIV, Crohn’s, Wasting Syndrome, and Hep C. No one would disagree these are SERIOUS and potentially TERMINAL conditions and 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.

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 Alzheimers and you have another 36 patients for a total of 96 patients in the entire state.

Pain, Spasm and Nausea account for 113,796 patients or just shy of 95% of the program.

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.

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’?

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.

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 patient patients come on their own, if for no other reason that chronic narcotics are not helping them and Bill Schuette is constantly on the news talking about medical marijuana patients and their ‘backaches and sore shoulders’. Cancer patients are under the care of oncologists in hospital cancer centers. They are not, in many cases, allowed to offer medical marijuana as a matter of hospital policy. HIV patients are in federally funded programs in many cases. 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.

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 qualify 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. Let’s remember the forgotten medical marijuana patients. They are there, go find and educate them. Let’s get them into the program.


By Robert Townsend|December 22nd, 2013|Medical Marijuana|0 Comments
original article

Are you pushing marijuana?
You need to organize a forum at Wayne State or similar and invite Doctors to hear your spiel.
Educate Doctors because they make the call on drugs for the vast majority of those 'real patients'.
Surely you are not asking laymen to do Doctors work and advise on drugs for treatment for cancer and aids?

Once weed is legalized by Congress the States will work with Doctors for education and supply.
Shit - the politicians in Lansing and Oakland County are already to go with it.
Writing laws that mean nothing until Congress acts.
In the meantime it looks tacky to have Doctors pushing specific drugs like that is what they are there for.
Might as well be pharma agents toting around free TV's with video loops installed.



Don't let it consume you man.
Only you and Bill Schuette are concerned about this.
Cancer patients know their options - it is widely known that weed helps nausea for cancer treatments - every Doctor in America is aware of it.
I am not about to advise them how to do their Doctoring.
Maybe you are so inclined: Wayne State in a forum - be professional and they might show up to listen.

Having lost most of my family to cancer before my very eyes, I believe the need for MJ does not actually lay within the diagnosis of cancer, but rather the "treatment". Essentially the cancer will not kill you, but rather a vital organ (brain, heart, lungs, ect) that will finally result in your death. Over the past couple decades I have watched oncology boom with cancer centers popping up all over the country as it has become the crude and profitable industry too many of us will one day face. As they have moved beyond "do no harm" into "quality of life" the harmless aspect of MJ becomes irrelevant and unnecessary to those in the "end of life" game. I have found the endless hospital visits facing these patients to be poisoned and cut open often lead to hospitalization for infections and other complications. Not many whom have been placed upon this assembly line will ever feel the "quality of life" sold to them and their families in the end IMO.

TheMan13 said:

Having lost most of my family to cancer before my very eyes, I believe the need for MJ does not actually lay within the diagnosis of cancer, but rather the "treatment". Essentially the cancer will not kill you, but rather a vital organ (brain, heart, lungs, ect) that will finally result in your death. Over the past couple decades I have watched oncology boom with cancer centers popping up all over the country as it has become the crude and profitable industry too many of us will one day face. As they have moved beyond "do no harm" into "quality of life" the harmless aspect of MJ becomes irrelevant and unnecessary to those in the "end of life" game. I have found the endless hospital visits facing these patients to be poisoned and cut open often lead to hospitalization for infections and other complications. Not many whom have been placed upon this assembly line will ever feel the "quality of life" sold to them and their families in the end IMO.

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I get that TheMan13; medicine is not always pretty.
There should be more information directed at those feeding the big money machines; but I really believe it should come from Doctors and not laymen.
Maybe I misunderstood the Doctor here: that's why I asked if he IS asking us to recruit patients to the MMMA.

I've watched many waste away, and it breaks your heart; but beyond maybe suggesting that a joint might help ease some of the side-affects and pain I am not qualified at all to advise them on their care.
That should be between the patient and the Doctor.
I would assume that many cancer patients that are not in the MMMA program use marijuana for just these sorts of relief.
I also would assume that their joining a program so public as this one is not what they personally want or need.
I've never heard of a cancer Doctor dropping a patient for dropping dirty.
Maybe it happens more than I know; but that sort of discrimination is usually the MO of pain Doctors and clinics.

I guess what I am most concerned about is this: The Doctor is asking us to help boost the numbers in the MMMA program by playing Doctor ourselves.
It's pretty obvious what's in it for him; but I'll be damned if I can make any sense of it for the rest of us.
I think what he is asking is immoral.

I hear ya Marty, that comment was not directed at you brother. I hadn't actually read your comment until after I posted my reply.

My comment was as to why more "cancer patients" do not grace the MMMA registry. Aside from the obvious lack of literal lifespan to complete a pot doc appointment, LARA's registration processes, finding a caregiver and them getting meds online for you. I believe in "end of life" treatment the script pad is an open book. Once hopped up on Rx cocktails without regard for health risk and addiction, MJ seems a pretty weak alternative. Even when the cancer is not terminal and MJ is intended to relieve chemo side effects, there is no time nor motivation to complete all the MMMA hoops diagnosis to treatment.

There are a number of reasons we don't have more cancer or aids patients in the registry. Many are treated at cancer centers or clinics where they do not have access to information on cannabis, generally by policy or complications of federal funding. Getting information to them is one way we can make a huge difference. They simply are not getting it now.

The second problem is that an elderly cancer patient may not have the knowledge or ability to grow their own medication. They may not have clue one as to how to find or 'hire' a caregiver to grow for them. With the sea change of attitude in Lansing, we may have legislation that for the first time since the start of the Act legalizes dispensaries/provisioning centers. This will remove a significant barrier to access to these patients, and now is the time to involve them in the program.

Dr. Bob

Great post. Thank you for the data provided. Very interesting to look at it this way.
My wife is my cancer patient. CBD is great for breast cancer and we are experimenting with it. She has post surgical pain and it also helps it.
I, too, am very shocked that more cancer patients do not seek medical cannabis treatment, considering the research available on the web.

Ironic title choice..
Wmt

woodsmantoker said:

Ironic title choice..
Wmt

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yeah that!!
We do not require or request that cancer patients participate in the "program". We just help. The "program" is a failure. Why should I put a terminal patient thru the horse shit that is section 4?
Never again will I get a call from the surviving family 2 months after the patient died, over a card finally showing up.

You wanna help doc?
Maybe you should take a closer look at the people you are asking for help.

If I had to do it over again I would go see a doc and get my script, but not sign up with the state. I don't see any benefit to being on the registry.

st0wandgrow said:

If I had to do it over again I would go see a doc and get my script, but not sign up with the state. I don't see any benefit to being on the registry.

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Other than the Section 4 protection from arrest, the 2 year plus legal battle in the courts trying a section 8 defense, the attorney and expert witness costs, probable incarceration and job loss, and the extreme stress of being involved in the criminal justice system, I couldn't agree with you more Stow. Lead the way!

By the way, nice way to divert attention from the subject of the post. I guess you like the idea of medical marijuana just being for 'back pain' and don't want to encourage cancer, seizure, glaucoma, and crohn's patients and the diversity they would bring to the program. Nor do you understand the political need for this not to be a 'one trick pony'. Do you fail to see how the program can be attacked as just for 'stoners with backaches' and how the same attack by the anti's doesn't work as well if they are talking about 'stoners with colon cancer'????

You know haters are going to hate. Passive aggressive types that feel that, even though we have a law allowing the medical use of cannabis, we shouldn't 'need' such a law because weed should be free anyhow- so let's attack the law, the program, and those that work within the system.

You haters are really trying to put an unsympathetic face on medical marijuana patients and the program to the general, non-marijuana using public that voted this law in. Nice job guys.

Dr. Bob

Well geez bob, I really wasn't trying to get your knickers in such a twist.

I see what you're saying, but "those anti people" are becoming more and more irrelevant every day. 58% of Americans now support completely legalizing marijuana. The suits in Lansing even see the writing on the wall now. While I understand what you're trying to do here, I don't really care. People with cancer, aids, seizures, etc are free to sign up if they wish. That's their call, not mine. I'm not a doctor. With the CNN special, and every other news outlet in the country running some type of story on the benefits of marijuana you'd have to be living under a rock to not be aware of this.

And yes, the registry is a joke. Look at all of the people with their nice shiny cards that have still gone through the legal grinder in this state. The protections that are claimed look good on paper, but fall way short of what was intended. My name being in some database in Lansing will protect me from nothing. If the police come knocking they'll get creative and make sure I'm not in compliance. That's what we pay them to do.

Your premise that section 4 offers protection from arest is incorrect. The program is broken and will be as long as our enemies control it. They lost the war on mmj. Since when do the losers get to write the laws?
We will do what we have always done. Help those we can, anyway we can. Irregaurdless of some stupid law.

Some people bitch n moan. Some people step up.

Hi all I have read Dr. Bob's article regarding the forgotten patients. I have to say I do agree with him and I am hoping to do a little work in this area myself. I also have to give him props for taking care of a patient that I sent to him. He went above and beyond what he needed to do. Thank you again Dr. Bob.

BelleIsle said:

Hi all I have read Dr. Bob's article regarding the forgotten patients. I have to say I do agree with him and I am hoping to do a little work in this area myself. I also have to give him props for taking care of a patient that I sent to him. He went above and beyond what he needed to do. Thank you again Dr. Bob.

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So you are going to require stage 4 cancer patients to participate in the program before you help them?

No I am in this to help all patients and as many as I can!!!!!

The system sucks. Having stage 4 cancer patients wait on the card is bs no doubt.
But the Rome was not built in a day. Considering the war on drugs and the insensitive drug laws of yesterday, we have come a long way.
In this militant age of NSA and drones, Im surprised we are able to have access to this plant at all. Its a sad way to view the world but...

Besides, while cannabis heals, its how we eat is whats most important to our well being. Eating healthy is not forbidden by any law, yet most stage 4 cancer patients are still not going to cut out the sugar and processed foods out of their diets. Because the system is rigged, at the time of total vulnerability (diagnoses), we are streamlined through the surgery>radiation>chemo.

NN are you suggesting that stage 4 cancer patients should just use cannabis without so much as a section 8 protection? Quit with the 'free the weed' attitude and realize, as CB said, that we have access to this plant and rules for that access.

The article suggests that we increase access to cancer, crohn's and hiv patients, folks that are not in the registry now. The discussion is about how to involve them in the program with the protection of the Act. It isn't about denying people access or telling them to go 'bare' and just wing it. Your argument that we shouldn't reach out to these folks is not helping patients. Just because you don't like me, or what I stand for (like standards and following the rules the voters gave us) is your own business- don't take it out on the patients or the program. It isn't about me, it is about bringing these folks into the fold and removing the 'stoner with a backache' attack on the program. We want these people participating, if for nothing else it helps them and we can point out the fact they are in the registry- just as the anti's will be quick to point out they are not.

For the record, a stage 4 cancer patient can do anything they want that improves the quality of their lives in my book. Getting certified is just one aspect of giving them protection under the law, but I don't see a cop or a court busting a clearly terminal patient's chops over a couple of grams to help them through chemo.

Perhaps we could take some of this negative energy and turn it towards coming up with some ideas on how to reach these folks rather than bicker among ourselves like a bunch of 5th graders on a playground. That kind of attitude is disappointing and doesn't look good to those reading it, both within and outside the mmj community. It is time you think beyond your attitude and look at a bigger picture.

Happy holidays rollitup

Dr. Bob

Here's an idea BOB, when you offer help....also be willing to follow through. I didn't ask you to come into my thread where I WASNT ASKING, and offer me something...I have however, messaged you many times fella, to no avail..."help"?

Correct me if I am wrong, but YOU FUCKING BETTER BELIEVE IT! WE know and understand the human rights violations in controling this plant AT ALL. I don't want rules to my health ass hole and I am well into the stage in my life where I will gladly tell you to you to go fuxk yourself and your rules. I don't need a doctors help dieing or rules to "protect" me from myself.

Let me tell you all something.. your surrounded by advocates willing to die for one another, and some that already are. You DONT GET IT.


Woodsmantoker.

woodsmantoker said:

Here's an idea BOB, when you offer help....also be willing to follow through. I didn't ask you to come into my thread where I WASNT ASKING, and offer me something...I have however, messaged you many times fella, to no avail..."help"?

Correct me if I am wrong, but YOU FUCKING BETTER BELIEVE IT! WE know and understand the human rights violations in controling this plant AT ALL. I don't want rules to my health ass hole and I am well into the stage in my life where I will gladly tell you to you to go fuxk yourself and your rules. I don't need a doctors help dieing or rules to "protect" me from myself.

Let me tell you all something.. your surrounded by advocates willing to die for one another, and some that already are. You DONT GET IT.


Woodsmantoker.

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See my previous post.