Van der Pop

VdP Voice | October 21, 2017

VdP VOICEKieryn Wang

ACCESS DENIED
How U.S. legislations lead to cannabis refugees

Photo by Morgan English

Photo by Morgan English

Imagine for a moment a devastating diagnosis. Or, the occurrence of an accident — the split second when you lose your footing, the impact of a car arriving head-on — and the potential for a lifetime of suffering. Real teeth-clenching pain. What are the lengths you would go to to access care? Would you move states? Leave your support systems behind?

When Angelina Fanous was diagnosed with ALS in July 2014, she had just turned 29, was living in Brooklyn and working as an editor at Vice. The news came the same month the State of New York passed Assembly Bill 6357, relating to the medical use of marijuana.

ALS, a degenerative and fatal neurological disorder also known as Lou Gehrig’s disease, is a qualifying condition for many states’ medical marijuana programs. Fanous sought the advice of one of the leading neurologists in the country. Sitting in his Upper East Side office, he told her that cannabinoid treatment was a waste of time.

Despite his condemnation, Fanous travelled to Colorado on the encouragement of a friend, where she tried cannabis-derived transdermal patches. “Immediately after using CBD I could feel my muscles relax. I could feel my body gain more agility,” she said over the phone. She knew she had found something that would offer her some relief from her symptoms as the disease progressed.

Fearing a delay in the implementation of a state medical marijuana program, she asked for a work transfer and packed her bags, leaving New York for Vice’s Los Angeles office.

“I lived in Brooklyn, I had no issues getting weed,” Fanous said. But she couldn’t access the products that helped her the most: “You can’t get oil and tincture and non-psychoactive weed on the black market.” She said she also would never have learned what she did without immersing herself in a market with established experts.

“Not a single doctor or neurologist or health care professional could give me good advice, or feel comfortable guiding me,” said Fanous. From her perspective, the health care system suffers from a “What could stoners teach me?” attitude.

Dr. Monya De, an L.A.-based physician, said there are other barriers, including those doctors face — and stigma is a big one. “Once you have marijuana available directly as a prescription, then your brand is medical marijuana clinic,” she said.

Participation in California’s medical marijuana program requires doctors to obtain a special license. Dr. De is not certified to prescribe cannabis, but she can recommend her patients see a doctor who is. “I’m in Los Angeles; there’s a place on every corner,” she said.

Physicians want to know if their patients are using marijuana for treatment, but many don't feel the need to gain knowledge of cannabinoid products, strains or dosage when they can rely on dispensaries to, well, dispense this knowledge.

Then there are doctors, like those employed by the U.S. Department of Veteran Affairs, Kaiser Permanente as well as some of the big universities, who are not permitted to prescribe pot. There's also the issue of a lack of medical research. As a Schedule I drug, researchers need approval from at least three federal agencies to conduct scientific studies.

All of this limits the options of law-abiding citizens. When Fanous was living with her sister in D.C., she couldn’t get products that would allow her to ingest her medication — just dry flower for smoking. She also lost access to the cannabinoids she finds most effective.
 
This is the reality for cannabis refugees. Today, while 29 states and the District of Columbia have laws allowing legal medicinal marijuana, everything from eligibility criteria to permissible substances vary by state. Recently, Fanous moved into her parent’s home in Ohio. The state established a medical marijuana program last year, but again the remedies that work for Fanous are not available.

Liz* is a journalist who suffers from a chronic pain condition following a car accident. She lives with her husband Greg* just outside of Boston, in a state that legalized access to medical marijuana in 2012. They’ve also lived in Colorado, New York and Pennsylvania — all states with medical marijuana programs. But despite multiple recommendations from various physicians, she’s been unable to access the program due to her husband’s status as a permanent resident.

Under the Immigration and Nationality Act 212, a federal document, waivers of inadmissibility include drug-related ones. They’ve consulted immigration lawyers and have been advised against Liz seeking the treatment her doctors have been suggesting for years. If the couple was ever found with the drug, Greg could be at risk for deportation.

The last time Liz tried pot was maybe once was when she was 13, and she steadfastly refuses to experiment by accessing what’s available through dispensaries, let alone on the black market. “Neither one of us can fathom taking that risk,” Liz said. She believes marijuana would help decrease her reliance on opioids while also increasing her mobility and appetite. She’s seen it work for friends.

“I’m put in a position into choosing between my ability to function and my ability to have my husband here,” said Liz.

Surely these are not the type of policies voters envisioned last November when they passed ballot measures in eight states to introduce or expand legal access to the drug. In April, a CBS News poll reported that 88 per cent of Americans support medical use of marijuana. But even with this cascading public opinion, Liz and many others remain in limbo.

Nichole Jankowski is a writer based in Toronto.

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