Ask the Expert: Medical Cannabis

Medical cannabis is an effective method for treating a variety of medical conditions. Legal in 30 states medical cannabis is approved for a number of qualifying indications. After its legalization in New York State in 2014, DENT quickly became the largest resource in Upstate New York for certifying and managing patients. With over 30 DENT providers qualified to certify patients, the DENT Cannabis Clinic oversees 6,000 medical marijuana patients and has become a tireless advocate for its acceptance and use by the medical community. We gathered commonly asked questions and gave them to Director of the DENT Cannabis Clinic, Dr. Laszlo Mechtler, who answered them on Facebook Live.  

Below is a summary of the presentation, keep scrolling to check out the entire Facebook Live!

1. How do I start the process? Do I speak with my primary care doctor to get a referral & appointment for your clinic?

At DENT, you must be referred to the Cannabis Clinic by a current treating physician. By beginning with this referral, our Cannabis Clinic providers can create a collaborative partnership with the patient and the referring provider, giving our providers the opportunity to learn the most we can about the patient’s current medical condition and previous medical history. This allows us to provide comprehensive care to the patient.

To begin the process, the patient (or referring provider) can download the referral form on the DENT website, give it to their physician to fill out, then have it sent back to DENT (fax number located on the top of the form). After receiving the referral along with office notes and diagnostic testing records, our medical director determines whether or not there is a qualifying indication based upon New York State (NYS) guidelines. From there, our Cannabis Clinic team will call the patient to schedule a consultation appointment. The chronic pain indication has a wait time of approximately 4 months upon receipt of the referral for an appointment.

Being seen by a provider does not guarantee the patient a certification. Further testing may be recommended or it may be found that the patient doesn’t qualify for the NYS program. If the patient does qualify they will receive their certification from the provider, at which point the patient has to go online and register themselves as a patient with New York State (instructions given to patient from our office staff). Once the patient has registered online and NYS has approved the account, the patient has the opportunity to print a temporary card off of their account that is valid for 30 days until their hard copy card arrives in the mail. The patient must have this card in hand along with the certification to enter a dispensary and obtain their medical cannabis product. Currently, there are 5 dispensaries in New York State (with multiple locations throughout the state). Locally, there are dispensaries located in Amherst and Williamsville (PharmaCannis, MedMen).

 

2.  What indications are approved in New York State?

• Amyotrophic Lateral Sclerosis (ALS/Lou Gehrig’s)

• Cancer

• Inflammatory Bowel Disease (IBD)

• Parkinson’s Disease

• Spinal Cord Injury with spasticity

• Epilepsy

• Neuropathies

• Huntington’s Disease

• Multiple Sclerosis

• HIV/AIDS

• Chronic Pain

•   PTSD

•   Opioid Replacement

Patients must also have one of the following associated or complicating conditions:

• Cachexia or wasting syndrome

• Severe or chronic pain

• Severe nausea

• Seizures

• Severe or persistent muscle spasms

• PTSD

• Opioid Use Disorder (must be in an Article 32 treatment program)

3. Is there any possibility of insurance companies working with patients to help with some of the cost?

“Unfortunately of the 6,000 patients in the DENT Cannabis Clinic, one third cannot afford medical marijuana,” said Dr. Mechtler.

That being said, DENT is working diligently to present evidence that proves to insurance companies medical cannabis works and is worth covering.

“We are doing this by extensively documenting our patient’s experiences with medical cannabis including efficacy, side effects and complications,” said Mechtler.

 

4. If you use medical cannabis will you fail a drug test for the company you work for?

Yes, most standard drug tests screen for THC and CBD, both of which you will test positive for if you use medical cannabis.

 

5. Can cannabis be used for chronic migraine?

Yes, medical cannabis can be used to treat chronic migraine.

“Chronic Migraine is defined as more than 15 headaches per month, of which 8 of those headaches have to be disabling migraines that last more than 4 hours a day,” said Dr. Mechtler.

“In 263 patients suffering from chronic migraine, of those treated with medical cannabis, 88.9 percent showed significant improvement,” said Mechtler.

 

6. What is the difference between CBD and THC?

A Cannabinoid plant has 3 major components, primarily made up of cannabinoids, flavonoids, and terpenes, it is also composed of THC and CBD.

THC is the part of the cannabinoid plant that has a psychoactive effect on the brain. This means that the THC affects CB1 receptors in the brain, giving people the feeling of being ‘high, and may produce side effects like anxiety and paranoia. However, THC also has positive medical effects and works well for nausea, anorexia, and pain management. 

CBD has no psychoactive effects and me “CBD is used more for treating the body, whereas THC is more for the mind,” said Dr. Mechtler.

Both have medical properties, however it has been found that depending on the patient, some patients need more THC while others may  need more CBD. Some patients may even require a combination of the two, known as the entourage effect. 

 

7. Is medical cannabis a good alternative to opiates?

Yes! Medical Marijuana is a great alternative to prescription pain medication because of its non-addictive properties. It has the potential to alleviate patients’ pain to the point that allows them to significantly reduce or discontinue their opiate medications.

 

The content of this post is intended for general educational and informational purposes only; it does not constitute medical advice. Readers should always consult with a licensed healthcare professional for diagnosis and treatment.