It’s been nearly three decades since California pioneered the therapeutic use of cannabis, but patients using medical marijuana still face a confusing patchwork of rules.
Before Jayden Carter turned 9, police were called 126 times to his school, home and other locations to address his violent behavior.The situation got so dire that Child Protective Services encouraged Amie to sign her rights to Jayden away, a step that would allow the state to put him in permanent treatment.
Jayden is one of Michigan’s 207 minors with medical marijuana cards. He’s been a cardholder since he was 9 years old, qualifying for nausea, migraines and eventually autism. Jayden was diagnosed with Asperger’s, ADHD and Oppositional Defiant Disorder when he was 2 years old. The disconnect between state and federal policies leads to all kinds of problems for patients. Medical marijuana is not covered by health insurance — leaving some patients with bills of over $1,000 per month. Only nine states and the District of Columbia recognize medical marijuana cards issued by other states, meaning patients must either refrain from travel, forgo relief for their symptoms, or risk arrest by taking marijuana with them across state lines. And just 10 states and D.C.
The federal government has taken minimal steps to protect or expand access to medical marijuana since California became the first state to legalize it nearly 25 years ago. In 2014, Congress approved an appropriations amendment that prohibits the Department of Justice from using federal funds to interfere in state-regulated medical marijuana markets. In 2018, it legalized CBD and other hemp products that contain 0.3 percent or less of THC.
“It seems like every time I go to school, teachers be waiting,” Jayden said. “Last year, I was getting accused of bringing weed stuff every day. I wasn’t, but they knew I had my card.”CPS came to the Carters’ home in October and concluded that Jayden and Amie were following the law — but the incidents with principals, doctors and CPS increased Jayden’s already heightened anxiety. In November, he withdrew from his public high school and enrolled in a part-time charter school.
Vicky Blake of San Francisco laughs in her senior living home during an interview. Blake has been a medical marijuana card holder since the 90s, when she was diagnosed with HIV. | Natalie Fertig/POLITICO In all that time, however, the blueprint for how states regulate and patients access medical marijuana has not changed very much. The FDA has approved two cannabis-based drugs such as Epidiolex, but the vast majority of medical marijuana programs function almost wholly outside of the traditional medical system: no prescriptions, no FDA regulation, no insurance coverage.
In 2018, the federal government legalized hemp, or cannabis with less than 0.3 percent THC. A broad swath of patients who relied on high-CBD/low- or no-THC cannabis products suddenly found their products federally legal. But five years later, CBD is still not regulated by the FDA, with no requirements on labeling, dosage, or testing. AAshley Morolla’s family drives nearly 20 hours from their home outside Flint, Mich. to a medical facility in Florida.
The Morollas are just one family improvising their own solution in the ever-widening gap between state and federal cannabis laws. Many medical professionals wish they were armed with better information and more comprehensive research. | Natalie Fertig/POLITICO, a fatal overdose from marijuana is highly unlikely — though people have died from doing something dangerous while under the influence of cannabis. But patients have had negative reactions after trying cannabis to treat symptoms of a disease they anecdotally heard it may help.
Arnsten says she screens for family or personal histories of mental health problems or heart disease before recommending cannabis — and recommends patients don’t choose smoking or vaping as their method of consumption. However, other doctors simply hand out a recommendation without a long discussion — and many patients try medical marijuana without ever consulting a doctor like Arnsten.
Patients who get their medical marijuana card through Montefiore Health System in the Bronx, meanwhile, don’t pay for the visit — which saves them about $200. “My therapy [is] shooting pool and shooting darts,” Amie explained, describing her escape from the daily stress of being a full-time caregiver. “I get to listen to loud music. I don’t need to think about anything going on. And all I need to focus on is making that shot.”
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