ASA in the News

Matlin Smith, Las Cruces Sun-News

He got a severe knee injury in 2000. Soon after, there were three knee surgeries and many doses of high-strength pain medication. This Las Cruces man, a former school teacher for 15 years who asked to remain anonymous, needed a better way to manage his pain that didn't rely on strong opiate painkillers, he said. So he became one of the first registered users of medical marijuana in New Mexico through the state Department of Health's New Mexico Medical Cannabis Program.

"I educated myself," he said of the program.

His wife is a certified caregiver through the program and he said he's now able to function with help from the medical cannabis he takes as a tincture - an extract taken with something similar to an eye dropper.

Types of cannabis and methods of use

There are several species of cannabis, a genus of flowering plant, said Dr. Hilda Chavez, a naturopath with Tesoro Health Center who has 35 years of experience practicing in natural medicine like herbs, massage, exercise and meditation. She is a NM Medical Cannabis Patient Consultant.

The species are:

Cannabis sativa: A strain found in Mexico and Central South America. The sativa plant is tall with narrow ,serrated leaves. It has THC - the psychoactive-inducing part of the plant - and the effects are primarily on the mind and emotions.

Cannabis indica: A strain found in Asia and India and grown in the US. The plant is short and stocky. Indica's effects are primarily physical and some emotional, including relaxation, sedation and pain reduction.

Cannabis ruderalis: This strain is also called hemp and has no THC.

Cannabis hybrid strains: The result in cross pollination of various strains. The effects are often stronger than the original strain.

Cannabinoids are the medicinal component of the cannabis, or marijuana, with THC being the most notorious because it "makes people high," Chavez said.

The main health-related cannabinoids, or CBs, are good for epilepsy, anxiety and insomnia among other conditions.

To qualify for the Medical Cannabis Program, patients must meet one of 17 conditions, among them are cancer, glaucoma, multiple sclerosis, Post Traumatic Stress disorder and HIV/AIDS.

The program was created under the Lynn and Erin Compassionate Use Act, which, according to the New Mexico Department of Health, allows the beneficial use of medical cannabis in a regulated system for alleviating symptoms caused by debilitating medical conditions and their medical treatments.

"Cannabis is an ancient herb and in many cultures, they drank it, ate it and applied it topically," said Chavez.

Today, there are many different ways for medicinal marijuana patients to reap the benefits of the cannabinoids outside of smoking the plant, which, Chavez said, is the most expensive option.

There are tinctures and extracts to help control the dose by a couple of drops under the tongue. Topical applications ease achy joints and muscles without the mental affects. And drinking it in juice or tea, or taking cannabis capsules, can serve as a painkiller and is better on the liver, as is making cannabis butter to put in baked goods for consumption.

"There is real value in education in the different delivery methods," Chavez said. "(Most patients) want quality of life and to be able to function and they don't want to be high."

Chavez, a practitioner, and medical cannabis patient since 2007, sees around 10 patients a day who have been referred by general practitioners, oncologists, psychiatrists and other medical professionals to be screened for, and educated about, the program. "The majority of patients I see are legitimate adults not interested in recreational use. I make sure the patient understands what they're getting into. They can't just go home and smoke pot. Their card has to be renewed every year, so we have to see improvement," Chavez said.

There are currently 22 states that have medical cannabis programs enacted.

There are a total of 23 licensed nonprofit cannabis producers in New Mexico, said Vivian Moore, a representative of the only licensed nonprofit producer in Doña Ana County. There are about 10,000 patients statewide, with 600 locally.

Moore said 50 percent of those in Doña Ana county have a personal production license - which is provided as part of the program certification - allowing them to grow their own plants.

Through the program, Moore said, the state protects doctors and medical professional who participate from any retribution. All patient and physician information is confidential.

"Doctors draw the line at certifying patients for fear of repercussions," Chavez said. "It's not that many doctors don't want to help their patients - they do - but their hands are tied."

Chavez, being a naturopath, said it's natural for her to help patients whose ailments are helped with cannabis. Through the process, she said more doctors and patients become educated and are able to get into the program, having safe access to getting well.

According to the NMDOH, marijuana is classified by the federal government as a "Schedule I controlled substance," which means it cannot, by law, be prescribed by any health care professional. New Mexico law, however, allows doctors to recommend medical cannabis for patients, who are then referred to the cannabis program. Once patients go through the process to get their medical card, they may possess six ounces of marijuana at any given time.

Running the risk

As with every medicine, there are side effects to medicinal marijuana.

Some of the short-term side effects include like dizziness, drowsiness and short-term memory loss, according to WebMD. More serious side effects include severe anxiety and psychosis, stemming predominately from the plant's THC level.

THC - the factor that makes the plant illegal for recreation use - can also cause rapid heart rate, increased blood pressure, rapid breathing, red eyes, dry mouth, increased appetite and slow reaction time.

These effects are reduced after three or four hours, WebMD says, but marijuana can remain in your system for as long a month after use. Lingering affects can mean impairment for several days or weeks.

Medical marijuana is also not monitored like Federal Drug Administration-approved medicines, according to WebMD.

According to the National Institute on Drug Abuse, heavy marijuana use can lower men's testosterone levels and sperm count and quality. It could also decrease libido and fertility in some men who are heavy users.

Cannabis, kids and pets

Even for legitimate medicinal marijuana users, the substance can still pose a risk to pets and children who may get a hold of it by accident.

A recent veterinary study in Colorado and data gathered by Pet Poison Helpline indicate that marijuana poisoning in pets is on the rise, especially following the legalization of marijuana in New Mexico's neighbor to the north.

According to the Pet Poison Helpline's data, while it's rare, pets can die form marijuana poisoning if they inhale smoke, ingest the dried plant or eat food laced with marijuana.

Signs of marijuana poisoning in dogs and cats include glassy-eyes, stumbling, dilated pupils, vomiting and even coma, according to the helpline.

Treatment for this poisoning includes IV fluids, anti-vomiting medication, oxygen, blood-pressure monitoring, and in severe cases, ventilator/respirator support.

Children are also susceptible to dangerous encounters with medical marijuana.

Americans for Safe Access - an organization that seeks to ensure safe and legal access to cannabis for therapeutic uses and research - recommends keeping all medical marijuana out of plain sight, like in a medical jar with other medications, stored in an area children cannot access. For patients who cook with medicinal cannabis, ASA recommends clearly labeling any food products containing the substance as medicinal, and keeping them far away from any children's food.

"Use discretion when medicating, and do not do so when your child is present," reads a statement on the ASA website. "Specifically, think about medicating when you have several hours open before any interaction with the child or after (they're) already in bed."

The group also encourages parents to talk to older children, explaining the purpose of medicinal marijuana, its private nature and that, like any other prescription medication, it's not for your child.

For more information about the New Mexico Medical Cannabis Program, visit nmhealth.org/mcp.

Matlin Smith may be reached at 575-541-5468.

A closer look

The qualifying conditions eligible for the Medical Cannabis Program:

Cancer
Glaucoma
Multiple sclerosis
Epilepsy
Spinal cord damage with intractable spasticity
HIV/AIDS
Painful peripheral neuropathy
Intractable nausea/vomiting
Severe anorexia/cachexia
Hepatitis C infection currently receiving antiviral treatment
Crohn's disease
Post-Traumatic Stress Disorder
Amyotrophic Lateral Sclerosis
Severe chronic pain
Hospice care
Inflammatory autoimmune-mediated arthritis
Cervical dystonia
- NM Department of Health

Guidelines for safe use of medical cannabis:

Respect the law.
Use common sense.
Do not drive or operate heavy machinery under the influence of cannabis.
Do not mix cannabis with alcohol, as it may cause dizziness, vomiting and nausea.
Do not smoke cannabis if you have lung disease or respiratory illness.
Do not share joints or other smoking tools with others.
Do not cross state lines in possession of cannabis, as it is a federal offense.
Do choose organic cannabis to minimize exposure to unknown pesticides and other chemicals that may compromise your immune system.

- Dr. Hilda Chavez, Tesoro Health Center