Now for the bad news. In a recent blog one of the Producers endorsed a patient suggestion that working patients, when faced with the possibility of being drug tested for cannabis use, ask their medical provider for a prescription for Marinol (dronabinol) a synthetic THC, to show the employer when their drug screen turns up positive for THC. Please DO NOT ATTEMPT THIS. Marinol is a controlled (Schedule III) substance and as such is tracked by the state Board of Pharmacy. If you are enrolled in the medical cannabis program there is no legitimate reason to prescribe marinol. Your provider risks losing his medical license or worse, criminal action for prescribing a controlled substance under false pretenses. The law passed to establish the Medical Cannabis Program does not address or attempt to regulate employer drug policies and will not protect patients from being dismissed from their job. The best way to handle this is to learn what the actual policy is from the HR dept. and to find out if being in the Program makes a difference.

I am personally willing to write a letter of support for my established patients so long as they agree to restrict their cannabis usage to non- working (and non- driving) hours. Employers are within their rights to insist that their employees be drug free while on the job.

Finally an FYI. There will be a Medical Marijuana panel discussion at Bookworks at 4022 Rio Grande Blvd NW Abq on Sat. Feb. 23 @ 3pm where I will be representing the medical providers. I have seen the proposed topics and it should be a very interesting and informative experience.

Hope to see you there.

This blog will be devoted to Post Traumatic Stress Disorder (PTSD) which is the only mental health condition accepted by New Mexico as a qualifying condition for the medical cannabis program. Patients with this qualifying condition comprise the largest single group
of medical cannabis patients.

PTSD has the special requirement that the diagnosis must be made by either a psychiatrist (MD) or psychiatric certified nurse practitioner. If it is made by any other type of practitioner such as a psychologist (PhD), social worker, counselor or even a medical doctor who is not a psychiatrist, the application will be immediately rejected. In fact, the application must be accompanied by either a medical record or a letter verifying the diagnosis of PTSD which has been signed by the psychiatrist (or the psychiatric certified nurse practitioner).

Sometimes the diagnosing practitioner will also sign the state form for certifying the patient for the medical cannabis program. More often they will not. This is not a problem, for as long as the documentation of the diagnosis accompanies the application, any medical practitioner certified to prescribe medications under the controlled substances act (narcotics) can sign the cannabis evaluation form.

We have received many phone calls from patients with PTSD who believe they were diagnosed with the condition by a psychiatrist when in fact they were not. If you do not have the medical documentation in your possession to check this, then please Google name of the practitioner and check his credentials.

As is true for the other qualifying conditions, the DOH requires that patients first try and fail standard medical therapies before applying for the cannabis program, There is no exception for PTSD, so you cannot be diagnosed and recommended by a practitioner at the same time, you have to try some therapies and give them a chance to work.

Medical cannabis is an excellent treatment for PTSD and has made a real difference in the quality of life for many people. Not only is it useful in treating the anxiety, depression, nightmares, intrusive memories, hypervigilence and social isolation which characterize the syndrome, it may actually work to blur the memory of the precipitating event..

The most common phone question we are asked is “how do I go about getting a New Mexico Medical Cannabis card?”  I answer this by asking what medical condition do you have that you wish qualify under; the process will vary with the condition. New Mexico has 16 medical conditions (listed in this site) a number of which have special requirements, such as PTSD and Chronic Pain.  Future blogs will deal with the specifics of each of these 16 conditions. Today I will discuss the aspects of the process which they have in common.

First and foremost all applicants must be residents of New Mexico at the time the application is made. A copy of a New Mexico drivers license or state issued ID card must accompany the application. You can set up an appointment with Albuquerque Integrative Medicine if you have been issued a temporary license but your application will not be accepted by the state without a copy of the permanent one.

In order to certify your application for the medical cannabis program I must be able to certify that

–the patient has a qualifying condition which is disabling
–the potential health benefits of medical cannabis likely outweigh the health risks for the patient
–the patient has current unrelieved symptoms which have failed other medical therapies

The third requirement is the one which is the most difficult to satisfy for most applicants. In New Mexico medical cannabis is considered by the state to be a treatment of last resort, which means that the patient must have tried the standard medical therapies before trying cannabis.

The Dept of Health requires documentation of the above in the form of medical records from a medical practitioner (doctor, nurse practitioner or physicians assistant) who is licensed to prescribe narcotic medications. The most useful medical record is a history and physical which describes the medical condition and its treatment history. All patients having non psychiatric illnesses have a right to their medical records. It will be necessary to sign a release form which must be submitted to the office of the treating practitioner. Records can released directly to the patient or to the consulting practitioner doing the medical cannabis evaluation. The office supplying the records has the right to charge the patient for reproducing the records, which can be expensive if the records are extensive. It is more economical to have them sent to us via fax or mail, as one practitioner will not charge another for this.

After the records are reviewed the evaluating practitioner must decide if they provide the necessary information. If so, then an appointment may be scheduled.if not additional records may be needed. Sometimes in clear cut cases the appointment can be arranged first and records can follow.

According to the guidelines set forth by the American Academy of Cannabinoid Medicine, a medical cannabis evaluation should consist of a medical records review, obtaining a medical history from the patient and performing a directed physical examination.  At Albuquerque Integrative Medicine we follow these guidelines and you can expect an initial visit to last 45 minutes in most cases. The overwhelming majority of patients seen in the office are recommended for the program and they are provided with a packet containing their completed application and supporting documents along with mailing instructions and contact information for the Dept. of Health. Please note that once the application is sent, the Medical Cannabis Program office will communicate directly with the patient.
The Program has 30 working days ( 6 weeks) to process the application. This will include a review by a medical doctor, and approval is at the sole discretion of the DOH. If approved the patient will receive an identification card and a list of medical cannabis producers. Patients not approved receive a letter outlining the problems with their application and what must be done to make it acceptable. Albuquerque Integrative Medicine has an approval rate of better than 99%.  We ask that patients contact us after receiving their card so that we can answer any questions they may have about the functional aspects of the program.

The meeting was attended by approximate 200 patients and it was great to see the outpouring of support from the members of the New Mexico Medical Cannabis Community. Testimony against the petition was provided by three psychiatrists, two state representatives and a state senator. Especially moving was the the testimony provided by the patients and relatives of patients with PTSD who related how medical cannabis has dramatically improved their lives and those of their loved ones.

Prior to the consideration of the PTSD petition, a representative of the Department of Health presented a report detailing the current status of the Medical Cannabis Program.  There are now over 8000 patients using medical cannabis in New Mexico. PTSD patients make up approximately 3,300 of that number and Severe Chronic Pain patients number approximately 2200. In response to a direct question from a board member, the DOH representative denied that there was any problem with the supply of Medical Cannabis in New Mexico, and that 3800 patients had their personal production licenses. This was met by considerable skepticism from the audience as may be expected from just about anyone connected with the Program. If you have had any problems obtaining medical cannabis I urge you to contact the DOH to inform them of this.

Dr. Rosenberg @ Albuquerque Integrative Medicine

I have just received a copy of an article from the Los Angeles Times about medical cannabis used to treat epilepsy in a young child. It can be found at http://www.latimes.com/news/local/la-me-customized-marijuana-20120914,0,7012444.story and speaks about CBD, Harborside Health Center in Oakland and their issues with the federal government, but mostly its a great story that once again demonstrates the healing power of this ancient herb. Check it out.

Finally, I want to remind everyone that the next meeting of the New Mexico Medical Cannabis Medical Advisory Board will be held on Wed. Nov. 7 at 1:00 in the auditorium in the Runnels Building at 1190 St, Francis Dr. in Santa Fe. If you haven’t already heard about it, there will be a petition presented by a psychiatrist to remove PTSD as a qualifying diagnosis. I doubt very much it will be approved but it should prove very interesting to watch. Hope you can make it to lend your support.

-Dr. Rosenberg @ Albuquerque Integrative Medicine