Somebody mixed my medicine, I don’t know what I’m on.
Somebody mixed my medicine, now baby it’s all gone.”
From “My Medicine,” by The Pretty Reckless
To dose or not to dose. That is the question I ponder.
I’m limping toward an office with a small sign reading, “Medical Marijuana Evaluation.” I never thought I’d see this surreal situation Ohio. I’ve no clue what to expect. I only know my medical records were electronically transferred; my greatest hits of CT and MRI scans. My brain, Jimmie, raises the obvious question: “Should we have checked the parking lot for narcs or DEA vehicles? Is this really legal?” The old paranoia that accompanies a drug buy rises in the back of my throat.
“Calm down,” I counsel myself, “it’s the law of the land for God’s sake, a states’ rights thing.”
I reach the door, open it and enter. I pause, blink, turn and walk back out. In the hall, I consult Jimmie again. “Was that real? What did we just see? Could this be an ill-timed flashback from a prior field trip to the frontal lobes?” We decide to walk back in. Sure enough, we saw it: All the office walls are covered with marijuana wallpaper. It’s like stepping through a portal to Southeast Asia or being an extra in a Jumanji film. It’s Martha Stewart meets Tommy Chong. I like the vibe.
On one leaf-covered wall, there is a television looping informational videos on conditions treatable with medical marijuana. Unlike the pharmacists who have glared at me like I just murdered their dogs, the staff here is relaxed and friendly. Huh. I fill out the paper work and sit back to enjoy the educational segment playing.
After ten minutes, I am called back. The physician I meet says my case is “easy” since my spine looks like a Middle-School science project. It turns out he is a friend of my spine surgeon who, every eight months or so, burns out six efferent spinal nerves to minimize how far the pain can travel. The procedures are unpleasant, but they decrease pain and increase mobility so I get them done. This physician has a memo from my pain doc I am “highly motivated” to find alternatives to opioid-based pain killers. This much is true. While they have helped manage my pain for years, they are getting to be a hassle. Because of the rampant abuse of opioids and related deaths from overdose, getting a prescription filled can be harder than convincing someone to donate a kidney.
The abuse problem is complex. One of the best books on the problem is Brian Alexander’s “Glass House: The 1% Economy and the Shattering of the All-American Town.” It follows the rise of the opioid epidemic in Lancaster, Ohio, where the main industry (Anchor-Hocking Glass) has been decimated through buy-outs and Wall Street style piracy. A few people got rich; the majority watched their livelihood and community fall apart. If we allow the destruction of an entire industry for short-term profit, we rob thousands of people of the meaning that comes from access to gainful employment. Alexander makes the point that when one’s life has been upended into poverty, opioids look pretty good compared to flipping burgers and living at the “Y.”
Aware of this context, I met the physician and he walked me through the basics of medical marijuana in Ohio. I thought “Around Kent” readers might find a summary of what I learned useful. Although I know cannabis is effective in relieving my type of pain, I am still thinking through what being a registered user would mean in Ohio. The first complicating variable is that, although the marijuana products I could access are legal for medical purposes in Ohio (and thirty-two other states) they are still federally illegal. That means that at the federal level, the drug is classified (or mis-classified in this case) as a Schedule I drug. Schedule I is for drugs with no currently accepted medical uses (accepted by lawmakers, not physicians). Since the Obama administration, the feds have not tried to shut down state-approved medical cannabis nor prosecute users.
In my mind that means they have not done so yet. It is disheartening that, despite the mountain of evidence that medical marijuana does have accepted medical uses, most of our illustrious leaders at the federal level (red and blue), remain mired in a 1937 prohibition mindset. Perhaps this is not surprising since the majority of our federal representatives hit puberty in 1937. The wind blowing through their mummified brains stimulates dust, long-ago memories of Reefer Madness and FDR fireside chats. But fear not, lawmakers have passed a law making it a federal crime to sell wine with a brand name including the word "zombie" (true story). Thank goodness they have not skirted the critical issues.
In Ohio, patients register with the State and possess an Ohio-issued patient or caregiver identification card. Readers can find all the information at https://www.ohiopainmanagement.com/. The law allows use of medical marijuana via oils, tinctures or extracts, plant material, edibles (food containing THC) and patches. Vaporization of medical marijuana also is permitted but smoking and other combustion of medical marijuana are not. Word on the street is that this latter prohibition against smoking is not strictly followed. In addition, employers can still include marijuana in “drug-free workplace” policies. Some patients who use medical marijuana can lose their jobs. Also, people fired for medical marijuana use are not eligible for unemployment compensation (because no drug user in our culture should ever have access to rights or due process). Further, because marijuana is still technically illegal at the federal level, medical marijuana users cannot own firearms. This reflects a general law that any illegal drug user be prohibited from purchasing/owning firearms. This last prohibition is a non-issue for me but having a job is pretty important.
Right now, there are about 75,000 medical marijuana patients in Ohio. 7% of these are veterans which says a lot because only 7.6% of U.S. citizens are veterans. The average age of the patients is 55 because, for most people, growing old hurts. What I have learned from research and field trials in states where marijuana is legal, is that my type of pain responds well to Cannabidiol or CBD. This is not the same CBD being sold over the counter at local grocers. It is held to state formulation and dosage standards so the buyer knows what is being bought. In tinctures that mix CBD with THC (tetrahydrocannabinol) the CBD cancels out the psychoactive properties of the THC. Some tinctures mix the two 1:1 while others, are more 15:1 and even 30:1.
My question remains: to dose or not to dose? My mistrust of government makes it a risky proposition. My history of pain makes it a tempting proposition. What would you do?
Elliott Ingersoll is a psychologist and licensed clinical counselor in Ohio. He is professor of Counseling in the CASAL Department at Cleveland State University. He has authored or co-authored four books and over thirty articles and book chapters on topics as diverse as integrating Integral theory into training mental health professionals, psychopharmacology, and spiritual approaches to counseling.
Dr. Ingersoll consults with Integral Institute (www.integralinstitute.org) as a trainer in the Integral Psychotherapy program and as co-director of the Integral Psychology Center. He has studied and practiced Eastern and Western spiritual and physical practices. He is a founding member of Integral ReSource Group, a private consulting firm offering psychotherapy, coaching, and corporate consulting.