State Medical Marijuana Law Creates Haze Of Ambiguity For Medical Community

Jacob Bell

New Member
GENESEE COUNTY, Michigan – Vicodin didn't cut it for Paul Hayes. Neither did Oxycontin.

The 39-year-old Grand Blanc resident said the pain medications he was prescribed after a serious car accident in October 2009 made him feel nauseous and left him anxious.

Hayes suffered a broken pelvis and ribs and a traumatic brain injury in the crash and now lives in a constant state of pain.

"It started to make me sick and I would throw up," he said of his pain medications.

At the suggestion of his family, Hayes turned to the Greenlight Wellness Medical Marijuana Certification Clinic in Burton.

Hayes said his family physician wouldn't have qualified him to receive a medical marijuana card from the state and his insurance wouldn't cover the cost of the doctor's visit.

"The pain is still there and it's nothing compared to what it used to be," said Hayes, who uses medical marijuana daily. "I don't get sick like I used to. ... It's definitely made it more pleasant."

Michigan voters approved medical marijuana through a ballot initiative in 2008. Although users must be certified by a doctor to receive a state medical marijuana card, the drug still is illegal under federal law.

It is not regulated by the U.S. Food and Drug Administration and doctors cannot write a prescription for it.

Crackdowns by health systems and insurance companies are driving people like Hayes to look for alternative ways – such as going to Greenlight – to receive their medical marijuana certification.

"In order to get a medical marijuana certification, you have to get a doctor who is not affiliated with a hospital and has set up their own clinic," Dr. Kumar Singh, who owns the Burton clinic and another in Troy, said of how some people receive certifications.

Getting certified

Marijuana's classification as an illegal drug by the federal government creates a conflict between state and federal law for health corporations, insurance companies and doctors in Michigan.

For the most part, doctors working for major health plans either are barred from approving people to receive the drug or can choose how they operate within their own, private office.

That is what created the need for medical marijuana clinics across the state, said Singh, who opened Greenlight about six months ago.

It is unclear how many medical marijuana clinics there are in the state and in Genesee County because they are not regulated, said Celeste Clarkson, manager of the compliance section for the Bureau of Health Professions within the Michigan Department of Licensing and Regulatory Affairs.

To qualify for a visit to Greenlight, Singh first conducts a phone screening. Once a person passes that screening, he or she is allowed to come to the clinic where Singh either will review a person's medical records or conduct an exam to determine if he or she qualifies to receive medical marijuana.

"If I feel that they could benefit from medical marijuana, then they will get their certification," said Singh, who had been working as an urgent care doctor in Cadillac before opening Greenlight.

It costs $99 a year to use the clinic.

More than 6,830 people in the state provided a Genesee County address on their medical marijuana registration, Clarkson said.

Each of the county's three major health organizations handle medical marijuana somewhat differently.

Doctors working at McLaren Regional Medical Center are prohibited from qualifying patients to receive the drug, hospital spokeswoman Laurie Prochazka wrote in an e-mail.

Physicians working in family practice clinics affiliated with McLaren also are barred from approving their patients, she wrote.

Hurley Medical Center doesn't have any knowledge of its staff physicians recommending medical marijuana to patients, hospital spokeswoman Ilene Cantor said.

At Genesys Regional Medical Center, "Genesys upholds the federal law by not allowing marijuana in any form on Genesys premises," according to a statement from hospital spokeswoman Cindy Ficorelli.

But it's unclear if Genesys doctors are prohibited from certifying their patients since the hospital statement said treatment protocol between doctors and patients is confidential under federal medical privacy laws.

Tracking which doctors have approved patients for medical marijuana within the county is too difficult, Clarkson said. Doctors are tracked by their medical license number and aren't categorized by location in the state, she added.

About 2,200 doctors across the state have approved patients for medical marijuana, Clarkson said.

Challenges arise

A package of bills working their way through the state legislature aim to clear up the haze around the medical marijuana law. They would give doctors a clear understanding of what they're allowed to do, said Rep. Phil Cavanagh, D-Redford Township, who is the sponsor of one bill.

Cavanagh's bill would ensure patients have an established relationship with the physician who approves the medical marijuana certification.

Doctors treating patients for illnesses such as cancer and HIV/AIDS would have to be the physician who certifies them for medical marijuana.

"I'm trying to find a happy medium," Cavanagh said. "I'm trying to find a definition of these laws and have something that will work in the future."

Dr. Steven Newman, president of the Michigan State Medical Society, said having an established relationship is beneficial for the patient and physician because it limits the possibility of drug interactions.

"There is no drug control of this," he said. "It's a lot like having somebody sell food goods from their house rather than through some regulated agency."

Hayes said when he started using medical marijuana, he informed everyone involved with his recovery. He didn't want to face any interactions or medical problems down the road.

He stopped taking all other pain killers and now grows his own medical marijuana at home.

Cavanagh's bill would circumvent voters' intentions to allow medical marijuana by shutting down medical marijuana clinics, Singh said. Patients would have no place to receive their certification since most doctors in mainstream hospitals, clinics and health organizations won't or cannot approve them.

"This new legislation that may be coming out is a surreptitious way to squash the whole medical marijuana act," he said. "It's going to be impossible for a patient to get certified."

For Hayes, who said his pain is a five to eight out of 10 every day, smoking medical marijuana has given him some semblance of his former life.

"I don't sit, eat Cap'n Crunch and watch cartoons," he said. "It takes away all my tension."

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