Caution: May Induce Euphoria.
I periodically meet John at the rehabilitation center where I receive occupational therapy for my arthritic fingers, and where he receives treatment for the stroke he suffered several years ago. The stroke left his right arm and leg paralyzed.
I’m 64 and John’s a little older. We joke about our disabilities; but when I mentioned that I take Celebrex, a cloud passed over his eyes. He said he’d taken it daily for 15 years. He’s convinced that Celebrex caused his stroke.
While Celebrex provides substantial relief from inflammation, I have no desire to suffer a stroke, so I take the drug only once a week. I have other physical problems I need to take into consideration as well. I have wicked allergies, and eight years ago my immune system collapsed. Bad things happened, including sudden hearing loss. In an effort to prevent further damage, I stopped smoking pot and drinking booze, and weaned myself off the pharmaceutical drugs I’d been prescribed. I started practicing Qi Gong meditation.
I started being careful about what I ingest. I don’t want to stress my system. But as I age and my arthritis worsens (I’ve had one finger joint replaced already), I need more relief – not just to type, so I can earn a living – but to accomplish simple tasks like tying my shoes. My primary care physician understands my dilemma, and when I said I wanted to try medical marijuana, he gladly sent my records to Dr. Jill Griffin in Northampton, Massachusetts.
Dr. Griffin opened her practice in January 2013, immediately after Massachusetts voters eliminated criminal and civil penalties for the use of medical marijuana. Her office is across from Cooley Dickenson Hospital, near Smith College. The community is liberal, intellectual and artsy, with many people living alternative lifestyles. As Police Chief Russell Sienkiewicz noted when we spoke, the occasional public smoking of pot in Northampton is nothing to get excited about.
Chief Sienkiewicz applies his discretionary powers in accordance with the values of the people he polices. But Puritanism dies hard, and prohibition persists. As I entered Dr. Griffin’s office, a sign warned me that patients are not allowed to bring marijuana into the building, and the receptionist gave me a handout explaining that while I was breaking no state laws by enrolling in the program, I would be “violating federal law and could be subject to prosecution.”
I hadn’t taken a puff and already I felt a little paranoid. But the waiting room was crowded, so I forged ahead. I scheduled an appointment in person (my hearing loss makes phone calls impossible) and saw Dr. Griffin several weeks later.
Dr. Griffin was dressed casually, but all business. She had reviewed my medical records carefully, and we discussed my situation for half an hour before she presented me with a physician’s certification for the humanitarian medical use of marijuana in Massachusetts. She suggested I mix an ointment high in Cannabidiol (CBD), the part of marijuana proven to have anti-inflammatory qualities, with the gel my rheumatologist prescribes, and rub the combo on my fingers several times a day. She also suggested I buy a vaporizer and take two puffs in the evening before bed, to help me sleep.
Alas, Dr. Griffin is not allowed to tell anyone where to buy pot, so I left her office certified to possess, but woefully unsupplied. I also needed paraphernalia, so I drove straight to Hempest, an outlet store in Northampton that sells clothing made of hemp and related items. I took it as a favorable sign that Ben, the young clerk, wore a medical marijuana t-shirt. Indeed, Ben is a patient of Dr. Griffin’s, and he’s writing a thesis on medical marijuana. He cheerfully helped me find a suitable “vape.”
Later that day I acquired some buds, went home, and took an exploratory puff.
It was “Déjà vu all over again,” as Yogi said. I felt spiritually enlarged and humbled. I remembered what fascinated me about my soggy back yard. I got the munchies and a burst of creative energy. I typed for hours without pain.
The pain, naturally, returned, and so I began my quest for an ointment high in CBD to rub on my screaming fingers.
In California, where five percent of the adult population has tried and benefited from medical marijuana, a patient in my predicament would simply go to a dispensary. But that’s not possible in Massachusetts. The law passed in 2012 requires the state to establish at least one dispensary in each county, but the Department of Public Health has found a reason to deny every applicant in my part of the state.
So I called a dispensary in Connecticut, and was summarily told they couldn’t serve me because I’m not a resident. With that rude awakening, I began to realize the range of obstacles medical marijuana patients face. Balms and salves are offered on the internet, yes, but so are phony dispensary licenses. One must be careful, and even Leafly.com (which provides updates about the cannabis legalization movement worldwide) recommends consulting with a physician to determine which strain is right for you.
So I returned to Dr. Griffin to interview her about her practice, and learn more about my options.
Doctor, Please
Dr. Griffin is an attractive, down-to-earth mom with short blond hair. She lives with her partner Kim. There’s a Bob Marley poster in her private office.
Dr. Griffin is also courageous and compassionate. She grew up in a rural community where the local doctor made house calls and kept his medicine in a tackle box. Inspired in part by his example, she became a doctor and initially practiced emergency room medicine in Alaska.
I asked her why she opened a medical marijuana practice.
“I’d moved to Northampton and was practicing life-style medicine,” she replied. “Diet, sleep, exercise, meditation. And I was making house calls on a bicycle, which is why I call my practice PedalMed. One woman I was visiting was too sick to go to the doctor. So her family got her pot, and she immediately became a different person. She had energy and appetite. She wanted to go shopping. Another patient was dying from melanoma. He wanted to die, and the marijuana helped him a lot. It improved his feelings. I thought, “How can something like that be bad?””
From a bureaucratic perspective, opening a medical marijuana practice wasn’t hard. Special schooling wasn’t required. As a licensed MD, Dr. Griffin only needed two credits of continuing education from the Massachusetts Medical Society. She now has 200 credits, acquired by attending conferences given by the American Academy of Cannabinoids, and by reading books. She’s an expert at what she does.
“Cannabinoid receptors have always been in the human body,” she explained. “There are CB1 receptors in the brain, and CB2 receptors in every cell of the body. They’re there because the body produces its own cannabinoids.” (For those interested in the science, she recommends Understanding Marijuana by Mitch Earleywine.)
Dr. Griffin compared the purpose of cannabinoids in our bodies to that of a dimmer switch. “It’s how we naturally maintain homeostasis. If we’re having anxiety, the neurons are over-firing. It’s the same thing with pain. Once a cell figures out it’s getting too many signals, it produces endocannabinoids.”
Scientists still don’t know exactly why CBDs reduce inflammation and pain. What is known is that the compounds work together to create an “entourage effect.” One cannot get from any single compound the same level of relief provided by smoking or otherwise ingesting the cannabis plant.
The esoteric qualities of marijuana’s healing properties are elusive, and Dr. Griffin carries the burden of prescribing a medicine that is subject to many popular misconceptions. The current law makes matters worse by preventing her from having working relationships with the people most knowledgeable about the strains – the “caregivers” (a person allowed by law to supply one medical marijuana patient) and dispensaries.
“The toughest part is the loneliness,” she said wearily. “I’m second-guessing myself all the time now.”
Dr. Griffin misses the benefits of working with colleagues. And her sense of isolation is worsened by the sad fact that hospitals in the area have instructed physicians not to write recommendations for cannabis for their patients. Some doctors informally send patients to Dr. Griffin, but they ask not to be named in the person’s medical record as a referring physician.
But, she said, the situation is improving. Early on, people would call and berate her. Now they call and say thanks, especially oncologists. Dr. Griffin compares her experience to that of gay people who were initially afraid to “come out,” but are now more willing, as society becomes more accepting.
The situation with local law enforcement is improving as well. “Initially there was a lot of confusion around the paperwork,” she explained. “My patients were being arrested and I spent a lot of time in court. But the cops are fine now,” she said. “The Department of Public Health sent a letter and now they all know. It’s evolving.”
Not many doctors dare to do what Dr. Griffin does, and when I asked what keeps her going, she immediately cited the “dramatic” results. “It’s overwhelmingly rewarding,” she said. “Marijuana treats so many conditions in general. It is especially effective for arthritis and diseases of aging. One can get off a dozen meds just by using medical marijuana.”
Access remains the biggest issue: the delay in opening dispensaries and the absurd provision in the law that allows a caregiver to provide for only one patient. “There are people out there good at growing. It’s organic with no contaminants,” she explained. “But it is hard getting this to people who need it.
“It takes years to put the infrastructure in place,” Dr. Griffin sighed.
The Marijuana Consultant
For information about access to medical marijuana, Dr. Griffin suggested I visit marijuana consultant Ezra Parzybok. A few days later I interviewed Ezra at his house, built in 1900, in the Riverside neighborhood in Northampton. I felt comfortable the moment I stepped inside.
Ezra is passionate about marijuana. He’s articulate too. He graduated from Rhode Island School of Design and received an MFA from Bard College. But, as he said, “You can’t reach diverse people when you take social justice to the art gallery.”
Seeking a more socially productive career, he taught art to teen mothers in Holyoke. He also worked at a hydroponics store where he met dozens of local growers. Ezra especially enjoyed helping medical marijuana patients. The process appealed to both the humanitarian and the sculptor in him.
His sense of having found his place intensified when he became one of Dr. Griffin’s patients. It is legal in Massachusetts for registered medical marijuana patients to cultivate a 60-day supply (estimated to be a cool ten ounces), until the long-awaited dispensaries kick in. Applying his artistry and scientific knowledge, Ezra does exactly that. He consults with growers, and offers instruction on the basics of growing organic medical marijuana. He has a website and he blogs.
“I come from an erudite place,” Ezra observed as he rubbed a soothing, homemade ointment high in CBD on my arthritic fingers. “I feel deeply that people with serious medical conditions deserve a knowledgeable consultant. I love the science and the fact that I can prevent some little old lady from getting turned off from what she researches on the internet. People need alternatives.”
Wanting to reach more patients, Ezra at one time sought to open a dispensary with a woman in the alternative medicine business. But the state requirements, packed in a 50-page document that could choke a horse, were insurmountable. The costs, which exceeded half a million dollars, included a lot of cash in the bank, an exorbitant application fee, and a security system that videotaped each plant’s progress from seed to sale. Dispensaries are also required to have a GPS delivery tracking system. All of which seems like a backhanded way of enforcing prohibition and limiting dispensaries to big corporations.
“It’s like making hardware stores illegal, and limiting each state to a handful of Home Depots,” Ezra said. “But luckily there are already hundreds of otherwise law-abiding growers. The system has been in place for fifty years, and we don’t need centralization.
“Business is exceeding expectations,” Ezra added optimistically. “I’m not a criminal. I’m an educator.” And the science is fascinating. “Modern medicine is becoming more aware of the mind-body connection and the raw data confirming marijuana’s efficacy,” he emphasized. “We’re beginning to understand how euphoria heals; how openness and connectedness help return us to a state of grace where pain is minimized. Science confirms this.”
Alas, science doesn’t matter to the creationists in Congress – which is why people need lawyers.
The Awkward Interval
For background on the evolution and status of medical marijuana law in Massachusetts, Dr. Griffin referred me to attorney Richard Evans. A marijuana activist for nearly 40 years, Evans is a fit 70 year-old who led me on a brisk, hour long walk through the forests and fields surrounding his home in rural Northampton. It was a beautiful autumn day. The sun was shining, and the swamp maples and shrubs were turning an array of gorgeous colors.
Evans has been working with the National Organization for Reform of Marijuana Laws (NORML) for decades. He’s proud of having been the force behind NORML’s adoption of the Principles of Responsible Cannabis Use. He takes a broad view of legalization, and in 1981 authored the first comprehensive marijuana regulation/taxation plan introduced as legislation in Massachusetts. Although his bill has gone nowhere in the Massachusetts legislature, it has served as a model for legislation in other states.
I asked Evans what had changed in the 30-plus years since his bill was first introduced, and without hesitation he credited the Drug Policy Foundation and massive funding from philanthropists like George Soros. “NORML focused on educating the public,” Evans said with a self-deprecating chuckle. “But people didn’t need to be educated, they needed an opportunity to enter a booth and cast a vote, without fear. By funding state initiatives, the DPF gave people the opportunity to express their views, without fear of being exposed as supporters of reform.”
The 2012 initiative changed Massachusetts law to protect debilitated patients, healthcare providers, and providers of medical marijuana from punishment and penalty. But hurdles still exist. “We’re in the Awkward Interval between prohibition and legalization,” Evans said as we stopped on a ridge and gazed at sparkling waters of the Mill River. “Until dispensaries are allowed to open, enforcement of the law depends on the “discretion” of individual police chiefs. The chief in Northampton is a progressive,” he notes, “but that doesn’t mean the chiefs in other towns won’t see the law differently.
“Cops aren’t the only people who are confused,” he added. “We regularly get calls from physicians and others struggling to understand what they must do, or not do, to gain the benefits of the law and protect their liberty – or their job, or their scholarship. Just yesterday I met with a cancer survivor, a medical marijuana patient whose graduate studies in nursing are jeopardized because the school is demanding a “clean” drug screen. The excuse offered by the school was that their federal funding would be put at risk if she were to matriculate. “
Dick Evans is not a criminal defense lawyer. He can only help people who want a license to open a dispensary or cultivate marijuana. And while Massachusetts voters have decriminalized possession of less than an ounce, possession and cultivation of marijuana still violate federal law. There’s nothing Evans can do if DEA agents decide to swoop down on dispensaries and small growers.
“Fear,” he says, “is the common denominator. Marijuana prohibition was conceived in fear, and sustained for seven decades by fear. When voters had the opportunity to express their views without fear, things started to change. When fear about marijuana, or being caught using it, is vanquished, then and only then will we know that our long struggle has succeeded.”
Transcendental Medication
As we shook hands and said goodbye, Evans invited me to an event to be held two days later at UMASS Amherst. By happy coincidence, the UMASS Libraries were archiving NORML’s papers for posterity. They were honoring NORML founder Keith Stroup, its current executive director Allen St. Pierre, and Lester Grinspoon, the legendary Harvard-based author of Marihuana Reconsidered (1971). Evans also invited me to a cook-out to be held afterwards at his cabin on the Connecticut River.
Nothing points one in the right direction like synchronicity, and where weed is involved, synchronicity abounds. Indeed, my marijuana consultant Ezra attended the UMASS event, as did Ben, the medical marijuana patient I met at Hempest.
Ben and Ezra immediately bonded, and the three of us sat together while Stroup and St. Pierre charted the history of the legalization movement, from the heady days of the 1970s, through the “dark era” initiated by Reagan and prolonged by every president since. They explained that the feds still embrace the “reefer madness” mindset of the DEA and its stepchild, the prison industry. And they warned that although arrests are down from 750,000 a year to 125,000, an entirely new set of problems has arisen, often related to interests that profit from prohibition.
Encouraged, nevertheless, by the progress made in recent years by individual states, about 40-50 of us retired to Evans’s campsite on the Connecticut River. Marijuana is a social drug, and it was inspirational being among veteran activists like Grinspoon, Stroup and Evans. It was fabulous fun, as well, being around the new champions of the cause: folks like Ezra, my politically and spiritually astute consultant, and Ben, who is tuned into the sacred traditions, and drawing strength from Dr. Griffin, whom he describes as a “saint.”
I especially enjoyed talking with Keith Stroup. A youthful 70, Stroup has long white hair he keeps brushing off his face. He said that social change depends on courageous individuals – that achieving social justice is a higher purpose that requires people willing to risk their personal liberty.
Stroup feels vindicated by the introduction of medical marijuana laws in so many states. But we haven’t reached the promise land yet. He smiled when I asked if he felt the younger generation would carry the fight forward. Yes, Baby Boomers are still leading the way, but, he assured me, young people aren’t strapped by the stigma and false assumptions we endured. He seemed to feel that everything was on track.
The irony, of course, is that marijuana helps point the way. And whether or not you indulge, our many and varied personal liberties are inseparable from everyone’s right to smoke pot.
As daylight faded, six of us sat in a semi-circle around the campfire. Keith was on my left. On his left sat Lester’s delightful wife of more than 60 years, Betsy. She commented on how beautiful the sunset looked, as a heavy autumn mist settled on the wide Connecticut River. Lester, age 86, was deep in conversation with Ezra, age 44, and Ben at 22.
Time slowed into silence at the river bend. All was right with the world: four generations of one mind, with nothing more to say, watching the sparks from the campfire fly into the night.