San Francisco Chronicle

The basics

EVERYTHING YOU NEED TO KNOW TO MAKE YOUR WAY TO THE RIGHT CANNABIS PRODUCT FOR YOUR CONDITION

- By David Downs

How patients go about getting legal marijuana

1 Indication

You need a health reason to get a doctor’s recommenda­tion to use medical marijuana. In practice, most people have a qualifying reason. The most common are chronic pain, insomnia, anxiety, inflammati­on, depression, cancer and seizure disorders. Thanks to Propositio­n 215, the Compassion­ate Use Act of 1996, the California Constituti­on states that qualifying conditions are “the treatment of cancer, anorexia, AIDS, chronic pain, spasticity, glaucoma, arthritis, migraine, or any other illness for which marijuana provides relief.”

2 Recommenda­tion

You can ask your primary care doctor for a recommenda­tion. It’s essentiall­y a doctor’s note saying that you could benefit from using cannabis. But more often than not, patients get a doctor’s recommenda­tion from a physician who specialize­s in writing medical cannabis recommenda­tions. Most cannabis recommenda­tion practices do not require an appointmen­t and do not require you to bring in your medical records or proof of insurance. (Insurance generally does not cover a recommenda­tion.)

When asking for a recommenda­tion, be honest. The doctor will ask if you’ve already used cannabis and if it has helped in the past. Doctors are required to perform a good-faith exam before writing a recommenda­tion. That can cost $40 to $100, and recommenda­tions usually expire in a year.

Talk to a doctor before using cannabis if you have a personal or family history of mental illness, heart disease, high blood pressure, angina or irregular heartbeat, chronic obstructiv­e pulmonary disease or an immune disorder, or if you are pregnant or breast-feeding.

Also talk with your doctor about potential drug interactio­ns, as cannabis can increase or decrease the effects of certain drugs, most commonly opiates, alcohol and benzodiaze­pines.

3 Acquisitio­n

Now that you have a doctor’s note for cannabis, you can legally acquire it. Most folks go to a medical cannabis store, called a dispensary, or use a delivery service. Fewer folks join a private collective to obtain cannabis, or grow their own. Cannabis patients have a defense in court for possessing as much as is medically necessary. State guidelines suggest possessing less than 8 ounces or six mature cannabis plants. Thanks to Propositio­n 64, which legalized recreation­al use, you don’t even need a doctor’s note to legally possess up to an ounce of flowers and 8 grams of cannabis extract, or grow up to six plants.

4 Administra­tion

Like any drug, medical cannabis is not a silver bullet. It doesn’t work for every person and every condition. It requires some trial and error to find the right type of product and how much to take. And it can have side effects. Doctors say a beginner’s dose might be as little as 2 milligrams of THC — the main active ingredient in cannabis.

Discuss what’s right with your recommendi­ng physician and adjust based on medical effects. No two people are the same, and two people with the same condition might take different cannabis products. Each mode of medical cannabis has pros and cons.

The most common side effects of cannabis include dizziness, dry mouth, increased appetite, temporary memory impairment and, in some cases, anxiety — plus rapid heartbeat, red eyes and coughing from inhaled cannabis. Less common side effects from using too much cannabis can include nausea and dysphoria.

Unlike most other drugs, including alcohol, there is no lethal overdose level for cannabis. Patient support groups, health consultant­s and dispensary staff can be helpful in finding the right formula and dose for you.

 ?? Illustrati­ons by John Blanchard / The Chronicle ??
Illustrati­ons by John Blanchard / The Chronicle
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