Family of doctors helping to reinvent medical marijuana
The Knoxes are a clan of four doctors living in Oregon and California who specialize in medical marijuana. They seem to be doing quite well selling something that’s illegal in many states, working with those they know best.
“We’re all fighting the same fight,” said Janice Knox, the founding doctor behind American Cannabinoid Clinics in Portland, Ore. — and the mother of two fellow physicians and the wife of the other.
“I think when they do see us they’re surprised at who we are,” she said of her patients. The family aims for something not always associated with medical marijuana: professionalism.
Knox led the family’s move into medical marijuana in 2012, when she retired from a decadeslong career in anesthesiology.
After she stepped away from the job, she got a call from a “card mill” — a practice known more for writing prescriptions for medical marijuana quickly than for close attention to patients’ needs. One of the doctors couldn’t be found. Could she fill in?
Knox wasn’t sure. One of her colleagues, a marijuana enthusiast, had been sent to rehab. And despite going to college at the University of California at Berkeley, she was a square — had never seen or smelled marijuana “at a time when drugs were everywhere,” she said.
But she had always been interested in natural treatments, and she agreed to fill in — and was pleasantly surprised to see the patients weren’t a bunch of a reprobates.
Nor was Knox content to sign prescriptions and send patients on their way. Some had questions, as anyone would when told to take any drug. What strain was best? What about dosage? And was smoking pot better than a cannabis edible or a cannabis oil or a cannabis hand cream?
Knox didn’t know. “I was embarrassed because they expected me, a physician, to tell them how to use this medicine,” she said. “I couldn’t answer them. I did not know anything about cannabis.”
Undaunted, she delved into research of what’s called the “endocannabinoid system” — a network of receptors in the body and brain that respond to cannabis and regulate, among other things, immune response, liver function and the production of insulin.
Knox has read all the studies she could, attended conferences and been certified as a cannabis specialist. She learned, for example, the difference between THC, the cannabis compound, or cannabinoid, that gets people high, and CBD, a cannabinoid that offers therapeutic effects sans psychedelia.
Knox’s husband, David Knox, an emergency room physician for 38 years, kept his day job but also started working at the clinic. He knew nothing about the endocannabinoid system but quickly saw the potential of cannabis as a treatment for epilepsy, cancer-therapy side effects and pain.
Meanwhile, some other Knoxes were getting in on the game. Rachel Knox, 35, and Jessica Knox, 31, seem closer than many siblings. After leaving Portland, where they grew up, they lived together in Boston while Jessica finished her undergraduate degree at Harvard and Rachel did a post-baccalaureate program in preparation for medical school at Tufts. Then both entered Tufts medical school, graduating in 2012.
After they completed their residencies, Rachel Knox ended up back in Portland, while her sister moved to San Francisco. But telemedicine allowed Jessica Knox to work with her sister and her mom at the American Cannabinoid Clinics, where the family battles the card-mill mind-set. Instead of seeing as many patients as possible as quickly as possible — a model that led to “doctors becoming millionaires,” Rachel Knox said — the family would actually practice medicine with cannabis.
Every client is different. Some don’t want to get high or might have anxiety that doesn’t respond well to products high in THC. Those new to marijuana use might turn to edibles. But marijuana edibles are notoriously easy to overdo.
Veteran pot smokers, meanwhile, might wish to turn to vaporizing, which Jessica Knox said “is certainly cleaner, often less harsh, and definitely less stigmatic than smoking.”