Dear Doctors: Even if you Disapprove, You Need to Educate Yourself

Dear Doctors,

I understand. Marijuana, for all that it has been legalized, is still a controversial topic when it comes to its uses in medicine. It wasn’t that long ago that medical professionals feared reprisal for prescribing it, either from government bodies, law enforcement, or insurance companies. Despite all the mounting evidence suggesting its benefit in treating various conditions and its relative safety, it’s hard to overcome the conditioning of several years that viewed it as an illicit substance.

Even if you disagree with the use of marijuana, however, it is important that you educate yourself about it from reliable sources, and not just about the negatives either.

Why?

Because regardless of how you feel about it, I guarantee that you have patients who either use it or are exposed to it regularly. Ignoring for the moment the problems surrounding making your disapproval obvious making it more difficult for your patients to discuss their health, use, symptoms of concern, and so on; not being educated about marijuana on a medical level puts your patients at risk. Continue reading “Dear Doctors: Even if you Disapprove, You Need to Educate Yourself”

Dear Doctors: Even if you Disapprove, You Need to Educate Yourself
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Open Letter to Prime Minister Trudeau and Premier Wynne: Legalize Patients

To the Right Honourable Prime Minister Justin Trudeau and to the Honourable Premier Kathleen Wynne:

My name is Ania Bula, I am a citizen of Canada living in Ottawa, and currently a recipient of Ontario Disability Support Payments (ODSP). I am also a registered medical marijuana patient.

I receive this prescription to help me manage the symptoms of moderate-severe Crohn’s disease. As a quick background: Crohn’s Disease is an autoimmune condition that affects my digestive system. Symptoms can take place anywhere from the mouth down to the anus. This condition causes my digestive system to become inflamed and swollen, which in turn causes it to be very delicate. During flares, the inflammation can be so bad that the lightest pressure causes the membranes to tear and ulcerate, causing blood loss. The inflammation can also cause blockages in my intestines that need to be operated, a loss of digestive ability leading to malnutrition, as well as causing severe pain, nausea, vomiting, and diarrhea. Needless to say, it is not a pleasant condition to have.

I have been treated for Crohn’s, in addition to other conditions, for close to a decade. The primary medication I receive is an immune suppressant by IV once every 6 weeks.

The prescription marijuana serves two purposes. The first is symptom management. Marijuana helps with pain and nausea control. Without it, many days are too painful for me to function appropriately. I cannot get out of bed, I cannot keep food down, I become malnourished and have to be admitted to hospital. Once there I am usually prescribe harsh steroids which, while helping minimize the flare, also causes damage to bones and joints already ravaged by this and other conditions.

Because I can take marijuana in ways other than through oral ingestion, it makes the pain treatment more effective. Frequently, the swelling in my intestines prevents more severe oral medications like dilaudid, Percocet, morphine, and others, not to work effectively. Moreover, the side effects of opiates can often mirror some of the same symptoms I am already dealing with like nausea.

I take small doses of marijuana throughout the day, which helps me get work done: either paid work like writing, or even just domestic chores like making dinner. For me, marijuana has been the thing that has helped the most when it comes to regaining some semblance of normalcy when it comes to quality of life. It has kept me out of the hospital on more than one occasion. It has helped me feel human again, when many of my conditions conspire to do the opposite.

In addition to symptom management however, marijuana also helps actually treat my condition. Studies have shown promising results when it comes to difficult cases such as mine. Many patients who have not responded to conventional therapies alone, have managed to go into remission when given the added treatment of marijuana.

Why am I telling you all this.

Recently, under the direction of Prime Minister Trudeau, the Canadian government has started the process towards legalization of cannabis. While this news makes me happy, there is a much more pressing issue facing patients that I believe could be addresses even before legalization can officially happen.

Medical Marijuana, ever since the new rules put forth by the Harper Government, is not covered by insurance. Not even that provided by ODSP.

The cost of marijuana is high. The standard dose of 1 gram per day can run you about $10 per day. For those of us with larger prescriptions, the associated cost is even higher. Often patients are forced to choose worse or less helpful strains in order to deal with the cost. My prescription can cost me up to $600 a month. As someone who lives on a fixed income from ODSP, that number is far beyond what I can reasonably afford. As a result I have had to go into debt to get my medication, borrow money from friends, ask strangers on the internet for monetary help, and sometimes make the decisions between groceries or my meds.

This is not a decision that should ever have to be faced by patients. Even if the mmj was only for symptom management, it would still be an essential part of my treatment. The increased stress surrounding the ability to get my medication also has negative side effects on my conditions itself, which are sensitive to anxiety and stress.

I am asking you to please help patients like me. To work to make our medicine a help and not an additional burden. Healthcare is, I believe, an integral Canadian value. We’ve built a national identity out of being the country that cares for its sick, and I am asking you to please continue that tradition. Help us get our meds covered. Help us not have to struggle to get treatment when already living on an extremely fixed income.

Sincerely,

Ania Bula

Writer of Young, Sick, and Invisible

Alyssaandania.com

Open Letter to Prime Minister Trudeau and Premier Wynne: Legalize Patients

Interview for Bi Any Means

I sat down with Trav Mamone of Bi Any Means to discuss my book, my new vlog, disability activism, atheism, and more. You should take a listen if you get the chance.

Listening through the podcast I realized that I accidentally used  an expression I’ve been trying to eliminate from my vocabulary because of it’s ableist implications. A good reminder that even people who care about these issues make mistakes and it is up to us to make amends when we do. To those who were hurt, I apologize and endeavor to do better in the future. Mea Culpa. I’m sorry.

Teal Haired Ania Cartoon blushing and looking apologetic
I’m sorry

As such please note: CN for use of Insane as a pejorative.

Listen to the Podcast Here

Interview for Bi Any Means

Medical Marijuana is an Accessibility Issue: An Open Letter to Mayor Jim Watson

Dear Mayor Jim Watson,

My name is Anna “Ania” Bula, and I am a medical marijuana patient. I use mmj to treat the symptoms of severe Crohn’s disease.

I was diagnosed in 2008, after having lost nearly 60 pounds in the space of 2 months. Crohn’s disease is an autoimmune disorder that affects the digestive system. It causes inflammation of parts of the digestive tract which results in tears and ulcers. Among its symptoms are severe and frequent pain, exhaustion, nausea and vomiting, and diarrhea. The inflammation can get so bad, that it causes blockages which can lead to bowel death that require surgery. At times it feels like my body is trying to digest itself. Imagine, being able to feel your own intestines, simply because they are so inflamed that the pain outlines them for you.

Since my diagnosis I have been hospitalized several times as a result. I’ve had countless medical procedures. The severity of my pain and frequency of my symptoms makes it difficult for me to work. On more than one occasion I have lost employment or positions at work because of interference from this disability.

I have had to miss classes, and my grades which were always very good, dropped because I was simply unable to maintain the energy required to go to class.

There is no cure for Crohn’s disease. I will have to live with this for the rest of my life and I am only 27 years old.

Continue reading “Medical Marijuana is an Accessibility Issue: An Open Letter to Mayor Jim Watson”

Medical Marijuana is an Accessibility Issue: An Open Letter to Mayor Jim Watson

They Called the Cops on Me

For the first time ever, I had the cops called on me.

Ever since I started smoking my medical marijuana, I have done my best to be a courteous neighbour. I check in with those across the hall and adjacent to me to make sure the smell doesn’t leach through, and let them know that if ever it does to please let me know. During winter, it is too cold to go outside, especially with my balcony door freezing shut.

With the weather improving dramatically this week however, I have started trying to go outside onto the balcony when I smoke.

This is the first time I have had the cops called on me.

I checked with my neighbours again, which leads me to believe that it wasn’t any of them. That leaves my upstairs neighbour. It’s not the first time I have suspected that when the wind blows just right, the smell sometimes wafts towards her window. I’ve heard it slam shut a time or two. The woman who lives there is someone I know. Someone who she has come to for advice before.

So it comes as a surprise to me that her first resort would be to call the cops, rather than talking to me or even sending me an anonymous message.

If she doesn’t know that I have a prescription, then she just tried to get me arrested.

The cops, when they arrived were pretty relaxed. They made it clear that they had no real quarrel with what I did in the privacy of my home, before I had the chance to tell them that this was prescribed medicine. Though apparently the fact that I have a prescription was noted from having spoken to officers previously.

It was relatively a low stress event. I was told to be careful, so that they wouldn’t get called out again, and was otherwise just left marvelling over the fact that my attempt to be responsible and nice by smoking outside backfired so spectacularly. I went through a variety of emotions: amusement over the irony of the situation, irritation over the completely lack of necessity of it all, and underneath it all, a vague sense of discomfort.

I didn’t know why I was uncomfortable. The cop had been nice. Ultimately, nothing really happened other than a few minutes spent at my door. I hadn’t broken any laws, and my skin colour and relative affluence made it a much less risky scenario. True, if Alyssa had been home, there would have been the added stress of potentially dealing with a cop’s bigotry. I was pretty much safe, so why did I feel so anxious.

Like a pin in your clothing that you can’t find, it scratched at me and made my irritation grow.

Then a friend messaged me, checking despite my protestations that I was fine. She told me that sometimes, people will get this feeling of anxiety or feeling unsafe because of an interaction with authority such as this.

It was only a few minutes before I realized that she was describing exactly what I felt. Someone used the police against me, and might again. They were trying to intimidate me. They had no way of knowing if their actions might get me arrested and they did it anyway. The cops might be called again, and the next one might be less friendly.

Now every time I have to take my meds, I have to wonder whether this time I will hear another knock on my door. My balcony was no longer a happy sanctuary where I could sit back and smoke a bowl while reading or drinking my tea. Now I had to worry about whether the wind was creating a wind tunnel that would get me in trouble again? I keep my door open so that I can feel the breeze while I work. Now, I have to worry about a wind change creating a vacuum.

The one place where I should be able to medicate in safety and comfort, is no longer inviolable. Every toke could mean another visit from the police. For doing something that I am legally allowed to do.

If she had only spoken to me, or even sent me an anonymous note.

They Called the Cops on Me

MMJ 101: But Doc, How Do I Take It?

Edit: This is a non comprehensive list. I will be working on a series of instructional videos to better demonstrate different methods.

One of the daunting aspects for new medical marijuana users is deciding how best to consume their new medication. I missed out on the learning experiences of youth weed experimentation, so I got to be that awkward adult asking the guy at the head shop to show her how a bong worked.

It was sitting in a park with my friend Rachael that I learned how to use a pipe. Foolishly, I thought you just lit the herb and inhaled right? We sat there in the park for a while, and I barely felt any of what we were smoking. Finally, Rachael looked at me sideways and asked “You’re blocking the holes while you inhale right!?” The resulting puff ended with me hacking out a lung and my friend rolling down the hill laughing at me.

In reality, patients are sent a bottle filled with dried buds of a pungent herb, and given no instructions on what to do with it. The Health Canada insert warns you to avoid smoking, but doesn’t give options. Someone new to marijuana is given no direction on how to proceed. For all that I was clueless in many ways, I am not alone:

 

Different methods have different benefits and disadvantages, but they seem to fall into two major categories: Inhaling and Ingesting. This may not be a comprehensive list. People who take marijuana are a creative bunch as I have come to learn.

Continue reading “MMJ 101: But Doc, How Do I Take It?”

MMJ 101: But Doc, How Do I Take It?

Marijuana Safer than Booze

Scientists confirm that marijuana, whether medical or recreational, is safer than both alcohol and tobacco. One of the considerations that went into this statement has to do with the lethal dose determinations.

When it comes to determining the danger of various drugs, there is a need to compare the lethal dose to the standard dose. How much do you need to get high, versus how much will kill you. One of the dangers of addiction with a chemical tolerance component, has to do with the fact that a higher tolerance means a higher consumption. In the case of drugs with a low ration of needed to get high to lethal dose, increased consumption can mean higher fatalities due to what people call overdose.

Continue reading “Marijuana Safer than Booze”

Marijuana Safer than Booze

MMJ 101: Are You Worried About Becoming Addicted?

Whenever I bring up the topic of medical marijuana, whether openly asking people to bring up myths and questions, or discussing it with someone who knows about my own use, the first topic to come up is invariably the one of addiction.  People are concerned about the addictive properties, and like anytime a patient takes treatment for pain, there are the inevitable questions about whether we are worried about becoming addicted.

I’ve addressed some aspects of addiction and addictive properties in the first MMJ 101 post. Most importantly I discussed the fact that no one pauses to consider the importance of ending pain. It is such an important point that it bears stressing again. Chronic pain has severe long term consequences, and causes long term changes to the body. Treating it is a high priority. To question whether we are sure we have to treat pain, is to underestimate its importance, and this is something that most people, unless they’ve experienced it themselves, can have a hard time comprehending. To them, it’s just pain.

To have an honest discussion of addiction, we must first understand what it is. The social perception of addiction is that it is a series of bad decisions that lead to a chemical dependency. Some views stop there and collapse addiction entirely into chemical dependency, often joking of being “addicted” to caffeine or sugar.  At some point one becomes physically dependant on the chemical, creating a driving need, and ultimately the addicted person has to make another choice, this time to give up their addiction and begin the long hard road to recovery.  This view often fails to distinguish between addiction and any craving or yearning for something that one enjoys, and thus regards addiction as an act of irresponsibility.  There are some variations on this perception, ranging between people believing that addiction is wholly the result of some internal flaw within a person, and others believing that it is entirely the result of a chemical dependency.  Neither view grasps the true nature of this phenomenon.

Continue reading “MMJ 101: Are You Worried About Becoming Addicted?”

MMJ 101: Are You Worried About Becoming Addicted?

MMJ 101: Barriers to Use

Among one of the concerns regarding medical marijuana are the potential barriers to the use of this medication. In places, medical marijuana is still not legal, but even in places where it is, like Canada, there are still challenges that present themselves. While my experience is limited to Canada, I find that a lot of the barriers that exist remain the same. If you have experiences you would like to share, please feel free to include them in the comments.

Knowledge – Patient’s

One of the first and biggest barriers to medical marijuana is a lack of information as to how to go about getting a prescription. It used to be that you had to fill out a large complicated set of forms to be submitted to Health Canada. The application would then be handled by some bureaucratic process at which point you would be approved or denied.

In March 2014 the rules changed. Now, instead of filling out a Health Canada form, you fill out a form directly with your choice of dispensary. The Health Canada website provides you with a list of licensed dispensaries, and most of them have their forms available online.

The forms include two parts: personal information, and doctor prescription.

The prescription form has to be filled out by a medical doctor, and includes dosage information as well as the doctor’s office information.

The forms are mailed to the dispensary, which confirms that the doctor who filled out the prescription is properly licensed, and you become a registered patient.

Knowledge – Doctor’s

While patients are uninformed, so too are doctors. When I was first looking for a prescription, I asked my GI for it. He said no. I was surprised since he actually seemed supportive of my occasional use.

Over the next few months, whenever marijuana came up with other doctors like those at the ER, they recommended that I get a prescription. I was torn, doctors seemed supportive of the idea, but yet I seemed unable to get a prescription. Finally, I decided to bring it up with my GI again and ask why he was unwilling to give me one.

It turned out that my doctor was under the impression that a condition had to be fatal in order to allow for the use of medical marijuana. Even though he thought that pot would be beneficial for me, he believed he wasn’t allowed to prescribe it for me.

Other doctors are unaware of the current available research. I had one ER doctor believe that marijuana was counter-indicated for Crohn’s even though Crohn’s is one of the few conditions that have had studies confirming the benefit of marijuana.

Patients are not the only people being fed misinformation about medical marijuana. Doctors are just as likely to have mistaken ideas about its use, its addictive properties, and so forth. The new rule changes make doctors the gatekeepers to prescriptions, but no efforts have been made to properly educate them. This leaves it up to patients to educate them or find a sympathetic doctor.

Even those patients who are more knowledgeable in the effects and use of marijuana may find it difficult to find a sympathetic doctor. It is counterintuitive to most patients to push their doctors for explanations. Since there is the fear of being labeled a drug seeker, patients might also worry about seeming over-eager about the acquisition of a prescription.

Continue reading “MMJ 101: Barriers to Use”

MMJ 101: Barriers to Use