“I don’t know how you’ve been functioning.”
My new psychiatrist’s assessment may seem harsh when you read it, but to me her matter-of-fact words came as a massive relief.
Hearing, just over a year ago, that my Attention-deficit/hyperactivity disorder (ADHD) was a “10 out of 10” meant I could stop blaming myself for it. My therapist would later add anxiety and Post-traumatic stress disorder (PTSD) to my ADHD and dysthymia diagnoses. My coping mechanisms had gotten me farther than could typically be expected, apparently. Hearing this, I felt a touch of pride and less like a failure.
My response: “Not well… That’s why I’m here.”
I’d been waiting nearly 30 years for an accurate assessment that would explain why I almost constantly felt like I was coming apart at the seams. Thanks to the passage of the Affordable Care Act, removing many insurance coverage barriers to mental health care, and my recent move to California—the supposed medical marijuana capital of the country—finding some relief finally seemed to be within reach.
I didn’t anticipate it taking 15 months to get my hands on a product that could alleviate some of my symptoms while my doctors figured out a long-term treatment protocol.
I didn’t expect to get healthy, or even just functional, quickly. I had a realistic attitude about unravelling decades of misdiagnoses and missed diagnoses, and of how much such a long process can straight-up suck.
The barriers to obtaining pharmaceutical drugs when you need them can be significant. Doctors’ appointments require time off work and often sizable copays; prescription testing and juggling require time and money spent at the pharmacy; and the side effects (both temporary and ongoing) can require starting medications one at a time while enduring periods of feeling worse instead of better.
These factors make access to medical marijuana even more important.
At one of our early sessions, my therapist suggested that my ADHD and anxiety could both be mitigated by medical marijuana. As a psychologist, she can’t prescribe medications herself, but encouraged me to get my card—basically a certificate-sized annual prescription from a doctor.
With my therapist on board and three marijuana-indicated conditions—ADHD, dysthymia and insomnia—in my medical records, I figured, what doctor wouldn’t sign the form?
I got the answer at my annual exam a month later, when my new primary care physician wouldn’t even discuss medical marijuana with me.
I was irritated, but shrugged it off. Medical pot has been legal in California since 1996—and it’s not known as one of those states where pot is legal “but barely accessible.” Surely, finding another, cannabis-friendly doctor wouldn’t be hard.
I hadn’t considered there might be continued stigma within the established medical community. And I hadn’t counted on California having allowed individual counties to administer the program—or the council in my new home city of San Diego passing a slate of restrictions, resulting in a wave of dispensary closures.
I Googled, Yelped and WeedMapped for days, trying to figure out which listings were open and which of those were accepting new patients. I’d moved to Southern California unexpectedly, without a car, so I couldn’t just spend days driving around to see what information was current. Phone numbers were disconnected; emails went unanswered.
My hunt for an anxiety-reducing agent was causing huge spikes in my anxiety.
If medical marijuana is legal, why did it look increasingly like I’d have to know somebody to get it? My physical therapist worked for Scripps—a medical group with four hospitals and thousands of doctors in my area—and posited that perhaps some of my doctors’ refusals to even refer me to outside resources were related to their employers.
I looked at him blankly: “But it’s legal.”
He shook his head and said he wished he could help, but as a non-prescribing physician he wasn’t informed enough give me good advice.
I heard similar friendly apologies and stories like mine over and over—from new friends, from medical personnel, from random people on buses. Numerous people told me that they knew they qualified for a card, but that obtaining one was such a hassle, they just purchased their pot illegally.
Having smoked my share during the years I lived in Chicago before decriminalization, I didn’t begrudge anyone their purchasing avenues or reasons for having it around. But I was looking for a more regulated product, preferably one I could ingest with a vape pen, so my new roommate’s house wouldn’t smell like a dispensary and I didn’t have to live in a cloud of smoke.
The oils are more complicated to produce than just growing a plant and they’re more expensive to try at random—especially if you ignorantly buy pens that require filling cartridges yourself (as I did). But they’re cheaper in the long run and dispense a more consistent dose; both those aspects were crucial as I wanted marijuana that would help me be consistently functional, not occasionally high.
By the time summer rolled around, I’d researched and found a new primary care physician.
But an appointment that should simply have been about getting acquainted so that she could administer ongoing meds set off six weeks of terrifying anxiety, thanks to an incorrect scale registering dangerous weight-loss and my new doctor’s interest in rare disorders.
She saw the anxiety disorder in my chart. But because I was “tall and thin,” she suspected I might have Marfan Syndrome—a disease that affects 0.02% of the population—and sent me to heart specialists, for x-rays, and to the lab for a massive amount of blood-work.
I called her office less than a week later, after going through all these tests, and told the nurse I was unable to eat at all and could hardly work for my anxiety. Could we discuss marijuana as my therapist was now urging me to do?
The nurse said: “Dr. Less-Than-Helpful [not, obviously, her real name] cannot discuss medical marijuana.”
I repeated that I was so anxious I couldn’t eat, and that the doctor was so concerned about my weight loss—didn’t she have another doctor she could refer me to?
“Dr. Less-Than-Helpful cannot discuss medical marijuana.”
She must have said it six or seven times. I pleaded with her. But Dr. Less-Than-Helpful didn’t offer to call in something temporary like Ativan to my nearest pharmacy, or make an appointment to discuss alternative care, or call again to check on me.
How could a medical professional be so callous? Was she labeling me “drug-seeking,” or just bad at her job? And what was with the repeated auto-response from her nurse?
Finally, someone I’d gone on two or three dates with and had “420 friendly” in his bio was kind enough to help me out. While he was one of the people who found obtaining pot illegally to be less of a hassle, he said he would ask around to see who he knew with a legally obtained card.
The clinic he referred me to was great. It had taken almost a year to find it, but the doctor there was the first to validate my symptoms and guide me through which marijuana strains to seek out and which to avoid.
Despite having a waiting room full of people, he didn’t rush me at all. He was compassionate and empathetic; he even asked me if I had ever smoked before—and did I want help considering which delivery method would be most suitable?
The remaining challenge was finding a dispensary and the right product—issues exacerbated by my low income.
San Diego has a fair number of delivery services, but their sites largely cater to recreational use, and to people with extensive knowledge of strains as well as the gear needed to ingest it. Since I had previously just smoked whatever was around, courtesy of others, I felt like I was throwing darts at random as I intermittently scraped together enough cash to try the next thing.
At that point, a personal contact came to the rescue once again. When I unexpectedly heard from someone I’d previously dated, I remembered that he had a legal prescription, and that the product he had was exactly what I wanted.
This man was willing to drive me to his dispensary where, for just $70, I was set up with the battery and cartridge that would last months, even if I used it every day.
I may have cried in the car on the way home.
Full cannabis legalization is hitting California, thankfully. In November we will vote on the Adult Use of Marijuana Act, which is being touted as helpful for the drought and as a possible tax revenue windfall.
I’m hopeful that as more states eliminate the last remaining barriers to full access, it will become truly available for those of us who use it to treat ADHD, anxiety, PTSD and other conditions—and to mitigate the side effects of other necessary medications.
True legalization will also go a long way to breaking down the remaining barriers and stigmatization within the medical community—barriers that greatly exacerbated my difficulty in obtaining what has been life-changing treatment.