Cannabis cards in Utah: a complex and broken system

by AMIE SCHAEFFER

The following is the third article in a series. Read the other articles here and here.

As I continue to weigh the pros and cons of acquiring a medical cannabis card to treat my multiple sclerosis symptoms, I spoke with a patient who has navigated the system. 

Utah resident and medical cannabis user Jamie —who preferred not to give her last name—obtained her medical cannabis card with the Utah Therapeutic Health Center’s guidance. Her experience in getting approved for the card was a good one. 

“They were extremely knowledgeable, friendly, and helpful,” stated Jamie. 

Jamie started medicating with cannabis due to chronic lower back issues, spasms, and sciatica pain and noted it also helped reduce anxiety and acted as a sleep aid. The more significant problem, according to Jamie, is accessibility to quality medicine within the state.

“Getting the desired products that cater to the benefits I seek can be unavailable a lot of the time,” explained Jamie.

This seems to be a common theme: a lack of quality, accessible products within the state. Although Health Department issued 14 dispensary licenses, only eight of those are up and operational. With new laws restricting products to being purchased only within the state, patients are served a double whammy. To add insult to injury, a state-wide shortage of crops is also hitting consumers hard.

“I’d like to add that I’ve worked at one of the grow operations, and I was disappointed as to what was available as options for edible applications in the program,” said Jamie. “There should be other options for patients.”

Mignon Walker, MD, has been a qualified medical provider (QMP) since last fall and acknowledged that the Utah Medical Cannabis System has kinks. 

“The process is notoriously difficult to navigate [for patients] without some help… I do help them understand where to go and how to navigate the state’s website in addition to the instructions I have posted on my website,” stated Walker. “Only the most determined are likely to complete it, especially if they don’t have help.”

Like Jamie, Walker sees a lot of benefits for patients using cannabis. “In addition to reporting amazing pain relief, patients also report getting better sleep, feeling less stressed, and even improved relations with their partners. I always recommend using cannabis in a very reverent way; after all, this is a plant that has been used for thousands of years.”

Finding a QMP who is actively taking patients can be another hurdle. According to the Utah Department of Health, a QMP cannot recommend medical cannabis to more than 175 patients at any given time. There are over 23,000 cardholders in the state, and that number is expected to grow. Many doctors in the state choose not to become a QMP because cannabis is still listed as a schedule 1 substance and is illegal on the federal level. 

“[Doctors] find it difficult to see past this unfortunate social stigma, preferring to treat patients with FDA-approved medications, including opioids and benzodiazepines or invasive procedures, but even then, they often aren’t able to adequately alleviate chronic pain, anxiety, etc. Some also worry about lack of standardized dosing and “control” over how much a patient takes,” said Walker. 

Dr. Talbott, a pain specialist, based in Park City, chose not to become a QMP, although he did write medical recommendation letters before the new laws came into play. 

“It is a tricky situation because of the risks for physicians, and this risk is created by the federal government. When a physician actively enrolls their patient in the program, they are crossing a line drawn by the federal government, specifically the DEA,” Talbott stated.

Talbott was frustrated at the restrictions put on the patient/doctor relationship. “There should be no limits on how many patients a physician can treat. No other limits exist in this state limiting how a physician treats their patient. Limiting the way a physician treats their patient is unethical and potentially illegal.”

Walker understood that being treated by a new doctor can be intimidating. “Finding a new provider and bridging this socially awkward topic can be stressful for patients when their regular provider is not a QMP,” she explained. “The good news is, most QMPs are easy to talk to and don’t have a reflexive judgement that the patient is ‘just drug-seeking’ when the topic comes up. The QMP they find may not be as close or convenient as their regular doctor, but some practices, like mine, have found ways to reduce the stigma, keep appointments discrete, and provide education so that patients are likely to choose the products that are most likely to bring relief.”

What I have learned is this is a complex and broken system. What I would like to see as a patient is easier access to information on providers, products, and the system in general. MS (like many conditions) is an ever-morphing disease. My neurologist has treated me for 14 years, and I trust her completely. I am still not confident enough to decide on a medical cannabis card. Honestly, it is a frustrating position for a patient.