inSIGHT medical marijuana
this issue of inSIGHT explores medical marijuana in San Diego, California.
inSIGHT April 2012 ISSUE 1 Medical Marijuana $6.55 inSIGHT Editorial Board Terry Eiler Darcy Holdorf Emine Ziyatdinova Patrick A. Trayor Bryan Thomas Anita Vizireaenu Madeline Gray Matt Adams Mitch Casey Joel Prince Priscilla Thomas Heather Haynes Junru Huang Becca Quint Cayce Clifford Jim McAuley Maddie McGarvey Patrick Oden Rebecca Miller Wayne Thomas Medical Marijuana April 2012 ISSUE 1 Page 4 7 13 17 The Doctors The Addicts RUDY REYES Editor's Letter While I was shooting this story Nicole Scott, the founder of the Legal Cannabis Institute, took me to a doctor's office where patients could get medical marijuana recommendations. It looked much like any other doctor's office: off-white walls, magazines cluttered on small tables that sat between every few chairs. The girl behind the desk, however, looked more like a hippie than a nurse, in her short skirt, short-sleeved shirt, her long brown hair parted down the middle. The movie "Reefer Madness" played on a flat-screen TV that hung from the ceiling. A closer look at the magazines revealed titles like "Kush," "Nug Magazine," and "The West Coast Leaf." The four patients waiting were blue collar looking guys probably in their mid-twenties to early thirties. I couldn't help but doubt their need for marijuana as any kind of medicine. Then one guy got up. He could hardly walk. Nicole, the gregarious entrepreneur, asked him what was wrong. Back pain. He was here to renew his recommendation. She suggested a tincture. Another guy chimed in, he had tried that tincture. He lifted his arm up. He couldn't do that before the medical marijuana. Both men said that they were still able to work because they used medical marijuana to cope with their pain. I realized that these guys really were in pain. They needed something. If it was not marijuana, it could be Vicodin or even Oxycontin. They would be waiting in another doctor's office seeking another drug. One with different side effects. One that might alter their quality of life. I felt bad for judging and jumping to conclusions. I hope that the stories in this magazine will help you explore medical marijuana from the standpoint of the patients and not the pundits. Samantha Alyn Goresh Photographer, Writer, Managing Editor The DEA inSIGHT 1 The Patient RUDY REYES Words and Pictures by Samantha Alyn Goresh R udy shakes hands, he hugs or pats strangers on the back like they are old friends. He gives advice. He campaigns. He is always campaigning. It's late Sunday afternoon, and Rudy is putting up signs, yellow, with black writing, "Elect Rudy Reyes for San Diego 2nd Dist East County Supervisor". Name recognition is necessary. Rudy stops at a gas station on a busy corner. He goes inside to ask the young attendant if he can put a sign up on the property and walks out of the gas station smiling. "That guy inside. He remembered me. I'd spoken at his school a few years ago. You see? People remember me. They remember my story." Rudy leaves his house, he sets an alarm every time he leaves because his apartment has been broken into twice. "It looked to me like that night, the earth was gonna open up and we're gonna fall to hell. It was just devastating." --Elena Lorta, Rudy's mother udy Reyes is in constant pain. His animated personality easily distracts people from the scars that cover his body. Even though the sun is setting, Rudy can only be out in it for short periods of time, his skin grafts will become dry and brittle, the pain exacerbated by the sun's heat. When he gets home he needs to medicate. Rudy sits down at the kitchen table in his small apartment and opens up a mason jar. The pungent scent of marijuana fills the air. Inside the jar is a stem with bright green clusters of dried, curled up leaves covered in tiny sparkling crystals. The marijuana has an organic, earthy smell to it. It is the Indica strain of the plant, "I suffer from constant nerve damage [my] body is constantly tingling and itching but Indica takes that away from my mind," Rudy explains, pointing to his temple for emphasis. Rudy takes one small cluster of leaves off of the stem. He has been out in the sun for a while so he decides to use his bong. The cannabis will get into his system faster than with his preferred vaporizer. He presses the R marijuana into the bowl at the end of four intricate water chambers. The water will cool the smoke before it gets to his lungs. As he inhales, the water bubbles, the clear glass bong fills with opaque, white smoke. He exhales smoke from his mouth. He coughs. The pain begins to disappear. Rudy's mother, Elena Lorta, recalls the night of the fires: October 26, 2003. They lived in the mountains in northern San Diego County and had seen wildfires in the past. She did not think she needed to worry when Rudy woke her up and told her that they had to leave because the fires were getting close to their homes. Elena recalls, "I'm heading out the door and I see just whirlwinds of fire. And then I see big cannon balls of fire shooting from across the way into my yard. It looked to me like that night, the earth was gonna open up and we're gonna fall to hell. It was just devastating." Rudy was able to get his family to safety but he sustained burns on almost 75 percent of his body. Due to the extent of his injuries the doctors inSIGHT 4 Rudy's burns were so extensive that the doctors wanted to amuptate Rudy's fingers, but he fought to be able to keep them at the University of California San Diego Burn Center kept him in an induced coma for two-and-a-half months. The pain would have been too much for his body to endure. When his doctors brought him out of the coma, Rudy remembers that they tried different combinations of drugs to help with the pain, but his body began to turn green. He was overdosing on the medicine he needed just to get by. Rudy was running out of options. In 1996 California voters passed Proposition 215, the Compassionate Use Act, which decriminalized medical marijuana. Less than a year before Rudy was injured in the fires, the California legislature passed Senate Bill 420 which clarified some aspects of Proposition 215. Rudy's doctors thought that medical marijuana might be a possible alternative therapy to treat his pain. Since marijuana is still illegal under federal law, his doctors could not directly prescribe it to him. They brought in an outside doctor to recommend the drug. Rudy describes himself as being, "one of those DARE type folks." Though he had tried marijuana before, he actively worked as a mentor to middle school students and drug use had never been a part of his life. Considering his situation, he felt he had no other choice. Rudy was eventually able to find a cousin who could bake marijuana into some cookies for him. According to Rudy, within two weeks of bringing the cannabis cookies into his treatment regimen, his doctor began to see a drop in his blood pressure. He also noticed that the tightness in Rudy's muscles was beginning to relax. Rudy has a hard time finding the exact words to explain how the medical marijuana differed from the pharmaceutical drugs. He recalls that once, while he was on morphine in the hospital, Rudy felt like the doctor could have cut his arm off and he would have been in such a stupor from the medication that he would not have even cared. While the morphine seemed to relax his whole body and mind to the point of not functioning, Rudy explains that the marijuana seemed instead to distract him from his pain, "like I was watching,`Gilligan's Island,' or something." He liked that the marijuana didn't make him feel as irritable as he did on painkillers. The marijuana helped him sleep. He slept without nightmares about the fire, which he believes has helped him cope with his Post Traumatic Stress Disorder. He says he is not addicted to marijuana and never wakes up in pain with the need to medicate in the middle of the night, as many patients who take traditional painkillers do when their medicine wears off. For the past eight years Rudy has been using medical marijuana to deal with the day-to-day pain of his burns, as well as the 50 surgeries he has had to endure since the fire. He believes that it has given him a quality of life that he would not have achieved had he used the pharmaceutical painkillers and antidepressants that doctors prescribe to burn survivors. Rudy sees medical marijuana as being hugely beneficial to his recovery. Since it is still federally illegal, doctors cannot prescribe marijuana. They can only inSIGHT 5 Rudy exhales after taking a hit from his bong. RUDY REYES continued recommend it to patients and many doctors are hesitant to even do that. Rudy hypothesizes about other reasons that doctors would not recommend medical marijuana to patients who might benefit from it. "That hospital, they lost a lot of money because I didn't walk out taking their pills and drugs and pharmaceuticals and antidepressants. You gotta stop and think about that. That's a big loss and if they do it for everyone coming out of there that ruins the business doesn't it?" Rudy credits his Native American heritage for his use of every part of the cannabis plant. He cooks the used marijuana from his vaporizer into brownies. Rudy likes to have, "edibles," a common term for medical marijuana when it is baked into foods, on hand if he needs to medicate but cannot smoke. He also uses the trimmings from the plant, which contain some THC (the active substance in marijuana). He puts the trimmings through a juicer to create a lotion for his dry skin. Rudy claims that the cannabis mixture prevents him from inSIGHT 6 The Doctors Dr. Bob Blake is quick to say that he is not like the other doctors. With his grey hair, wire-rimmed glasses and short-sleeved Hawaiian print shirt, his looks are far from surprising for a San Diego doctor who starts his morning with a swim and ends his day with a walk on the beach. "You're not going to find lines of 20-something guys going out my door," he bluntly states. "Some of those doctors will just sign the papers without asking any questions, but I take the time to talk to my patients, so I can only see a few each hour." This retired emergency room doctor now spends his days writing recommendations for medical marijuana. In 2001, a car accident left Dr. Blake's then wife severely injured. Dr. Blake feared that she might spend the rest of her life dependent on painkillers and suffering from their myriad side effects. A friend of his suggested she try medical marijuana and gave her a doctor's recommendation. Eleven years later she leads a normal life, and only uses medical marijuana sparingly to deal with her pain. "I came away from that with a very favorable impression of marijuana's medicinal abilities," said Dr. Blake. Many doctors who recommend medical marijuana will cite medical studies and definitively tell their patients that marijuana smoke does not cause lung cancer. Dr. Blake is more cautious. He informs his patients about the medical research, but he tells them that they are not 100 percent conclusive and that medical research is always changing. He recommends that his patients use a vaporizer. For patients that cannot smoke or use a vaporizer, he recommends edibles, although the medicinal effects of edibles will take longer than smoking. When Dr. Blake evaluates his patients he looks into their reasons for taking the drug. If a patient tells him of an anxiety attack, he pries for specifics. He wants to make sure that it was, in fact, an anxiety attack; not something more serious that might need treatment other than medical marijuana. Many people complain that there are not enough regulations on the doctors who recommend medical marijuana. They fear that doctors with lax ethical standards recommend the drug as a way to make easy money. Dr. Blake believes the regulations are in place, but rarely enforced. Another doctor who recommends medical marijuana, Dr. Fredericks*, explains that the state drafted its medical marijuana laws in a way that allows the doctors medical discretion because the marijuana is able to treat many maladies. In his years of recommending medical marijuana, he has seen many of his patients decrease, if not eliminate, their dependence on pain medications, as well as medications for depression, anxiety and bi-polar disorder. Fox News pundit, Bill O'Reilly, once accused medical marijuana doctors of being drug dealers, Dr. Fredericks says, "I am a drug dealer. That's what doctors do. We are in the business of supplying drugs." n *name changed for privacy inSIGHT 7 A "budtender," at a medical marijuana cooperative measures out a patient's perscription. Rudy puts up signs at highway exits for his campaign. He chose yellow because he did not want people to associate him with one political party. RUDY REYES continued enduring the open sores that severe burn patients with skin grafts have to deal with. After inhaling smoke from the wildfires, Rudy's lungs are more sensitive than most. He has learned that he cannot smoke a joint. It is too harsh. He coughs too much. He has slowly become accustomed to smoking from a bong with extra water filters. He coughs, but there are times when the immediate pain relief outweighs the temporary aggravation. Rudy cites studies that show that smoking marijuana might not be as harmful to people's lungs as many think, which is the opposite of the DEA's official position on marijuana. In the 1970s Dr. Donald Tashkin of UCLA's Division of Pulmonary & Critical Medicine, began exploring the effects of marijuana smoke on people's lungs. To the surprise of many, including Dr. Tashkin himself, his first study showed that smoking marijuana has only a small negative effect on people's lungs, and was significantly less harmful than smoking cigarettes. Other studies have since corroborated his findings. Tashkin and other researchers also have yet to find any direct correlation between marijuana smoking and lung cancer. Many medical marijuana activists, doctors and patients point to Dr. Tashkin's research as evidence that medical marijuana is safe to smoke. The DEA, however, has used other findings within Dr. Tashkin's studies to show that marijuana is in fact as harmful to the lungs as cigarette smoke. They emphasize the fact that though Dr. Tashkin's studies show no direct correlation to lung cancer, it does not mean that smoking marijuana is safe. Since marijuana is still a Schedule I Controlled Substance, it is hard for doctors to gain access to medically test it. The majority of research that the DEA cites in their stance on marijuana comes from countries such as New Zealand, France, and Brazil. The California Medical Association has recently began to petition the government to reschedule marijuana so that they can properly test its medical safety. Though the majority of the arguments for and against medical marijuana are "I've come to realize the roots of the problem are always political." --RudyReyes inSIGHT 9 Rudy chats with Congressional candidate Dick Eden (middle) at a training session for political candidates who seek the Labor Union's endorsement. RUDY REYES continued scientific Rudy believes that the political side is important as well. "I'm running for office because I've come to realize the roots of the problem are always political. Who's prosecuting medical marijuana now? The politicians." Rudy first ran for County Supervisor in 2008. "I try to give back. And for somebody that's been through as much as I have that's all we can do." With his visible injuries, Rudy feels a responsibility to be a spokesperson for people who benefit from medical marijuana. He is clear to distinguish between medical marijuana and overall legalization of the drug. He feels that medical marijuana needs more regulation and the only way he can make that happen is by holding political office. Rudy fears that there are too many doctors who will give recommendations to people who just use the drug recreationally. This can be detrimental to patients like himself who are truly in need. Rudy envisions a system in which doctors, caregivers (people who grow medical marijuana for patients who are unable to) and patients must take educational courses to understand the medical marijuana regulations. Such regulations would cut down on people getting recommendations who did not medically need them and the doctors who profit off of those people. If the local inSIGHT 10 The Addicts "I was pretty much perpetually stoned for six years," explains Ben. Ben is a marijuana addict. He has been sober for 20 days. He says he got, "okay," grades in school, has a decent job, but he wonders if he could have done more with his life if he had spent less time trying to get high. "When you're addicted to anything, you do all this selfish stuff. But you don't even notice because it's all about you. It's all about how you're feeling. It's all about, `okay i need to get on this level.' You steal weed from your friends, you just never think about other people's feelings." Ben never had a medical marijuana card. He says it was easy for him to get weed even without the card. Shayna* got a medical marijuana card because she loved getting high, but also because friends told her it might be an alternative treatment to the antidepressants she was on. She hates that she has a medical marijuana card. She once threw it away in desperation, but her dispensary had her card on file. She shudders as she remembers climbing into the dumpster behind her apartment complex to get the weed she had thrown away in an attempt to quit. She thinks she might be sober if she did not have that card, but she is also thankful that she did not have to deal with, dangerous or, "unhealthy," people on the streets to feed her addiction. Shayna cannot stay sober if she is near weed. If she hangs out with friends who smoke weed she will get high, and she can't stop once she starts. She gets high, and then she cannot sleep, so she drinks wine. The wine upsets her stomach, so she smokes more weed. She goes to work tired and as she drags through her day she swears that she will never smoke again. "And then at some point in the day, I'd switch. I'd be so stressed out. [I would think] I'm gonna go home and smoke a bowl." Many medical marijuana doctors will tell you that it is not addictive, that Ben and Shayna are not really addicted to marijuana. Dr. Rebecca Crean Ph.D. of The Scripps Research Institute Committee on the Neurobiology of Addictive Disorders explains that this addiction is real, "[As marijuana use] continues, it biologically crosses into dependance with chemical and structural changes in the brain." Lindsay Sides, a social worker at Lasting Recovery, an addiction treatment center, says that a majority of her patients are like Shayna. They get a medical marijuana card to treat their depression or anxiety, but the marijuana makes those symptoms worse for them. Sides watches her patients go through a marijuana withdrawal. "But after two-and-a-half weeks, it's like a fog lifts. They are back to their old self, they are able to start to focus and set goals." Though Ben struggles with his marijuana addiction he believes that some people can benefit from marijuana as a medicine, "I shouldn't smoke weed `cause I'm an addict. But lots of people have diabetes and if they eat too much sugar thats damaging to them. Should we make sugar illegal?" Dr. Crean also believes that marijuana can serve a purpose, and like any other medication, patients must weigh the pros and cons to treat their disease. n *name changeed for privacy inSIGHT 11 A medical marijuana patient tends to his plants. He has a small room in his house dedicated to growing his medicine. Though his cultivation is legal, he still fears that state or federal police might arrest him and seize his medicine. If he is tried at the state level he can use his medical need as a defense. The DEA Much of the medical marijuana story takes place in nondescript buildings. It is easy to walk by a dispensary and not even know it. The Balboa Medical Center was one of those buildings. The small, box-like building with curtains blocking any view of the inside, sits unmarked in the midst of strip malls and car lots on busy Balboa Avenue. On January 31, the California Cannabis Coalition posted to Facebook that the Drug Enforcement Agency (DEA) was raiding the Balboa Medical Center. They encouraged activists to go there to record, "this latest attack on sick people and safe access in San Diego." Jeanette Lowry was volunteering at the front desk when the Narcotics Task Force and the Drug Enforcement Agency entered the building. "The first thing they did when they came in was take the cameras out of the ceiling and cut off all the wires. I thought that was kind of sneaky considering we would have no footage of what went on there. If it's all legal then why [would they do that]?" Back in December of 2011, the California State Attorneys sent letters to the landlords of medical marijuana dispensaries warning them that their property would be seized if they did not evict their tenants. Amy Roderick of the DEA explained that the DEA was at the Balboa Medical Center because they were, "executing a federal warrant." She reiterated the DEA stance that marijuana is a Schedule I Controlled Substance and is illegal under federal law. Some people feel that the Obama administration has been harder on medical marijuana than under the recent Bush administration. Professor of Law, Alex Kreit offers another explanation, "Under Obama there was this impression that [if] you are truly trying to comply with your state's medical marijuana laws you are going to have some kind of protection from federal prosecution. I think a number of people relied on that and have been put in terrible situations. Under Bush at least you knew the risk you were taking." He goes on to explain that currently people who are on trial for medical marijuana in federal courts cannot use compliance with state law as a defense. Due to this catch-22, it is unknown if the DEA is in fact targeting people in violation of state law. Kreit also points out that each county in California interprets the law differently. San Diego prosecutors have a more stringent view of medical marijuana dispensaries and cooperatives than prosecutors in the rest of the state. Kreit explains, "In Oakland they have a very smoothly running system, a handful of dispensaries that are well-regulated and there's no complaints, there's no problem. But in a place like San Diego when you try and regulate after there are places in existence, those places have a vested interest in trying to stay open and it makes it ten times harder to get anything done" n inSIGHT 14 Rudy usually uses a vaporizer which bakes the marijuana until the THC turns into a vapor that he can inhale through a tube. RUDY REYES continued government sponsors these courses they could also serve as revenue for the city. In 2009, San Diego's City Council formed a Marijuana Task Force, or as Rudy bluntly calls it: the "Task Farce." The task force's job was to bring recommendations to the City Council for how the city of San Diego could regulate medical marijuana within California's state law. They approached law professor Alex Kreit to head the task force. Since much of his research has been in drug policy and law, they figured he would bring an unbiased legal view to the team. "I think going into it there was a lot of skepticism on the part of folks in city council [and others] about whether the task force was going to be able to come up with recommendations that would be reasonable," explains Kreit. Kreit views the task force as a success in that it brought together people from different backgrounds with diverse perspectives on marijuana policy. They were able to set aside their differences and write policy recommendations based on existing California law. While the task force was making their recommendations, San Diego's City Council was changing. During the elections, voters were focused more on city pensions than medical marijuana issues. By the time the task force brought their recommendations to the City Council, there were fewer members who supported medical marijuana. They took many of the suggestions that the task force created, but they added stricter zoning regulations for where people could legally open dispensaries. "The zoning meant that there were very few places in the city where medical marijuana dispensaries could operate. inSIGHT 15 The nerve damage Rudy suffered from the fire left him with little feeling in his hands. The green glow in Rudy's sink is from an attachment on the faucet that lets him know when the water is at a safe temperature. inSIGHT 16 inSIGHT 17 Rudy embraces his girlfriend Christina. He feels, "so blessesed," to have her in his life. RUDY REYES continued Places where, really, it wouldn't be serving the people who had the most legitimate medical need," Kreit explains. He points out that the main reason the provision in state law for cooperatives and dispensaries even exists is because some patients are too ill to grow their own medicine. Rudy and other activists felt that the ordinances were too restrictive, so they gathered thousands of signatures, which ultimately forced the city council to rescind the ordinance. Kreit sums up, "So as a result, it's still a completely unregulated system we have in San Diego. It's not good for patients. It's not good for the community." Though medical marijuana has improved Rudy's quality of life, he is still unable to work and collects disability. Before the fires he had been pursuing certificates in archaeology, which he did eventually finish. He spends his days keeping abreast of what is happening in the archaeology world. He uses his research skills to examine local policies that involve his prospective job as County Supervisor. He goes to City Council meetings. He questions the city's potential plans to put a power plant on the outskirts of his community. He testifies for medical marijuana. As the June election for County Supervisor approaches, Rudy spends more time "politicking." He has collected enough signatures to be officially on the ballot and continues to pick up endorsements from many democratic groups. Rudy's Facebook followers see frequent posts that illustrate his political views, anything from medical marijuana issues from across the country to criticisms of government corruption. Rudy met his girlfriend Christina Gunther on one of San Diego's rare foggy days when he was able to go the beach. They have been together for almost two years. "I am so blessed to have her in my life," says inSIGHT 20 Rudy stands in front of his mother's house, which had to be rebuilt after the 2003 fires Rudy, smiling. Christina actively supports his campaign by going to meetings with him and helping him put up signs. Since Rudy cannot spend much time in the San Diego sun, the couple spends the majority of their time inside, watching movies or television, playing sudoku or cooking together. Christina accepts Rudy's need to medicate, though she does not partake. Rudy's mother, Elena, has a new house on the property that was ravaged by the 2003 fires. Tears come to her eyes when she remembers the pain of seeing her son in a coma, remembering the fear that at any moment, "They're gonna come and tell me he passed on." Rudy's family survived the fires, but now his mother is battling cancer. Even though Elena watched her son experience many benefits from medical marijuana, she does not feel like it is for her. Rudy and his two siblings think that medical marijuana could help her with the severe nausea she has been experiencing from chemotherapy. Rudy points to some research that suggests marijuana could possibly shrink cancerous tumors. "Rudy keeps saying he's gonna bring me brownies! Oh, no no no! It's more acceptable for the younger generation now, and, if it helps him with his pain, it helps him feel better, why not? But I won't try it," explains Elena. Though it pains Rudy to see his mother suffer through her cancer treatments without the benefits of medical marijuana, he takes solace in the fact that his activism has helped others. He recalls an elderly woman to whom he had given advice about including medical marijuana in her cancer treatments. During a chance encounter a few years later that woman told Rudy that she felt like his guidance had helped save her life. "Maybe I'm not gonna be able to help my mom but I already know that I've helped another. It's well worth it." n inSIGHT 21 inSIGH April 2012 ISSUE 1 Medical Marijuana $6.55 HT