We have good news for anyone who has previously avoided attempting to obtain a Medical Cannabis Card based on age or the lack of a qualifying condition under state law. The state unveiled a new electronic verification system (EVS) last month. In so doing, they also made it easier to petition the Compassionate Use Board (CUB).
The CUB is tasked with reviewing all Medical Cannabis applications pertaining to underage patients and those without qualifying conditions. It is the board’s responsibility to approve or deny such applications on a case-by-case basis. Up until recently, however, petitioning the board has been cumbersome. That is no longer the case with the new EVS.
We recently published a post discussing the new EVS. If you read that post, you are aware of the fact that the state introduced the new system as a more streamlined experience. Multiple improvements were made in hopes of giving both medical providers and patients a better online experience when applying for new cards, renewing existing cards, and checking records.
How does the new EVS improve petitioning the CUB? By giving medical providers the ability to submit CUB petitions and documents directly from within the system. Prior to August 2024, petitions in documentation had to be submitted through a separate platform.
The new EVS makes it possible for a medical provider to initiate the petitioning process right from the start. But the system is also programmed to automatically invite medical providers to submit CUB petitions on behalf of patients who need them. In essence, the medical provider no longer needs to remember to do it. The system automatically invites them to do it.
Medical providers will see an automatic CUB petition that requests information the board needs to make its decision. Information covers a variety of issues, including:
On its website, the state points out that a patient’s medical team doesn’t have to support the decision to apply for a Medical Cannabis Card. But they do need to be made aware of the petition.
Doing everything online, through the new EVS, eliminates some of the burden previously borne by both Qualified Medical Providers (QMPs) and Limited Medical Providers (LMPs) alike. By eliminating the secondary step of having to submit petitions and documentation through a separate channel, medical providers are more likely to take care of everything on the spot, during a visit with the patient.
So, what does all this mean to you? Perhaps you have avoided trying to get a card because you don’t think you qualify. Or maybe you are the caregiver of a minor you believe could benefit from Medical Cannabis. With the new EVS in place, it is now easier for you and your medical provider to petition the CUB. Now might be the best time for you to apply.
Note that everything else about the process remains the same. After submitting the petition and documentation, you must wait for the CUB to take up your application at their next meeting. The board has the final word on whether you are approved.
If your application is approved, you will be issued a Medical Cannabis Card electronically. That card represents your legal right to visit any Medical Cannabis pharmacy in the state to purchase medicine.
Utah’s Medical Cannabis program allows caregivers to purchase cannabis medicines on behalf of patients with the possession of a valid Caregiver Card. Have you heard of this card? If so, did you know that the state differentiates between primary and secondary patients for the purposes of obtaining and using a Caregiver Card?
There are several different Medical Cannabis Cards available in Utah. The standard Patient Card is the most commonly issued card. It is intended for adults who live in the state, are eligible to consume Medical Cannabis, and are able to obtain their medicines on their own.
The Minor/Guardian card is for adults with legal guardianship over minors who have been approved to use Medical Cannabis, while the Utah Non-Resident Card is for Medical Cannabis users visiting from out-of-state.
The purpose of the Caregiver Card is implied in the name itself. A caregiver is an adult who provides the majority of day-to-day care for a patient. In the case of someone eligible to use Medical Cannabis, one of the caregiver’s primary responsibilities might be running to the pharmacy to pick up the patient’s medicine. That is the purpose of the Caregiver Card.
With a valid card, a caregiver can purchase Medical Cannabis products on behalf of the patient. However, the patient must also have a valid Medical Cannabis Card. A patient must also designate a particular caregiver in the EVS before that caregiver can purchase Medical Cannabis on their behalf.
All of this brings us to the topic of primary and secondary patients. A distinction is made in the Utah regulations because the law allows caregivers to provide care for more than one patient. The first patient for whom a caregiver provides care is the primary patient. Subsequent patients added thereafter are considered secondary patients.
Note that fees differ based on patient status. For example, the initial fee for a Caregiver Card with a primary patient is $68.25. Caregivers pay $15 to add secondary patients. The first renewal for a Caregiver Card, regardless of the number of patients attached, is free. Subsequent renewals are $14.
The process for obtaining a Caregiver Card is pretty straightforward. The first step is for the patient to enter the caregiver’s information in their own EVS profile. In essence, the patient is designating that person to be their caregiver. After that, the rest is up to the caregiver.
The caregiver:
Applications are reviewed within 15 days of submission. Assuming everything is in order, the caregiver will receive a new card electronically. The card can be printed on paper or carried on an electronic device. One way or the other, the caregiver must present their card whenever visiting a Medical Cannabis pharmacy.
One more thing we feel you should know is that the Medical Cannabis obtained by way of a Caregiver Card is only intended for the patient being cared for. If the caregiver wishes to use Medical Cannabis as well, they must obtain a separate Patient Card.
Utah’s Caregiver Card affords caregivers the opportunity to purchase Medical Cannabis on behalf of those they care for. Understanding that caregivers may work with more than one patient, regulations allow for both primary and secondary patients. Now that you know the difference, perhaps you are interested in obtaining a Caregiver Card. Learn more with Utah Marijuana.
How well a drug or therapy works – what we in the healthcare field refer to as ‘efficacy’ – can be measured in different ways. Efficacy for a bone fracture treatment would be measured by how well the bone actually heals. Efficacy for cancer therapy might be measured by whether the therapy leads to remission. But what about Medical Cannabis? How is its efficacy measured?
The first thing to note is that Medical Cannabis doesn’t cure anything – at least as far as we know at the current time. When one of our medical providers recommends Medical Cannabis, the main goal is symptom relief. Whether or not it actually works determines its efficacy. And in some cases, the best measurement is quality of life.
It turns out that quality of life (QOL) is a standard measurement in medical science that can be applied in a variety of ways. For example, doctors may ask patients to complete a questionnaire designed to inquire about quality of life in relation to general health. The EQ-5D-5L questionnaire is a classic example.
The interesting thing about quality of life is that it is totally subjective. Patients can respond to a number of surveys in a variety of ways, leading researchers and medical providers to draw different conclusions about QOL.
Medically speaking, quality of life measurements are intended to account for:
There is no single way to measure quality of life among patients. Likewise, QOL measurements can indicate different things for different therapies. So what does all this mean to the Medical Cannabis patient?
It all points to the reality that patient experiences differ. Your experience with Medical Cannabis will not be identical to anyone else’s. You may share some similarities with other patients, but the details of your experience will be as unique as you are. No two Medical Cannabis patients are exactly alike.
Just know that your quality of life is important. You deserve the opportunity to live the kind of life you want to live, just like patients relying on any other treatments to feel better. Medical Cannabis has been recommended as a treatment because your healthcare provider believes it offers you the best chances of enjoying improved quality of life.
If your quality of life isn’t where you expected it to be when you first started using Medical Cannabis, don’t be afraid to get together with your medical provider to talk things over. It could be that you just haven’t been using Medical Cannabis long enough to notice a substantial improvement. But it could also be that you need to adjust the way you medicate.
We want to close this post by addressing patients who might be eligible for Medical Cannabis but haven’t yet applied for a card in Utah. If this group includes you, and you have been reluctant to apply because your only concern is symptom relief, we hope you’ll consider this one fact: symptom relief is sufficient motivation to utilize a medical therapy.
Prescription pain medications do not cure disease. Yet doctors prescribe them in hopes of providing symptom relief. Medical Cannabis is no different. No, Medical Cannabis doesn’t cure persistent pain or PTSD. But it can make symptoms more manageable. It can take the edge off.
There are several ways to measure Medical Cannabis efficacy. One of them is its ability to improve quality of life. Here’s hoping your quality of life has improved since you started your journey.
Have you heard about the new Electronic Verification System (EVS) for Medical Cannabis patients and providers in Utah? The Department of Health and Human Services (DHS) has been talking about it for several months now. The new EVS was officially launched on August 12, 2024.
If you are a current Medical Cannabis Card holder, don’t panic. You don’t need to do anything special to use the new EVS. You do not even need to find a new website address. You log on to the system via the same website you used before. You’ll find that your profile is still intact and that all your information is up to date.
From the state’s perspective, the new EVS makes for easier program administration. But the updated system also benefits providers and patients too. We encourage you to check out the new EVS as soon as you have some spare time.
Most of the changes made to the state’s Medical Cannabis program over the years have been intentionally designed to make the program better. The same reasoning has been applied to the new EVS. According to the DHS website, the new system offers six key improvements:
Bear in mind that every new online platform has its growing pains. The new EVS should be a substantial improvement over the system it replaces. But over the next several months, we should all expect some hiccups.
If you are new to Medical Cannabis in Utah, the whole EVS thing might seem foreign to you. The first thing you need to know is that the EVS is your gateway to all things Medical Cannabis in Utah. You will need an account on the system just to apply for a Medical Cannabis Card.
The EVS shares account information with the UtahID program. If you already have a UtahID, you will use the same credentials to create your EVS account. If you don’t have a UtahID account, you will have to create one before you can use the EVS.
The EVS is where you submit your Medical Cannabis Card application. It is where your medical provider enters information about your medical condition, current health, etc. Finally, the EVS is the platform through which you pay for your card and renew it the following year.
One last thing to note is that nothing changes for visitors hoping to gain access to Medical Cannabis while in Utah. The state still issues visitor cards through the EVS. Visitors need to establish EVS accounts and provide supporting documentation with their applications. It is not possible to obtain a visitor card without going through the EVS.
We commend the state for continually working to make Utah’s Medical Cannabis program better. An upgraded EVS is just the latest step taken by state regulators to streamline and improve access to Medical Cannabis. We are looking forward to positive reviews from both patients and providers alike. Hopefully, the newly launched EVS will exceed everyone’s expectations. If it doesn’t, it will be back to the proverbial drawing board for DHS.
It is getting increasingly more difficult for those who oppose Medical Cannabis to claim that there isn’t enough scientific evidence in support of it. Clinical research continues to come in. The latest such research supports using Medical Cannabis to treat pain, anxiety, and depression.
Citing a lack of clinical evidence in support of Medical Cannabis has been a longstanding practice among cannabis opponents. We don’t fault them for that. Up until a few years ago, the point was valid. Thanks to so many years of federal prohibition, quality studies into Medical Cannabis and its efficacy were few and far between. But things have changed.
As Medical Cannabis has become more accepted around the country, the number of clinical studies being done at any given time has also increased. That is good. Studies produce helpful data. And the more data we have in support of Medical Cannabis, the more likely the chances of seeing it eventually being treated just like any other prescription medication.
The previously mentioned study was recently published in the Journal of Nurse Practitioners. It involved a group of patients purchasing Medical Cannabis products at a rural Virginia cannabis dispensary. All the patients who agreed to participate in the survey-based study were at least 18 years old.
In addition, researchers limited participation to patients using Medical Cannabis to treat chronic pain, anxiety, depression, or insomnia. Patient responses were scored based on six reference points:
The data showed positive results for patients across the entire spectrum. Approximately 28% reported experiencing better health while 57% said their quality of life had improved. Surprisingly, patients reporting anxiety and insomnia seemed to enjoy the most relief with Medical Cannabis.
In addition to Medical Cannabis efficacy, the research data also revealed a significant reduction in the use of prescription medications once patients began a Medical Cannabis regiment. Considering some of the prescription meds doctors normally turn to for chronic pain and insomnia, that’s good news.
Traditional pain and insomnia medicines come with side effects that can be quite unpleasant. For that reason, long term use is not advised for either prescription painkillers or sleeping pills. Medical science has been looking for alternatives for years. Perhaps we have finally found one in Medical Cannabis.
We are always open to new research data that helps us understand Medical Cannabis better. Every bit of data helps. In the case of this recent study out of Virginia, we need to keep in mind that we are talking about a small-scale study. How small? Just 31 participants were involved after removing candidates without the proper qualifications.
A study involving such a small number of patients doesn’t qualify as hard science all by itself. But combined with a growing body of evidence including dozens of other studies conducted around the world, it adds yet more evidence in support of Medical Cannabis.
Here in Utah, persistent pain is the most common condition cited by Medical Cannabis Card applicants. The second most cited condition is PTSD. But who knows? Depending on what future research shows, insomnia, anxiety, and depression may account for larger numbers of Medical Cannabis patients.
In the meantime, don’t be afraid to reach out to a medical provider if you believe your medical condition qualifies you for a Medical Cannabis Card. You can visit any one of our clinics throughout Utah to consult with a Qualified Medical Provider (QMP).
One of the funny things about the practice of medicine is that no treatment or therapy enjoys a 100% success rate. Not even Medical Cannabis. We do our best to educate patients who come to us for help with obtaining a new card and managing their medications. We would hate for anyone to assume that getting a Medical Cannabis Card equals a guarantee that their problems will be solved.
There is little doubt that Medical Cannabis is an effective treatment for a variety of conditions. Persistent pain is at the top of the list. But there are no guarantees that consuming Medical Cannabis will ensure a pain-free life. It is also unlikely that a medical provider will recommend cannabis exclusively. In so many cases, obtaining a Medical Cannabis Card is just one part of a broader treatment strategy.
Medical providers frequently encourage patients to combine Medical Cannabis treatments with other strategies. The goal is never to just get a patient onto a particular medication and nothing more. At least it shouldn’t be. There is so much more to feeling better than taking medications of any type.
One of the first things any medical provider should point out to patients is that obtaining a Medical Cannabis card does not preclude all other medications. More than one patient has benefited from combining Medical Cannabis with other prescriptions previously recommended. A patient should never just assume that Medical Cannabis will be the only medication they ever need.
By the way, this illustrates why medication management is such an invaluable service to patients. Patients taking multiple medications do not always have the knowledge or skill to manage them effectively. A medical provider willing to help can go a long way toward maintaining patient safety and maximizing symptom relief.
Aside from other medications, medical providers are likely to consider other treatments in addition to Medical Cannabis. For instance, a patient experiencing persistent pain might be encouraged to undergo physical therapy. Another patient might be encouraged to try occupational therapy as a way of returning to what would be considered ‘normal’ life.
Something else to consider are lifestyle changes. Medical providers go down that road because they know how lifestyle choices can impact health and wellbeing. A classic example is recommending that an arthritis patient works on losing excess weight.
Extra weight just puts more stress on already painful joints. Lose some of that weight and you reduce the stress. In turn, this should lead to at least some measure of pain relief.
That same arthritis patient would probably benefit from regular exercise as well. Exercise can strengthen muscles, ligaments, and tendons. Increased strength provides more support for the joints. That leads to additional pain relief.
Weight loss and exercise will probably not eliminate the patient’s pain entirely. This is especially true if the patient is dealing with osteoarthritis. But losing weight and exercising can enhance the benefits of using Medical Cannabis to manage persistent arthritis pain.
What we are trying to express here is that patients should maintain an open mind. An open mind has led us to discover just how beneficial Medical Cannabis can be to treating conditions like persistent pain. But that same open mind dictates looking at other possibilities.
If you have a Medical Cannabis Card, has your medical provider recommended other strategies as well? Sometimes that is how it goes. Sometimes, the Medical Cannabis Card is just one part of a much broader strategy for improving patient wellness.
Ever since Utah implemented its Medical Cannabis program, we have noticed a somewhat acrimonious relationship between state officials and some companies involved in the Medical Cannabis industry. That’s too bad. There’s really no good reason for it. Take the Department of Health and Human Services (DHS). DHS documents clearly demonstrate the department is interested in consumer health, particularly where pain is concerned.
If you are not sure we are telling the truth, we invite you to read the DHS ‘Guidance on the Suggested Use of Medical Cannabis | Chronic Pain’ document. You might not agree with everything in it and that’s okay. But at least knowing what the state has to say about Medical Cannabis and pain should make it clear that regulators are not the enemy.
One of the first things that sticks out in the state report is the acknowledgment that there is “moderate evidence to support the conclusion that medical cannabis and cannabinoids can have clinically significant beneficial effects in the management of chronic pain.” This is huge when you understand how far we have come since California first began pushing Medical Cannabis in the 1990s.
DHS not only acknowledges the evidence, but they also actually cite a lot of it in their report. Although the report does not go on to conclusively recommend Medical Cannabis as the best treatment for chronic pain, it does cite dozens of studies showing evidence that it can work.
The DHS report mentions something about Medical Cannabis users that we have known for years: most of them rely on their medicines to manage chronic pain. According to national statistics cited by DHS, 87-94% of the patients seeking to use Medical Cannabis do so for chronic pain management.
Here in the Beehive State, quarterly reports demonstrate that number as being closer to 80%. Even so, it is clear that chronic pain is the number one condition people are seeking Medical Cannabis for.
It is worth noting that we are starting to see a gradual departure from the word ‘chronic’ in favor of ‘persistent’. That is probably not accidental. While chronic pain has no clear definition, a generally accepted rule of thumb is that it is pain felt daily or almost daily for a minimum of three months. But in Utah, pain lasting at least three weeks can be managed with Medical Cannabis. Referring to it as ‘persistent’ rather than ‘chronic’ reflects the time difference.
We are pleased to see that the DHS guide recognizes that treatments may vary from one patient to the next. For example, the guidance explains that some patients might find ingestible products, like gummies and tinctures, more effective than vapes and dry heating raw flower.
The guide also talks about combining CBD and THC for better pain relief and side effect management. Frankly, it is a little surprising to see such information in a state guide. Combining the two cannabinoids for better pain relief is something manufacturers and Medical Providers talk about, but it is not something we generally hear from state regulators.
As we wrap up, it’s important to note that the state goes out of its way in the DHS document to remind Medical Cannabis patients that smoking is prohibited. This is important because some of the studies cited in the guide refer to smoking. DHS reminds readers that smoking is mentioned only in the context of the studies themselves. Regulators do not condone smoking Medical Cannabis.
So now you know what the state says about Medical Cannabis and pain. They really aren’t the enemy.
The first quarter Medical Cannabis program newsletter published by the state earlier this year includes an entire section on the low and slow approach to Medical Cannabis treatment. One of our team members saw it and began wondering how many new patients had never heard of it before. We decided to publish this post as an explanation.
Utah now has more than 83,000 Medical Cannabis Card holders. We are adding thousands to the roles every quarter. That tells us there are plenty of new Medical Cannabis users throughout the Beehive State who may not be familiar with the low and slow principle.
The low and slow approach two Medical Cannabis treatment is easily illustrated by taking a dip in a swimming pool. Imagine a hot, summer day complete with a blazing sun and no breeze to help you cool down. You are ready to take the plunge, but your brain tells you not to do it. Instead, you are just going to dip your toe in the water. You just want to see how cold the water is before you jump in.
This is essentially the low and slow approach to Medical Cannabis. Rather than taking as much as you can as frequently as possible, you start out slowly. Let us look at both aspects of the principle a little more closely.
Since Medical Cannabis isn’t provided via traditional prescription, you may not have exact instructions from your doctor. The low aspect of the low and slow approach is to start out with the lowest possible dose – just to see what happens. But how low should you go?
We recommend having a conversation with your Pharmacy Medical Provider (PMP). Ask them where to start based on your condition and symptoms. A PMP is arguably the most qualified person to recommend a starting dose.
In addition to a starting dose, your PMP can also recommend a delivery method. Different forms of Medical Cannabis can offer different effects. Here is where the slow component comes in. Do not be ready to jump up to a higher dose if your initial dose doesn’t seem to work. Give it time. You might also try a different delivery method at the same dose. A different delivery method could make all the difference in the world.
When it is time to increase your dose, do so slowly and gradually. The goal is not to get from zero to sixty as quickly as possible. In fact, your goal is just the opposite.
The goal of the low and slow approach is to guide you to the most optimal dose and delivery method. It is to ensure that you are using the smallest possible amount combined with the most effective delivery. That way, you are not taking too much too frequently.
By the way, this approach is not limited to Medical Cannabis. Medical providers tend to take the same approach to prescription medications. They understand that you can get too much of a good thing, which is why they write prescriptions the way they do. Work with your PMP and medical provider to do the exact same thing with Medical Cannabis.
The low and slow approach is a proven strategy that has helped untold numbers of patients realize maximum benefit from Medical Cannabis. If you have any questions about low and slow during your next appointment with a medical provider, do not hesitate to ask. The only way to get answers is to ask questions.
Earlier this year, the state wanted to get a better idea of how medical providers are plugging into the Medical Cannabis program. So they sent out a survey. Both Qualified Medical Providers (QMPs) and Limited Medical Providers (LMPs) could complete the survey. Needless to say, the survey offers up some interesting information.
For the record, QMPs are licensed by the state to recommend Medical Cannabis to a patient count equal to 1.5% of the total number of Medical Cannabis Card holders in the state. They have undergone continuing education and attained a license from the state. LMPs have not been specifically licensed because they have not completed the educational requirements. Yet they can recommend Medical Cannabis to a total of fifteen patients.
The first interesting thing we noticed is who actually responded to the survey. Most responses came from advanced practice registered nurses (APRNs). An APRN can be one of four types of advanced practice nurses: nurse practitioner, nurse midwife, clinical nurse specialist, and certified registered nurse anesthetist.
For the purposes of the survey, the state also included responses from physician assistants and licensed physicians. Whether or not the survey data indicates that APRNs are more likely to recommend Medical Cannabis than other providers is not clear. Perhaps that is something to be studied later on.
We were also fascinated to learn that the majority of the respondents were QMPs. We are not necessarily surprised, given that QMPs are demonstrably more invested in the Medical Cannabis idea than their LMP counterparts. But it would have been nice to glean more data from LMPs.
While the types of survey respondents are certainly interesting and worth looking at, the most important data from this survey demonstrates that the services QMPs provide are far more than just Medical Cannabis Card assistance.
This is important to us given the fact that state regulators went out of their way during the early days of the program to prevent card mills. The last thing they wanted was provider offices giving away Medical Cannabis Cards like candy. We already know the card mill problem hasn’t become reality here in Utah. Survey data backs that up.
Approximately 72% of Utah’s QMPs offer general patient education in relation to Medical Cannabis therapies. We think that this is huge. Education is key to getting the most out of a Medical Cannabis treatment. But let’s not stop there. What types of additional education are QMPs making available? Survey data suggests the following:
In addition to education, 62% of Utah QMPs also screen for other medical conditions. Additional screening is good for patients because it provides a much better picture of overall patient health and wellness. Screening for additional medical conditions also informs a medical provider’s recommendations.
It is probably a fairly safe bet that at least some QMPs and LMPs offer very little by way of Medical Cannabis services other than helping patients obtain their cards. But it is also a safe bet that some QMP clinics offer other services. Our very own KindlyMD clinics offer a number of additional services including therapy and medication management.
Data from the recent state survey paints a very positive picture of medical provider participation in the Medical Cannabis program. We couldn’t be happier. Card mills have been avoided while patients are the beneficiaries of services provided by medical professionals dedicated to helping them feel better.
