Who is Mario Enriquez? [2:11]
What was Mario’s first medical marijuana purchase? [3:18]
What did the moment feel like when Mario made his purchase? [4:14]
How Mario go introduced to cannabis [5:49]
Mario’s favorite ways to consume cannabis [10:06]
How the coronavirus pandemic has affected Mario’s day-to-day marijuana usage [12:54]
What is Mario’s next project? [17:05]
Is Tim still seeing new patients? [19:33]
Mario’s plan for 4/20 [25:26]
How you can learn more about Utah Patients for Cannabis and Natural Choices [29:48]
Utah Patients for Cannabis and Natural Choices
Mario is a medical marijuana patient and the president of Utah Patients for Cannabis and Natural Choices. His group helped spearhead the proposition to collect signatures alongside with the Utah Patients Coalition. Also, he was the first patient in the state of Utah to buy medical cannabis.
The first day cannabis flower was not available. He decided to purchase cartridges of sativa and indigo.
Because of his past experience with dispensaries, the purchase felt normal. However, when he walked out the door he realized that he was the first person to purchase medical marijuana in Utah. He received a huge reaction of tears, hugs, and happiness from everyone.
Mario started as a recreational user. However, he was diagnosed with a rare condition called ocular albinism at a young age. He also has nystagmus, which makes his eyes move back and forth all the time. That causes constant eye pain all the time.
Along with helping to medicate his pain without pills, cannabis helped him during school stay calm and focused.
Dry flower vaporizers are what’s allowed with Utah law. However, he also enjoys smoking it because you can better experience the flavors.
The pandemic has not changed Mario’s day-to-day usage. In fact, with the increased anxiety that comes with the pandemic, Mario has continued to use medical cannabis to medicate.
Note: anxiety is not a qualifying condition for medical marijuana in Utah.
Although medical marijuana is legal in Utah, Mario feels his work is not done. There are still conditions he feels needs to be added to the list of qualifying conditions. Also, patients would like to be able to ignite medical marijuana and consume it in a way that is comfortable for them.
His group is still working with legislators to improve the state of medical marijuana in the future.
Yes, Tim is still seeing new patients. With the coronavirus pandemic, his clinic is practicing social distancing. However, Utah law still requires face-to-face visits so they are making accommodations to do this, including visiting the elderly at their homes.
To schedule an appointment, you can go to https://utahmarijuana.org/clinic or call (801) 851-5554.
Mario was able to get a job working at Perfect Earth Pharmacy in South Ogden. He will be helping out the Logan store on 4/20.
Visit their Facebook page at https://www.facebook.com/UPCNC/.
Blake’s Backstory [1:36]
What Blake Discovered When Testing CBD Products [3:24]
How Blake became the Chief Scientific Officer for Zion Pharmaceuticals [5:33]
What does Blake think about the Medical Marijuana rollout? [9:15]
Zion’s process for producing medicines [12:41]
Where will Zion’s products be sold? [13:35]
What’s the path for recreational marijuana becoming legal in Utah? [20:03]
Prior to Prop 2, did Blake believe a time would come when Medical Marijuana would be available in Utah? [21:59]
Blake’s goal with Zion Pharmaceuticals [24:21]
What is the best blend of cannabinoids for PTSD? [27:47]
What is the best blend of cannabinoids for pain? [28:51]
What is the best blend of cannabinoids for nausea? [29:57]
How can someone learn more about cannabinoids? [30:15]
Blake Smith is the Chief Scientific Officer for Zion Pharmaceuticals. Zion Pharmaceuticals has a cultivation license and they should be ready to grow within the next two to three weeks.
They also have one of the processing licenses, so they can do everything from extraction all the way to making the final product.
Blake’s area of expertise is isolating specific cannabinoids for therapeutic purposes. He worked in pharmaceuticals as a bioanalytical chemist for a long period of time. He then left that and went into academia.
During that period of time, his daughter was diagnosed with a genetic condition that gives her seizures. A parent’s alliance he belonged to at the time suggested CBD products might be able to help her.
Instead of jumping right into providing her with CBD, he tested a number of products in his lab.
What he found was most CBD products were not what the company claimed them to be. CBD companies will tell you what the potency or cannabinoid content is. They’ll say that their products are pesticide free.
However, Blake’s test discovered pesticide and metal residues. He also found the potencies were not consistent with what CBD companies claimed them to be.
It was the wild West. Not all products were bad, but there were a lot of products that were not what they claimed.
These were CBD products found in dispensaries and CBD stores, not on the black market.
Blake got involved with a group that was growing hundreds of acres of industrial hemp. Specifically, he helped identify some issues they were having during that farming process.
Later, they asked him to join as their Chief Scientific Officer.
Their team extracted and processed thousands of pounds, if not tens of thousands of pounds of industrial hemp.
When the legalization of Medical Cannabis was announced in Utah, Zion Pharmaceuticals decided they wanted to shift into making actual medicine. For example, a cancer patient with nausea could be given cannabis to make them feel high. However, the team wanted to start addressing the nausea directly. The cannabinoid Delta-8-THC, which also stimulates dopamine, could be used to help with nausea.
By adding dosing parameters around the medicine, this would become something that doctors should be interested in.
Blake thinks Utah is moving in the direction of what people wanted. Most of his experience with doctors has been fairly positive, but they have no idea how to write a prescription. This is why people like Tim are needed to help during this rollout.
Utah allows for industrial hemp products. The reason why this becomes really, really important to us is because if you look at most marijuana strains, the biggest difference is the total amount of THC and terpene profile. That would be like trying to treat every disease known to man with ibuprofen and Benadryl.
Hemp has high concentrations of cannabinoids, such as CBG and CBB, which have been shown to help with neuropathy.
Utah is pretty forward thinking in allowing industrial hemp, knowing that there is no difference between industrial hemp and marijuana except for the THC content. Zion is focusing on providing specific cannabinoids for very specific therapeutic purposes.
Zion grows marijuana, then extracts it just like they would anything else. They also have a hemp extraction process, so that they can find very interesting genetics on the hemp side, extract those, isolate their cannabinoids, and supplement them into the medical market.
Zion’s products are available to any pharmacy that wishes to sell them. Zion is not a pharmacy, so they rely on pharmacies to buy their products.
Some pharmacies want to only carry their own products. However, if pharmacies are really doing this for the benefit of patients, they’d want to offer a variety of products for a variety of conditions.
Also, people who are experienced users run into “walls,” where they don’t get the same effect every single time from their product. For example, avid smokers of marijuana like to try different things. If a pharmacy is only carrying their own products, they are denying the patient the ability to choose from a wide variety of products that they might help them.
Blake believes that Utah will move to recreational when we have an extremely solid medical program first to show that we’re responsible about how we think about medicines. There is never going to be a quick transition. He believes that if we don’t do this responsibly, Utah will add even more restrictions rather than opening things up.
Yes. While at University of Utah, he talked with lots of doctors. He says most doctors were pretty open to medications that help their patients as long as it meets the criteria of (1) they know it is safe, (2) they know the efficacy, and (3) they know what the dosing should be.
Blake’s goal is to determine what specific cannabinoids do and see how they can use them for therapeutic purposes. They are following a good process and they are focusing on safer extraction methods.
A combination of CBC, CBN, THC, Delta-8, and Delta-9. A combination between Delta-9 and Delta-8. He would then add CBN to help relax. CBC will help activate the endocannabinoid receptors.
Blake recommends low levels of THC and Delta-9. He would also add CBG, CBD.
Blake recommends Delta-8, CBD, and CBG.
There is lots of information out there. Some are good and some are bad. But there are scientific papers.
Zion is also performing studies on cannabinoids.
Who is Narith Panh? (00:00)
What does the community mean to Dragonfly Wellness? (03:56)
What experience does Narith have with marijuana outside of his work with Dragonfly Wellness? (06:55)
What are Narith’s favorite ideas for the Utah marijuana system? (07:40)
What kind of products can we expect from Dragonfly? (15:33)
What problems does Narith see with the Utah system from the perspective of a pharmacy? (22:34)
What are Narith’s suggestions for people who want to get medical marijuana in Utah? (29:42)
How do I get in touch with Narith, Dragonfly Wellness, or the podcast in general? (46:15)
UtahMarijuana.org
DragonflyUT.com
Utah in the Weeds Podcast
Narith Panh is the son of Cambodian refugees who came to America. He’s also passionate about cannabis, and the Chief Strategy Officer at Dragonfly Pharmacy. Dragonfly has been a hot topic of discussion on Utah in the Weeds for weeks, so it only made sense to bring him on to chat about the current medical marijuana situation in Utah.
The short answer: everything. Narith, and many members of his team, are immigrants who are first-generation Americans. The Utah community welcomed their family with open arms, and now they want to give back.
Narith recalls patients who cried tears of joy after getting their medical cannabis and witnessing for themselves just how impactful and beneficial it can be for them. That, he says, is what it’s all about.
Since his girlfriend’s family lives in California, he often finds himself traveling back and forth. As such, he has experience in the recreational market in California, which has given him an insight to the pros and cons of their system. He uses this knowledge to provide the best possible service for patients from Dragonfly and, indeed, from the Utah medical marijuana system as well.
Narith is passionate about cannabis. He wants to expand on some of the things that can make Utah the best medical marijuana state in the country. One of the things he cites as a huge fundamental advantage of the Utah system is the ability for producers to bring CBD into the cannabis ecosystem – essentially allowing products that are a mixture of CBD and THC. These two compounds are synergistic and work together to maximize the user’s experience.
However, in many states, producers are forbidden to mix the two chemicals. But not in Utah. This brings down the end user’s cost significantly, since the license for producing CBD costs $2,000 per year, whereas the license for producing THC is $100,000 per year. Being able to couple CBD products with THC brings costs down significantly across the board, which means a smaller financial burden on patients.
Another key concept that Narith is interested in is the seed-to-sale tracking method the state is mandating for all sellers of marijuana. This system requires that each marijuana plant is tagged when it reaches 8 inches tall. Then, once it’s processed into flower, it’s tagged again. Then again as an oil, and so on until it is sold as a finished product (for example, a THC cartridge).
The reason this is so important can be highlighted with the problem in 2019 with black-market THC cartridges causing severe illness in dozens of people. As it turns out, almost all of those bad vape cartridges were traced back to one source, but it took months of hard investigative work. With the seed-to-sale system in Utah, a bad cartridge could be traced back to its origin, production halted, and a recall issued in a matter of hours.
First, let’s clear up one thing. Dragonfly Wellness is not a dispensary. In fact, Narith personally hates the word “budtender”, because it implies a more casual “slinging” of product, rather than a true medical consultation coupled with the sale of marijuana.
Dragonfly Wellness is a pharmacy. It specializes not only in selling marijuana products and devices, but also in medical advice, dosing, and patient care when it comes to cannabis.
Another couple of misconceptions to clear up: First, getting marijuana flower will not be a problem. It’s the most popular form of marijuana by a considerable margin, and will be available. However, an open flame cannot be used to smoke the flower. Instead, it will have to be puffed through what’s called a dry herb vaporizer. Dragonfly offers a wide selection of dry herb vaporizers, from entry-level handheld puffers to state-of-the-art heavy-use systems like The Volcano.
The other misconception to be cleared: No, marijuana flower will not be sold in blister packs. State legislators were considering forcing producers to package flower in blister packs (similar to how you might find over-the-counter pills) with the safety of patients in mind, but they found it would have only been a burden on both patients and businesses, with no added safety to users. So, thankfully, they scrapped it. Your flower will come how it’s supposed to: in jars.
As for the products that Dragonfly will be offering, expect to find a dazzling array of marijuana products. Everything from an already highly-recommended 25-to-1 tincture (that is, 25 mg CBD to 1 mg THC), to capsules, to edible gelatin cubes, to topicals, to the almighty flower, is available. They also have a wide selection of consumption devices so you can get the marijuana experience you need.
Dragonfly Wellness also has something you can’t get in a typical dispensary: a medical consultation. When you enter Dragonfly Wellness, you’ll have a meeting with a pharmacist, either out on the floor or in a private office. He or she will walk you through marijuana use and help you pick out the proper dosage and consumption method. The goal here is to get patients the most effective cannabis experience possible, without going overboard.
Narith’s biggest issue, currently, is all of the confusion and misinformation. Dragonfly has to turn away dozens of people every day who come into the pharmacy thinking that a letter of recommendation from their doctor is enough. It’s not. In order to gain access to the pharmacy, you need a valid medical marijuana card, which you can only get through an evaluation by a licensed medical professional (such as Tim Pickett).
It’s no one’s fault that this misinformation was spread. After all, this entire medical marijuana system was built from nothing in, really, under a year. In governmental terms, that’s lightspeed. It’s expected that there will be a few hiccups. Thankfully, Dragonfly is doing all they can in order to accommodate as many people as possible. In fact, they’re risking it all for their patients.
Last week, Tim touched on the fact that Dragonfly was taking on a huge risk by opening so early in the rollout. Narith explains that there is a very direct reason for that. It wasn’t them jumping the gun. On the contrary, they understood the risks and knew that the first few weeks would be rocky. But they could not, he says, delay the care their patients so desperately need in order to protect their own financial interests.
Is it tough right now? Definitely. Narith makes it clear, however, that seeing the tears of joy roll down the first-ever Utah medical marijuana customer’s face makes it all worth it. That’s what Dragonfly Wellness is all about.
House Bill 425 made it possible for Dragonfly Wellness to take letters of recommendation for cannabis use from doctors in lieu of a medical cannabis card while the card system suffers from logjam. At the time of this podcast, HB425 had not yet been passed.
At the time of this podcast’s recording, Narith says that patients should not wait until House Bill 425 clears. This is because, even if it passes with no problems, it will still take some time for the change to be implemented. That seed-to-sale tracking system that was mandated by the government does not yet have the ability to process, verify, and approve letters of recommendation. Software changes will have to be made, which will take time.
So, Narith says, patients should continue to go through the current medical card system with a doctor’s evaluation. That would ultimately be the fastest way to get their cannabis.
Narith also makes a point to note that Dragonfly Wellness is not trying to rock the boat. As the first cannabis pharmacy opened in Utah, it’s all eyes on them. They will be strictly adhering to every law that applies.
For example, Dragonfly is not allowed to make suggestions about which doctors to use. Dragonfly is also not allowed to sell merchandise or advertise on the radio. In fact, Narith would not have been allowed to appear on a video version of this podcast, because he was wearing his Dragonfly Wellness uniform. Doing so would, under state law, constitute an advertisement.
Dragonfly won’t toe the line on any of these rules. They’re the only cannabis pharmacy in the state, so they’re not going to risk forsaking their patients by getting shut down.
How to get in touch with Narith and Dragonfly Wellness:
Go to DragonflyUT.com and subscribe to the newsletter for the fastest information
Follow Dragonfly Wellness on Facebook and Instagram
How to get in touch with the podcast:
Call Tim’s office at 801-851-5554
Visit Tim’s clinic websites at UtahTherapeutic.clinic and UtahMarijuana.org
Email the show directly at UtahInTheWeeds@gmail.com
Who is David Sutherland? (00:00)
What was David’s monthly drug routine like after his car accident and rehab? (04:00)
How did David make the journey from all those drugs to solely cannabis? (06:00)
What does David envision his life would be like without cannabis? (13:20)
What would David say to patients who are afraid of getting off painkillers? (15:37)
How does Chris compare his largely non-medical experience with cannabis to David’s medical one? (18:00)
As one of the first people ever to use it, what are David’s thoughts on Utah’s medical marijuana system? (22:10)
For Tim, how has the system been on the provider side? (31:48)
How can I get in touch with Tim and the Utah in the Weeds podcast? (36:05)
UtahMarijuana.org
DragonflyUT.com
Utah in the Weeds Podcast
David Sutherland is the first-ever cardholder for medical marijuana in Utah. He comes on the show today to share his story with cannabis, and his experience with the new medical marijuana system in Utah.
David works for the state doing IT work. Eight years ago, he was involved in a car accident that left him with a concussion, burst vertebrae, a broken sternum, and nine shattered ribs. After two years of intense physical therapy and rehabilitation, he was left with permanent chronic back pain and ongoing muscle spasms.
David had to use a back brace for months. He went through approximately 200 vicodin per month, and was on a daily dose of gabapentin, Celebrex, and a slew of antidepressants, anti-anxiety medications, and muscle relaxers.
David had obviously heard of the medical benefits of marijuana before. He noted feeling primarily excited about getting off of painkillers, but also nervous. For him, and indeed for many in his situation, a life without painkillers can seem daunting, or even impossible.
He was worried about how his family might react when it comes to his cannabis use. And of course, because he started his cannabis use before medical marijuana was legal in Utah, and therefore was in violation of federal and state law, he was apprehensive about conflicts with law enforcement.
David got his start in treating his pain with cannabis about four years ago, when he went on a camping trip to Colorado. Despite his tragic accident, it seemed as though luck had not yet abandoned him. He won a Powerball lottery to the tune of about $10,000, and decided to cash it in and spend some at one of Colorado’s recreational dispensaries.
That seemed to do the trick, and David spent the next 8 to 10 months weaning himself off of the prescription drugs in favor of a cannabis-based solution.
It’s a good thing he did, too, because as soon as his doctors discovered that he had been using marijuana, they cut him off of the prescriptions. Believe it or not, that’s the standard move for someone who wants to experiment with cannabis as a pain treatment.
Tim Pickett touches on just how harmful this philosophy can be when trying to find the best treatment for someone with chronic pain. For a patient, going cold turkey from opioids and antidepressants can be a death sentence.
The reason many doctors do this, he explains, boils down to two key factors. First, many doctors are still uneducated about the benefits and science behind marijuana. Second, since many doctors are simultaneously medical professionals and business owners, they want to limit their liability when it comes to illegal drug use.
The solution, then, is both education and a legal framework that allows patients to decide whether or not they want to try marijuana to manage their pain, and to provide a safe context for which they can switch from opioids to cannabis. The latter is now in the works in Utah.
Before his transition to cannabis, David was depressed and suicidal. Day-to-day life was not only physically grueling, but mentally exhausting as well.
Now, with cannabis, David feels more clear-headed, energized, and calm than he ever was on traditional medications.
The prevalence of stories like these speaks to the undeniable benefit that marijuana can have for those with chronic pain.
David would speak to his own experience. Many of those who are afraid of getting off of painkillers are really just afraid of the pain itself. David would reassure them that cannabis can not only be a perfect substitute for painkillers, but that it can actually be better at managing pain than opioids.
David argues, and Tim agrees, that while painkillers lessen the pain, they don’t eliminate it. It’s always there. Cannabis, similarly, lessens the pain, but it also takes your mind off it. David compares it to putting the pain in a box and placing it to the side. It’s not like cannabis completely erases pain; nothing does. Rather, it prevents the pain from bothering you.
While Chris, having not been in an accident as severe as David’s, can’t really comprehend what it’s like to go through the kind of physical pain, rehab, and drug use that characterizes a lot of medical marijuana journeys, he can certainly see the remarkable impact it has on those with chronic pain.
As someone who has used and enjoyed recreational marijuana, Chris wants to see less stringent requirements on who can get access to it. He points out that it’s the patient, not the doctor or the government, who experiences the pain. Therefore, it should be the common philosophy that the patient has the right to say whether or not they want to try cannabis.
He also explains that, contrary to the way some medical professionals act, using marijuana to treat pain is not a new concept by any stretch of the imagination. In fact, medical marijuana has been used in parts of the United States for decades. We should use this fact, as well as more education, to remove the stigma around marijuana, so more people can experience the benefits that David has.
David’s outlook on the medical marijuana system in Utah is very optimistic. As an example, he delves into his experience at the Dragonfly marijuana pharmacy:
Despite official dosing recommendations made by Tim, which should have enabled David to skip this step, the pharmacist still elected to have a meeting with David to discuss his dosing and delivery method. David explains that while this wasn’t necessary for him, dosing advice could be essential to someone with less experience in marijuana use, and whose doctor did not give dosing advice.
The meeting, he said, consisted of the pharmacist asking about his prior marijuana use, listening to David’s needs, and taking his words and thoughts into account.
David did mention that there was a rather startling lack of measurement on some of the tinctures, such that the buyer would have to calculate for themselves how many droppers to take in order to get the correct dose. This could be particularly difficult for those preoccupied with pain and illness, or the elderly.
He describes the prices as reasonable, and maybe even cheaper than Colorado recreational products. The podcasters attribute some of this to the fact that, in Utah, medical marijuana products are not taxed. Instead, there’s a $3 transaction fee on purchases of any size, whether you’re buying $5 worth of product or $5,000.
David expresses his gratitude that the Utah system appears to be patient focused, rather than profit focused. This ensures that patients truly get the product they need at a reasonable price.
Tim’s phones have been ringing nonstop. There was clearly a lot of pent up demand for medical marijuana in Utah, and we’re now seeing a massive influx of inquiries about it. There are over 100 phone calls a day at Tim’s comparatively small practice, so it’s no surprise that the system is a little backed up.
There are tons of applications waiting to be approved. Compared to the number of people who want them, medical marijuana card issuing has been extremely slow.
Tim points out that this represents a problem for Dragonfly pharmacy, which is ultimately a business. They could have waited a few weeks before opening, but chose to get in early. Now that the system is backed up, business is only trickling in. It’ll likely be a few weeks or months before business at Dragonfly is in full swing, which means they could go under before they even really get started.
Despite the issues with the system, the podcasters all agree that the government should stick with the current system and wait for the logjam to break up before making any confusing adjustments.
To get in touch, use the following methods:
How did the podcast get started? (00:00)
Why are many doctors hesitant to get on board with marijuana? (05:46)
What can people expect from this podcast? (07:29)
What is the current state of medical marijuana in Utah? (10:43)
What is Tim, as a medical marijuana expert, going to be bringing to the podcast? (14:52)
Are you going to be able to show patients how to use marijuana? [15:48]
Why do so many say there’s no medical use for marijuana? (22:00)
How can one go about getting medical marijuana? How will the pharmacies work? (26:55)
If I have questions about medical marijuana, or I am a cannabis professional and want to come on the show, how do I reach out? (35:37)
Leafly.com
UtahMarijuana.org
UtahMarijuana.clinic
IAmSaltLake.com
Utah in The Weeds Twitter
The Utah in the Weeds podcast is the brainchild of experienced podcaster Chris Holifield and veteran medical marijuana consultant Dr. Tim Pickett, PA-C. Chris and Tim had recently spoken on the 420th episode of Chris’s other podcast, I Am Salt Lake, and the two had such rapport that they decided to start a new podcast altogether, dedicated to the use of marijuana in the great state of Utah. Enter, Utah in the Weeds!
Marijuana has a history of being demonized. From social stigma around anything marijuana-related to fears of marijuana use leading to heroin addiction, many people shy away from marijuana entirely. We seek to break down those walls by demystifying some misconceptions about marijuana and shining some light on the benefits medical marijuana could have for millions.
It’s not just us, either. In fact, certain schools around the country have introduced degrees related to marijuana. The marijuana industry is constantly changing, and one of the most noticeable changes is its legitimization in the professional and educational world.
We want to bring more and more professionals from the marijuana industry onto his other podcast, I Am Salt Lake. However, doing so would require a rebrand, we decided to bring that idea to life with a brand-new podcast, Utah in the Weeds, where listeners can expect everything cannabis! From interviews with cannabis professionals to demonstrations of use, we are looking to inform Utah about everything there is to know about marijuana.
At the time the podcast was recorded, the first medical marijuana pharmacy was just about to be opened, barring a passing inspection by the government. Calling them pharmacies is little more than an attempt to legitimize the medical marijuana industry, and a more apt name might be “dispensaries.” However, that is a minor gripe compared to the huge benefit that the legalization of medical marijuana would have for the population of Utah.
Ultimately it will be the role of an educator. I want to bring on cannabis professionals, authors, pharmacists, and doctors to discuss the ins and outs of the medical marijuana industry. I also plan to perform direct education by demonstrating some of the practical concepts in marijuana, such as growing and usage.
If you’re a professional in or around the cannabis industry in Utah, please reach out! You can call at 801-841-5554 or email me at tim@utahtherapeutic.com!
We think so, but this is something we’re still unsure of. In Utah, you’re not allowed to use an open flame to consume your medical marijuana, meaning you must ingest it in the form of an edible or vaporize it using a special tool called a dry-herb vaporizer. Some vaporizers allow you to dial in an exact temperature in order to ignite and release different unique sets of cannabinoids.
Igniting marijuana flower at one temperature will release a completely different set of cannabinoids than another temperature, since each group of cannabinoids have different combustion points. This allows the user to customize their marijuana experience and fine-tune it to their exact needs!
This goes back to the fact that misinformation about marijuana has been spreading like a bad plague for decades. As children, many of us were told that marijuana is a gateway drug and leads to heroin use. We were constantly reminded that it could land you in jail and is, therefore, nothing but bad news.
Part of the problem is the strict dichotomy of the way people think about marijuana and its relation to the medical field. Many people favor legalizing marijuana because they want safer, more trustworthy solutions to ailments than some of the drugs currently dished out by the medical industry. By the same token, however, the medical field has now been charged with the herculean task of introducing medical marijuana to those same people. The result is a ton of misinformation about marijuana, which causes confusion and slows down the process of change.
But things are changing. People are being educated about its benefits, and the truth is coming to the surface. We’ve seen in the last few years just how much progress has been made, with 11 states legalizing recreational marijuana for those over 21 years old, and 33 states allowing the use of medical marijuana.
Here’s the basic process for obtaining marijuana in the state of Utah: First, you’ll need to go online and pre-register for a medical marijuana card as a patient. Then, you’ll meet with your doctor, who must be a qualified medical cannabis consultant, and get approval from them to receive your card.
You’ll only get approved for a card if your doctor finds your condition to qualify for treatment with medical marijuana. After the appointment, and if you get approved for a card, one will be emailed to you. Then, you’ll go to a pharmacy and purchase your marijuana.
Here’s where things can get confusing. When you enter the pharmacy, you’ll typically meet with the pharmacist, who will help determine the dosage you need. If you got your card through Tim, however, you’ll be able to skip this step, since Tim gives dosage recommendations as a service. Only one or two providers in the entire state, Tim predicts, will have the knowledge and experience in cannabis to provide dosing recommendations.
To get in touch, you have a number of options, including:
It’s finally here! Utah is opening the registration process for Utah Medical Marijuana Card patients on Sunday, March 1st. Here is everything you need to know.
First, patients must have a recommendation letter from a qualified medical provider in Utah. These are PAs, NPs, and physicians who are registered with the Department of Health.
IF YOU DO NOT HAVE A LETTER, READ MY ARTICLE ABOUT FINDING A PROVIDER AND BECOMING A QUALIFIED PATIENT.
Once a patient has this recommendation, starting on Sunday, March 1st, at 9:00 am, patients may go online to the Department of Health Website and register through the EVS (Electronic Verification System).
That process includes registering for an account and filling out personal information on the patient and their health condition. There will also be information for guardians who will need to register for patients under 21, or unable to care for themselves. These patients will also need a companion or guardian card.
Patients will pay $15 to the Utah Department of Health for the card to be processed.
A Qualified Medical Provider (QMP) will then go online and complete the recommendation and certification for the Medical Marijuana Card to be approved. During this phase of the process, QMPs may recommend dosing guidelines in the patient’s chart in order to allow patients to purchase a 30-day supply of Medical Marijuana for their condition.
If the medical provider does not list dosing guidelines for the patient’s condition, the patient will need to meet with a pharmacist or state-employed physician to again review the medical records and condition and receive dosing guidelines.
Patients with UtahMarijuana.Clinic or Tim Pickett, PA-C will have dosing guidelines listed in the state EVS system and will be able to bypass meeting separately with a pharmacist.
Patients will receive the card in digital form, by email. It may take up to 15 days to review and issue a Utah Medical Marijuana Card after receiving the completed application. For patients without an email address, they will need to contact the Utah DOH directly for instructions, the card will be mailed.
Patients who are under 21 or unable to care for themselves, who require guardian cards or Utah Compassionate Use Board approval will get their cards within 90 days (3 months), depending on the Compassionate Use Board. Please speak with your medical provider about this process.
Bring the card photo on a phone, or a printed version, and a valid ID with you to the Utah Medical Marijuana pharmacy (dispensary) on or after March 2nd to purchase Medical Marijuana in Utah. There will be two dispensaries open in March, and 6 more by June 2020. The rest of the 14 dispensaries won’t open until late 2020, as the patient population grows. Find a list of Utah dispensaries and their locations here.
When did you get introduced to medical cannabis? [6:07]
How do you respond to people who say that this is just a way to make marijuana recreationally legal? [8:09]
What’s the history of medical marijuana? [13:05]
How do you get a medical marijuana prescription or recommendation? [14:08]
How will patients be monitored? [16:37]
What type of treatment do you normally start patients with? [17:55]
What effect does the THC-CBD tincture produce? [19:04]
How will dispensaries be set up? [23:10]
How are providers trained on medical cannabis? [24:10]
Where can I go to find out more information about medical marijuana in Utah? [26:33]
How can medical marijuana be delivered in Utah? [27:23]
Why wasn’t anxiety included as a qualifying condition? [32:22]
What has been the most rewarding part of this work? [39:35]
How can people contact you? [45:46]
UtahMarijuana.org
Utahmarijuana.clinic
IAmSaltLake.com
I have quite a few people that have had life changing experiences because of cannabis. I have family members with cancer, and cannabis benefited them remarkably.
A good friend of mine, who ended up in the cannabis growing industry in Utah and is one of the growers, said to me “Hey, we’re going to get into this medical cannabis. There’s nobody doing it. The state is building this multi-million dollar industry from the bottom up, but there’s no one helping patients get access.” He drove me crazy all last year about it until I started looking into it. Last summer when I really started diving in.
My response to these naysayers is to please come to my clinic, come talk to the people and listen to the people that I see. Sure, I see people who are using it both recreationally and medically? Yes, but those are not the patients that I see.
The patients that I see come in at 68 years old saying, “I’m addicted to Percocet. I can’t get off my five pills a day. I’ve never smoked weed in my life, but I just want to quit taking these pills.”
That person has a legitimate need for some alternative. Cutting them off from their narcotics is not the right thing to do, but this is what makes sense.
I’m not saying that we need to give them marijuana forever. The goal is not to switch them to medical marijuana for the rest of their life. The goal is to reduce their opioid use now and see where that takes them.
As early as the 1970s medical marijuana was being delivered in California.
In the 1990s, a law was finally passed. However, because of federal laws, physicians were getting indicted by the federal government, and they had to fight for their right to discuss it and recommend it to patients.
There are very few providers in the state of Utah, including myself.
You can ask your regular doctor to write a recommendation for one of the 15 qualifying conditions in Utah, which include pain lasting longer than two weeks.
The majority of people who use medical cannabis are using it for pain. Nausea, chemotherapy induced nausea are also common among people who are prescribed medical marijuana.
If they are willing and knowledgeable about this, then they can say yes. However, the reality is they’re not doing it.
A reason for this is the scope of medicine. Once a doctor recommends medical marijuana, are they then going to recommend a delivery method? Are they going to recommend that you take pills or a tincture or you vape it? Do they even know that those options are legal. What is the dosing that they want you to try?
If your doctor has experience with cannabis, they might know already how much they can handle with an edible. If this is somebody with no experience, they need that instruction, or they need at least somewhere to go find the information.
In Utah they’ve set up a good system for followup. A patient will come in to see me initially, and then they’ll need to come see me again in 30 days. Their card, once the Utah Department of Health makes those cards available, will be good for 30 days.
You will then have to go back for a follow up. During that period of 30 days, you’re going to try to get your therapeutic dose established and then come back for a checkup.
After 30 days, you’re going to see that provider every six months to renew your card and make sure that the therapy is good.
I recommend that those people start with a tincture because they can get the lowest possible dose.
I recommend a THC-CBD ratio of at least one-to-one. The evidence says that we need to be using these things together.
We also use CBD to keep the psychoactivity or the high to a minimum. This is because we can increase the CBD dose in comparison to the THC, and we can keep people from becoming forgetful and dizzy.
It works on the mind to disassociate you from your pain. It’s not necessarily making the pain go away. It’s letting you be okay with the pain. The CBD has the neuro-protective effect, protecting the brain. It’s also protecting the nerves, so they just work together.
The people that I talk to in the growing and the producing industry are putting together a dispensary that looks and feels as professional as possible. All of the dispensaries are going to have pharmacists or medical providers on staff, which is going to increase their cost quite a bit, but they’re going to be trained.
If a doctor doesn’t recommend a delivery or dosing system, then the patient needs to meet with a pharmacist at the dispensary to get that recommendation because they’re only going to be able to buy a 30-day supply.
However, unless you have a Utah medical marijuana card, you won’t be able to get access to the dispensaries.
Currently, there is no formal training. We are all self-taught.
However, I’m going to be teaching cannabis medicine to PA students at the University of Utah and Rocky Mountain University. It will be a few lectures long, discussing Utah law, the endocannabinoid system, where we’re at with medical cannabis, the delivery systems and how to keep patients safe. Those lectures will start later this spring, and will part of their regular pharmacology program.
You can go to UtahMarijuana.org. There you’ll get information about all of the qualifying conditions, how to find a medical provider, what to expect at a visit, what the diagnosis of pain might look like, etc.
You can’t use a flame, meaning you cannot smoke a joint or use a bong. That may seem ridiculous, but when you talk about cannabis from a medical standpoint and you want to make it look like medicine, there is no medical reason to have a lighter
Marijuana can be electrically heated, which is a safer method of delivery. You’re not getting the carcinogens from the flame and the combustion. You’re just heating it between 320 and 450 degrees. This activates all of the terpenes and the cannabinoids in the plant and safely delivers it to the respiratory system.
Anxiety was discussed as an option. However, overdosing on THC makes people anxious and paranoid. With cannabis, some people are genuinely more susceptible to becoming paranoid and highly anxious than other people.
Seeing people reduce the amount of prescriptions that they take. It changes their lives, including the way they function and how they take care of their kids.
They are not getting high. They are just becoming more of who they wanted to become.
I have seen people stop stealing drugs out of their families drawers because of cannabis. I have seen patients who are fully functional, high performing people who’ve gotten off their opioids on their own.
It’s important that these people have access to this. You cannot say enough about these people being given more control over their own illness. I do this because I think people have the right to control their illness better, and this gives them more control.
UtahMarijuana.org is a great place to start. That’s going to give you a lot of information.
UtahMarijuana.clinic is my clinic website.
You can also call me at 801-851-5444. I answer all the phones right now because I want to talk to every patient myself. I want to be involved in the whole process from the beginning.
Click on any topic to link to that section.
Yes, Medical Marijuana is already legal in Utah. This was first voted by the passing of proposition 2 in 2016 and a compromise bill, with updates making it more similar to prop 2, was passed. This bill, the Utah Medical Cannabis Act is the current active legislation on Utah Medical Marijuana.
The qualifying medical conditions to be eligible for a Utah Medical Marijuana Card include:
Curious about becoming a patient and being evaluated for a Medical Marijuana Card? Read this post.
Google search can find available providers in SLC. You could also try Utah Patient Coalition, they keep a list of willing providers across the state.
Another option is, of course, to ask your primary care provider or specialist. This is the best option if you want the visit covered by insurance because if a patient has a long-standing relationship with a provider that is willing and qualified (with the appropriate malpractice in place), they can do the recommendation during a normal visit. Usually this requires a long term patient-provider relationship (greater than three months) and a visit that is billed for the complaint, not for Medical Marijuana.
There are some providers who specialize in Medical Cannabis who are available for referrals. These clinics, including UtahMarijuana.clinic provide comprehensive education, dosing, and delivery recommendations for their patients.
Medical profProvider note: Malpractice coverage should specifically cover cannabis recommendations before seeing patients.
After March 2020 patients will be able to find a list of willing providers at the Utah Department of Health provider locator page.
Most of the willing providers have been limited, by the state, to 175 patients total. Unless this changes with legislation this year there may be providers who reach their maximum within the first few months. I am not suggesting patients rush to get a card, but it will be interesting to see if Utah decides to limit providers moving forward. Stay in our email list to be notified of those changes.
Finally, after March 1st, when all providers must log their patient letters/recommendations into the system, it will be interesting to see if many of the “recommending providers” have run out of patients to see. That is because many providers have been limited to 175 patients in total. This will leave less available and willing providers if the Utah legislature does not change the law and let some of us become the specialists we need to be for patients to get the access they deserve.
In any case it is difficult to find a quality Medical Marijuana specialist. Seek specialists who belong to groups like the Society of Cannabis Clinicians and work with Utah Patient Coalition first. Ask your primary care provider for a referral, or call our office and we can help you find someone you can trust.
Most visits will require a $250-$300 charge. No insurance covers a patient evaluation for Medical Marijuana as the primary reason for the visit. This is covered more here. New York State is starting to force insurance companies to pay for the visit, but this has not happened in Utah yet, or in any other state.
Many office visits include the initial consultation with a free follow-up appointment to adjust the therapy. Once you are stable on your dose, you will follow-up every 6 months to renew your certification.
The monthly cost of Medical Marijuana depends on how much you need and what delivery system you choose. It is common to spend between $100-$200 per month. One day, hopefully, insurance will start to cover Medical Marijuana.
While patients can use a Visa, MasterCard, and in some cases HSA funds to pay for the medical evaluation and recommendation, cannabis will not be available for purchase with any credit cards in the dispensaries. This is because it is still listed as a federal one schedule one substance and Visa and MasterCard have not yet allowed transactions for marijuana purchases.
Being a medical provider that recommends cannabis to your patients requires a few specific considerations. First, know that you will likely be limited to 175 patients unless you are board-certified in pain, palliative care, oncology, neurology, anesthesia, or gastroenterology. If that makes you reconsider even getting involved, you are not alone.
Providers need to attend a 4-hour CME course, approved by the Department of Health, to be eligible for the title of Qualified Medical Provider. The course is offered online or in person.
See this article for other considerations about becoming a medical provider.
Providers also will require specific malpractice insurance and must pay $300 to the state for registration.
There are providers who can offer “best practice” guidelines and provide education on delivery methods (oral, vape, flower, oils) and dosing (how much and how often)? But, some providers will give a recommendation and let patients figure it out on their own. If they don’t provide dosing then the patient is required to visit with a pharmacist or another doctor to establish dosing “guardrails”.
This might not be a big issue for seasoned users, but anyone who wants more information on the science behind the medicine, ratios of CBD to THC may want to double-check with their provider prior to the visit. If find that your provider does not offer this service, try finding info here.
To obtain a card, patients with a recommendation will go to the UDOH website and apply for their card. Some providers will start to do this step in the office, but not much is known of the system yet.
At this point in time a $15 charge is estimated for the cost of the actual card. It will take up to two weeks for the patient to receive their card. Therefore, if you are a patient already with a recommendation and apply for your card on 1 March, you will not have access to purchase any Medical Cannabis in Utah until at least 15 March, plan accordingly.
Here is a link to an article about the dispensaries. Utah did a good job of spreading those dispensaries out and keeping the number low, although some disagree with the privatization of the cannabis pharmacy system. Many of the companies that own a dispensary are local growers or are Utah residents.
No dispensaries are open in Utah yet. And they will not open until March or later of this year. There will be a total of 14 dispensaries, scattered throughout the state to make sure everyone has availability of product. This means you may need to travel to Nevada, Colorado, or another legal state to obtain your marijuana and return to Utah with it. There are certain legal considerations to know about this.
For example, it is still federally illegal to travel across state lines with marijuana, but there is little enforcement and prosecution of this in small quantities that are allowed by Utah law. I obviously don’t condone breaking the law, and I also know this is a tough situation for patients to be in.
Patients will be required to show valid identification and an official Medical Marijuana Card issued from the Utah Department of Health to enter dispensaries. No observers or medical providers will be allowed in the pharmacies unless they are themselves medical cardholders.
No flames or food! Patients cannot smoke a joint, use a bong or bowl, or have brownies, cookies, or candy edibles in Utah. There are no established benefits of using a flame to combust the marijuana for inhalation when you can use an electric vaporizer to warm the product and get more medical value and a better entourage effect from the Terpenes and different cannabinoids in the plant.
Here are more information on various leading vaporizers, such as Pax or Davinci.
From a medical standpoint, there are few reasons to bake cookies or brownies in order to get the medication ingested. Patients can simply use a liquid suspension with a dropper.
Raw cannabis flower WILL BE AVAILABLE in dispensaries; blister packs will likely not be needed after this legislative session. This is the list of legal product types you can have and use in Utah:
PATIENTS MAY NOT SMOKE MARIJUANA (NO JOINTS), MAY NOT BUY EDIBLES – CANDIES, COOKIES, BROWNIES ETC. IN THE STATE. THESE ARE NOT PERMITTED UNDER THE LAW.
92% of patients will use Utah Medical Marijuana for pain, according to this graph based on users. Marijuana can be very beneficial to pain patients as it is synergistic with opioids, meaning it works well together and allows people to use fewer narcotic medications. Lower dose narcotics are always safer for patients.
You can read more about examples of patients with pain in this article that I wrote last week.
Growers and producers in dispensary owners are busy working on good products. I met with one of the growlers from Zion cultivars last week and discussed strain types and possible product combinations that will be available in the first dispensaries to open in Salt Lake City.
Proper Hempco.com has been working on a formulation of 2.5 mg THC/10 mg CBD for some of my patients who require a micro-dosing or very low-dose sensitization protocol. These will be very good for new users because it will keep the psychoactivity or “hi “to a minimum. There were previously no ultra low dose products being developed for Utah.
I encourage all providers to help patients find the lowest possible therapeutic dose of THC for all conditions and all patients, based on current best practice guidelines.
In early February I will be interviewing with the I Am Salt Lake Podcast. Subscribe and support this local podcast and learn more about what we are working on.
February 12th at 6:00 pm, in partnership with Salt Lake Culinary Education Center, UtahMarijuana.org is hosting a provider information session for medical providers and staff to come and learn more about cannabis as a medicine and how to navigate deciding whether or not to recommend Utah Medical Marijuana Cards in practice.
I will discuss best practices and clinically Useful information. We will go through a typical patient visit, what to expect as a medical provider, what the patient should expect from you. We will go through some simple guidelines to follow, and I will provide resources on how to get more information from me.
This discussion is not associated with the Utah Department of health and there is no CME available for attending. This is strictly to get patients and providers the best possible clinical information to keep people safe and educated. I believe we need to listen to each other and listen to patients in order to do this well.
Throughout the month UtahMarijuana.org will be putting out articles on the most common conditions that cannabis is helpful for and guidelines for users to learn how others have reduced prescription medication.
We are very excited to work with guest writers including legal counsel, clinical pharmacy, and nursing contributors in the next few months. A diversity of viewpoints will make this project much more usable for you as a reader.
Please be careful. Personalized education, dosing, and delivery recommendations are a key part of having a good relationship with marijuana medicine. Plant-based medicine is complex and requires a thoughtful approach from both the provider and the patient. There is no substitute for good medical advice from a caring medical provider.
This is an exciting time to be a patient and a provider in Utah. We are certainly at a turning point in medicine and I am happy to be a part of it with you and for you.
I am very excited to have been invited to I am Salt Lake podcast. I hope they will release my interview sometime in February 2020. I encourage all of you to like their Facebook page and subscribe to the podcast in anticipation!
Finally, I am also excited to bring you recorded interviews with real patients suffering from injury and illness who have found Medical Marijuana to be a useful tool in regaining control of their lives. I hope to bring you at least one of these interviews per month, with unique perspectives.
All in all I hope you see that this is a comprehensive project, it is very exciting and I look forward to working with each and every one of you. As always, please leave comments and suggestions below, like us on Facebook, Instagram, and Twitter!
I Am Salt Lake Podcast has invited me to come interview with Chris and Krissie Holifield in early February! Please like their Facebook page and subscribe to the podcast! I am super excited to have this opportunity. Subscribe to the email list for updates as I have more info!
February 12th or 20th we will be having a local meeting for prospective Qualified Medical Providers (QMPs) to discuss best practices and clinical information to help you with medical marijuana evaluations and treatment guidelines. We will have an attorney on-site to answer questions about some of the legal issues surrounding this issue. I am also reaching out to a clinical pharmacist for specific condition dosing guidelines.
This will be a great opportunity for you to come and learn about marijuana medicine, best practice guidelines, the new law, dispensaries, and safety information. Comment below or reach out to me if you have specific questions you would like answered. I will do my best.
We are very excited to work with guest writers including my own attorney, clinical pharmacy, a local nurse, and another QMP in the next few months. We believe that a diversity of viewpoints will make this project much more usable for you.
Finally, I am also excited to bring you recorded interviews with real patients suffering from injury and illness who have found medical marijuana to be a useful tool in regaining control of their lives. I hope to bring you at least one of these interviews per month. Join the email list to get these delivered directly to you.
All in all, I hope you see that this is a comprehensive project, it is very exciting and I look forward to working with each and every one of you. As always, please leave comments and suggestions below, like us on Facebook and Twitter!
