Should You Talk with Your Aging Parent About Medical Marijuana?
The times, they are a-changin' — and some are choosing relief over reluctance
For her 65th birthday in December 2016, Linda Greenblatt of Las Vegas got an unusual present. Her step-daughter, 36-year-old Sheryl Greenblatt, bought her a $200 medical marijuana card.
“I had been on her about living a healthier lifestyle and telling her she didn’t need all the dangerous medications she was on,” Sheryl Greenblatt said. “So, for her birthday I got her the medical marijuana card.”
The card itself is free. The visit to the doctor who prescribed Linda Greenblatt’s medical marijuana card was $200.
“I knew nothing about cannabis,” says Linda Greenblatt of the plant from which marijuana is derived. But, she’d heard the buzz. “It’s kind of hard to ignore all the positive research,” she explains.
A Burgeoning Trend
Medical marijuana is currently legal in 29 states, the District of Columbia, Guam and Puerto Rico. In 1996, California was the first state to allow for use of cannabis medically. Each state has its own rules and conditions for which cannabis can legally be prescribed. However, on the federal level, the Food and Drug Administration (FDA) has not approved the marijuana plant as medicine.
Linda Greenblatt, who has been plagued with a lifetime of medical issues, began speaking about cannabis with her step-daughter and Sheryl’s father (her husband) years ago, long before Nevada began legally dispensing medical marijuana in July 2015. “The fact is, I am on a lot of very dangerous medications because there are so many things wrong with me,” she says.
“Turning to cannabis was a matter of getting disgusted that all the medicines she was on were breaking her body,” says Sheryl Greenblatt. “So I supported Linda when she and my father came to me to discuss cannabis.”
Confronting Bias Against the Treatment
According to clinical psychologist Nimali Jayasinghe, who is in private practice in New York City specializing in care of older adults, “A conversation about medical marijuana use is complicated only if we allow emotions and misconceptions to dominate.”
Dana Rosenbaum’s mother has cancer that has metastasized into her bones, but the older woman dismissed the idea of cannabis for a long time.
“I thought it was a good idea because I had heard so many good things about it,” says Rosenbaum, 38, of New York City, of her mother’s eventual decision to try an initial low dosage. “I thought if anything, it would relax her.”
Dr. Tom O’Brien tries to quell some of the fear.
“I tell my patients, ‘This is not Fast Times at Ridgemont High and your parent is not Spicoli,’” says O’Brien, a prescriber of medical marijuana in New York City. (He is referring to the 1982 comedy film in which Sean Penn plays a stoned high school student named Jeff Spicoli.)
O’Brien adds that there needs to be more education about cannabis to remove the negative stigma associated with what he calls the M word. “My job is to help my patients get comfortable and be functional.”
A Noticeable Shift
Dr. Craig Blinderman, director of Adult Palliative Care Service and associate professor at Columbia University Medical Center, says he’s seen a change in the conversation over the past year and a half since New York State legalized medical marijuana — as if a taboo has been lifted.
“In my experience there has been an advocacy rather than a skepticism in the conversations about cannabis I have had with my patients and their adult children,” he says.
“For a conversation to be open and productive, there needs to be an awareness that both fearfulness and over-enthusiasm can get in the way,” says Jayasinghe. She suggests that adult children should be asking their parents the same questions about cannabis that they are asking about their parents’ other medicines, including, what problem do you hope it will help? And, what do you know at this point about its potential benefits or potential unwanted side effects?”
How to Do It
If you do plan to help your parent seek out a legal prescription for cannabis, it’s not as simple as just going to the doctor. Here are some basic steps to follow:
1) Check on your state’s laws. Find out if your parent is eligible to use cannabis in his/her state for his/her medical condition. The National Conference of State Legislatures has links to each state’s government website where medical marijuana laws are listed.
2) Find a physician. Not all doctors who can legally prescribe list their names publicly on state registries. You may also try this list. Or, ask your doctor or your parent's doctor for a recommendation. Blinderman says most of his patients come to him through word of mouth.
3) Book a medical appointment. Have your parent get a full physical workup to determine if his/her condition: a) meets the criteria for legal use in the state in which he or she lives; b) can benefit from cannabis use. Then have a conversation with the physician. Ask about which formulation is best for your parent’s condition: vapor, oral tablet, liquid oil (for under the tongue), edibles, etc. Not all states allow all formulations.
4) Wait for your cannabis card. Once the doctor has written a prescription for a medical marijuana card, it will arrive from the state through snail mail. It can take as long as two weeks.
5) Find a dispensary. With his/her medical card and a separate ID, your parent will need to pick up the prescribed cannabis from an approved dispensary. Caregivers can register with their state’s Department of Health to get a caregiver card to pick up the cannabis for the patient.
6) Make an appointment to pick up the prescription, then prepare for the cost. At this time, neither private health insurers nor Medicare nor Medicaid cover the cost of medical marijuana.
Price Concerns May Get in the Way
The cost has limited Greenblatt’s use.
“If I could afford to take more, then I would,” says Greenblatt, who admits that at $120/month she is selling off family valuables to pay for the medicine.
“I would rather have her live with credit card debt then live without quality of life,” says Sheryl Greenblatt, pointing out that for Linda after only six months the cannabis is already effecting positive change. “She hasn’t been sick since she’s been on it and she has pain relief.”
The choice to go off cannabis because of the cost or to go into debt in the name of pain relief could soon be a thing of the past. There have been recent court rulings in both the United States and Canada that could change how insurance companies view cannabis.
In fact, as part of an historic ruling in New Jersey, earlier this year a judge took into account the dangers and addictive qualities of opiates (for which insurance companies pay) as compared to the safety concerns over marijuana. She ordered the plaintiff’s insurance company to pay for an injured worker’s medical marijuana.
“You cannot overdose and die from cannabis as you could from oxycodone,” says Blinderman of the opioid, which is man-made. “There is no dose of cannabis you could take to make your heart stop beating. It’s not synthetic, it’s safer and addiction is less likely to be a side effect.”