The medical tourism trip to Michigan

Photo: Tetrahydrocannabinol (THC) an active compound in marijuana, sometimes used medically to reduce pain, nausea, the effects of PTSD, and other symptoms

By Matt Clevenger

Ohio legislators approved medical marijuana last year with the passage of House Bill 523, which established the Ohio Medical Marijuana Control Program and set up a timeline to have dispensaries serving eligible patients throughout the state no later than September of 2018.

In the meantime, a small group of doctors and health care professionals are already bringing relief to patients from any of the 20 state-approved medical conditions that can now be treated legally with medical marijuana. Using a legal loophole that allows for the use of “affirmative defense letters,” these doctors are granting Ohio patients access to Michigan’s already well-established medical marijuana program, allowing them to legally cross the border and bring back dispensary-quality medical marijuana in all of its many forms.

The Times,They Are a Changin’

According to figures from the National Organization for the Reform of Marijuana Laws (NORML), 30 states have already legalized medical marijuana use including Alaska, Hawaii, and the District of Columbia. Eight states (Oregon, Washington, California, Colorado, Alaska, Massachusetts, Washington, D.C., and Maine) also allow recreational use, despite the fact that marijuana remains illegal under federal law.

Ohio law spells out a list of conditions that can now legally be treated with medical marijuana, including AIDS, amyotrophic lateral sclerosis, Alzheimer’s disease, cancer, chronic traumatic encephalopathy, Crohn’s disease, epilepsy or another seizure disorder, fibromyalgia, glaucoma, hepatitis C, inflammatory bowel disease, multiple sclerosis, pain that is either chronic and severe or intractable, Parkinson’s disease, positive status for HIV, post-traumatic stress disorder, sickle cell anemia, spinal cord disease or injury, Tourette’s syndrome, traumatic brain injury, and ulcerative colitis.

“Marijuana was put here for a reason,” says “Mary,” a 31-year-old multiple sclerosis patient currently living in Miami County. “It treats every one of my MS symptoms that I’ve ever had.”

Mary was diagnosed with MS in September of 2013.

“I was very ill, and I ended up in the hospital for a week,” she recalls. “The entire left side of my body went numb. I had to get a spinal tap. I had to get an MRI. From there I was at the doctor’s all the time: I had all this follow-up testing. I was off work for three months, because I was using a walker to walk.”

Still suffering and unhappy with the options presented to her, Mary switched doctors, hoping to find a better way to treat her MS symptoms.

“They had me on Copaxone, which is a shot that I had to take for my MS,” she says. “I had to give it to myself, somewhere on my body, three times a week.”

Fed up with conventional treatments, Mary decided to try smoking marijuana. To her surprise, she says it works so well that she stopped taking all of her prescription meds in August of 2016.

“I feel like a medical marijuana refugee,” she says. “It’s the only medication where I can fully function as a wife, mother, daughter, granddaughter, school mom, sports mom. I can go to the grocery—I couldn’t do that before because I was swimming in my head with a medication fog. That fog is gone now.

“I was on five medications,” she continues, noting that just one of her previous prescriptions also cost about $9,000 each month. “There’s no comparison. Let’s say I smoke a quarter ounce per month. Depending on the quality, that might cost me $100.

“I’m not going to say I never hurt. I’m not going to say that medical marijuana takes away all of my pain, because I am in pain. I have MS and I’m not on any prescription medication for it. So yeah, I am in pain, but I can think. My head is clear. I’m a fantastic mother. My kids are very active in school.”

Mary is interested in getting a legal medical marijuana recommendation, but until then, she says she doesn’t feel comfortable openly admitting she uses marijuana. “I try not to be very open about it because of where we live,” she explains. “I haven’t told the kids. Right now I could get in trouble if my son went to school and said something, but if it were fully legal, it wouldn’t matter.”

She says many doctors wouldn’t recommend her marijuana, opting for prescription medications instead, despite her protests.

“If you don’t take the medications the way you’re supposed to take your medications, doctors will discharge you from their practice,” she says. “They call it non-compliance, because they’re not going to be your doctor if you’re not going to do what they tell you to do.”

Fortune Favors the Bold

House Bill 523 lays out a clear timetable for Ohio’s Medical Marijuana Control Program to get the state’s dispensary system up and running smoothly. Unfortunately for some, the timetable doesn’t require Ohio dispensaries to be fully operational until September of 2018, although medical marijuana is technically legal in the state now.

Nevertheless, a small group of doctors working through a company called Omni Medical Services is already providing “affirmative defense letters” that offer Ohio patients access to other medical marijuana state’s dispensaries and at least some degree of protection in both legal and child custody matters.

“There are no prescriptions for medical marijuana, until the federal government actually takes it off the Schedule 1 list,” Omni Medical Services Marketing Manager Louis Johnson explains. “So what we issue is an affirmative defense: they are recommendations, instead, that the doctor issues.

“Our intention is to do a transition from affirmative defense to certification as soon as the state is ready,” he continues. “All of our patients who are under affirmative defense, once the state comes onboard, we will transition them to the state certification program.”

Founded in Michigan, Omni Medical Services started offering affirmative defense letters in Ohio right after House Bill 523 was approved last September, and has already seen a tremendous response from patients. The company, which also operates medical marijuana certification clinics in Michigan, Illinois, and Florida, has already established locations in Toledo, Cleveland, Lima, and Columbus and is working to set up clinics in Dayton and Cincinnati soon. Toledo is a popular clinic, most likely because it borders Michigan, where a dispensary is located.

Johnson won’t disclose exactly how many affirmative defense letters have already been issued, but he says the response has been even better than anticipated. “I can tell you it’s been hundreds and hundreds and hundreds, and leave it at that,” he says. “It’s been phenomenal, actually. The only reason it hasn’t been overwhelming is because we haven’t advertised yet. All of the patients that we have seen have been [through] word-of-mouth.”

According to Johnson, Omni seems to be the only company in Ohio doing what they do.

“People have been coming to us in tears because we are doing this,” he says, “and that’s part of the excellent feeling that we get in serving Ohio residents.”

To obtain an affirmative defense, Johnson says the best way to start the process is to call Omni Medical Services and schedule an appointment, which usually takes about 15 to 30 minutes.

“It’s quite a simple matter to have their primary care physician or specialist fax their records to us,” Johnson says. “Once our physician has determined that they qualify, they receive their affirmative defense, then they are able to go directly from qualifying and receiving their affirmative defense to a dispensary in Michigan to get their meds.”

By law, patients must renew their affirmative defense every 90 days. Those appointments are cheaper than the initial office visit and can be done by telemedicine using a service such as Skype.

Nationwide, Omni Medical Services employs dozens of doctors, but the company is just starting out in Ohio. “Right now, we’ve got three doctors practicing throughout the state, and we have a few more coming onboard within the next 30-45 days,” Johnson says. “But we’re able to see everyone.

“There are so many people in need that somebody has to do this,” he says. “Even though, a lot of times, the media and other opposition websites confuse people and make them believe that they are not allowed to do this yet. We are here because we have done this for years, and we took the time to read the law.”

Many physicians only have pharmaceuticals at their disposal to treat these serious conditions. Although pharmaceuticals can help alleviate symptoms, some of the side effects alter one’s quality of life—and the prescription for pain killers can be discontinued when patients can’t pay for them or medical requirements prevent doctors from continuing to prescribe them.

The Devil’s in the Details

Most, but not all, Michigan dispensaries are happy to serve Ohioans with affirmative defense letters, and when it comes to medical marijuana, it turns out that it really pays to shop around. Prices for raw bud vary greatly, ranging from approximately $200 to $400 per ounce, and some dispensaries also offer memberships that entitle patients to discounts.

Michigan has somewhere between 50 to 100 dispensaries throughout the state, and a quick Google search brings up several maps with their locations. But before patients pack their gear for a road trip, there are still a few issues that even legal marijuana users should consider.

Michigan dispensaries allow patients to purchase up to 2.5 ounces of raw bud at one time. That’s good, because if the affirmative defense doesn’t hold up in court for any reason, possession of less than 100 grams of marijuana carries a much smaller penalty than possession of over 100 grams under Ohio law (one ounce of bud typically weighs 28 grams).

“For simple possession, under 100 grams is a minor misdemeanor, which means it is a $150 ticket,” says attorney Brice Keller, who has practiced criminal defense in the Dayton area for the last four years. “From 100 grams to 200 grams is up to six months in jail as a misdemeanor. Above 200 grams is a felony that could be up to a year in jail. Marijuana paraphernalia falls into the same category as the minor misdemeanor 100 grams, so it’s a $150 ticket.

“To do the affirmative defense, you’re supposed to have a doctor recommendation and explain to the court how you were using the marijuana in a way consistent with how the law would allow you to use it,” he explains. “Pretty much anything that isn’t combustion—vaping, edibles, oils, topicals, just straight eating it—all of these things would be acceptable.”

Keller says he isn’t sure what would happen if a patient with an affirmative defense were caught smoking their medical marijuana through a pipe or other traditional method. “You’d probably end up with just a paraphernalia charge,” he says, “because there’s not really an enumerated penalty for what happens if you smoke your marijuana.”

Asked if he thinks an affirmative defense would be effective in local courts, he emphasizes its use in child custody matters, as the use of medical marijuana alone cannot be the determining factor to reduce parenting time.

“I’d have to say it just depends,” he concludes, optimistic yet skeptical. “But you’d be better off with the letter than without it. You have to get the precedent set that the letters are working. Once you have precedent, the idea that it’s been successful before is substantial help to people who face the same problem in the future.”

For Omni Medical Services locations and more information, please call 888.470.0008 or visit OmniDoctors.com.  For more information on medical marijuana, please visit MedicalMarijuana.Ohio.gov or NORML.org. 

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Matthew Clevenger
Reach DCP freelance writer Matt Clevenger at MattClevenger@DaytonCityPaper.com.

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