En español | My first experience with medical marijuana was when I was 17. I visited a girlfriend's house for the first time. It surprised me to see that her father was smoking marijuana in the living room. I'd never seen an adult do that before! My friend explained that her dad had colon cancer. He had become excruciatingly thin and wasn't expected to live much longer. Pot was the one thing that stimulated his appetite, which kept a little weight on his body and gave him a bit more energy. Unbothered by my awkward questions about her father lighting up a joint in the living room, my friend was happy for anything that could help her beloved dad.
Relief and respite
Fast forward one decade and I was the one caregiving for a parent with terminal cancer. It was an uphill battle to get my mom's discomfort under control. The side effects of chemotherapy, radiation and medication piled up. Mom wasn't doing anything but sleeping, but it wasn't quality rest. I heard her moaning and saw her grimacing in pain. She barely ate and constantly battled nausea and digestive woes. Bag after bag of IV fluids was the only way to stave off dehydration. She was depressed about her illness and about knowing that her body would not survive the cancer. After months of adjustments, trying to find her relief and better quality of life, I gently suggested — and she agreed — it was time to try the one option we hadn't yet: medical marijuana.
My mom's cancer had spread throughout her body, including her lungs, so smoking was not an option for her. But edible marijuana was. Although she was a bit hesitant ("It's not going to make me act weird, is it?” she asked. “Not any weirder than usual,” I joked), she was hopeful that it would help. The first time my mom tried the edible marijuana, she was able to eat (and keep down!) the medicine along with dinner and even asked for something sweet for dessert. We watched a movie together (her in her living room hospital bed, me curled up on her couch) and it tickled me to see her chuckling at Will Ferrell's antics. I watched her more than I watched the movie. For the first time in a long time, she looked relaxed. Almost happy. That night, she slept. No pain. And so, I was able to sleep too. Medical marijuana gave us both respite that night and in her final months of life.
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Marijuana as medicine
Since caregiving for my mom, several of my family members, friends and clients have shared stories of how they've also benefitted from medical marijuana. Like myself, many of them didn't know where to start to obtain it, what the laws and rules are surrounding it, and what the “right time” is to consider it an option in the course of managing and living with a disease.
Unfortunately, the patients with the most severe symptoms — the infirm, the immobile, and the dying— may have the most difficulty incorporating medical marijuana into their treatment. This is where their caregivers come in.
Caregivers are the front line in helping patients obtain and use marijuana as medicine. And although marijuana is legal in most states for medicinal purposes, that doesn't mean that patients and caregivers automatically have access to it.
How do patients and caregivers obtain medical marijuana?
Medical marijuana laws are determined by each state's statutes and regulations. The first step is to become educated on what your state permits. By late 2020, 36 states and four territories have legalized medical marijuana, with varying rules about who can buy or grow it, when and where a person can use it, and how much they can have.
The person who wishes to have medical marijuana will have to qualify as a patient. Generally, that means having diagnoses of certain conditions and a doctor's involvement in the decision to seek medical marijuana certification.
From there, the caregiver who wishes to be designated as the patient's medical marijuana caregiver must apply for the role. If more than one person cares for the patient and the state allows multiple medical marijuana caregivers, more than one person may be designated.
Who makes a good marijuana caregiver?
Selecting a designated caregiver means choosing someone who is reliable. They should be willing to educate themselves on the laws and the benefits and drawbacks of medical marijuana. They need to be able to purchase it for the patient whether through an ordering process or transporting it themselves. It's important for the patient and caregiver to feel comfortable with the use of the medicine and its possible effects on the patient. The caregiver also has to qualify under the state law's eligibility requirements.
How do you qualify to become a marijuana caregiver?
There are a few factors that make a caregiver eligible. Caregivers must be a certain age, and may have to pass a background check, take a certification course and submit the proper application to the agency that oversees medical marijuana. Other factors may apply, too. For example, in my home state of Florida, caregivers must be a parent or legal guardian or have authority under a health care surrogate designation or power of attorney for health care.
There may be disqualifying factors that prevent a person from being accepted as a designated caregiver. In Florida, a marijuana caregiver is not allowed to be employed in the medical cannabis industry and can't be the patient's doctor. Once accepted, the caregiver may have to renew their registration occasionally and cannot assist a patient if the registration has lapsed.
What is a marijuana caregiver allowed to do?
Depending on the state, there are varying degrees of assistance a caregiver can provide to a patient to help them use medical marijuana.
The caregiver may purchase the medicine from a licensed dispensary. Marijuana purchased from other sources may not be considered medical marijuana — and could be illegal to possess.
In some states, caregivers are allowed to cultivate the plant themselves. There are limits on how many plants a caregiver may grow, and they will need to comply with the legal amount.
The caregiver may administer the medicine, which means they can help the patient use it. The caregiver should be willing to become knowledgeable about the different types of marijuana products available and how they manage different symptoms and conditions. Physically using the medicine may be difficult for patients with disabilities or weakness, so the caregiver should discuss the different forms of delivery with the dispensary. Patches or oils applied to the skin may be easier for the patient to use versus edible medicines or vaporized or smoke-able cannabis.
Depending on the area of the country, the caregiver will have the authority to transport the medicine. They will be allowed to possess it on behalf of their care partner. Just like in states that allow cultivation of plants, there are limits on the amounts of usable marijuana that a caregiver can possess legally.
When is the right time for a patient to use medical marijuana?
The answer to this question depends solely on the patient and their readiness. If there are any questions about whether it is appropriate for the patient's current condition, the patient and their caregivers should talk to the patient's doctors. Learn what is available and legal for the patient and caregiver to use and whether it is a valuable tool to add to their treatment toolkit.
Above all, I encourage caregivers and patients to not wait to explore medical marijuana until it is the medicine of last resort. There was no gift greater to me as a caregiver than to see my mom able to laugh, to eat, to rest after months of suffering. Medical marijuana freed her from her pain, and for that, I'm forever grateful.