Challenges May Be Ahead For Physicians Who Recommend Medical Marijuana

In a single day, Dr. Binoj Matthew can see anywhere between 25 and 60 patients at Tetra Health Centers.

Tucked away in the Arden-Arcade neighborhood, this clinic is one of dozens of medicinal marijuana evaluation businesses in town.

Matthew is the medical director of the clinic. He determines whether patients would benefit from using medicinal marijuana.

“We pride ourselves on exclusively focusing on patients who actually have legitimate medical conditions and No. 2, we give them some idea that is based on fact ... in terms of how you approach this," he says.

People seeking a recommendation fill out paperwork with their medical history.

Matthew has a thorough conversation with each patient to find out if they have what he calls a “bona fide medical claim.” He says there are a few ways to tell.

“Surgical scars, disabilities in terms of the use of wheelchairs, ambulation problems, obvious physical signs," Matthew says. "The other most obvious way is medical records. We’re big on that."

Californians voted to legalize recreational marijuana last November, but until next year, the only legal way to buy and sell marijuana is for medical purposes.

Nate Bradley, executive director of California Cannabis Industry Association, says the recreational market may affect medical marijuana recommended businesses.

“There still will be a market for it, it’s not going to completely go away though I do expect a slight reduction," says Bradley. "I know some of the recommendation providers aren’t as excited about that, but I think most of them will adapt and figure out a way to adjust their business models so they can still function in this world."

Between 2015 and 2016, Tetra Health Centers saw nearly 7,000 patients.

The company had planned to open a second location in California. Instead, it’s expanding into Florida, where medicinal marijuana was recently legalized.

The new laws may also affect patients. A Sacramento woman says even though she doesn’t have to, she plans to renew her medicinal marijuana card. She has asked to remain anonymous for this story.

In October 2015, she was diagnosed with triple-negative breast cancer.

She thought she’d have the support of her doctors to use medicinal marijuana.

"My oncologist team knows nothing about it. They have no education on it. They don’t recommend it,” she says.

So, she did her own research, got a recommendation and found a dispensary that was knowledgeable and whose products were lab-tested for safety.

“I couldn’t have gone through the chemotherapy without using medical cannabis because it helped me so much. I could eat. I could sleep. I could smile. I could go to my kid's baseball game,” she says.

Individuals with medicinal recommendations aren’t restricted by how much marijuana they can purchase and use.

But under the new laws, recreational users can possess up to 28.5 grams of marijuana and 8 grams of concentrated cannabis.

Business licensing for recreational use will begin Jan. 1, which means medical dispensaries may also have to consider expanding their clientele.

So, how will the two operations co-exist?

“That’s the million-dollar question. How are the state legislature and the governor’s office and the regulators going to reconcile the medical system that was passed in 2015* and the recreational, adult use initiative that was passed last month?” Bradley says.

*Editor's note: The use of medical marijuana was approved by California voters in 1996 when they passed Proposition 215 the Compassionate Use Act . In 2015, California lawmakers passed a package of bills creating the regulatory framework for medical cannabis. These bills include AB 266, 243 and SB 643.