Los Angeles Marijuana Clinic Blog

Medical marijuana is increasingly becoming the treatment of choice for many chronic back pain patients. Conventional treatment therapies such as over the counter non-steroidal anti-inflammatory medications – NSAIDS – (such as ibuprofen, naproxen sodium, or aspirin) can be helpful but can cause side effects such as stomach upset, nausea, gastric bleeding, and ulcers. Prescription medications like other NSAIDS (like Celebrex) or opiates (like Vicodin or Norco) can be effective at treating pain but can also cause many adverse and unacceptable side effects. The addictive potential of opiates is very concerning to patients who struggle with chronic pain and need relief; it is this concern that leads patients to consider using medical marijuana, a very effective treatment for chronic back pain.

Medical marijuana laws are designed to ease pain for migraine sufferers and other people with conditions that leave them in chronic pain. Now they are also causing headaches for employers.

Luke Vezey, a Colorado Springs man with a medical marijuana card state law requires to light up legally, was fired from his job for failing a drug test.

Vezey, who suffers from chronic stomach pain, told Colorado's KKTV Thursday: “What I do is strictly for my stomach. I do it out of work, I've never come in under the influence.”

He worked as a guard at a private-jail facility which has a zero-tolerance drugs policy he says he was aware of when he was asked to take a random drug test. He failed the test, was placed on leave, and then received a certified letter firing him.

Vezey has hired a lawyer to fight the decision, but Colorado Springs lawyer Kevin Donavon (who is not involved with the case) says the law is confusing.

“There is no prescription, marijuana prescription. It's a recommendation by the doctor and if you have that recommendation that allows you immunity from prosecution,” Donavan said. But nothing in the law prevents a user from losing his o her job after a positive drug test. Vezey's former employer declined to comment, citing privacy reasons.

Last month, New Jersey became the 14th state to make marijuana legal for medicinal purposes, and an additional 12 states have pending legislation – meaning more and more employers will find themselves considering adding a Marijuana FAQ to the employee handbook. Only Rhode Island specifically protects workers from being fired for their medical use of the drug.

Taken on doctor's recommendation or not, pot use remains illegal under the federal Controlled Substances Act. But in October the Department of Justice announced that federal agents will target users and distributors only when they violate both federal and state laws.

Where does that leave employers? It's all uncertain legal ground.

Consider California, where in 2008 the state Supreme Court ruled 5-2 in favor of computer data storage company RagingWire Telecommunications (No. 1700 on Inc's 2009 5000), which fired a systems engineer–a disabled veteran who lit up to ease his chronic back pain–for failing a drug test.

The court said that Proposition 215, which allows use of marijuana for medical purposes with a doctor's recommendation, does not protect workers for being fired for violating federal drug laws before, during, or after work hours.

What's more, an employer who knowingly hires a medical marijuana user is “arguably complicit in an activity that's illegal under federal law.”

Montana also has upheld an employer that fired a worker who failed company drug tests, but each state law is different and the issues haven't been fully tested in the courts. In Montana's FAQ for medical marijuana users, the answer to “What should I tell my employer if I am subject to a drug test?” is “The law is silent on this issue.”

Then there's Michigan, where the law says a registered user can't be “subject to arrest, prosecution or penalty in any manner or denied any right or privilege including… disciplinary action by a business.” But another part of the law says “nothing in this act shall be construed to require an employer to accommodate the ingestion of marijuana in any workplace or any employee working while under the influence of marijuana.”

It gets even hazier when you consider the Americans With Disabilities Act, under which an employee fired for using pot for health reasons could in theory pursue a lawsuit claiming discrimination. Is pot-use, for example, a reasonable accommodation you need to grant an employee in chronic pain? Or, if an employer has a zero-tolerance policy for drug use, would creating an exception for medical marijuana users create another kind of legal exposure? And what about employees who operate heavy industrial equipment or have other job responsibilities where workplace safety standards come into play?

Advocacy group Americans for Safe Access already has reported hundreds of complaints of discrimination by employers. ”It's a gray area to know what you can do,” Danielle Urban of employment law firm Fisher & Phillips told the National Law Journal. ”But I think it's still risky to just fire someone for using “

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I live next to a place where people buy marijuana with great frequency. And not in the way that your neighbor upstairs pushes a few dime bags here and there—this is a full-blown storefront, with free coffee and a TV and couches for people to lounge on. Carefully stapled bags, "prescription" printed on one side, are pushed out of a little window similar to the kind manned by bank tellers or postal clerks. The child-proof amber prescription bottles are the same kind that Cephalexin or Xanax comes in, but with ink-jet-printed labels reading ISH slapped on them, citing CA Health and Safety Code 11362.5-7. And that's because this is all, still, legal in the failing great state of California.

Prop 215, also known as the Compassionate Use Act, brought about the legalization of medicinal marijuana in California in 1996, making operations like my friendly neighborhood pot shop, the Long Beach Organics Collective (read the reviews!) possible. What were originally envisioned as collectives made up of the terminally ill or chronic pain sufferers coming together in peaceful, self-supporting agrarian enclaves, growing and sharing their marijuana amongst themselves, has blown up into big business in recent years. San Francisco, with a population of under a million, is home to just twenty-three tightly regulated dispensaries. The city of Los Angeles is home to at least 540 pot shops, a figure that is said to be larger than that of all the Starbucks in the City of Angels. (There are just slightly a bit more than 1700 Starbucks in the whole state.)

In LA, billboards and print ads offering cheap medical marijuana evaluations are a regular sight. Their aesthetic borrows heavily from The Chronic and Doggystyle era rap album art, mixed in with a token bit of medical iconography; cannabis leaves abound. Banished to the back pages of local alt-weeklies, just a page’s turn from the escort ads, the target audience doesn’t seem to be cancer patients, people with glaucoma or those suffering from spinal injuries.

My pot shop is just a few blocks north of downtown Long Beach, a neighborhood that fell on hard times before the Great Recession hit. Then the already empty retail spaces expanded storefront by storefront, leaving many blocks largely vacant. While opening a more traditional business in any of these spaces would require surviving the excruciatingly slow and arcane process known as obtaining a business license, opening a pot shop has been the easier route. They are not the target of federal raids that still can and do target places like the hookah bar down the block which was so shady that a heavy chain and padlock was kept across the doors even during their so-called “business” hours, as they openly sold marijuana inside—all while operating under a business license for selling beauty and hair care products, one of the easiest to obtain. The Obama administration has called the feds off of dispensaries that abide by California law, regardless of the all-trumping federal laws against marijuana.

Now the Long Beach City Council has passed an ordinance in the hope to curtail the ever-expanding number of dispensaries. It sets a buffer zone around schools for one thing; it also mandates that all marijuana sold be grown within the city's limits.

There are three schools within just a few blocks of my pot shop. The closest, just a half block away, is a pre-school, which seems to indicate the end of the establishment. Community activists have been highly vocal in their support of these proposed laws, citing crime, ugliness and sketchy people. To them, dispensaries are no better than your average casita.

That has not been my experience.

My thoughts on the local pot shop began with a bowl of water. José, the intimidating, tall and wide guy who sits watch over the doctor’s office-like waiting room, set it down outside the front door. “For the dogs,” he said, as I walked past with my own beagle, Sigmund, “so they can have a drink.” My pot shop wanted to be a good neighbor. This was just the first step in what has become a growing neighborhood charm offensive. As it occupies the sole retail space on the block, the LBOC is continually looking to insert itself into the community, hoping to become loved and indispensable to stoners and marijuana teetotalers alike.

A good friend who lives nearby in an apartment she owns, inside of which she often smokes medicinal-grade marijuana picked up from one of those old-fashioned (illegal) drug dealer types. She recalled her response to the LBOC opening by miming taking a drag off a joint then speaking in fits and starts around a fake cough: “Fuck, man. What about my property value?”

And in a sense, yes. One of two things are highly likely to happen if you stand out front of the LBOC for any extended period of time: a patient will offer to sell you the weed he just procured at the dispensary, or someone will ask if you have a club card and if you can buy for them. I often recognize my high school-aged self in the faces of the shotgun-riding passengers sitting in cars parked in the 30-minute spot out front—it’s a green zone! That must have been the face I put on while someone over 21 went into the gas station to buy me beers. I’ve watched teenaged skater kids rip into the stapled-shut bags—police procedural rules bar cops from unsealing stabled prescriptions—more than eager to get at their purchase. Once one pulled out a huge bud right on the street corner, holding it up against the sky to examine the color of its hairs, the pockets of THC crystals.

But then there’s a philosophy student from Cal State University Long Beach, with a grey-flecked ponytail, that I see regularly. He walks incredibly stiffly, uses a cane. To pet my dog, Sigmund jump up and put his paws on the man’s waist; he is unable to bend over. He found himself on suicide watch after making a bad choice during a doctor's visit; he said that if a proposed treatment wasn’t going to help, he just wanted it to all end.

And there’s a grandmother with a motorized scooter who comes with her pre-teen grandson. She motors past the younger and not-visibly-suffering patients to pick up a quarter of her strain of choice.

Phase two of the charm offensive blew way past the doggie water bowl. One early weekday morning, I saw a flock of blue t-shirts milling around out front, trash bags in hand. The back of each shirt was silkscreened with a white cannabis leaf, with the words CLEAN UP CREW running beneath. The blue-shirted legal stoners made their way through the neighborhood, picking up trash with the help of latex gloves. Others swept up dead leaves and debris—surely including a fair number of hastily torn "Prescription" bags—from the sidewalk.

They clean up every weekend now, with at least a dozen people making up a given Saturday or Sunday’s crew. The volunteers are familiar faces from weekdays at the dispensary—the same twentysomething-heavy crowd, but with quite a few more female volunteers to balance out the bros. And they don’t do some half-assed cleaning job. This is far from being a spotless neighborhood, the grass and sidewalks littered with an array of trash and leftover food—chicken bones and stripped cobs of corn impaled on sticks, sold by street vendors, along with various fast food packaging and wrappers. On weekends now, the sidewalks are spotless, the landscaping free of clinging bits of trash, no dregs of meals half ground into the sidewalk.

There’s definitely a Mafioso feeling to the whole thing—as if the residents in the neighborhood are “being taken care of.” It’s not like we’ve all been gifted iPods that fell of the back of some truck, but with all of the political debate going on, the charm offensive does make it feel like I’m unwittingly giving something back, if only my own attitude, for these cleaner streets, for the dog water and also for the dog bag dispenser they later installed outside. I use the bags—they’re the biodegradable kind, the ones that won’t clog up landfills like the cheap plastic sandwich bags I used to buy for picking up after my dog.

The charm offensive is not entirely working. A stroller-pushing mother unleashed a fierce tirade on a pair of street cleaners the other Sunday. Even as they were picking up trash, she pointed them out to her husband as if they were breaking car windows or stencil-bombing people’s front doors: “Look baby, there’s two of them now,” she said.

Then, yelling across the street, not pausing as she pushed he daughter forward: “Now you’re fucking out here picking shit up off the street?” she yelled.

The Mafioso thing is definitely getting to some more than others.

I became the best of neighbors to the LBOC completely by chance way too early recently when my trusty beagle sidekick and I foiled a robbery attempt. Out for a morning walk, not even half-awake myself, Sigmund and I passed by someone walking up the sidewalk around the corner from the front of the dispensary. I vaguely remember saying hello, which is totally out of character for me, especially when resignedly taking the dog out anytime before 6:00 a.m. This makes me think that Sigmund howled at the man—and his beagle howl is raw and loud, a painful sound to hear. On my way back, I saw the same guy messing with the metal gate covering the LBOC's glass doors. He was trying to dismantle the cameras, as it turned out. José told me all of this the next day. He said that as they were playing back the security tape, just when the would-be burglar was trying to take the camera down, the footage showed Sigmund and I walking past, and the burglar took off.

Even before the City Council passed the "locally grown" part of its initiative, the LBOC had moved into the empty office space next door. They quickly put up walls, added new doors and may have already started growing a crop right here on my block. The front of the grow operation space has large plate-glass windows looking out on the street. They hope to decorate them with rotating art installations. None of this may matter, in light of the school-zone buffer laws. But they seem to think that if they can make the neighborhood love them enough, all the laws might just go away.

Willy Blackmore lives in Long Beach, where he works for a PR firm and also writes sometimes.

Photograph by Katherine Hitt, under a Creative Commons license.

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While many medical cannabis patients sit on the sidelines, and the cities try and figure out how they are going to address the medical cannabis clubs. Our local Prop 215 community remains in large part, living in fear.”will they close my local collective?”

Warning: Even if medical marijuana is legal in your state and you have a valid prescription, your employer can still fire you for using it. A Michigan man learned this the hard way after failing a drug test given by his employer of five years, Walmart.

Joseph Casias has cancer and a brain tumor, and has a marijuana prescription to help him deal with his chronic pain. He claims that he never came to work under the influence, but the company's policies are strict–and apply even where pot is legal for medical use.

ast November, Casias sprained his knee at work. Marijuana was detected in his system during the routine drug screening that follows all workplace injuries. Casias showed WalMart managers his state medical marijuana card, but he was fired anyway.

“I was told they do not accept or honor my medical marijuana card,” says Casias.

In an e-mail from headquarters, WalMart spokesman Greg Rossiter explained the company policy. It states: “In states, such as Michigan, where prescriptions for marijuana can be obtained, an employer can still enforce a policy that requires termination of employment following a positive drug screen. We believe our policy complies with the law and we support decisions based on the policy.”

Walmart is challenging his claim for unemployment benefits, which he has collected since November.

Walmart fires Michigan man for using medical marijuana (Thanks, Carol!)

The recent medical marijuana ordinance passed by the Los Angeles City Council has nothing to do with today's activities as that law has not been finalized. However, the City Attorney's office contends the sale of marijuana is illegal under state law. Collectives, where the costs of cultivation are shared, are legal, they say.

City Attorneys also “sent eviction letters to owners of 18 different dispensaries and owners of the properties engaged in the sale of marijuana by dispensary employees,” according to a press release, which is posted in full with more specific details below:

INJUNCTIONS SOUGHT AGAINST MEDICAL MARIJUANA SHOPS FOR NUISANCE ACTIVITY

LOS ANGELES - The City Attorney’s Safe Neighborhoods Division today filed nuisance and narcotics abatement lawsuits against three Los Angeles medical marijuana dispensaries following extensive law enforcement investigations. The lawsuits, filed by Assistant City Attorney Asha Greenberg, Assistant Supervising Attorney Ahn Trong, Deputy City Attorney Rebecca Gardner, seek narcotics injunctions due to repeated violations.

Medical marijuana dispensaries Organica and two Holistic Caregivers locations named in the lawsuits are charged with violations of the Narcotics Abatement Law, Public Nuisance Law and the Sherman Food, Drug and Cosmetics Law. The civil lawsuits seek to stop the sale of marijuana at the facilities.

Organica Inc, located in both Culver City and Los Angeles, has been the subject of two search warrants and 12 purchases of marijuana products and plants. None of the marijuana sold to officers had proper labeling as required by the Sherman Law for drugs sold to the public. The owner, Jeffrey Joseph is also the subject of an arrest warrant for sales of marijuana.

Law enforcement officers received complaints in January 2009 that persons associated with Organica passed out flyers for the dispensary near Culver City High School as classes were being dismissed. Officers have found students to be in possession of marijuana apparently purchased from Organica. Persons stopped in the vicinity of Organica also admitted supplying the shop with marijuana laced edibles and picking up large quantities of marijuana from Organica for delivery to other dispensaries.

Two Holistic Caregivers locations in South Los Angeles were part of a Drug Enforcement Administration multi-agency investigation of seven dispensaries owned by Virgil Grant. Law enforcement officers conducted several undercover buys at each of the locations, as well as executed two search warrants at Grant’s home and the dispensaries, resulting in the recovery of large quantities of marijuana products. Grant was convicted on a federal indictment in June 2009 of possession with the intent to distribute a controlled substance and is awaiting sentencing.

In addition to the abatement lawsuits, the City Attorney’s Office sent eviction letters to owners of 18 different dispensaries and owners of the properties engaged in the sale of marijuana by dispensary employees.

In January, the City Attorney’s Office secured a preliminary injunction against Hemp Factory V, located in Eagle Rock, prohibiting the operators from unlawfully selling, serving, storing, or manufacturing controlled substances on the property, including marijuana. The operators are also prohibited from providing marijuana without first having it tested by an independent laboratory for pesticides or other poisonous substances. The case was the first in the state to hold that the Sherman Food, Drug and Cosmetics Law, which prohibits the sale of misbranded and adulterated drugs, applies to sales of marijuana.

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Clinical depression is a very serious illness. People with this condition have long-term, often debilitating feelings of sadness and low self-esteem. There can be suicidal thoughts. Depression makes ordinary tasks such as going to work, cooking, cleaning, even personal hygiene, very difficult.

Once the symptoms have been evaluated by a doctor, prescription medications are routinely prescribed. There are many types of anti-depressant medications: tricyclic antidepressants, MAOs(monoamine oxidase inhibitors), SSRIs (selective serotonin reuptake inhibitors), SNRIs (serotonin-norepinephrine reuptake inhibitors) and a few others.

Early, and then continued, use of marijuana does seem to be associated with an increased risk of psychosis and hallucinations, but allow us to quell some incipient panic.

Caveats, after all, are our specialty.

Previous studies had found a link (not necessarily a cause or effect) between cannabis use and psychosis. So researchers in Queensland, Australia, decided to investigate further and have now established what they consider a fairly strong connection between the length of marijuana use and the likelihood of psychosis in young adults.

The researchers even checked out pot use and psychosis symptoms among siblings just to make sure they haven't been missing some genetic or environmental factor. They don't seem to have been.

So pot use may well play some kind of role in what the researchers term "psychosis-related outcomes."

But, the researchers write in their conclusion: “The nature of the relationship between psychosis and cannabis use is by no means simple."

As they point out: "Those individuals who were vulnerable to psychosis (i.e., those who had isolated psychotic symptoms) were more likely to commence cannabis use, which could then subsequently contribute to an increased risk of conversion to a nonaffective psychotic disorder. In addition, analyses that incorporated adjustments for depressive and anxiety-related disorders led to a reduction in the strength of the association between cannabis use and psychosis-related outcomes. This suggests that depression and/or anxiety disorders may mediate or moderate the pathways between cannabis use and psychosis-related outcomes. We plan to further explore these issues in more detail in future studies."

This is fascinating and provocative stuff, especially as it pertains to young adults' still-developing brains. But the key word from the first paragraph is "associated."

So as for these headlines? "Long-term cannabis use can double risk of psychosis," "Study finds cannabis use is 'crazy-making'," "Teen pot smokers at high risk of mental illness," "Marijuana smoking teens prone to schizophrenia"… Perhaps some panic-quelling is in order.

Here's the full study, published online Monday in the Archives of General Psychiatry.

For a different look at marijuana, here's a recent L.A. Times story: UC studies find promise in medical marijuana

(Not cures, just promise.)

– Tami Dennis

Credit: Daniel Karmann / EPA

Is marijuana responsible for John Patrick Bedell's suicidal

assault on the Pentagon? Yes,
says Washington Post blogger Charles Lane, although
his theory of the plant's criminogenic effects is slightly more
sophisticated than Harry
Anslinger's. Instead of obtaining “effective treatment for his
obviously serious mental illness,” says Lane, Bedell sought help
for his insomnia from a California physician, who gave him a
recommendation for marijuana. “Bedell's loved ones' anguish at his
death,” Lane writes, “may be compounded now by the knowledge that,
at one important moment in his troubled life, a doctor gave him
help obtaining more marijuana—as opposed to real help.” Lane
believes this incident illustrates his point that “the legalization
of physician-recommended pot in California is a prescription for
disaster because it authorizes the 'treatment' of a wide range of
real maladies with a spurious 'medicine'…that might be
ineffective or actually harmful.” Although Lane thinks marijuana's
medicinal benefits are generally fictitious, he is willing to let
cancer and AIDS patients use it, as long as they're dying.
Furthermore, he wants to “debate legalizing marijuana as a
recreational drug.” In short, Lane is prepared to consider a legal
regime that would have allowed Bedell to obtain all the pot he
wanted (something he apparently managed to do anyway), as long as
no one called it a medicine.

Lane is right that a lot of recreational pot smoking is
masquerading as medical use in California, and he is also right to
suggest that general legalization would be better than the current
situation. But given his confidence that Bedell's maladjustment,
wacky beliefs, and violence were all symptoms of a disease that
psychiatrists know how to treat, I'm not sure how Lane can so
readily reject the idea that people are using marijuana as a
medicine when they use it to alleviate such quotidian psychological
problems as stress, anxiety, depression, and insomnia.
Psychiatrists do treat such problems with government-approved
pharmaceuticals, after all. Lane cites one psychiatrist who “knows
of no research to support the notion that marijuana is a safe and
effective remedy for chronic insomnia.” The psychiatrist agrees pot
“can be a sedative,” but adds, “You could say the same thing for
alcohol.” Well, yes, you could. And you would be right, unless
everyone who has ever taken a nightcap has been imagining its
effectiveness. Likewise, marijuana surely helps some people who
have trouble getting to sleep, which is the problem for which
Bedell sought medical assistance. If marijuana were treated like
alcohol, there would have been no reason for Bedell to seek a
doctor's recommendation entitling him to purchase it, but that
would not have changed the nature of the benefit he got from
it.

Lane suggests Bedell's California physician was negligent. But
it sounds like he gave Bedell what he wanted, and Bedell was
pleased by the results. I can see how that might offend those who
believe doctors should treat patients like children instead of
paying customers. Did marijuana use compound Bedell's problems or,
as he believed, relieve them? I don't know, but I am willing to
entertain the possibility that marijuana, like
psychiatrist-prescribed pharmaceuticals, can improve people's
ability to function as well as impair it. If Bedell had obtained
whatever “effective treatment” psychiatrists thought appropriate
but had nevertheless shot guards outside the Pentagon, would Lane
have blamed that prescription for the attack?

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As emotions over medical marijuana and the locations, and numbers of the dispensaries allowed heats up in every city across the state of California… There is still no greater place to live. In one afternoon a properly documented marijuana patients can visit a marijuana doctor, be evaluated, and with 30 min be on his or her way looking for their new favorite medical cannabis club. Of which there are more than a few to choose from.

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