- [Instructor] Side effects of smoking marijuana
can be segregated into acute side effects
that happen at the time of use and chronic ones,
dizziness, nausea and vomiting, vivid dreaming, et cetera.
There's long been a recognition
that chronic marijuana users may develop
some mild cognitive changes when you do formal testing
and so that's always a concern
and I want to bring this up
because when I discuss the pros and cons of this
with a patient, in the clinic with the door closed,
I want them to know that there's the possibility
it may help their symptoms but there's also,
there are negative effects
that they need to take into consideration.
It's an individual decision that I'm not making.
I'm there to provide information to the patient
so that they can make an informed decision
about whether this is something they want to pursue or not.
Well so, this all really has come to the fore in our state
because of the ballot initiative in 2008.
So the Michigan Medical Marijuana Program
was established on the heals of the approval
by voters in the state
to allow marijuana use for medical purposes.
So they created this program
to administer a registration process.
So to become a registered user
you are obliged to go through this process.
You have to be a resident of the state of Michigan
and there are other requirements that are important
to fulfill that I'll talk about in a minute.
It's administered by the state,
the Department of Licensing and Regulatory Affairs.
This office reviews applications
patients or caregivers send in.
It issues registration cards
and it maintains confidential records and statistics.
And it's the main official source of information
on the Michigan Medical Marijuana Act of 2008.
So I know you can't read this
but this is just a screen shot of the website.
So this is from michigan.gov,
okay it's the Licensing and Regulatory Affairs,
so if you want to look this up on your computer,
michigan.gov and you can type in MMMA or MMMP
and it should eventually get you to this page, okay?
And again, I know you can't read it
but there's lots of information here.
This is the source where you would go
to get the official state approved forms
to register for the program,
so you can download the forms onto your computer.
They're PDF files.
Fill them out
and it requires the authorization of a licensed physician,
so an MD or a DO has to sign the physician form
and that's shown here.
Again, I know you can't read it.
Don't worry about the details.
This is just what the form looks like.
It's a five page form.
This is the instructions.
This is the part that we as physicians see,
so I'm requited to put my name here.
I'm required to put my
Michigan medical license number right here.
I'm required to sign the form down here
and I'm required to certify
that the patient I'm signing this form for
has a medical condition for which this is approved.
So this is not approved
for all types or medical or neurological disease.
There are categories of disease,
but again, you can't read it,
this is the box that we check here
for MS patients.
So MS is an approved indication
for the use of marijuana for medical purposes,
so again, I fill out this part here,
I check this box, I put your name, your date of birth here,
any comments I want to make here.
I sign the form and I date it
and that gets sent in along with
the other four pages of the form
where you're required to put your demographic information.
There's a registration fee of $100.
The state processes the forms
and they send you a registration card.
So just for some frame of reference,
some statistical frame of reference,
it turns out since this program
started accepting applications in early 2009,
there have been almost 150,000 applications.
Okay, and more than 80,000 of them have led
to approval and issuance of a registration card.
Sometimes the applications are denied.
Usually it's because the applicant hasn't fully provided
all the information that's required.
So they're quite strict about filling out
everything on the form.
They'll send it back to you as an incomplete form
if it's not handled appropriately.
And there's a small office somewhere in Lansing
that processes all the paperwork here.
And they're backlogged.
So the website will tell you
that things that were received in February
are being processed now.
So people are going through all the information
so it takes some time for the registration to be approved
and your card to be issued.
Now what I wanted to know
and what the website doesn't tell you yet
is some other information,
for example, you know, how many people
are qualifying under the different disease categories.
So how many of these are MS patients
verus cancer patients for example.
How many providers in the state have been approving these?
Is it a small group of individuals?
Is it being done widespread?
So they claim to be collecting statistical data here
but nothing available yet.
So what the state doesn't do is provide you with marijuana.
It just provides you with the authorization
in the form of an official registration
to be a certified user.
And now there are controversial sites
where you can go, that are marijuana dispensaries,
you can show your registration card
and it allows individuals to get access
to marijuana for medical purposes.
You actually can also be approved
to grow your own marijuana plants
if you want to undertake that.
Don't ask me, I don't have the foggiest idea how to do it.
Patients ask me, what do I do next and I don't know.
But there are places in your community, I would bet,
that you can get access to marijuana in a nonclandestine,
on the street corner kind of way.
So there are dispensaries where you can go
and the official cards are honored.
It's a cash purchase.
Your insurance isn't gonna cover this so,
and they don't give you any advice
about how much to take or how often
to take it or anything like that.
Don't ask me, I don't know either.
But it is available and I wanted you
to appreciate that there is a process here.
So I gotta wrap up from a time standpoint.
So CCSVI is still a very hot button issue.
It's really unclear to us the extent
to which it occurs in MS patients.
I personally feel very strongly
that people should not undergo invasive procedures,
angioplasty procedures or stent placements
unless they're enrolled in a careful,
well designed study, okay?
So if you want to help the field,
go somewhere that's doing a study on this.
But don't go somewhere and just have the procedure done
'cause you think it's gonna work,
because we just simply don't know yet
and there are risks.
So marijuana can be used
to treat a variety of MS-related symptoms
and the use in this context, again,
I would strongly encourage people
to go through the Michigan Medical Marijuana Program
to get certified and registered.