I've been approved to use medical marijuana in Washington, D.C.
I decided to apply for medical pot after hearing about soaring patient enrollment in the program over the past six months. And guess what? It's pretty easy to get a card.
The medical marijuana industry is booming in the nation's capital thanks to loosened regulations and a hands-off approach by the federal government.
More than 2,100 patients were enrolled in the D.C. medical cannabis program by early January, up from 362 in May. The business is still small compared with medical pot in some other states, but the expansion has been so intense that growers and dispensaries can barely keep enough marijuana on the shelves to satisfy patient demand.
Just ask Vanessa West, the general manager at Metropolitan Wellness Center, one of the city's three functioning dispensaries. She's struggled to keep her patients medicated over the last few months.
Credit: Geneva Sands
"Supplies have been extremely limited," she told Fusion. "So we've been hurting in that sense and the patients have been hurting, as well. We just don't have a lot of product to sell them."
The sudden growth made me curious: can anyone get medical pot? Even me?
Over the course of a few weeks, I spoke with a local politician, a grower, a dispensary owner, and other folks in the business. They all agree. The program — while not completely accessible — is a lot easier to join than a year ago. Moreover, we're just entering the medical pot boom, they say. Enrollment is going to explode once word reaches the public.
Credit: Kent Hernández and Gabriella Peñuela
The nation's capital has been at the center of the marijuana debate in the past year, but not because of its medical program. In November, D.C. residents voted to legalize small amounts of marijuana for recreational use, a move that Republicans in Congress tried to block by defunding the program in a national spending bill. Mayor Muriel Bowser recently said she will "explore every option" to forge ahead with legalization, but it could create tension with Congress, which oversees the city's budget.
Medical marijuana, however, will be protected. While Congress acted to thwart D.C.'s marijuana legalization this past November, they also included language in their spending bill that prohibits the Department of Justice and the Drug Enforcement Administration from using their funds to prosecute medical marijuana businesses that are following the law. So even if the District's broader legalization program meets resistance, people will still be able to access medical pot with relative ease.
D.C. residents have been cool with medical marijuana for a long time. Voters passed a ballot initiative in 1998 that would have created a medical program, but Republican-led efforts in Congress blocked the law from going into effect for more than a decade.
Congress lifted the ban in 2009, which in turn prompted the D.C. City Council to pass a medical marijuana law with more detailed regulations. The legislative wheels moved slowly, but the city's first marijuana dispensary opened its doors in 2013.
Credit: Linda Davidson / The Washington Post via Getty Images
The program was highly restrictive, ostensibly to keep Congress from interfering again. Patients needed to have a serious medical condition to qualify, such as HIV/AIDS, cancer, multiple sclerosis or glaucoma.
"Council was still nervous because we didn't want to implement something that was far reaching that Congress would then step in again and just undercut," said Councilmember David Grosso, the most vocal marijuana supporter on the council. "Instead we moved a bill that was a fairly arcane, kind of nuanced bill that was hard to comply with."
Credit: Geneva Sands
Those restrictions kept enrollment low and limited commercial possibilities. Such a stringent program, however, started to seem a little silly in the past year, as full-scale legalization began to gain momentum in the District.
In January, local activists launched a campaign to legalize the cultivation and possession of small amounts of marijuana for personal use. The initiative seemed likely to pass from the outset, with polls showing solid support among residents.
City officials faced a potential embarrassment. Cannabis could be legal for fun, but highly restricted for medical purposes. In July, the city council passed an emergency bill that greatly expanded the program.
They removed the list of qualifying conditions — meaning a recommendation for marijuana treatment would now be completely up to the doctor. If your doctor was registered to prescribe marijuana, they could do so for “any condition for which treatment with medical marijuana would be beneficial."
The measure also lifted tight restrictions on grow operations. Cultivation centers could now maintain up to 500 plants, a sharp increase from the previous cap of 95 plants.
Credit: Kent Hernández and Gabriella Peñuela
The changes radically revamped D.C.'s medical marijuana regulations, transforming it from one of the nation's more conservative programs into one of the most liberal, nearly on par with California.
The quick shift sent the city's cultivation centers scrambling to expand their operations. Corey Barnette, the owner of District Growers, told Fusion he's had a hard time meeting the demand.
"The unfortunate reality is that the cultivation process takes time," he said. "And I don't think that standing in June — when we had 200 or 300 patients in the entire program — that anyone thought that by end of November that we would be knocking on the door of 2,000."
Credit: Geneva Sands
The slowdown meant that dispensaries might run out of a certain strain and have to offer patients a less-than-optimal substitute. Barnette said the growers are catching up, though. "It's definitely put a load on us operationally," he said. "But now we've ramped up and we're actually growing at capacity." He expects to meet the demand early this year.
The city's licensing process doesn't help. Of a total of 10 licensed cultivation centers in D.C., only three are operational. The rest of the licensees still haven't opened for business, according to the D.C. Department of Health.
Barnette isn't just thinking about more plants. He would also like to expand into edible products and is hoping to join ranks with a celebrity chef in the D.C. area.
All of this suggests we're reaching a tipping point for the city's medical pot market, which is part of the reason I decided to apply for the program.
You could say I'm a candidate for medical pot the same way you might say I'm a candidate for a back massage. I don't have any major health problems and almost never take a sick day. But like most people, there are ways that I could feel better.
I started to think about what ailments I have that marijuana might treat (a backward approach to wellness, but perhaps no less valid). A couple common ones came to mind — stress, indigestion and muscle soreness — so I gave it a try.
The hardest part is finding a doctor authorized to prescribe pot. The program is easy enough for them to join, but for a number of reasons — views on marijuana, dependence on federal funding — not a lot of doctors have signed up. According to the latest statistics, only 191 physicians have asked to participate in the program thus far.
The doctors authorized to recommend pot aren't typically advertising it, either. When I saw my regular doctor for a check up, I asked if she would prescribe marijuana for either stress or indigestion. She said she wasn't signed up for the program and wasn't interested because it was too much of a hassle in D.C.
Most people find a marijuana-prescribing doctor through a middleman, according to people in the business. You can ask at a dispensary, where they're usually familiar with the doctors. You can also connect with a sort of medical-marijuana fixer, who will set you up with a doctor's appointment for a fee.
I reached out to one such fixer, Shawnta Hopkins at MMJ Medical Marijuana Advocates Group. Judging by the organization's Facebook page, the mission takes greater inspiration from Harold and Kumar than Hippocrates, but still serves a vital role. Without her group, people would have a hard time finding a doctor registered in the pot program.
Credit: DC Medical Marijuana Consultants/Facebook
Hopkins wasn't a marijuana expert when she entered the business. Her other job involves buying and selling precious metals and she says she's never smoked pot ("I'm not even sure how to inhale," she told me). She saw the opportunity in the medical marijuana field and seized it, launching her operation in April 2014. The business now has a downtown office and four full-time employees, she said. She's developed a network of 15 doctors who will prescribe cannabis and she says that she uses her leverage as a referrer to broker lower rates for patients.
The physicians she works with have busy schedules, Hopkins told me, but she managed to find me an opening with a doctor in mid-December, just days after I touched base with her. She charges a finder's fee of $75.
Before I went to the appointment, she sent me a list of things I would need to fill out for the doctor:
—two documents that prove D.C. residency (driver's license, rental agreement, etc.)
—standard intake form for the doctor's office
—any medical documentation that backs up my ailments
—a medical marijuana program form from the District of Columbia
—a broad health history form requested by her organization
Most of this seemed pretty reasonable, but one regulation stood out as potentially worrisome for patients.
The District requires you to choose a single dispensary where you'll obtain pot. To switch shops down the road, you need to pay $90 and submit another form to the city. This could be problematic for lots of reasons, mainly because you're subject to the prices offered at the dispensary you selected. Also, if they run out of the strain of marijuana you've been using — perhaps something that's particularly well-suited for muscle spasms, for instance — you're stuck waiting until they get it back on the shelves.
My fixer connected me with Dr. Patrick Fasusi, an anesthesiologist and pain specialist with an office in a medical center near the Maryland border. I arrived there on a cold, rainy afternoon and joined five women in the waiting room.
I quickly realized that they were there for marijuana, too. The women, who were African American and middle-aged or older, had apparently been waiting for a long time and were getting impatient.
"My back is starting to hurt. My high is wearing off," one woman said loud enough for everyone to hear. "I gotta get turned up again. You want me to smoke here?"
Another woman joked that perhaps the reason the staff was taking so long was because they had access to the medicine in question. "They don't even know what time it is," she said, earning some laughs.
Another woman was accompanying her elderly mother, who presumably needed approval for marijuana, but had waited two hours to see the doctor. After quietly simmering for a while, she shouted at the office staffers behind the intake desk.
Meanwhile, I filled out the related forms and was called back to have my photo taken for my medical marijuana card. I stood against a yellow wall and smiled for a smartphone, trying my best not to look stoned (I wasn't, for the record).
A staffer asked me to pay for the appointment. Doctors don't typically take insurance for medical marijuana-related visits, I've been told, because the insurance companies may not reimburse them. Instead, I was charged $50 in cash for the consultation, bringing the total to $125, including the $75 finder's fee. I forked it over.
Credit: Omar Bustamante
Before long, I was called in for my appointment with Dr. Fasusi, a towering man with round, thick-framed glasses and a benevolent smile. I later learned through Google that he was a star soccer player at George Washington University in the 1970s and is also the CEO and owner of the Premier Surgery Center, where we met for the appointment.
He apologized for the hurry and quickly thumbed through my documents. He asked me about my problems — the stress and indigestion — and what kind of medications I take (a few over the counter drugs). Before we hit the two-minute mark of our consultation, he told me I was approved, but that I would need to return in four months so that he could check on my progress.
He didn't have time for many questions, but he did consent to have his name used in the article. "Why not?" he asked me. I explained that a lot of doctors aren't comfortable with having their name associated with medical marijuana. "They don't get it," he said.
And with that, I was approved. I still needed to clear the final hurdle: all my paperwork would be sent to the District of Columbia for verification, a process that could take four to six weeks because of an increasing backlog in applications.
The funny part is that I'm not sure if I'll go ahead and purchase medical pot. The prices are more expensive than what you might find on the street, running $58 to $70 for an eighth of an ounce, versus the $40 to $50 you might find on the informal market. True, you get a more refined product, or at least a more standardized one, but it's not cheap.
The payment to the doctor's office is another reason to pass. I was told doctors will accept insurance on subsequent visits after the initial approval, but even copays can be expensive. The overall cost seems like a lot for the government's permission to use marijuana, especially when D.C. voters just passed a law that would legalize cannabis possession for adults.
There's also a shift in mindset that goes along with becoming a medical marijuana patient. Marijuana use is often a culture of sharing. Are you supposed to cordon off your medical buds and tell your friends to stick to the stuff they bought from the delivery service? According to the law, you should.
You could raise ethical concerns, as well. The cannabis supply is limited in D.C. right now, so I would be buying marijuana that might otherwise go to a patient with a serious illness.
Finally, there's the stigma. Washington can't quite bring itself to fully acknowledge the value of medical pot. Congress passed a spending bill in December that forbids federal drug enforcement officials from messing with medical programs. Some are calling that de facto legalization of medical marijuana.
But de facto legalization isn't the real thing. Pot is still illegal under federal law, where it's classified as a Schedule I prohibited substance, on par with heroin. Your employer can fire you for using it. The federal government prohibits marijuana use, even for medical purposes.
For me, this aspect carries the heaviest weight. I'm 34 years old. I'm not sure I want to enroll in a medical program that could potentially block me from getting a good job down the road. Until Congress passes a law legalizing medical marijuana, users will still face this risk.
Luckily, I don't have a serious illness or chronic pain. For those people, this decision must be a lot harder.
Ted Hesson was formerly the immigration editor at Fusion, covering the issue from Washington, D.C. He also writes about drug laws and (occasionally) baseball. On the side: guitars, urban biking, and fiction.