MO pot

Eczema and glaucoma keep Juan Rosado awake at night. He thinks marijuana can help.

But he said his University City eye clinic isn’t certifying people for Missouri’s medical marijuana program.

“I just have to go a different route,” said Rosado, 65, of St. Ann.

People across the state are looking for doctors to certify them to buy marijuana for medical use, a process that started June 4. But they’re running into resistance. Marijuana isn’t regulated by the Food and Drug Administration — the federal government classifies it as an illegal drug. There are no federally approved standard dosages or safety testing, a less-rigorous review process and no insurance coverage, leading some family doctors and primary care physicians to shy away from certifying patients.

“The simple fact is that most doctors are uninformed about the use of marijuana as medicine,” said Dan Viets, head of the Missouri Medical Cannabis Industry Association and a longtime advocate for marijuana legalization.

Missouri is the 33rd state to legalize marijuana for medical use. In other states, the majority of marijuana patients have been certified by a small number of independent physicians or marijuana-specific clinics, Viets said.

Clinics are already popping up in the St. Louis region from Ferguson to west St. Louis County, advertising certification for about $200. On Wednesday, Green Health Docs, in Creve Coeur, had scheduled 48 appointments for a six-hour window. The Maryland-based multi-state company, which also has locations in Columbia and Kansas City, has been receiving inquiries from marijuana hopefuls since February.

Psychiatrist Zinia Thomas has certified more than 30 people for medical marijuana at her alternative medicine clinic in Brentwood. Most of them told her their doctors weren’t certifying people for marijuana use, she said.

“I believe in this medicine and I can teach someone how to use it safely and effectively,” she said.

On Saturday, Thomas offered to certify people at a party at Fried STL, a downtown cannabis-themed restaurant that serves fried food and sauces. The sauces can be infused with cannabidiol, or CBD, a non-psychoactive chemical in hemp that is marketed as a medical treatment. The restaurant is planning a similar event for July.

Advertisements for the “Coming Out party” promised “doctor signing medical cards” and “medical cards signed all day.” Thomas said Friday the intent was to offer a stigma-free place where, for $99, qualifying patients could get certified after providing their medical records, watching an informational video about marijuana, undergoing a psychiatric exam and visiting with her.

“We’re bringing it to them, in an environment where they’re comfortable and feel free as a patient, not a sort of ‘illegal drug user,’” she said.

Many doctors reluctant

Some states with medical marijuana programs have asked doctors to register as marijuana-friendly or as willing to prescribe marijuana dosages for patients. Missouri only asks doctors to certify that their patient has a qualifying condition. The state will not require certified patients to have specified dosages prescribed — they will be able to enter a dispensary and buy up to four ounces of marijuana or its equivalent in infused products each month. A person who wants more marijuana needs two physician certifications.

Advocates hoped that would make it easier for patients to get certified by doctors, but Viets thinks Missouri will see the same resistance from doctors as in other states.

“I don’t think doctors are hostile,” Viets said. “But most doctors work for somebody other than their patients: a hospital, or a clinic or some type of corporation, and in many cases it’s that corporation which is reluctant.”

Physicians groups including the St. Louis Metropolitan Medical Society and the Missouri State Medical Association opposed the ballot initiative voters approved in November that legalized marijuana for medical use.

The medical association, while not taking a stance on whether physicians should certify medical marijuana patients, said in early June that it won’t recommend the program for now.

“MSMA believes all treatments and therapies should be studied rigorously and be evidence-based,” Jeff Howell, the association’s director of legislative affairs, said in a statement. “Marijuana does not currently meet those standards.”

Veterans Affairs Hospitals can’t certify marijuana patients because of the federal ban. But VA physicians can discuss marijuana use with veterans, and veterans who take part in Missouri’s program will not be barred from VA health care and benefits.

BJC Healthcare, Mercy and SSM Health — three St. Louis-based healthcare providers that operate several hospitals and clinics across the metropolitan region — said that they have yet to formulate a policy.

SSM Health was the only provider of the three to clarify that it is not forbidding physicians from certifying patients for marijuana use.

Several other St. Louis-area healthcare providers did not respond to requests for comment.

“I would say to doctors and people who are skeptical about cannabis that there isn’t really anything that we could say or do to convince you 100% until you see firsthand how this is helping someone you know,” said Coltyn Turner, a marijuana patient in Jerseyville who recently started a foundation to raise money for cannabis research.

Turner was diagnosed with Crohn’s disease in 2011 but has been in remission since 2014, when he moved to Colorado and started using marijuana-infused oils and edibles, he said. Before then, he was prescribed medication that carried painful side effects and did not effectively combat his symptoms, he said.

At Green Health Docs clinic in Creve Coeur on Wednesday, posters explaining the chemical makeup of marijuana and its marketed effects adorned the walls of a small waiting room where two clerks filed patients’ information. Patients waiting for the sole physician, Dr. Steven Whealon of Mount Vernon, Illinois, could sample CBD oils and vapors.

When dispensaries open next year, products likely will combine CBD with plant compounds from marijuana that produce a “high.”

“A lot of people who come through our doors have exhausted every other treatment and nothing is really working for them,” said Green Health Docs spokesman Randy Shaffer. “They have a lot of questions, and a lot of apprehension.”

Patients who come to Green Health need to bring their medical records, Shaffer said. They visit with a physician, discuss their medical history, undergo an exam and talk about marijuana treatment methods.

Patients are turned away if they don’t have a legitimate medical need, he said.

“It’s not a wink-wink, nudge-nudge type operation,” he said.

Missouri voters legalized marijuana for medical use in November, starting a stampede of businesses looking to cash in on the emerging market. Sales are expected to top $100 million by 2025. Tax proceeds and licensing fees are to go to a new veterans health care fund and are expected to generate about $20 million a year.

June 28 is the first day a Missouri resident can apply with the state to legally purchase marijuana or infused products, when they become available next year. A person must apply with the state for a patient card within 30 days of receiving a doctor’s certification.


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