Author: Mr. Lee

This week was an important week for over 60,000 Missouri patients and counting.  It has literally been almost 2 years since voters approved an amendment to our state’s constitution to allow patients with chronic debilitating conditions to be able to possess, consume, grow, and purchase cannabis from licensed dispensaries.  Well… it’s finally here. Cannabis is finally legally available for sale in Missouri.  And somehow I have a late start on today of all days.  I doubt many other patients had that same problem.   I knew they didn’t hit their snooze button 3 too many times.  I imagine some patients waking up looking at the clock every 15 minutes starting around 730am, wondering if it’s time yet.  

Or at least not the ones I knew who were already waiting, lined up around the block, at the first dispensary to open up in the KC area. 

St Louis had their moment a few days before.  But this was our time.  Today was the day it finally became real.  Sure, I have a piece of paper from an office I’ve never been to, saying that someone official says it’s ok for me to grow a couple plants in my basement.   

But this is different…  

There is now a place that you can go to to purchase medical marijuana.  It’s been hard to ignore all the excitement coming from everyone I’ve talked to recently.   No more wondering why the weed guy isn’t hitting you back after you messaged them 10 times.  Maybe you should call again, I’m sure they’ll pick up this time.  

Reality is always less glamorous though.  Most have built this day up so much that it is going to be tough for anyone to live up to these expectations, realistic or otherwise.  Selection is limited, THC % isn’t what most were hoping for, and not to mention its $60 for an eighth and you can only get an eighth without hopping back in line.  I would argue most already knew this was going to be the case though.  Most knew we were going to have a rough start, but that it’s going to be ok because things are guaranteed to get better.  

So, let’s just mark this date on the calendar as a historic day for Missouri cannabis patients and reminisce, reflect, and nerd out for a little.   Let’s take it back….like waaaaaaaaaay back.

Most cannabis history buffs agree that cannabis has been used for thousands of years to treat certain ailments.  But it was a simple drink in India made from almonds, milk, honey, and cannabis, that led to the  first studies of the medicinal properties of marijuana documented in Western Medicine.  All of this was started by a drink called Bhang.

Medical marijuana has roots that date back to the mid 1800’s when a young Edinburgh graduate who had gained recognition as a clever chemist named William O’Shaughnessy traveled to India where he took a position at the Medical College Hospital in Calcutta.  O’Shaughnessy, who sought to learn everything possible about the colony, and eventually turned his attention to studying a unique aspect of India’s cannabis culture.  He was surprised at how many people were openly drinking the cannabis drink known as Bhang.  

In India, cannabis has been used to treat certain ailments by adding it to food and drinks for hundreds of years and is a feature of Hindu religious practices, rituals, and festivals — including the popular spring festival of Holi.  Bhang is probably one of the oldest nutritional foods, and drinks in the world still regularly used today. 

Even though it was tolerated in India, cannabis use was still very illegal and uncommon back in England.  British colonials looked at the drug with suspicion and feared that cannabis could cause murderous madness and become a threat to colonial power after reading about “lunatic asylums filled with ganja smokers” in the local papers.

While studying the health benefits and cultural significance of Bhang, O’Shaughnessy wrote “To forbid or even seriously restrict the use of so holy and gracious an herb as the hemp would cause widespread suffering and annoyance,” the report said. “It would rob people of solace in discomfort, of a cure in sickness, of a guardian whose gracious protection saves them from attacks of evil influences.” 

In his report, O’Shaughnessy does refer to the consumption of cannabis as a “vice,” however he also notes that the effect of Bhang intoxication is “of the most cheerful kind, causing the person to sing and dance, to eat food with great relish, and to seek aphrodisiac enjoyments.”

So naturally O’Shaughnessy decided to participate in these experiments to understand the effects of cannabis first-hand.  While at Medical College Hospital, O’Shaughnessy also recruited patients to be part of what some would call the first clinical marijuana experiments of modern Western medicine.  These experiments validated folk uses of cannabis in India, discovered new applications, and ultimately recommended cannabis for a great variety of therapeutic purposes.  In articles published between 1839 and 1843, he details the results of his research into the potential of cannabis to treat seizures, rheumatism, and cholera.   O’Shaughnessy established his reputation by successfully relieving the pain of rheumatism and stilling the convulsions of an infant with cannabis.

By the 1894 publication of the British government’s Report of the Indian Hemp Drugs Commission, the notion that cannabis caused murderous madness had been mostly put to rest.   Until you fast forward a couple decades to when Harry Anslinger rekindled the war on cannabis…but that’s another story, for another time.

While we wait for dispensaries, who will eventually be filling their menus with exotic strains and carrying something better than what I can grow in my basement, we can look back and reflect on how we got here.  It kinda started with a drink.  A drink that may not be available at most dispensaries.  So if you want to try something new or if you just need something to hold you over, give this recipe I found at Leafly.com a try.

If you’d like to try bhang yourself, here is a common bhang recipe:

Ingredients:

• 2 cups water
• Up to 1/2 ounce of fresh cannabis leaves and flowers
• 3 cups warm milk
• 1/4 tsp garam masala
• 1/4 tsp ground ginger
• 1/4 tsp ground fennel
• 1/2 tsp ground anise
• 1/2 tsp ground cardamom
• 1/2 tsp rosewater
• 1/2 cup honey or sugar
• Rose petals, mint leaves, chopped almonds or pistachios to garnish

Directions:

1. Heat water to a rapid boil, then remove from heat and add the cannabis plant material. Steep for about seven minutes.
2. Strain cannabis leaves and flower from water using a muslin cloth. Squeeze the plant matter until all liquid has been removed. Collect the water and set it aside.
3. Put the leaves and flowers into a mortar and pestle with 2 teaspoons of warm milk. Slowly but firmly grind the leaves and milk together, then squeeze the flowers to extract the milk. Continue this process until you have used about ½ cup of milk. Save the extracted milk.
4. Add chopped almonds, pistachios, rose petals, mint leaves or any other garnishes to your mortar and pestle, along with more warm milk. Grind until a fine paste is formed. Collect the extract and discard any additional nut fibers or residue.
5. Combine all the liquids together, and add garam masala, ginger, fennel, anise, cardamom, and rosewater. Add honey (or sugar) and the remaining warm milk.
6. Mix well, chill, serve, and enjoy.

Disclaimer – The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician and qualified professional regarding any questions you may have about a medical condition or health objectives for cannabis’s medical/recreational use.

Somehow I am amazed when I run into someone who is still trying to tell me that cannabis is illegal in Missouri.  The otherwise seemingly nice lady even continued to argue with me as I showed her my patient card (that I laminated myself), and a brochure about how she could become a patient.  “You’re out of your mind!”  

Granted…the brochure I had looked more legit than the “cards” we get from DHSS, especially when you’re talking to someone that doesn’t believe the program even exists in the first place. So I have to be a little understanding when a boomer goes off on the bearded and tattooed 30-something trying to tell her that the plant that she has been told for decades that is just as dangerous as crack or heroin, is now legal for people to consume.  What has this world come  to?!

I live out in the country, so honestly these types of run-ins are not all that uncommon for me.  Not just with cannabis, but on a number of subjects that I’m just not going to go into here.  I am regularly reminded that outside the major metros, Missouri is still very rural and some of my neighbors may not always be up on current events.  

At this point in my life, I’ve lived downtown, in the suburbs, and way out in the country.  I will say living in the country, away from the busy day to day grind of the city, is peaceful and a great place to raise a family.  It is also not without its inconveniences.  Getting anywhere, including groceries or gas, becomes a commute.  Cellular signal is shotty in some places so you tend to pick your carrier based on who has the best coverage where you live.  Not to mention the limited selection of restaurants or bars to choose from.  But that’s easy for most of us to get used to.

It is particularly rough on patients with mobility or transportation issues.  In most cases, a specialist may not be anywhere close to where they live.  Its for these reasons Missouri made some fairly progressive changes to their healthcare system in the hopes of helping patients living in rural Missouri.

In 2016 Missouri signed SB579 into law establishing new telemedicine practice standards, including explicitly allowing a valid physician-patient relationship to be established via telemedicine.  Long before that Missouri passed a law that allowed nurse practitioners to operate their own practice under the supervision of a licensed physician.  Both with the intent of making sure all of Missouri residents have access to proper healthcare services no matter where they live.  Sounds like a great cause, right?  That’s why I was surprised when earlier this year there was an effort to take away telemedicine, specifically for Missouri patients seeking access to medical marijuana. 

Luckily, that amendment died a swift death.  

So what is Telemedicine?

Telemedicine is a service that makes it possible for doctors to meet with patients on any smart device with video capability and good signal by means of real-time, live-video technology.  According to a survey by Software Advice, 75% of the respondents were interested in trying telemedicine.  Another study conducted by the Affiliated Workers Association showed that more than 60% of doctor visits are now handled over the phone.  Throw a pandemic into the equation and it’s not surprising that most patients are preferring real-time telemedicine over conventional face-to-face doctor evaluations.  Missouri doctors are, now more than ever, taking advantage of this technology to be able to see patients looking to become certified for the medical mariajuana program.

Kind Remedy, a patient certification clinic based out of Independence Mo, offers medical marijuana telemedicine services to patients as a way of improving patient access, by bringing medical marijuana health care services to previously under-served, rural and urban communities all across Missouri.  Patients with qualifying conditions are able to be evaluated and certified for Missouri’s medical marijuana program from the safety and comfort of their own home. 

Convenience

With so much already going on in one’s life, sometimes it becomes impossible to fit in a trip to the doctor’s office, and will often get put off in hopes that things will improve on their own or just go away.  (guilty!)  As I mentioned before, getting the proper healthcare can become an issue for patients when they have to travel greater distances to get access to medical facilities or specialists.  With telemedicine, patients can easily overcome these barriers.  

Telemedicine makes it possible to see a doctor while sitting in traffic, while you’re waiting for your kids soccer practice to let out, or even while you’re cooking dinner (not really recommended).  Regardless, the idea is to increase access by using a simple technology many of us already use regularly or have had to rely on recently during the pandemic.  With a video call, patients can get evaluated from the medical marijuana doctors or other specialists without affecting other priorities.

How does it work?

With telemedicine, the process of getting certified for cannabis use couldn’t be easier.  Patients are able to schedule their appointment on Kind Remedy’s website by filling out a short patient questionnaire, uploading any necessary medical records, and picking a time and date that works best for them.  If patients are unsure about how to get a copy of your medical records, or need application assistance, they have a team that will happily assist you.  

Once patients have completed and submitted your patient intake form, they receive a videochat link via email and/or text message that can be accessed through your computer, tablet, or smartphone. On the day of your appointment, you simply click the link to enter a virtual waiting room where you will wait to meet with the doctor. When it comes time for your appointment, you will be connected to one of their physicians through a video conference where they will review your medical records, discuss medical marijuana treatment, and write your certification.  With that certification, you will then have everything you need to register as a Missouri medical marijuana patient! 

Anyone who is considering adding medical marijuana as part of their current treatment plan is encouraged to call or text Kind Remedy at 816-379-6557 and learn how they can help or simply press the Get Started button at the top of their website.  

~Cheers!

The question I see more often than anything else online from Missouri medical marijuana patients is “When are dispensaries going to be open?!”  Unfortunately, license winners are at the mercy of the predetermined time line outlined in the amendment.  There isn’t a lot for most of us to do except maybe fire up the grow tent to hold us over and dream about the day when we can finally enter a dispensary and see walls of well light display cases lined with elegant little glass jars filled with all the different varieties of beautiful buds or concentrates for our eyes to feast on.  

Whether you prefer fruity or diesel terpenes, edibles or flower, topicals or tinctures, or concentrates.  Oh yes, the concentrates; solventless, CO2 extraction, rosin, wax, shatter, butter crumble, sugar, or diamonds and sauce.  If you happen to find yourself behind me in line at the dispensary, just know that I will be taking my time and trying to look at every product on the shelf until the helpful budtender behind the counter starts to get annoyed…then just let me see that Sour Diesel one last time while I end up settling on the first thing I looked at. (more on this later)

Until that day, what can we do?  Well for many Missouri patients, it will be their first time stepping foot inside a legal dispensary.  The number of selections and options may be dizzying for some to take in all at once. What’s the etiquette inside a dispensary?  What can I expect when I get there?  I know that’s what I was thinking my first time I visited a dispensary.  I got quite a few looks and chuckles from the more experienced locals who could tell I was new to this.  If there are such things as dispensary faux pas, I might have done them all.  After a fleeting, mildly embarrassing moment, they were nice enough to explain the ins and outs of what is considered the norm when visiting a dispensary.  Allow me to share a few things I learned the hard way so you don’t have to go through the same thing I did. 

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Don’t think you know everything.

Ask questions…and lots of them!  Cannabis is a new thing for a lot of Missouri patients, and it might feel intimidating the first time you walk into a dispensary.  Someone with out a lengthy history of cannabis use might feel silly or embarrassed to ask ‘stupid questions’, but don’t be.  Don’t worry, you are not the only one by far.  Budtenders are there to help you not challenge you.  Budtenders, like most cannabis enthusiasts, enjoy talking about their favorite subject…Cannabis!  Ultimately, with their help, you are trying to find the right strain, with the right terpene and cannabinoid profile, and the right delivery method, that works best for you and your condition.  It may take a couple trips to find the right combination but that’s what budtenders are for.  To help you navigate the different options until you find what works best for you.

Put away your phone!

Most dispensaries have a strict “No Phones’” policy so it’s best to keep your phone tucked away while you are inside a dispensary. Casually using your cellphone is discouraged because you could easily snap a pic at any time.   It’s also very rude to be on your phone while someone is trying to give you excellent service.  Trust me, scrolling until you find the bottom of whatever social media platform you’re on can wait a few minutes while a budtender focuses their time on you.

Don’t Linger

Visiting a dispensary can be exciting and while it may be tempting to try and make the experience last as long as possible, please keep in mind there may be other patients waiting for you to finish looking at every strain twice only to finally settle on the first thing you looked at. (…wow deja uv, this sounds familiar)  Once you have completed your purchase, most dispensaries would prefer you be on your way and not hang around for longer then necessary.  If you are wondering why the security guard is staring at you, it may be time for you to politely exit stage left.

Don’t talk about illicit activities

This is a big no-no.  You will most likely be asked to leave if you break this rule.  We all know recreational cannabis is inevitable eventually.  But not now, and its probably a few years off in Missouri at least.  Missouri passed a medical marijuana law, key word being medical, so saying the wrong thing like sharing with non-patients, driving while smoking, needing party favors, or taking cannabis across state lines, is all frowned upon and should be discouraged by all responsible medical marijuana patients.  Your right to consume cannabis should NOT be taken lightly.  Many people fought really hard for a long time for us to be able to enjoy the healing powers of cannabis.  Rights are hard to earn, and easily taken away.  You don’t want to be the person that ruins it for everyone else.  (I will hunt you down!)

Don’t Haggle

The price is the price.  There is a reason some cannabis is more expensive than others. There is a reason some growers charge more for their best stuff.  A lot of love and hard work went into growing that cannabis.  Some strains are really hard to get and highly sought after.  All the usual rules of commerce apply the same in the cannabis industry.  And just like some of your favorite spirits and liquors….the goods ones are normally more expensive, but you also get what you pay for.  I hate comparing the two, but facts are facts.  And don’t even complain about the tax rate. The budtender selling you your eighth can do absolutely nothing about that tax rate, and they didnt decide what it should be.  Trust me when I say that Uncle Sam is collecting his due from not just the patient, but also every cultivator, dispensary, and processor.  Render unto Caesar and all that….oh, and businesses can’t deduct expenses.  But thats a whole other bag of worms.

 Don’t draw attention to the dispensary

Most dispensaries operate on a fragile truce with their surrounding neighborhood.  A lot of dispensaries exist without any issues or complaints.  However, there will always be that one neighbor just waiting for someone to do the wrong thing and try and get the place shut down.  As tempting as it may be, leave your meds in its packaging until you get home and for heaven’s sake, don’t even think about sparking up in the parking lot.  

OK, I think that covers most of our bases on what not to do.  Now, what TO DO….

Bring your ID

Medical marijuana dispensaries are governed by some of the most stringent regulations out there.  They are not going to let you in without an ID.  Even if you were to go to your favorite dispensary everyday, at the same time of day, wearing the same clothes, they are not going to let you in.  It’s not that they don’t know you, or that they don’t want to help you, it’s that any slight misstep could mean they will lose the license they fought so hard to get.  Before you can leave the waiting room and enter the sales floor, you are going to have to show the front desk your ID and Patient ID Card

Ask Questions

I know I shared this already, but I think it bears repeating.  Don’t make the mistake by thinking that you know everything.  The science is always changing.  A lot of things we took as facts 10 years ago are being debunked as “Bro Science” , or things you might have heard from your ‘bros’ that you take as fact.  Good dispensaries are going to have an ongoing training program for their staff.  Asking a few questions can tell you a lot about what a budtender does or doesn’t know, and by that, if a dispensary is worth visiting again.  

Check out the menu online

If there is something specific you would like to try, it’s smart to call ahead and make sure their online menu is current.  This can help you avoid a disappointing trip when your favorite strain is also a popular one and the dispensary runs out before you can get there.  Some dispensaries may even be able to pull your order and have it ready for pickup when you get there!

Tipping your budtender is common…

Some people are surprised to learn that tipping a budtender is more common than you think.  $1 or $2 for small buys, $5 for bigger buys. Some might consider a dispensary as a retail business.  I will argue the fact that a great dispensary is judged not only by their product, but also by the service they provide their patients.  Sometimes more so the latter.  Budtenders, like a barista or bartender, provide a service for patients.  Budtenders help patients with all kinds of things like finding the right dosage, mode of delivery, or finding the right product with the right terpene profile that best suits their needs.  Budtenders often develop long-term relationships with the patients they help as they craft the individual patient therapy plan for that specific patient.  

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I share the same excitement that I’m sure most of you feel when I think about when dispensaries will finally be open for business here in Missouri.  Bottom line, the thing to remember is to have fun and enjoy your trip to the dispensary.  Don’t hesitate to ask questions, the budtenders are there to share their vast knowledge and passion they have for cannabis with you and help make your visit an enjoyable one.  Could really use a pic of the KC Cannabis coming soon banner….