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"They'll just say, 'It's impossible,'" Nick said, referring to how medical staff at these facilities respond to the idea of bringing in medical cannabis for patients. "It's like, if a family member brings in BenGay for their patient, we have to tell them, 'You can't do that unless you bring it to us and we have to run it by the doctor and we need to have a telephone order.' That's the context. That's how controlled it is."
Yet in nursing homes, there are plenty of patients whose lives would be better if they had access to medical cannabis. "There are all these patients who have chronic pain, insomnia, loss of appetite, depression, Parkinson's, agitation from Alzheimer's — all of the patients who are on a million medications to handle these things and the medications are creating a lot of the need for other medications. It was frustrating to know there wasn't a way to even try to see whether or not these patients would even benefit from cannabis."
Nick said he would be surprised if any but the smallest nursing facilities secretly allowed the drug on the property. "That's a huge risk for the owners to take," he said. "My hat's off to them. If there's nursing homes doing that, they need to be commended, because it's a huge risk. I don't know of anybody who's doing it."
But there are people secreting pot to the sick and dying, sometimes under the nose of administrators, sometimes with their tacit permission. An Oakland social worker we'll call Gladys said nursing home seniors in two facilities she knows of use cannabis for pain and anxiety, and in a dementia group "for hunger. Getting them to eat. They forget to eat. They don't want to eat. Food is not on their radar. ... And for sleep.
"A few have medical cannabis cards, but ... they can't show [them]," Gladys continued. "No controlled substances. Period. Not even if you have a medical marijuana card."
Gladys also requested that her real name not be used in this story because she could lose her job.
But some people have no such fears. Erich Pearson, founder of the SPARC medical cannabis dispensary in San Francisco, has spent ten years secreting marijuana to hospices. "They were skeptical at first and I was a bit nervous," he said of the hospice staff. "I went to the first meeting with the entire staff and I was young, 22, and the entire staff is all dressed up in nursing garb. I was getting looks like, 'What are you doing here bringing medical marijuana?' But the executive director was behind it and three weeks later, 9:30 at night I got a call from them: 'We got a new patient, can you bring marijuana right now?'"
The federal crackdown is making his partners cautious, but they're not willing to stop what they're doing. "I think they see the advantages of it — I don't think the program is tenuous," he said. "But it's certainly not on the books, for obvious reasons."
When Pearson approached a patient named Jim, he was resistant to smoking cannabis even though he was beginning to waste away because the nausea from chemotherapy was overwhelming and he couldn't eat. "I got to the point where I couldn't even stand the smell of food; it would make me throw up — just the smell," Jim said. "It got to the point where I was ready to have a feeding tube put in. Erich had approached me before and I had said, 'No, I'm really not interested. I just thought they were just, like, hippies and I really wasn't into that whole scene. It's just a totally different scene than I was used to."
But then came the harsh reality of eating through a feeding tube. "I said 'Okay.' I smoked it," Jim said of the cannabis that Pearson offered him. Jim said his quality of life changed quickly. "I was able to stand the smell of food. Then I was able to handle small plates of food. So the feeding tube was canceled."
That was in 2000. Pot helped Jim with his second cancer chemo — and with the pain from having his lymph nodes surgically removed.
About 213,000 people will die in California this year, many from complications related to heart disease and cancer. Meanwhile, dispensaries are closing in San Francisco, making it harder to get medical cannabis. "It makes me very angry," Jim said. "I think it's wrong.
"I'm just very disappointed in Obama regarding it, too," he continued. "It's about the same or worse than Bush. It's just very disappointing."
Neither of the state's two hospice associations has staked out a public position on medical marijuana. California Hospice and Palliative Care Association President Susan Negreen said the issue has come up but the board declined to take a position. Vitas — a mega-hospice corporation in California — declined to comment.
Caren Woodson, delivery dispensary manager from The Green Cross in San Francisco, said the service delivers lots of edibles to hospitals and senior patient care facilities. "We're personally experiencing a situation where more older home facilities and hospitals and hospice care facilities are creating policies that welcome use of cannatherapies," she said. "However the individual operation creates that particular rule rather than any general acceptance."
She also said that the federal backlash against medical marijuana appears to only be coming from the US Department of Justice. "The Obama administration has issued both Veterans Affairs recommendations and HUD recommendations around the use of medical cannabis specifying that local authorities have the right to make those decisions or exercise that discretion as they see fit," she noted.
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