The feeling begins as a ripple, nothing more, somewhere deep in her stomach. Quickly, though, comes another. Then another. Soon Deana Martinez's stomach is convulsing, and the whole of her day now hinges on the next moments.
If she vomits, she might not eat for the next 24 hours. She might not even leave the bathroom for much of it. She's 119 pounds. The medications she's taking – 15 different kinds, 25 pills a day to treat her advanced AIDS, her intestinal tie-ups, her constant pain after 21 surgeries – don't work if she can't keep them down.
So she reaches for a glass pipe packed with marijuana, flicks a lighter and inhales deeply.
And that is how Martinez now begins nearly every morning of her life.
"When I smoke," she said, "I stop gagging immediately."
"If I don't medicate right away, I'm puking."
In 2000, stories like Martinez's sold Colorado voters on approving marijuana for use as a medical treatment for certain conditions, including HIV. And for a decade, that's largely how the drug was used.
But in the past year, the number of people legally allowed to use marijuana in the state shot from about 10,000 to more than 90,000 – with 650 new applications and renewals received each day at the state health department.
And most are not like Martinez.
The statistically average patient is male – three-quarters of medical-marijuana patients are, according to the most recently available figures – about 40 years old, living in the Denver metro area and said on his application that he suffers from severe pain. Ninety-two percent of patients listed that catch-all condition – severe pain – as at least one of their reasons for seeking marijuana.
Many within that group use marijuana to treat medical conditions for which more conventional – and more researched – treatments exist. Marijuana works better, they say. They like the idea of naturally grown medicine. They distrust the motives of the pharmaceutical companies and the medical industry in general.
"I know the grower, generally; I know what goes into it," said Naresh Chandranatha, a 20-year-old medical-marijuana patient who said he suffers from Crohn's disease and migraine headaches, neither of which are specifically mentioned on the list of conditions for which Colorado allows marijuana as treatment, but both of which fall in the "severe pain" category. "I would be wary of taking something from a pharmaceutical company that isn't grown naturally."
In some cases, patients may see the dispensary as supplanting traditional health care, while others see the two as working hand-in-hand. And some embrace the new science of marijuana, while others rely on the tribal knowledge of dispensary workers – budtenders, in industry parlance – to guide them to what they hope works best.
"I do usually ask when I go there what's the flavor of the day," medical-marijuana patient Michael Boling said. "And they usually point me to the strongest thing they have."
That is not to say Boling doesn't see himself as an informed patient.
Like many patients, he varies his use between energy-boosting strains in the morning and sleep-inducing ones at night. He eats a marijuana-infused brownie or candy bar when he's looking for long-lasting effects, and he smokes when he's in search of a quicker onset.
Three years ago he ruptured a disc in his back while lifting a bag of concrete. For the pain that resulted – sharp stabs that he said pierce down his leg into his toes – doctors prescribed painkillers. But Boling, 37, worried about their long-term effects on his body. So last year Boling, who said he smoked pot when he was younger and then quit, applied for his medical-marijuana card.
"I wanted an alternative to what I had been doing," he said. "I wanted something that was more holistic."
Boling acknowledged that traditional painkillers work – even over-the-counter drugs such as Tylenol or Advil. But he said marijuana dulls the pain more and lasts longer.
His doctors, meanwhile, are of mixed opinions on his medical-marijuana use, Boling said. Some have been accepting, he said, while others have urged him to stop.
"It gets such a bad rap," Boling said. "Just because we smoke doesn't mean we're potheads."
But it doesn't mean that all patients run from the pothead image either. Chandranatha, for instance, has run a website called Denver Stoner, and he said part of what appealed to him when he started smoking pot recreationally about three years ago was the culture.
"I love going to the rallies and being with other like-minded people," he said. "I just think it's interesting that some people talk to their plants and play music to their plants. . . . There's nothing better than sitting around a tarp with a couple of friends and trimming plants."
Chandranatha still smokes recreationally, he said. But he got his medical-marijuana card about a year ago because he said he found that marijuana helps his digestive issues and prevents or lessens the severity of his migraine headaches. (A marijuana possession ticket Chandranatha received in 2008 also prompted him to get his card, he said.)
Now, Chandranatha said, his marijuana use is mostly medical.
"I won't smoke with other people when it's medical," he said. "I'll generally lie down and smoke a bowl on my own. But if it's recreational, I'll smoke with other patients."
Chandranatha is so convinced of marijuana's benefits that it is replacing traditional medical care for him. When he came down with pneumonia recently, he chose to go to the dispensary instead of the doctor's office. And a few months ago when he crashed on his skateboard going downhill at 35 mph – he said he had friends trailing him in a car to verify his speed – he did the same.
"It was like, 'Should we go to emergent care or Herbal Connections?' " Chandranatha recalled.
At the dispensary, he said, he got a massage, bandages and a cannabis-based balm for his wounds. The next morning, he said, he felt sore but was otherwise OK.
Avoiding the doctor is not an option for Martinez. She's seen 70 of them in the past two decades, though she is now down to two regular physicians.
Beginning in the late 1980s, her physical condition began mysteriously to deteriorate. She broke out in fevers and rashes, vomited often, had frequent diarrhea.
By 1999, she had begun using marijuana to control her nausea and allow her to eat, but the underlying medical problems only intensified. It wasn't until late 2008 when a nurse practitioner, on a hunch, decided to run a blood test and called Martinez in to talk about the results. "Deana," she said, "you have HIV."
About a month later, Martinez sat in a doctor's office as he informed her of the results of her T-cell count, the test that would determine how advanced the disease was. Most healthy people have a count of at least 500 sickness-fighting T-cells. Some have a count as high as 1,500. Martinez's count was 12.
Martinez started taking antiretroviral drugs. She also applied for her medical-marijuana card. For a time, she tried growing her own marijuana but kept killing her plants. Searching for a dispensary, Martinez found a mixed lot.
"Some of them were a little disappointing," she said. "It was just people handing out weed."
But soon she discovered a dispensary in Denver called Cannabis Medical Technology, where the owners, Andy and Lori Cookston, took an interest in her. In contrast to a traditional medical system that Martinez said she often found cold, the Cookstons listened to her and responded to her ideas. To help with costs, they placed her into a survey program they started to identify what strains of marijuana work best for what conditions – a program through which she receives some free marijuana.
Of all the medical providers Martinez sees, they are the only ones who make house calls.
"They're more than just my medicine people," she said. "They're in my heart. They care about me and my son. There's a relationship, a partnership with them that's more than you would ever get in the medical field."
Ben Young, an infectious disease specialist at Rocky Mountain Cares who is Martinez's AIDS doctor, said the system seems to be working. Marijuana has helped keep down the medicines that could save Martinez's life. Her T-cell count is now up to 259. Her pain is more manageable. And she has embraced her disease as a cause by urging everyone to get an annual HIV test.
Marijuana will not be the answer for everybody, Young said, but for Martinez, it helps. "When Deana first came here, she was literally walking in a fetal position in pain," he said. ". . . It's about getting maximum access to things that can make you feel better."
NewsHawk: Ganjarden: 420 MAGAZINE
Source: The Denver Post
Author: John Ingold
Contact: The Denver Post
Copyright: 2010 The Denver Post
Website: Medical-marijuana: Patients clouded in controversy
* Thanks to MedicalNeed for submitting this article
If she vomits, she might not eat for the next 24 hours. She might not even leave the bathroom for much of it. She's 119 pounds. The medications she's taking – 15 different kinds, 25 pills a day to treat her advanced AIDS, her intestinal tie-ups, her constant pain after 21 surgeries – don't work if she can't keep them down.
So she reaches for a glass pipe packed with marijuana, flicks a lighter and inhales deeply.
And that is how Martinez now begins nearly every morning of her life.
"When I smoke," she said, "I stop gagging immediately."
"If I don't medicate right away, I'm puking."
In 2000, stories like Martinez's sold Colorado voters on approving marijuana for use as a medical treatment for certain conditions, including HIV. And for a decade, that's largely how the drug was used.
But in the past year, the number of people legally allowed to use marijuana in the state shot from about 10,000 to more than 90,000 – with 650 new applications and renewals received each day at the state health department.
And most are not like Martinez.
The statistically average patient is male – three-quarters of medical-marijuana patients are, according to the most recently available figures – about 40 years old, living in the Denver metro area and said on his application that he suffers from severe pain. Ninety-two percent of patients listed that catch-all condition – severe pain – as at least one of their reasons for seeking marijuana.
Many within that group use marijuana to treat medical conditions for which more conventional – and more researched – treatments exist. Marijuana works better, they say. They like the idea of naturally grown medicine. They distrust the motives of the pharmaceutical companies and the medical industry in general.
"I know the grower, generally; I know what goes into it," said Naresh Chandranatha, a 20-year-old medical-marijuana patient who said he suffers from Crohn's disease and migraine headaches, neither of which are specifically mentioned on the list of conditions for which Colorado allows marijuana as treatment, but both of which fall in the "severe pain" category. "I would be wary of taking something from a pharmaceutical company that isn't grown naturally."
In some cases, patients may see the dispensary as supplanting traditional health care, while others see the two as working hand-in-hand. And some embrace the new science of marijuana, while others rely on the tribal knowledge of dispensary workers – budtenders, in industry parlance – to guide them to what they hope works best.
"I do usually ask when I go there what's the flavor of the day," medical-marijuana patient Michael Boling said. "And they usually point me to the strongest thing they have."
That is not to say Boling doesn't see himself as an informed patient.
Like many patients, he varies his use between energy-boosting strains in the morning and sleep-inducing ones at night. He eats a marijuana-infused brownie or candy bar when he's looking for long-lasting effects, and he smokes when he's in search of a quicker onset.
Three years ago he ruptured a disc in his back while lifting a bag of concrete. For the pain that resulted – sharp stabs that he said pierce down his leg into his toes – doctors prescribed painkillers. But Boling, 37, worried about their long-term effects on his body. So last year Boling, who said he smoked pot when he was younger and then quit, applied for his medical-marijuana card.
"I wanted an alternative to what I had been doing," he said. "I wanted something that was more holistic."
Boling acknowledged that traditional painkillers work – even over-the-counter drugs such as Tylenol or Advil. But he said marijuana dulls the pain more and lasts longer.
His doctors, meanwhile, are of mixed opinions on his medical-marijuana use, Boling said. Some have been accepting, he said, while others have urged him to stop.
"It gets such a bad rap," Boling said. "Just because we smoke doesn't mean we're potheads."
But it doesn't mean that all patients run from the pothead image either. Chandranatha, for instance, has run a website called Denver Stoner, and he said part of what appealed to him when he started smoking pot recreationally about three years ago was the culture.
"I love going to the rallies and being with other like-minded people," he said. "I just think it's interesting that some people talk to their plants and play music to their plants. . . . There's nothing better than sitting around a tarp with a couple of friends and trimming plants."
Chandranatha still smokes recreationally, he said. But he got his medical-marijuana card about a year ago because he said he found that marijuana helps his digestive issues and prevents or lessens the severity of his migraine headaches. (A marijuana possession ticket Chandranatha received in 2008 also prompted him to get his card, he said.)
Now, Chandranatha said, his marijuana use is mostly medical.
"I won't smoke with other people when it's medical," he said. "I'll generally lie down and smoke a bowl on my own. But if it's recreational, I'll smoke with other patients."
Chandranatha is so convinced of marijuana's benefits that it is replacing traditional medical care for him. When he came down with pneumonia recently, he chose to go to the dispensary instead of the doctor's office. And a few months ago when he crashed on his skateboard going downhill at 35 mph – he said he had friends trailing him in a car to verify his speed – he did the same.
"It was like, 'Should we go to emergent care or Herbal Connections?' " Chandranatha recalled.
At the dispensary, he said, he got a massage, bandages and a cannabis-based balm for his wounds. The next morning, he said, he felt sore but was otherwise OK.
Avoiding the doctor is not an option for Martinez. She's seen 70 of them in the past two decades, though she is now down to two regular physicians.
Beginning in the late 1980s, her physical condition began mysteriously to deteriorate. She broke out in fevers and rashes, vomited often, had frequent diarrhea.
By 1999, she had begun using marijuana to control her nausea and allow her to eat, but the underlying medical problems only intensified. It wasn't until late 2008 when a nurse practitioner, on a hunch, decided to run a blood test and called Martinez in to talk about the results. "Deana," she said, "you have HIV."
About a month later, Martinez sat in a doctor's office as he informed her of the results of her T-cell count, the test that would determine how advanced the disease was. Most healthy people have a count of at least 500 sickness-fighting T-cells. Some have a count as high as 1,500. Martinez's count was 12.
Martinez started taking antiretroviral drugs. She also applied for her medical-marijuana card. For a time, she tried growing her own marijuana but kept killing her plants. Searching for a dispensary, Martinez found a mixed lot.
"Some of them were a little disappointing," she said. "It was just people handing out weed."
But soon she discovered a dispensary in Denver called Cannabis Medical Technology, where the owners, Andy and Lori Cookston, took an interest in her. In contrast to a traditional medical system that Martinez said she often found cold, the Cookstons listened to her and responded to her ideas. To help with costs, they placed her into a survey program they started to identify what strains of marijuana work best for what conditions – a program through which she receives some free marijuana.
Of all the medical providers Martinez sees, they are the only ones who make house calls.
"They're more than just my medicine people," she said. "They're in my heart. They care about me and my son. There's a relationship, a partnership with them that's more than you would ever get in the medical field."
Ben Young, an infectious disease specialist at Rocky Mountain Cares who is Martinez's AIDS doctor, said the system seems to be working. Marijuana has helped keep down the medicines that could save Martinez's life. Her T-cell count is now up to 259. Her pain is more manageable. And she has embraced her disease as a cause by urging everyone to get an annual HIV test.
Marijuana will not be the answer for everybody, Young said, but for Martinez, it helps. "When Deana first came here, she was literally walking in a fetal position in pain," he said. ". . . It's about getting maximum access to things that can make you feel better."
NewsHawk: Ganjarden: 420 MAGAZINE
Source: The Denver Post
Author: John Ingold
Contact: The Denver Post
Copyright: 2010 The Denver Post
Website: Medical-marijuana: Patients clouded in controversy
* Thanks to MedicalNeed for submitting this article
