GLENS FALLS — There are medical marijuana dispensaries a lot closer to Glens Falls than Plattsburgh, but Curaleaf New York is hoping to win business here anyway.
The medical marijuana dispensary in Plattsburgh, which functions under the New York City-based company PalliaTech NY LLC, is holding meetings in Warren County to explain how to get a medical marijuana prescription and what the medication can accomplish.
Company officials are stressing that the drug is an alternative to opioids for pain.
Curaleaf is testing a delivery service near its Newburgh pharmacy and hopes to start one out of its Plattsburgh pharmacy next year.
“Once every two to three weeks, we’ll pick the day we’re heading south, (and) the day we’re heading west,” said Curaleaf Outreach Coordinator Steven Howell.
However, PharmaCannis has a pharmacy in Albany that is open five days a week, and VireoHealth has a pharmacy open Sundays, Mondays and Tuesdays.
Fiorello Pharmaceuticals plans to set up in Clifton Park, although the company hasn't set a date.
Curaleaf officials are confident that they can compete.
“We have the best prices in New York state, hands down,” Howell said.
The company also has a rewards program. On the second visit, patients get $5 off. On the fourth, $35 off.
Each dispensary is allowed to offer sales, rewards and other discounts, unlike regular pharmacies.
As a North Country business, Curaleaf is accustomed to patients with no internet service and no medical providers who can prescribe marijuana.
Staffers there help patients register their prescription online with the state. They also help connect patients to telemedicine doctors who can examine them from a computer screen and determine whether they could be helped by marijuana.
“I helped an 80-year-old woman get her card yesterday,” Howell said in a recent interview. “She already had her (prescription).
"But if you don’t have an email address, if you don’t have a computer, we can help you sign up with New York state to get your card.”
He connects potential patients to HelloMD or NuggMD, two telemedicine companies that employ doctors licensed to prescribe medical marijuana.
Howell watched a NuggMD doctor do an evaluation and was impressed.
“They’re thorough,” he said. “And they won’t charge you if they turn you down.”
NOT A CURE-ALL
Much of Howell's educational seminar is on what the medicine can do, and what it can't.
“We’re not pretending it will be a cure-all for everything,” he said. “It’s to improve the quality of your life. We want you to get a good night’s sleep and get some pain relief.”
The trouble is that medical researchers have generally not been allowed to run marijuana studies, he said.
Basic studies, such as having a group of patients take marijuana or an opioid so that researchers can see which reduces pain more, have not been widely done in the United States.
That's because its not legal nationwide for medicinal purposes.
But that has led to uncertainty regarding marijuana's effectiveness.
There is a list of symptoms that qualify for medical marijuana, but dosage levels and whether it works at all has to be determined case by case.
Anecdotally, marijuana's best successes are in reducing pain and seizures and increasing appetite in sick patients who can't eat enough.
REDUCES PAIN FOR SOME
Elizabethtown Dr. Herbert Savel, who is licensed to prescribe marijuana, warns that it is only to be used by people with severe, life-disabling conditions.
“It is not a free-for-all,” he said. “I will only see people who are under the care of a doctor for a serious illness.”
He is pleased with the drug’s ability to reduce pain.
“In some cases they can cut down on their narcotic use. Taking narcotics with cancer, it’s not great. This helps — less side effects than narcotics,” he said.
He saw a new patient recently who has multiple sclerosis and could barely move his left leg.
“He’s in significant pain,” Savel said.
He advised the man to try medical marijuana.
“It’s not offered as ‘This will work.’ It’s simply something to try,” he said. “With pain, in many instances, this has been found to help.”
Other afflictions are more complex to treat. For example, many try it for anxiety related to post traumatic stress disorder.
If it works, it can be used instead of Xanax or other drugs for panic attacks.
Xanax is a commonly abused drug among opioid addicts, and users have said the withdrawal symptoms are severe when they try to stop taking it.
So patients are eager to find an alternative, but there's a lot to consider.
First they must decide how to ingest marijuana.
It takes the drug about two hours to kick in if it's taken as a capsule, but its effects lasts four to 12 hours. If it’s taken under the tongue as a tincture, it acts more quickly, but wears off faster.
“You can’t untake a capsule. With the tincture, it’s more dosable,” Howell said.
TRIAL AND ERROR
He recommends marijuana to help anxious patients sleep, but the research isn't clear on that either.
There are many versions of the drug, with each company coming up with their own concentrations of THC, CBD and other cannabinoids.
The THC versions can make patients more anxious. So it's not as simple as walking in with a prescription.
“This is much more trial and error than any other pharmacy,” Howell said.
Pharmacists ask a host of questions before making recommendations on what to try.
The main question: What kind of symptoms are you trying to relieve?
Then, as the patient tries various doses over the course of a week or two, they can determine which is working best by considering how much the symptoms are reduced.
Since each company has its own concentrations, products from one may work better than another's.
“I know it helps people, because I see them walk in month after month,” Howell said. “It just helps a lot of people.”
Cost is a factor, too.
The typical price for a doctor's visit to see if a person qualifies for a prescription is around $150 in the North Country.
That doesn't include any followup appointments. The medical-cannabis certification give a patient who qualifies lasts for one year.
And medical marijuana is not covered by prescription plans.
So both doctor visits and the medicinal pot itself are out-of-pocket expenses.
In Glens Falls, Curaleaf will hold one-on-one, 15-minute health talks on Nov. 7 at Crandall Library, 252 Glen St.
RSVP to schedule a time by emailing firstname.lastname@example.org.
In Lake George, a seminar will be held from 6 to 7:30 p.m. Wednesday, Nov. 14, in the Caldwell-Lake George Library, 336 Canada St.
— Editor Suzanne Moore contributed to this report.