UPDATE: Medical Cannabis

With the legalization of medical cannabis (or marijuana) in Illinois, an alternative medication for treating a long list of medical conditions became available to residents. The State of Illinois requires strict adherence to many guidelines before patients are granted permission to take medical marijuana. The steps are straightforward and assistance to complete them is available. However, the guidance of a trusted physician with whom patients have built an established relationship is paramount to success.

Medical Marijuana

How Does Medical Marijuana Work?
When speaking of medical marijuana, we are referring to two specific groups of products derived from the sativa cannabis plant: marijuana containing tetrahydrocannabinol (THC) and marijuana containing cannabidiol (CBD). THC is the component that provides a sense of euphoria, or a “high,” while CBD has no psychoactive reaction. CBD products can contain varying amounts of THC. (We are not referring to CBD products derived from hemp, which contain no THC.) Both THC and CBD are effective in relieving pain, reducing nausea and anxiety and more. Other differences: THC has side effects and increases appetite (CBD does not) and CBD decreases seizures (THC does not). Marijuana products with THC can be smoked or inhaled or can be added to capsules, chews, lozenges, oil or mixed into food. CBD can be obtained in capsules, pills, oils, balms, edibles and in vape pens. The way medical marijuana is ingested changes its effectiveness, so patients’ physicians should help determine which chemical and in what form it will provide the most effective relief.

Medical Marijuana and Older Adults
There are over 39,000 registered adults in Illinois’ medical marijuana program, of which a third are 61 years old or older. Post Traumatic Stress Disorder, cancer and rheumatoid arthritis are some of the most common of the 41 approved conditions for which individuals receive marijuana, while other frequentlylisted conditions include Parkinson’s disease, Alzheimer’s disease and glaucoma. There is some question as to cannabis’s effectiveness to treat some of the conditions on the list. For instance, both The Michael J. Fox Foundation for Parkinson’s Research (michaeljfox.org) and The Parkinson’s Foundation (parkinson.org) found that the benefits of medical marijuana on Parkinson’s disease are inconclusive.

Legal History in Illinois
The Compassionate Use of Medical Cannabis Pilot Program became effective in January of 2014, with an expiration date of July 1, 2020. In August 2018, former Governor Bruce Rauner signed the Alternatives to Opioids Act that allows patients to use medical marijuana as a replacement for opioid pain medications. Anyone who receives a prescription for pain pills (like OxyContin® or Vicodin®) can be certified for medical marijuana. Other changes to the original program include eligibility of minors to participate in the Program, the removal of the fingerprint and background check requirement and the ability to get provisional approval while one’s application is being processed.

Buying Medical Marijuana
During the application process, patients select a dispensary from one of the 55 in Illinois and purchases may only be made from their designated dispensary. The patient may switch dispensaries but must register the change with the Program and can only be registered to one dispensary at a time. While the steps to apply for a registry card are fairly straightforward, patients can get help with the process for free through their local health department. They can also request help from their chosen medical marijuana dispensary. While the dispensary in not obligated to provide help with the application process, they are prohibited from charging for the assistance. It should be noted that both CBD and THC are illegal under Federal law. However, many states, including Illinois, have laws that make them legal for medical purposes.

How to Participate in the Program
Patients must meet several criteria and obtain a registration card from the State of Illinois. To begin with, they need to have received an examination within the last 90 days from a physician with whom they have an ongoing patient-doctor relationship. Along with reviewing their medical history, the diagnosis must be for at least one of the medical conditions approved by the program with documentation that the condition, or its symptoms, would improve with the use of medical cannabis.

The application fees for a registration card start at $100 per year. Patients who are veterans, receive Social Security Disability Income, Supplemental Security Income or have a terminal illness may qualify for reduced or no application fees. Patients also have the option of designating a caregiver who, once approved by the Program, will have the ability to purchase and administer medical marijuana to the patient. The fee for a caregiver card starts at $25. The Registry card needs to be renewed and the number one reason for patients being removed from the registry is for non-payment of the fees.

In our effort to keep our older adults, their loved ones and professionals informed on the topic of medical cannabis, CJE has presented information on medical cannabis in the past. Most recently, we introduced the topic during a Transition to Wellness educational program featuring an expert in the field, Leslie Mendoza-Temple, M.D., Medical Director of Integrative Medicine Program at NorthShore University HealthSystem. Be sure to watch for more informational programs from CJE focusing on this topic.