“The endocannabinoid system isn’t taught in medical school,” Vanessa Niles, M.D., an ob-gyn and founder of Synergy Health, a California-based medical cannabis practice, tells SELF. “You have to find a doctor who specializes in cannabis or has some level of training in cannabis to be able to certify you no matter which state you’re in.”
Your state health department should have a list of registered practitioners in your state that you can get in contact with. (Here’s the list for New York, for example.) Websites like Leafly and WeedMaps also run their own handy databases of cannabis doctors.
Another option, one that may be particularly attractive as the COVID-19 pandemic continues, is to do a virtual consultation with services such as NuggMD or Veriheal, which connect patients with registered cannabis doctors in their area via video chat.
3. Chat with the doctor to figure out a plan that works for you.
The goal of your evaluation with a cannabis specialist is to verify that you have a health condition that qualifies you for a medical cannabis card. And, from there, it’s to figure out the best way to start using cannabis to help manage your specific issues.
Remember that each state has its own list of qualifying health conditions that allow a registered doctor to certify patients for a medical cannabis card. There is some common overlap across states’ lists. For instance, cancer, HIV/AIDs, and chronic pain show up on many of the lists. But there are also some interesting discrepancies. In New York, migraine headaches and period pain (dysmenorrhea) are not listed specifically as qualifying conditions, for example, but they are in New Jersey.
But you might be surprised at how open to interpretation those conditions may be. Migraines may not be a qualifying condition in New York, but chronic pain and “pain that degrades health and functional capability as an alternative to opioid use or substance use disorder” are listed. “There’s a whole subset of conditions that people may not know would qualify under chronic pain and things like that,” says Dr. Kessler, who was actually the doctor who certified me. Issues like chronic headaches, gastrointestinal issues, and pain related to TMJ may actually qualify under the umbrella of other conditions, he explains.
Although the exact format of the conversation will be different depending on your doctor, expect to be asked about any other health conditions to keep in mind, any other medications you might be taking, and any concerns you might have about using cannabis in this way.
“It’s important to understand what the patient’s symptoms are and what time of day they want to take their medication,” Dr. Niles says. The timing is especially key because that will help the doctor give recommendations about different cannabinoids and cannabinoid ratios to look for in products. For example, some may give a more uplifting, energetic feeling that can be taken during the day while others provide a relaxing effect that’s better suited to nighttime.
During this evaluation, the doctor should also give you a heads-up about any side effects you might experience. Those could include an increased heart rate, nausea, and dizziness.
You should walk away from this evaluation with a solid idea of what to get at a dispensary, but no doctor in the country is allowed to actually legally prescribe cannabis. That means you won’t get a specific prescription that a dispensary is required to fill exactly the way you might get a prescription for an antibiotic filled at a pharmacy, Dr. Tishler says. But your doctor should give you as much guidance as possible to get what you need.
4. You may need to register with the health department, depending on your state.
Each state has its own rules and processes for medical cannabis patients. In some states, such as Connecticut and New York, patients need to register with the state health department on their own before getting their card, which can be an annoying bureaucratic step but isn’t usually a huge hurdle.