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Appalachia Health News tells the story of our health challenges and how we overcome them throughout the region. 

More Than 8,000 Receiving Medical Cannabis In W.Va.

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Bob Fisher and his wife live in Fairmont. Fisher uses medical cannabis for back pain.

Medical cannabis is finally available to more than 8,000 patients in the Mountain State. Lawmakers greenlit the product in 2017, but it wasn’t until this year that a dozen dispensaries opened.

Now 60-year-old Fairmont resident Bob Fisher has access to a product that eases his back pain.

“I have two herniated discs in my lower back. Sometimes it's not so bad, sometimes it's really horrible,” Fisher said. “Like right now, I'm going through a spell where I'm going to Quasimodo coming out of the bell tower thing where I sort of drag one leg behind me.”

Fisher said that as a child of the 70s, he’s no stranger to some recreational cannabis use. But having post-traumatic stress disorder and back pain got him curious about the medicinal benefits of the plant.

He read up on the topic and was eager to participate in West Virginia's program. However, he didn’t get his hopes up either. He had to wait five years for the product to be available.

“I waited until I actually saw news reports of active growing actually happening,” Fisher said. “Once I saw that someone actually had seeds in the dirt, that's when I went ahead and did my application.”

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Bob Fisher makes brownies out of his medical cannabis. Edibles aren't legal in West Virginia, but Fisher can make it himself with product from dispensaries.

Fisher can now buy the product, though it’s not covered by insurance and isn’t cheap. He bakes brownies with it most often. He still takes pain medicine to ease his back problems, but he’s not taking nearly as many pills since he started cannabis. Fisher said it’s not a cure-all, but it gives him physical and mental relief.

“I can read or watch TV and be able to function without sitting and thinking about how miserable I am,” Fisher said.

The proposed benefits of medical cannabis are wide ranging. That’s because it taps into your endocannabinoid system. Much like your nervous system, it impacts every part of your body.

“I think within the next decade, we'll see a whole new host of uses for medical cannabis,” said Dr. Meredith Fisher-Corn. She created the curriculum every doctor in West Virginia, and some other states, must take before they begin recommending cannabis.

“Every day, I read through the medical literature and I examine the medical cannabis studies, I do,” Fisher-Corn said.

She’s watched the research grow exponentially in recent years. She said the findings suggest a wider use for medical cannabis than what’s approved by the Food and Drug Administration. The FDA has only approved the cannabis components THC and CBD for those with cancer, HIV and a certain epilepsy.   

That means cannabis is an off-label medication, which isn’t uncommon. Fisher-Corn offered a way to reconcile the limited FDA recommendations with what newer research says is possible, but not proven.

“The current research has not found that cannabinoid therapies are superior to the current first line therapies for any condition. So in other words, cannabis should not be used before a patient tries their current first line therapy for any condition,” Fisher-Corn said.

Fisher-Corn said doctors don’t often learn about the endocannabinoid system, but she thinks they should.

“Patients are just trying to explore cannabis therapies, and they need their clinicians' assistance,” she said.

Patients in West Virginia are clearly interested. State law says doctors can’t advertise that they recommend the product, and still patients find doctors like Dr. Hassan Jafary. He’s a psychiatrist in Beckley.

He said older patients inquire about the product hoping it can ease them off pain pills.

“They know that this opioid, it doesn't matter if it helps you… it’s not safe,” Jafary said.

Cannabis is in no way a panacea for opioid use disorder. Health agencies say you can even get addicted to cannabis. But Jafary points out the big difference between opioids and cannabis.

“No study will ever show that it's ever killed anybody, you know?” he said.

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Dr. Heather Skeens sits with her brother-in-law Reid Glass outside the Greenbrier Hotel. Glass died of cancer in 2019.

Dr. Heather Skeens first took interest in medical cannabis while her brother-in-law, Reid Glass, had terminal cancer.

“He was in severe pain and couldn't sleep. He was very anxious all the time. Because he thought he would go to sleep and drown in his own blood because he had tumors throughout his lungs,” Skeens said.

She said Glass was prescribed opioids to ease his pain, but he also used cannabis. He had to get it illegally from a grower in Kentucky, where he had worked as an attorney, or from friends who had traveled to states where it was legal.

“It was the only thing that gave him a restful sleep,” Skeens said.

Taking care of her brother-in-law until his death in 2019 got Skeens interested in medical cannabis. She studied it in California and is licensed to recommend the product in a few other states.

She’s glad that dispensaries have opened in West Virginia, but she sees many roadblocks.

“Patients are really scared when they call, they feel like they're going to be judged… They ask a lot of questions like ‘Is my doctor gonna know?... Is my employer gonna know? And am I gonna get in trouble?’” Skeens said.

She also criticizes how few conditions qualify patients for medical cannabis in the state.

State lawmakers decide which patients have access to medical cannabis. That includes folks with Parkinson's or cancer or PTSD. But it doesn’t include other mental health conditions, such as anxiety or even substance use disorder.

“If I talk to my patients in Montana, these people over there, they're so accustomed to cannabis being a normal treatment… But on this side of the US, there's still a large stigma around it,” Skeens said.

Appalachia Health News is a project of West Virginia Public Broadcasting with support from Charleston Area Medical Center and Marshall Health.

Appalachia Health News Reporter, jleffler@wvpublic.org, 502-377-0438, @june_leffler

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