Opioid alternative? For some, marijuana helps control chronic pain

September 28, 2018

EDITOR’S NOTE: This is the fourth installment of a five-week series covering opioid use and treatment which will run each Thursday through Oct. 4.

BULLHEAD CITY — More than 5,000 of the 178,000 medical marijuana cards issued in Arizona are held by residents of Mohave County, according to the Arizona Department of Health Services, which published its latest monthly report on the state’s medical marijuana program in August.

The August report also stated that more than 87 percent of medical marijuana patients suffer chronic pain as their qualifying medical condition — that’s nearly 155,500 people. Other illnesses cited by at least 1,000 cardholders were cancer, post-traumatic stress disorder, seizures and glaucoma.

“A lot of people we work with are trying to not take opioids,” said owner/director Debbie Hunter of Debbie’s Dispensary, which opened a Bullhead City medical marijuana location in July.

Hunter understands the desire to find opioid alternatives. She suffered arm and shoulder pain after years of heavy lifting as a casino bellman and was prescribed narcotics to treat the chronic pain. Hunter said she felt dependent on the medication and saw it affect her day-to-day life. With the legalization of medical marijuana in Arizona, Hunter transitioned off of opioids. Now she hopes others find similar relief, she said.

Hunter and her brother Curtis Devine, CEO of Mohave Cannabis, have three farms that supply their retail locations in Bullhead City and Peoria, as well as other operators, and they have plans to open additional stores around the state.

Devine obtained his first state license in 2012 and grew marijuana in his garage but today Mohave Cannabis holds seven licenses, including a previous Mohave Green location in Mohave Valley.

There are two major strains of cannabis — sativa, a stimulant, and indica, a sedative. Hybrids are combinations of the two varieties.

Extracts and concentrates are made from the plant’s flower or bud; kief comes from the plant’s trichomes, or resin glands, that stick out from the plant making it look as if it is covered in frost; and hashish comes from compressed or concentrated trichomes, Hunter explained.

Medical marijuana can be added to other products to create hash oil, edibles, cannabis oil, cannabis butter, tincture, spray and cannabis topicals.

Patients can eat it, drink it, use it topically, smoke it, vape it or inhale it through a vaporizer.

The locations provide handbooks to patients that explain what cannabis is and how it works, Hunter said.

Debbie’s offers pages outlining the benefits of medical marijuana, the therapeutic potential of cannabis, the risks of using medical marijuana, instructions about proper use, warnings about what can go wrong — including when to recognize abuse, tolerance and dependence as well as the effects of drug interactions, use impairment and even when a call to poison control may be necessary.

There are also pages for logging dosage, effects, form of consumption and how that form worked.

Along with the handbooks is manufacturer-produced literature for some products that employees hand out, and manufacturers often send representatives to stores to meet with customers, Hunter said.

Mohave Green, the old location in Mohave Valley, was designed “like a fort,” said Hunter, who heads the company’s retail operations. “That was because my brother wanted to protect me.”

The new location also is highly secure, with a sophisticated surveillance system throughout the building and security at the door.

The reception and waiting area look more like a doctor’s office than a medical marijuana dispensary.

The retail store is separated from the front section of the location. There are office spaces and areas where supplies necessary in the sale of such products are stored. Like most other retail stores, there are spaces for sorting and other sales-related tasks.

The retail area resembles a jewelry store with glass cases and an airy method of display. Even the walls are customized with distinctive graphics, such as the logoed “D” in the store name. Debbie’s Dispensary also sells logo-emblazoned merchandise.

Seating in the waiting area is set up to foster discussion among customers. Providing customers with a friendly environment is important to Hunter, she said.

“While some people aren’t comfortable initially, they ultimately get past that,” Hunter said.

People can benefit from learning from one another about their experiences using medical marijuana, she said.

Cheerfulness toward patients is as important in the retail area as being able to answer their questions about the medical products sold there. Employees make customers feel comfortable by encouraging conversation. Job applicants are asked to be “real, thoughtful, welcoming, helpful, kind and caring,” Hunter said.

Hunter embraces kind and caring in her interactions with the community. Mohave Cannabis and Debbie’s Dispensary support the annual Bullhead City Fire Department Toy Drive, Boys & Girls Clubs of the Colorado River and Relay for Life, to name a few endeavors.

On average the corporation, whose motto is “Feel Like Your Best Self,” donates more than $50,000 to community nonprofits each year, according to Kristy Zavala, office manager.

Hunter and Devine are from the Tri-state, where they and their siblings were raised by a single mother.

“We were raised by a village,” Hunter said. “The community helped raise me.”

Dr. Frank LoVecchio, co-medical director of the Banner Poison and Drug Information Center in Scottsdale, said that medical marijuana as a viable substitute for opioids hasn’t been well studied — especially in humans.

“Most clinicians would welcome something that make our patients safer,” he said. “In theory” both substances offer “pain relief and relieve anxiety.”

Marijuana remains illegal under federal law even though it’s legal in some states.

That is one reason why marijuana’s therapeutic and medicinal uses have not been embraced by mainstream medicine, Hunter said.

“Lack of federal funding to do more extensive research on the medicinal benefits of marijuana have absolutely affected perception,” she said.

There were no documented marijuana overdose deaths in 2017, according to the Centers for Disease Control and Prevention. There were 49,068 opioid deaths in the United States in 2017, according to the National Institute on Drug Abuse.

Thirty-one states, Washington, D.C., Puerto Rico and Guam have legalized medical marijuana use since 1996. Eight states, including Nevada and California, allow it for adult recreational use.

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