When the COVID-19 pandemic hit last year, interest in medical cannabis and how to get a medical marijuana card skyrocketed.
For instance, in Massachusetts, the number of new registered medical cannabis patients more than doubled between the end of March and the beginning of April last year. And a study in the Journal of Addictive Diseases found that medical cannabis users with mental health conditions were more likely than those with other conditions to increase their use between March and April of 2020. Many of the patients in that study specifically cited worries about getting COVID-19 or giving it to someone else.
Spending more time at home with anxiety through the roof led plenty of people—including me—to explore their options for managing stress as well as many other health conditions at home. After years of experimenting with cannabis to manage my anxiety and migraines, I decided to get a medical marijuana card last year. I was curious about what the dispensaries near me carried, and I wanted a more stable and consistent way to use this medicine. Although the process was surprisingly easy overall, there were a few bureaucratic steps I wish I’d known more about—and I strongly suspect I’m not alone.
The exact process of getting a medical cannabis card differs from state to state, but they all tend to follow a similar pattern. If you’re curious about getting a card where you live, here’s a basic idea of what to expect.
1. If you have a primary care provider, try chatting with them first.
The first thing to know about getting a medical cannabis card is that to qualify, you will need to have one of the specific qualifying conditions that your state allows to be managed with medical marijuana. So the first thing you should do, Brian Kessler, M.D., tells SELF, is look at your state’s list of qualifying conditions (typically listed on the state health department’s website), see if you have one of those conditions, and then chat with your doctor to see what they think about you using medical cannabis to manage that condition. (Dr. Kessler is a sports medicine and pain management specialist based in New York City who certifies medical cannabis patients online through NuggMD.)
Although it might seem like a superfluous step considering that, for most of us, our primary care doctors aren’t able to certify people for medical cards, it really is a good idea to check in with them first, Jordan Tishler, M.D., president of the Association of Cannabis Specialists, tells SELF. They will likely have a good idea of how other treatments have (or haven’t) worked for you in the past, and they can give you a heads-up about any potential interactions with medications you may be taking.
And if you’re interested in using cannabis to manage a new issue, like new back pain, “those things deserve an evaluation and a workup” before assuming that cannabis is the answer, Dr. Tishler says.
There’s also the issue that, to get certified to use cannabis for some health conditions, you may need to have documentation from your usual doctor on hand. That documentation could be something like MRI results, X-rays, or doctor’s notes, Dr. Kessler says. “Anything that has the diagnosis on it” would work, he says. So having this initial conversation with them first is a great way to get the ball rolling with a medical provider you already trust and to get any documentation you might need down the line.
2. Get in touch with a doctor who is registered to certify you for a card.
In order to get your medical cannabis card, you need to be certified by a doctor who is registered in your state to do those certifications. So if your primary care doctor also happens to be able to certify medical cannabis patients, you can easily get your certification from them. But not everyone is so lucky, because most general practitioners aren’t experts in cannabis medicine, so you will likely need to seek out a specialist.
“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. From there, you and the doctor will 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 overlap; for instance, cancer, HIV/AIDs, and chronic pain show up on many of the lists. But there are also some interesting discrepancies. For example, in New York, migraine headaches and period pain (dysmenorrhea) are not listed as qualifying conditions, but they are in New Jersey.
But you might be surprised at how open to interpretation those conditions may be. Migraines may not specifically 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. “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 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, 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.
Ultimately, though, these requirements will depend on which state you’re in. “In California you don’t have to do anything,” Dr. Niles says. “Once the doctor approves you, they push a button and send you your recommendation instantly through email, and you’ll get a hard copy in the mail.” If you have any questions about what you need to do after getting certified, talk to your doctor or check your state’s health department website for instructions.
“For most people, getting the card isn’t a big deal,” Dr. Tishler says. “I always suggest that people try it themselves, but if they get stumped then we can help. If we can’t help, we have access to the state cannabis commission so that their service people can get involved if they need to.”
5. Once you have your card, you can use it at a dispensary.
You will likely have to wait a few weeks for your physical card to arrive from your state health department. In the meantime, you may receive a temporary medical cannabis card that you can take to a dispensary and use to purchase medical cannabis according to your doctor’s recommendations.
The staff at the dispensary, a.k.a. your budtenders, can also help answer questions about the specific products they carry. You should be prepared to go in with your doctor’s recommendations, but know that different dispensaries carry different products, so yours they may not have exactly what your doctor has suggested (which is why Dr. Tishler sometimes recommends specific dispensaries).
And when you go to a dispensary, be sure to bring your card with you. You may also need to bring another form of ID and cash because not all dispensaries take credit cards.
6. Consider talking to a cannabis pharmacist if that’s something your dispensary offers.
Cannabis pharmacists, pharmacists that receive special training in the way cannabis works in the body and interacts with other medications, are becoming more and more common in dispensaries. Some states, including New York, even require dispensaries to have cannabis pharmacists on staff.
If your dispensary offers you the chance to speak with a cannabis pharmacist before making a purchase, Dr. Kessler and Dr. Niles suggest you give it a shot. Each dispensary will have its own product line, Dr. Niles says, so the pharmacists have specialized knowledge about which specific products at that store might be useful for you.
But Dr. Tishler points out that cannabis pharmacists at dispensaries may not exactly be an unbiased source of information. “They are trained as a pharmacist but employed by the dispensary,” he says. “So there is a certain conflict of interest there.”
7. Don’t hesitate to follow up with your care team if you have questions.
Cannabis can affect people in different ways, and even qualified doctors and pharmacists can’t always predict how a particular product will work for an individual patient. So it’s important to remember that finding a medical cannabis plan that actually works for you may take some trial and error.
If you try something and you don’t like the way it made you feel, you don’t feel like it did what it was supposed to do, or you’re having trouble getting your card, get in touch with your cannabis doctor. “I tell people multiple times, ‘I’m going to send you my email,’ and that’s because I want to know how you’re doing,” Dr. Tishler says. “That includes if you’re having trouble getting signed up.”