Don't Get High….. Get Well

Re: LA County Proposed Ordinance to Severely Control Edibles and Concentrates in Dispensaries

To the Honorable Councilmember Ed P. Reyes

I am a Board Certified Internist having practiced in Santa Monica and Venice for 30 years. My sub-specialty is in psychopharmacology, so my transition to becoming a practicing Cannabinologist was very comfortable.

I am not a politician or “activist”. I am a Physician. My responsibility is solely to my patients and my positions in this letter are entirely on their behalf. During my patient visits, I determine whether some form of Cannabis might be of benefit to them. Then together, through an education process, the patient and I determine whether this might be the case for them.

My patients use various methods to medicate themselves with cannabis products. Most of them are very motivated to look for non-combustible means of medication administration. Vaporizing is certainly an answer and is commonly used, but this is not always practical. It is for this and other reasons that many of my patients, not wanting to smoke, turn to tinctures, concentrates, hash, (which is just cannabis) and edibles. It would be a great loss to my patients if these alternative means of ingestion disappeared. I love the idea of everyone growing their own cannabis, but that will not happen easily or quickly and my patients need help now. In addition, in certain jurisdictions, growing at home would guarantee a visit from child protective services. The current system may not be perfect and perhaps is not entirely legal, but it gives tremendous relief to my patients.

I have found Cannabis, in many forms, to help most of my patients. They are usually on other medications and I frequently speak with their Physician as to how to best move forward. There is no doubt in my mind, that nearly 100% of the Physicians I have personally met and/or spoken with, are primarily concerned about their patients smoking their Cannabis. Not a single MD I have spoken with is comfortable having their patients use Cannabis in a smoked form, but nearly all of them are very much behind tinctures, concentrates and edibles.

Attached to this letter is a photo of a wall in my exam room. It shows, as if on an old pharmacy shelf from the 1800’s – 1900’s, many Cannabis tinctures in both Sativa and Indica forms – all were manufactured by major pharmaceutical companies still in business today. “Active ingredients” were not listed,  the physicians of the day tested the “strength” of these tinctures physiologically, meaning they had patients try it and see what happens.  This process is similar to what I have done for the last 30 years with current pharmaceuticals. As I like to say, back to the past…

Many of my patients use tinctures and edibles exclusively. Many have either never smoked and haven’t since college or have no intention of  ever smoking. I know for certain that if my patients were left only the smoke-able form of cannabis, they would be extremely unhappy. More to the point, I would not be able, as their physician to advise them what to do. We should all be careful to monitor and regulate the concentrates and edibles, however, on behalf of my many patients who rely upon these products.

There is another significant group of patients who are being forgotten and these are the patients that everyone agrees the Compassionate Use Act was meant to address. I am referring to the most ill patients with cancer or HIV that have a depressed immune system. Many oncology doctors and HIV specialists are reluctant to have these patients smoke cannabis as there are various types of mold that once inhaled can at times lead to a fatal infection in these immune compromised patients. They need tinctures, edibles and even hash suppositories.

There may be additional regulations and controls required in the dispensary systems, however, the wholesale destruction of the current system would leave many thousands of patients without their medicine. If the above arguments and those made by others to protect the product selection, lead to a reasonable and rational “dispensing solution”, we have all done our job. However, if  all sides cannot reach accord, I would propose another solution that might be inflammatory to some, but IF required, could be a tenable solution: raise the minimum age to 21, unless accompanied by a parent.  As well, institute some strict but patient-friendly regulations and move forward with the city of Los Angeles working together to allow the safe growth of LA based cannabis medicine.

On behalf of my many patients, I would ask that we seriously consider holding off on major dispensary changes until this issue is given adequate consideration by all involved.

Kind Regards,

Allan I Frankel, MD

Below are listed the important people involved. Calls and/or emails from all of us would be helpful to all….thanks, allan

Councilmember Ed P. Reyes
200 North Spring Street, Room 410
Los Angeles, CA 90012
Phone: 213-473-7001
Fax: 213-485-8907
E-mail: councilmemeber.reyes@lacity.org

Councilmember Rosendahl
councilman.rosendahl@lacity.org

Councilmember Hahn
councilmember.hahn@lacity.org

Councilmember Zine
councilmember.zine@lacity.org, councilmember.zine@lacity.org