Running a medical marijuana practice: 'Every day I feel like I’m on the right side of the battle'

marijuana leaf
If medical marijuana isn't available, patients will turn to the black market, says physician Barry Gordon.

Barry Gordon, M.D., opened a medical marijuana practice in Venice, Florida, on January 3.

“I went from zero to over 700 patients" in less than six months, he told FierceHealthcare.

So Gordon isn’t worried about the success of his new practice, the Compassionate Cannabis Clinic, or about Attorney General Jeff Sessions, who would like to put him out of business.

“I absolutely don’t understand what his agenda is,” said Gordon, who has a few other things to say about Sessions that he doesn’t want to see in print.

Barry Gordon, M.D.
Barry Gordon, M.D.

Sessions, who for years has opposed legalization of marijuana, recently made headlines when he personally asked congressional leaders to undo federal medical marijuana protections. The protections, known as the Rohrabacher-Farr amendment, prohibit the Justice Department from using federal funds to prevent states from implementing their own laws that authorize the use, distribution, possession or cultivation of medical marijuana. 

Sessions said the amendment inhibits the Justice Department’s authority to enforce the Controlled Substances Act and linked the protections to the opioid epidemic and violent crime.

Marijuana is illegal under federal law, which rates it as a Schedule I drug, the same as heroin. But 29 states, including Florida, have legalized the use of medical marijuana, as well as the District of Columbia and the territories of Guam and Puerto Rico. Deputy Attorney General Rod Rosenstein has also said that marijuana is an unlawful drug.

RELATED: Medical marijuana use linked to lower Medicare spending

Patrick DeLuca, executive director at the Compassionate Cannabis Clinic, is less diplomatic than Gordon. “They are prohibitionist dinosaurs,” DeLuca says about Sessions and Rosenstein. “They are on the wrong side of history.”

In fact, a bipartisan group of senators on June 15 reintroduced a bill called the Compassionate Access, Research Expansion, and Respect States (CARERS) Act that would allow patients to access medical marijuana in states where it is legal without fear of federal prosecution. It would prevent federal law enforcement from prosecuting patients, doctors and caregivers in states that have legalized medical marijuana.

Patrick DeLuca
Patrick DeLuca

It’s too late to reverse states’ legalization of medical marijuana, said DeLuca, which a Quinnipiac poll conducted in April found was supported by 94% of the public. 

“We have come too far. They can’t stuff this back into the bag,” DeLuca said.

And they shouldn’t, says Gordon. Medical marijuana is giving people an alternative to narcotics, including the opioid painkillers that have created an epidemic in the country, to the extent that drug overdoses are the leading cause of injury death in the U.S.

RELATED: Efforts to curb opioid epidemic remain top priority for CMS

From emergency doc to pot doc

Before his high blood pressure caused him to retire to Florida, Gordon said he spent 32 years as an emergency medicine physician in Ohio, where he watched the opioid crisis unfold. Doctors were overprescribing narcotics, and before the adoption of prescription drug monitoring programs, had no idea if patients were getting medications from three or four different doctors.

In the emergency department, he and other doctors were sometimes reviving patients addicted to drugs who overdosed twice in the same day. Doctors would revive them, they’d leave the hospital and be back that same day.

The patients who come to his cannabis practice have three desires, he said. They want to feel the best they possibly can, they want to do it naturally and with less reliance on narcotics and they want to be legal.

While the regulations vary from state to state, doctors who run a medical marijuana practice aren’t dispensing cannabis. They perform an examination of the patient, determine if medical marijuana is an appropriate treatment and write a letter of medical necessity saying the patient needs cannabis to treat his or her condition. In Florida, the patient must have a qualifying condition.

The average age of patients at the Compassionate Cannabis Clinic is 54, said DeLuca. Patients have sought medical marijuana to treat conditions including post-traumatic stress disorder, ALS, AIDS, Parkinson’s disease, epilepsy and many cases of cancer, he said.

RELATED: Undercover doc says practices can learn from medical marijuana dispensaries

Many of his patients illegally used marijuana before Florida passed its law legalizing cannabis for medical use, Gordon said. They like knowing they can get marijuana from a dispensary where they know it is safer than buying it on the street.

Florida is the first southern state to have a legal medicinal marijuana program. The state’s dispensaries are doing a good job and his patients are satisfied with the results, he said.

An advocate in the fight

Gordon says he feels a responsibility to advocate for his patients. He thinks the pushback against medical marijuana is fueled by big pharma, which wants to keep selling narcotics and other drugs to patients who are finding relief from marijuana, a plant that people have used for thousands of years.

If medical marijuana is not available, patients will turn to the black market, he said.

While it was expensive to start up a medical marijuana practice—he spent $30,000 on legal fees alone to ensure compliance with state regulations—Gordon isn’t fearful about the future. He speaks out to educate people about medical cannabis.

RELATED: Pot 101—Doctors lack knowledge about medical marijuana

However, it’s not easy to operate such a practice, said DeLuca. “This is the most complicated practice of medicine in the world. It’s unnecessarily complicated,” he said.

The Compassionate Cannabis Clinic was one of the first cannabis practices in the state. “People come to us who are unhappy with conventional medicine.”

DeLuca says medical marijuana practices will be here long after Sessions has left the government.

“Anything is possible,” he said. “But you have to look at the whole picture. There’s a lot of smoke coming out of Sessions and Rosenstein.”

Sessions has long been opposed to marijuana, but “he hasn’t gotten his way. He likely will not get his way. Sessions is this nightmare of ‘reefer madness,'" he said

And unlike so many divisive political issues, “cannabis is an issue that transcends party lines,” he said.

As for Gordon, he said he has found his calling. “Now I’m a medical cannabis practitioner. It’s been a very gratifying practice. Every day I feel like I’m on the right side of the battle,” he said.