“Pain management is cannabis first, opioids last” - Interview with Michael Brennan
Karen Berger, PharmD, Medical Writer
Michael Brennan lives in Moorestown, New Jersey, with his cat Duncan and dog Stella Blue. He volunteers with the Coalition for Medical Marijuana – New Jersey as a Board Member and Patient/Caregiver advocate. Besides cannabis advocacy, which Michael describes as therapeutic, he enjoys hiking, nature, fine arts, ceramics and sculpture, photography, painting, street art, and music in his spare time.
Michael recalls an “off the cuff” remark from his neurologist in 2006. The neurologist told him, “Michael, you would be a good candidate for medical marijuana. It’s a shame you live in New Jersey, where it’s not legal.” He then started research on the benefits of medical marijuana, looking up peer-reviewed studies. Before cannabis, he says, “they recommended a spinal cord stimulator to manipulate pain signals to the brain.”
Michael has been treated with opioids for his spinal injuries, as he says, “opiates are a standard treatment for spine injuries and do an effective job.” However, like most patients, he has had a challenging experience with the side effects opioids bring. “Initially, you’re a patient desperate for relief without awareness or concern for the side effects brought on by that relief – depression, physical dependency, constipation, sleep problems, and suffering the worst isolation, all in reckless desperation to end the suffering,” he explains.
Michael wanted to try medical marijuana for chronic pain and intractable skeletal muscular spasticity. He was overwhelmed by the relentless pain, awful side effects, and was terrified of opioid addiction. He worried about the stigma of medical cannabis and fear of prosecution, even consulting his attorney for advice.
Like many patients, Michael did not have an easy experience. He had to fire his primary care physician after several failed attempts at conversation about marijuana. “He would literally stomp his feet, spin and abruptly leave the room, stating loudly, ‘I refuse to discuss this!’” Additional office visits with this doctor and other colleagues elicited the same response.
Michael consulted the New Jersey Medical Marijuana Program’s (NJMMP) physician search tool and found what would become his current family doctor. However, it was 2012 at this point, and it took a year to establish a “bona fide relationship” as required to receive an NJMMP card.
The nearest ATC (alternative treatment center) was the Compassionate Care Foundation in Egg Harbor, New Jersey, “a 90-minute drive each way, and too far for my body to do.” Michael had to pay $285 to certify his son as a caregiver.
Michael recalls his first medical cannabis experience: “With a trusted friend on the phone, I meditated, settled myself in, and lit my first Doobie in thirty years. R E L I E F was effectively and clearly spelled out that night.” For 12 years, Michael had needed forearm crutches to get around, and several weeks into medical cannabis treatment, he only needed one crutch.
Michael credits medical cannabis as life-changing. He is on the lowest dosage of prescription medications he has been on in decades. He walks a mile daily with his cane and service dog, Stella Blue (and lost 30 pounds). “Pain management is cannabis first, opioids last,” he says.
Although Michael finds the quality of medical marijuana to be good at the dispensaries, there is a “serious lack of affordability,” he says. His doctor recommends 3 ounces per month, but he can only afford a half-ounce. “The doctor orders 84 grams, but I can only afford 14 grams on sale, which is wrong! Imagine what relief is waiting with the missing 70 grams,” he says. He also finds the selection something to be desired. “Patient access is severely limited to what is left when the patient arrives.” Michael responds well to cannabigerol/CBG, so he checks the website for availability before making the trip. “Yet there’s no way the patient can reserve or hold an order – first come, first served, and the ATC employees have no idea what or when it may be available.”
Like MyCureAll, Michael believes that insurance should cover medical marijuana. “I cannot afford NJMMP products. Insurance must cover the cost, as any other medication. It is not fair, nor is New Jersey’s sales tax on medical marijuana, the only medication taxed.”
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