Ask Legalization Nation: Clinic Visits 101; Strong Ganja Issues

Exactly how one obtains a medical cannabis recommendation in California; and alternatives to too-strong ganja.

As we went to press earlier this week, Colorado’s legalization Amendment 64 had a 75 percent chance of passing, according to online prediction market Washington’s Initiative 502 had an 87.5 percent chance of passing, Intrade reported, while Oregon’s Measure 80 had just a 17.5 percent chance of passing. For the latest initiative outcomes and all other weed-related election news, see our Legalization Nation blog at Below, we answer frequently asked questions in our occasional series “Ask Legalization Nation.”

I’ve smoked pot on and off for two decades, but meeting dealers is turning into too much of a hassle for a grown man. I think I’m ready to get a medical marijuana card so I can just go to my local dispensary. Outline the steps. — Smokeless in Santa Barbara

First of all, you won’t get a “card” unless you apply for one from the state of California, which is not mandatory. Patients need a doctor’s “recommendation” — essentially a doctor’s note saying, “I recommend this person use cannabis.” To get a medical marijuana recommendation, you could ask your primary care physician, but a lot of people go to a specialist or clinic that exclusively evaluates patients for recommendations.

These clinics advertise widely, so pick up an alt-weekly newspaper, like the Express, or use Google to find one nearest you. Check the clinic’s consumer reviews. Ask friends. You want a clinic that’s well reviewed and established, so when dispensaries call to verify your recommendation, they don’t get a disconnected number or a broken website link.

Call up the clinic to set up a same-day appointment. Visits can last as short as ten minutes or as long as forty minutes. We’ve seen recommendations advertised as costing anywhere from about $40 to $100. Recommendations generally last for a year.

You can bring your medical records to the appointment, but from what we’ve witnessed, many people don’t bring any. You must be eighteen years old, have a valid California ID, and fill out some forms, however.

Under Proposition 215, “seriously ill Californians” can get a doctor’s note for marijuana to treat “cancer, anorexia, AIDS, chronic pain, spasticity, glaucoma, arthritis, migraine or any other illness for which marijuana provides relief.” Pain, insomnia, and tension are three chief reasons patients sought pot recommendations, according to a survey at an Oakland clinic.

The doctor usually wants to know why you want to use cannabis (e.g., pain relief for an injury, stress-related insomnia, anxiety, etc.). They often ask if you are already using pot, how long you’ve been using it, and how it is working for you. The doctor may want to know more about your specific condition. Be honest about how cannabis helps you.

You might be turned down for cannabis use to treat schizophrenia, or if you’re pregnant, attempting to conceive, or you’re under eighteen. The doc may check your blood pressure and weigh you. Under state law, a licensed physician must provide an “adequate” quality of care, or he could face sanction if someone complains to the medical board and an investigation ensues.

Afterward, and other dispensary locator sites can point you to local medical cannabis clubs or delivery services. Again, read reviews. Make sure to bring your valid doctor’s recommendation and a valid California ID to the club. Tell them you are a “new patient.” Sign-up usually takes a few minutes while they verify your recommendation.

Weed is too strong now. I had one puff of this medical-grade, and I was way too high. It gave me anxiety, made me catatonic, then I ate two huge slices of pie. Can you recommend something that’ll just calm my nerves before I go to bed? — Lightweight in San Francisco

Delta 9-tetrahydrocannabinol (THC) is the main active ingredient in cannabis. Medical cannabis in the United States can test upwards of 22 percent THC by dry weight. If you have low tolerance, stay away from that stuff, and stick with a low-THC strain.

Individuals with low or no tolerance have told us they enjoy strains that test at 8 percent THC or less. They also report preferring strains with at least 1 percent cannabidiol (CBD) in it. CBD is the second-most common active ingredient in marijuana. CBD decreases the psychoactivity of THC, yet lengthens THC’s effect, so you get a gentler, longer experience.

Pot comes in two general families, indica and sativa, with indicas being more sedative and sativas being more euphoric and racy. In San Francisco, low-THC, indica-dominant hybrid Jilly Bean is a reported favorite.

Many dispensaries don’t test, however, so another option may be “pre-rolls.” Dispensary pre-rolls are pre-rolled joints that start at around $5. Clubs make cheap pre-rolls with shake — a ground mixture of less-potent leaf and trimmings, rather than strong bud.

Low tolerance tokers report a puff or two of a cheap pre-rolled blend provides the light high and sleepiness they’re after. Extinguish the barely smoked joint in a Doob Tube for re-use. The odorless, $1 tube cuts off a joint’s oxygen without ruining its conical shape.

Seeds and Stems

Judging packages for the sixth annual Patients’ Choice San Francisco will be ready this week, contest organizers report. The Northern California medical marijuana competition and fundraiser for Americans for Safe Access San Francisco hopes to raise tens of thousands of dollars this year by selling $300 Judges Packs. In exchange, patient judges get to sample dozens of entries and vote electronically for the best flower, concentrate, and edible. Winners will be announced November 18.

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