Pubdate: Sun, 03 Apr 2016
Source: Philadelphia Inquirer, The (PA)
Copyright: 2016 Philadelphia Newspapers Inc
Author: Jan Hefler


Awful Pain, but Still She Struggled With Decision.

Dana Kelley recalls the exact moment when her neurologist suggested 
she try medical marijuana.

The retired Army Intelligence linguist said it caused her emotional 
upheaval and led her to question her willingness to continue living 
in constant pain.

Kelley's neck and back were severely fractured in a car crash three 
years ago in her hometown of Pennsville, Salem County. She underwent 
five surgeries, including a fusion of a large part of her spinal 
cord, and was prescribed morphine and opiates.

Last September, Kelley, 53, met with Andrew Medvedovsky, a 
board-certified neurologist and pain specialist with RA Pain 
Services, at his Turnersville office, one of several in South Jersey. 
She didn't know then that he was one of the 360 doctors statewide who 
is registered with the New Jersey Medical Marijuana Program and who 
approve patients to use cannabis.

Patients and their advocates say a shortage of enrolled doctors is 
one of the big reasons that so few patients - only about 7,000 
statewide - have been able to obtain cannabis. When the program 
started, the number of doctors was so small that many patients were 
traveling to a North Jersey gynecologist who had enrolled and who was 
willing to examine non-gynecological patients to give them cannabis 

'Are you serious?'

In an interview last week at the Turnersville clinic, Kelley said she 
went to Medvedovsky to ask for an injection to relieve her continuing pain.

"He said because of my underlying condition and the phone book of 
things that have been tried on me, he didn't see the point of 
sticking another needle in me," she said. He also told her: "I don't 
mind if you walk out, I would understand," before he finally 
mentioned she should consider cannabis.

Kelley's mind raced: "You're talking to me about a piece of grass, 
like oregano, and I've taken many pharmaceutical drugs ... and still 
have so much pain I want to bang my head against a wall? Are you serious?"

Medvedovsky is an easygoing doctor who's been practicing medicine for 
nearly eight years, including four years as a resident at Virginia 
Commonwealth University. He said the stigma surrounding marijuana - 
that it's a "drug used by hippies to get high" - is so pervasive that 
he finds himself getting nervous when he recommends it to a patient.

"It's not a miracle for everyone, but it sure helps some people," 
Medvedovsky said. Since he enrolled in the program last July, he has 
recommended cannabis for more than 300 patients. He said the results 
surprised him - 80 percent, including Kelley, have given him glowing 
reports about how it helped them.

But Medvedovsky said he wasn't on board four years ago when the state 
program began. "I didn't want to be seen as a weed doctor," he said, 
explaining why he didn't sign up right away.

Marijuana is an illegal substance under federal law, and the American 
Medical Association has said more studies are needed to determine if 
it is effective and safe. New Jersey is one of 22 states with a 
medical marijuana program; Pennsylvania is among several states 
considering creating one. There are five dispensaries in New Jersey.

Insurance does not cover a patient's doctor visits, and Medvedovsky 
and some other doctors in the program charge new patients about $400 
for visits before they can be approved. Every 90 days, patients are 
required to have a follow-up visit that costs $100.

Medvedovsky, 33, who earned his medical degree from Ross University, 
opened his clinic in Turnersville just for medical marijuana 
patients. One reason he said he decided to join the program was some 
patients confided that they had used marijuana illegally and that it 
had helped stop their pain. He said he wanted to offer patients an 
alternative if they failed to get relief from conventional 
treatments. "It's an effective drug," he said.

In New Jersey, patients are eligible for cannabis only if they suffer 
from one of about a dozen ailments, including cancer, Crohn's 
Disease, multiple sclerosis, and epilepsy. But Medvedovsky said there 
are "gray zones" in which a physician has discretion to determine 
whether a patient's symptoms meet the requirements.

Medvedovsky said many patients come to him and complain of a vicious 
cycle in which their pain leads to a lack of sleep, irritability, 
loss of friends and employment, and then to a lack of exercise and to 
other ailments. Chronic pain is not on the list of ailments that 
qualify a patient for cannabis, but Medvedovsky said that if a 
patient has secondary ailments, such as severe muscle spasms, he or 
she may meet the requirement.

A report released last month by the Health Department found the 
majority of cannabis patients suffer from intractable skeletal 
muscular spasticity.

Kelley is among them. At first she worried about the stereotypes 
surrounding cannabis, saying many people believe it is used by 
"lawbreakers and those who want to get high." But after three weeks 
of weighing the decision and discussing it with her fiance, she 
decided to give cannabis a try.

First, Kelley had to be weaned from Fentanyl, a highly addictive 
opiate that she had been using. She feared that she would become 
vulnerable to another round of excruciating pain and that the 
marijuana wouldn't work. At one point she felt so low, she told her 
fiance she wished she had died in the car accident. "I felt I was 
trapped in my body and how could I go on?" she said.

Seeing a future

Kelley wept at Medvedovsky's office when she recalled how she had 
revealed to her fiance her feelings of hopelessness. She was about to 
start using cannabis the next day but had serious doubts about it.

Then, 10 days after she started using it, she said she felt as if a 
cloud had lifted. "I won't say it's a miracle cure," Kelley said. "I 
will always have pain, but it's not unbearable anymore." For the 
first time in three years, she sees a future without constant agony. 
She can walk with a cane and has lost 50 pounds.

But with her joy came anger. "My government had kept me from having 
this relief," Kelley said. When she visited Medvedovsky, she thought 
marijuana still was illegal in New Jersey.

Audrey Rosania, who screens Medvedovsky's patients, says others also 
have reported success with cannabis. "I'm a big believer," she said. 
"It works."

Kelley said she purchases an ounce of cannabis a month at the 
Compassionate Sciences dispensary in Bellmawr. She bakes cannabis 
into cookies or smokes it when she needs quicker relief.

Reflecting on her four months of recovery, Kelley's words tumbled 
out. Suddenly she stopped, and looked over at Medvedovsky, who sat at 
his desk during the interview, listening and nodding.

"I never got to thank you, Doctor," she said, stopping suddenly. "I 
want to thank you," she said, smiling.
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