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Mike O'Connell, 44, of Fargo, talks about how medical cannabis has helped him recover from opioid addiction. Derek Murray / WDAY

Patients face roadblocks 2 years after North Dakota voters approved medical marijuana

FARGO — Mike O’Connell shifted uneasily in his chair as he talked about the opioid addiction that gripped him for more than five years.

He used to take up to 12 prescription drugs daily for back pain and severe anxiety, and as his tolerance increased, he ramped up the doses to keep the pain and withdrawal symptoms away.

Now 8 months clean from pharmaceuticals, O’Connell said he’s found “new freedom” in medical cannabis.

“It’s the best thing ever, it is. And not to be sick, you know, is the best feeling ever too,” he said.

O’Connell, 44, of Fargo, said he had to “jump through hoops” but finally received a referral in April through Midwest Mental Health Clinic, an independent facility in Moorhead.

Sheri Paulson, 52, of Galesburg, N.D., tells a similar story.

She has multiple sclerosis and a secondary neurological condition that causes sharp pains in her face. Both are qualifying conditions for medical cannabis.

Paulson said she had to “debate” Sanford Health providers to get a certification card.

“I was shocked when it came in the mail,” she said.

While some say they’re unable to get access to medical cannabis, other patients of large medical centers and smaller health care facilities in Fargo-Moorhead are getting referrals.

Policies vary

Sanford in Fargo was the target of a small group of protesters earlier this month, who claimed the medical facility is putting up roadblocks to medical cannabis.

However, according to a statement released by Sanford, each doctor can decide whether to certify, based on what they feel is “medically best” for patients.

The statement also said patients legally using medical marijuana are allowed to do so at Sanford hospitals in North Dakota and Minnesota.

At Essentia Health-West, chief medical officer Dr. Richard Vetter said Essentia is “finalizing its policy” and “may allow” some providers to certify for medical cannabis if they feel it’s an appropriate option.

Jacki Gervais, an addiction and psychiatric nurse practitioner at Midwest Mental Health, said of the hundreds of North Dakota and Minnesota patients who come through their doors, fewer than 30 have been referred to use medical cannabis.

Gervais said while she’s not a major advocate of the alternative treatment, she is open to it.

“If this is something that my patient feels is going to benefit them . . . I owe it to them to allow them to explore it,” she said.

At ima Healthcare, an independent practice of internal medicine doctors in Fargo, physician Mark Yohe said seven providers on staff can refer patients for medical marijuana use.

He said with cannabis, some patients can go off narcotics they were taking for chronic pain, spasms or other ailments.

“Most of them have been miserable with what meds they’re taking. At points in their lives, they may have been over-medicated,” Yohe said.

Altru Health System in Grand Forks allows health care providers the discretion to choose to certify patients’ requests for medical marijuana ID cards, according to Altru general counsel Joel Larson.

“We have lots of excellent doctors who go, ‘You wanna try goat yoga and it might help you? Then let’s try goat yoga,’” Larson said.

But, Larson said he believes that providers’ comfort with the research behind medical marijuana might make them wary to certify patients’ conditions.

“THC treatment is not taught,” Larson said.

Of the other independent doctors in Fargo contacted, some said they focus on procedures rather than medication or don’t have anyone on staff who can refer patients to medical marijuana, while others didn’t return calls for comment.

Vetting patients

Perhaps the biggest challenge of referring patients for medical cannabis is making sure they want it for medicinal purposes.

The North Dakota Department of Health spells out that patients seeking it must have an established relationship with their medical provider.

If a new client comes in asking for a cannabis medical card, “this probably isn’t the right place for them,” Gervais said.

Yohe said by simply taking some time to talk with a patient, together they can usually determine whether it’s a viable option.

Paulson plans to try cannabis oils, now that she’s cleared by Sanford as having qualifying conditions for its use.

She said she was insulted when doctors first questioned whether she “just wanted to get high” or feared she would “become lazy” using medical marijuana.

In the future, she said she hopes they can be “more open minded.”

As of June 27, more than 680 people in North Dakota have received medical cannabis cards, according to the health department’s division of medical marijuana.

Reporter Wren Murphy contributed to this story.