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Arizona Medical Marijuana Program Expansion May Help Combat Opioid Epidemic

Within the first few weeks of 2018, the state of Arizona began accepting petitions to add additional medical conditions to its existing list of those that qualify a patient to legally participate in the state’s approved medical marijuana program. Many advocates of expanding the list of qualifying conditions for receiving legal medical marijuana assert that it could help to combat the state’s ongoing opioid crisis.

The prime argument in favor of this action’s potential to help fight the opioid epidemic Arizona currently faces is that more people may seek out medical marijuana treatment for their medical conditions than opioids. As no proven addictive effects have been found with marijuana, it is believed by many to be a far less harmful treatment option than highly addictive opioids. Moreover, any negative health effects attributed to marijuana are far less severe, by and large, than those associated with opioids, with the exception, perhaps, of the harmful effects of smoking. Alternative cannabis intake methods, however, such as marijuana edibles and vaporizing (or “vaping”) can ameliorate, or even eliminate, those risks as well.

Twice each year, in January and July, the ADHS (Arizona Department of Health Services) accepts petitions from the public to expand its list of debilitating medical conditions. Organizations and individual patients may submit information on particular illnesses, including their symptoms, prognoses, conventional treatment options and scientific research and evidence supporting medical marijuana’s potential efficacy as a treatment. Call Green Dream Doctors Phoenix or Tucson locations for more information on medical marijuana card. After receiving all the petitions submitted for a particular period, the ADHS reviews them and, if a petition adheres to the state’s guidelines, holds a public hearing to move forward the potential inclusion of that condition on the debilitating medical conditions list.

The ADHS reports that over 362,650 prescriptions for opioid medications were dispensed in the state of Arizona in the month of December 2017 alone. In April of 2018, 383,321 prescriptions for opioids were dispensed in Arizona. Between June 15, 2017 and the time of the first 2018 petition period, in January, Arizona experienced 820 deaths and 5,512 overdoses suspected to be opioid related. By the time a May 2018 ADHS Opioid Report was released, that number jumped to 7,604 possible opioid related overdoses, 16 percent of which were fatal. Of the Arizona residents suspected of overdosing from opioids in the month of April 2018, 41 percent were found to have received opioid prescriptions from 10 or more doctors in 2017. Yet only 35.5 percent, barely more than a third, of those doctors were found to have looked up whether a patient had other outstanding opioid prescriptions with other doctors in the Controlled Substances Prescription Monitoring Program.

Incidents of opioid overdoses and related death were highest among men over women, at 59 percent versus 41 percent, and the region of the state with the highest incidence of opioid overdoses and deaths was Maricopa County, at 4,674, followed by Pima County, at 1,309. There were between 102 and 338 opioid overdoses and deaths in each of Mohave, Yavapai, Pinal and Yuma Counties. The remaining counties in Arizona had 101 or less. Furthermore, in this same period, 730 babies were born in Arizona experiencing possible withdrawal symptoms related to the mother’s opioid usage. There were 4,917 doses of nalaxone administered outside of hospitals by emergency medical workers, law enforcement officers and others, with pharmacies distributing 14,854 nalaxone kits to the public.

In mid January of 2018, Arizona’s Governor, Doug Ducey, signed into law new guidelines aimed at addressing the problem in the state of opioid abuse. Among the new law’s provisions is a limitation on the number of days a doctor can write an initial opioid medication prescription for to five. Moreover, a doctor can only prescribe opioids to a patient for a maximum of 30 days. The law also grants immunity from legal prosecution or punishment to people abusing or involved in another’s abuse of opioids if that person calls 911 emergency services to report that someone is having an opioid overdose.

While other states work to address their opioid crises by placing greater restrictions on how prescription medications are administered, states like Arizona are looking at the potential for cannabis to help remedy the problem. Arizona’s northerly neighbor, New Mexico, recently ran a study on marijuana’s efficacy in combating its state’s opioid crisis. The study involved more than 400 patients already addicted to opioids and a team of psychiatrists and related professionals. What they found was that a fourth of participants were successfully able to eliminate their opioid addiction through use of marijuana. Time Magazine backs up these findings with a recent report of doctors prescribing 1,826 fewer doses of opioid medications on average in states were marijuana is legal.

This semiannual expansion period for the debilitating medical conditions list can help to fill gaps in treatment by identifying conditions overlooked when the program was first established. An example of such a condition is Post Traumatic Stress Disorder (PTSD), which did not appear on the initial list. Doctors heavily prescribed opioids to returning soldiers who then became addicted to their medications until cannabis helped provide safer, effective PTSD treatment and a means of kicking their opioid addiction. Team at Green Dream Doctors are here to help. Please visit our Phoenix location at 3001 W Indian School rd Ste #311 or our Tucson location 3502 S 6th Ave, Ste #120 Tucson, AZ 85713 conveniently located right accross from VA hospital on 6th ave.

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New LAW allows medical marijuana for VA patients

The U.S. Department of Veteran Affairs (VA) has issued new policies regarding medical marijuana and military veterans. According to the new directive, VHA Directive 1315, VA physicians are now cleared to speak with their patients openly about marijuana use as a possible treatment option. VA physicians are still prohibited, however, from outright recommending medical marijuana, let alone prescribing it. VA physicians can refer their paients to clinics like us.

Under the new directive, when a VA physician discusses medical marijuana with a patient, it must include the currently available clinical information relevant to the patient’s condition. The VA physician must then document the discussion in the patient’s medical record. If a VA physician becomes aware that a patient is using marijuana, that doctor is instructed under the directive to make any appropriate adjustments necessary to the patient’s treatment program. These decisions must be made on an individual basis and in league with the veteran him or herself. Further, these decisions must be founded on concerns for the safety and health of the veteran.

In another stipulation of the new law, veterans can no longer be denied services by the Veteran’s Health Administration (VHA) based on their participation in a marijuana program approved by their state, in this case Arizona. Any patient enrolled in an Arizona state approved marijuana program is now legally allowed to bring up marijuana use, whether currently using or considering it, with their VA doctor, and cannot be denied or refused services because of it. Moreover, the new law directs VA doctors to inquire of a patient’s marijuana use in order to modify the patient’s treatment accordingly.

VA doctors still, however, must comply with all U.S. Federal laws regarding marijuana, including the Controlled Substances Act. As such, the directive states, VA doctors may not fill out or sign any forms attesting to their approval, recommendation or even acknowledgement of a patient’s marijuana use, including for participation in a state authorized medical marijuana program. Ironically, as the Forbes article that broke this story reports, there is no provision in that or any Federal law preventing doctors, whether from the VA or not, from signing state approved medical marijuana recommendation forms. The U.S. Supreme Court ruled in 2003, in fact, that recommending medical marijuana to patients was protected under a physician’s First Amendment rights, assuming, of course, they do not actually provide the cannabis. Nevertheless, the restriction on VA doctors filling out and signing state approved medical marijuana forms remains, if only due to the VHA’s own say so. White House VA Secretary at the May 2018 time of this writing, David Shulkin, asserts that it is the role of the U.S. Congress and not the VA to change this policy provision, claiming the VA is not even permitted under current law to study, investigate or research the legitimacy of medical marijuana.

To discuss with a VA doctor the possibility of medical marijuana as a treatment for your condition, contact the physicians at Green Dream Doctors. There are now two locations: the original office in Phoenix and a new location in Tucson conveniently right across from the VA hospital.
3001 W Indian School Rd Ste # 311, Phoenix, AZ 85017 602 910 9628
or
3502 S 6th Ave, Ste #120 Tucson, AZ 85713 602 910 9628

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Arizona’s New Telemedicine Law Sends an Important Message

Arizona Governor Doug Ducey signed a bill (S.B. 1363) into law, on May 17, 2016, requiring private health plans to pay for telemedicine services across the whole state rather than only services received in rural areas of the state.

The State’s current telehealth coverage law, which went into effect January 2015, only requires commercial health insurers to cover telemedicine-based services provided to patients in rural areas. That deprives all the Arizona residents in non-rural areas from enjoying telemedicine services under their insurance benefit plans. (We imagine the citizens of Phoenix giving the Governor a collective “thumbs up” when he signed the new bill.).

With the passage of this bill, Arizona expanded coverage opportunities for telemedicine services. But there is still room to improve. For example, it covers only a limited set of telemedicine services (there are eight enumerated categories of “health care services”), rather than full equivalency of covering all services delivered via telemedicine to the extent the service is covered when delivered in-person. Additionally, the law also allows health plans to limit the coverage to those health care providers who are members of the plan’s provider network. The law contains no payment parity language, an important concept we have discussed extensively with policymakers. The revised statute becomes effective January 1, 2018.

Language has meaning, and words are important in statutory construction. Telehealth providers in other states can look to the Arizona experience as a lesson when advocating for and drafting telehealth commercial coverage laws in their home states.

The newly-revised statute provides as follows:

20-841.09. Telemedicine; coverage of health care services; definitions:

  1. All contracts issued, delivered or renewed on or after January 1, 2015 must provide coverage for health care services that are provided through telemedicine if the health care service would be covered were it provided through in-person consultation between the subscriber and a health care provider and provided to a subscriber receiving the service in a rural region of this state. The contract may limit the coverage to those health care providers who are members of the corporation’s provider network.
  2. This section does not prevent a corporation from imposing deductibles, copayment or coinsurance requirements for a health care service provided through telemedicine if the deductible, copayment or coinsurance does not exceed the deductible, copayment or coinsurance applicable to an in-person consultation for the same health care service.
  3. Services provided through telemedicine or resulting from a telemedicine consultation shall comply with Arizona licensure requirements, accreditation standards and any practice guidelines of a national association of medical professionals promoting access to medical care for consumers via telecommunications technology or other qualified medical professional societies to ensure quality of care.
  4. This section does not apply to limited benefit coverage as defined in section 20-1137.
  5. For the purposes of this section:
    1. “Health care services” means services provided for the following conditions or in the following settings:
      1. Trauma.
      2. Burn.
      3. Cardiology.
      4. Infectious diseases.
      5. Mental health disorders.
      6. Neurologic diseases including strokes.
      7. Dermatology.
      8. Pulmonology.
    2. “Rural region” means either:
      1. An area that is located in a county with a population of less than nine hundred thousand persons.
      2. A city or town that is located in a county with a population of nine hundred thousand persons or more and whose nearest boundary is more than thirty miles from the boundary of a city that has a population of five hundred thousand persons or more.
    3. “Telemedicine:”
      1. Means the interactive use of audio, video or other electronic media for the purpose of diagnosis, consultation or treatment.
      2. Does not include the sole use of an audio-only telephone, a video-only system, a facsimile machine, instant messages or electronic mail.

Currently, 29 states plus the District of Columbia have telehealth commercial insurance laws requiring commercial health insurance companies cover services provided via telehealth to the same extent those services are covered if provided in-person. Continued expansions in reimbursement mean providers can enhance telehealth offerings, both for the immediate cost savings and growing opportunities for revenue generation, to say nothing of patient quality and satisfaction. Commercial insurance reimbursement is among the five telemedicine trends driving health care transformation in 2016 and beyond.

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Arizona SB1420 Offers Relief to Card-Carrying Patients

The Arizona Senate has diligently been working on SB1420. If passed by the legislature, this new law will ensure the cannabis sold is safer for consumption and patients that need cannabis can afford it. This is a huge relief for the medical marijuana community. Proponents of the legislation say the high price of medical marijuana cards has limited the number of patients that can afford to legally treat their conditions. In addition, the law passed in 2010 did not include any safety standards for cannabis and cannabis products. While the bill is a long way from becoming a law, the ideas it offers show just how far Arizona’s legislature has come since passing the program.

State Policy
In the current program, patients who are eighteen years old can apply for a medical marijuana card. One simply takes the Arizona Department of Health Services (ADHS) Medical Marijuana Physician Certification form to the doctor. If the patient has one of the qualifying conditions that medical marijuana would be a suitable treatment for, the physician may fill out the certification form. Then, the patient submits online the ADHS Certification form, the registry identification card application, the ADHS Medical Marijuana Patient Attestation form, a current photo, a copy of a current ID, a copy of SNAP program participation, and the card fee.

If the applicant does not have a physician or his/her doctor does not prescribe marijuana treatment, the individual can go to another doctor like the ones in Green Dream Doctors cheap medical marijuana certification. They will evaluate the individual and fill out the ADHS certification form.

Proposed Fee Changes
The current card fee for individuals is $150. Those with proof of participation in the SNAP program may pay a reduced fee of $75. The card fee is not unreasonable. The problem is the medical marijuana card must be renewed yearly. For a renewal, the cardholder must resubmit the forms required for a medical marijuana card. That means paying for the physician to recertify the individual’s condition in addition to paying the card renewal fee.

For some cardholders, that puts the cost for a medical marijuana card out of reach, forcing patients to go without the relief found in marijuana treatment. The changes found in SB1420 would vastly lower the card fee. The rate for new applicants would be changed to $50, and renewals would be lowered to $25 a year. This would make medical marijuana a treatment possibility for a greater percent of the population.

Obstacles to Passing
The opposition to SB1420 feel that the fee changes to the state’s medical marijuana program would cost more than proponents realize. According to the Arizona Joint Legislative Budget Committee, the program will cost the state $16,926,100 in 2018. At the current fee of $150, that is approximately 112,841 new applicants and renewals in order to break even. The changes would mean a minimum of 338,522 new members or 677,044 renewals. Currently, the program has 147,237 individuals and caregivers. The state may not be equipped (i.e. administration, police, laboratories, dispensaries, etc.) to handle that kind of growth in program participation.

Safer Cannabis
One of the other changes is an inclusion of state standards for cannabis. Currently under the 2010 legislation, there are none. SB1420 would allow the Department of Health Services to establish quality standards. To enforce them, the ADHS would perform on-site inspections of marijuana dispensaries and caregiver cultivation areas. The ADHS would also require testing of cannabis and cannabis products for pesticides, heavy metals, chemicals, mold, and other contaminants. This would catch potentially dangerous edibles, oils, vapes, and plants before they reach consumers.

Additional Program Expenses
In order to cover the costs of the inspections and testing, the Arizona Joint Legislative Budget Committee added an additional $2,000,000 to the Medical Marijuana Program’s Budget. This would be paid to the Department of Agriculture to certify testing labs and oversee the testing of cannabis and cannabis products. The apportionment to the Department of Agriculture would raise the program’s budget to $18,926,100. Under the current rate, it would require an increase of 13,334 program participants. The proposed $50/$25 fees would require an additional 40,000 new applicants or 80,000 renewals.

Consumer Cost Reductions
While waiting to see if the Arizona Legislature will go through with the bill, patients in need of medical marijuana treatment can find other ways of reducing the costs of obtaining a card. Unless the patient is on the SNAP program, there is not a way of reducing the actual card fee. However, program participants can look for doctors and treatment programs that offer cheaper rates, like Green Dream Doctors cheap medical marijuana certification.

The benefit of using this type of certification center is the application fee may be included with physician and administrative costs. Green Dream Doctors cheap medical marijuana certification program walks you through each step of the application process. The program helps patients fill out the online application and uploads their documents on the same day as their appointment.

For more information on affordably obtaining a medical marijuana card, contact Green Dream Doctors in person at 3001 W Indian School Rd, Phoenix, AZ 85017, or call 602-910-9628

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Get Your MMJ Green Card with Green Dream Doctors

Its the best medical marijuana pot doctor to get your certification from

Are you curious about medical marijuana? Are you wondering how you can become an MMJ patient and how to qualify for your medical marijuana green card? Are you looking for an evaluation service you can trust?

No worries, we’ve got you covered.

At Green Dream Doctors, we are your one-stop shop for all your medical marijuana needs. We are the best medical marijuana certification clinic in Phoenix, Arizona. Our team of experienced and knowledgeable doctors and physicians are compassionate, caring, and eager to help you with your medical situation.

We know just how daunting it can be trying to get your MMJ green card, especially if you’re a first-timer. This is why we take the time to explain the process in detail to you, and then help you through it. Our team of trusted physicians know exactly what they need to do to help you through the process and get you where you need to be with as few bumps in the road as possible.

Want to know more about the medical marijuana certification process? Here is a short step-by-step guide to show you the qualification process works.

How to Become an MMJ Patient

1.         Gather Medical Records

In order to get your MMJ card, you need to have medical records that show you have a medical condition that qualifies you for the card. Don’t have any records? We might be able to help. Give us a call (602) 910 9628 and we’ll see how we can help.

2.         See One of Our Physicians

The next step in the process is to see one of our physicians. They will examine you in a friendly and comfortable atmosphere and help make sure that your condition will qualify. If for some reason you end up not qualifying for the medical marijuana green card at the end of the process, you will not be charged for this visit.

3.         Patient Application Upload

The same day as your evaluation with the physician, we will upload your application to be processed by the Arizona Department of Health Services. We upload the application for you for free and help you monitor where your application is in the process. Once your application is approved you should receive your card in the mail.

In addition to helping you qualify for your MMJ green card, we also do renewals. If you’ve already been through the process and know the drill, we can easily help you with your renewal so you won’t have to stress. We also have a variety of coupons that on our website that you can get special deals from.

Experienced and compassionate physicians, services that won’t break the bank, and a knowledgeable staff of professionals that are eager and ready to help: what more could you ask from a medical marijuana certification clinic?

If you have any other questions on how to become a medical marijuana patient, please feel free to let us know. We’ll see what we can do to help. Schedule your appointment today! Greendreamdoctors@gmail.com

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New Rehabilitation Center in Arizona Uses Marijuana to Help Patients Get Off Opioid Painkillers

A new rehabilitation center in Scottsdale, Arizona is starting to use marijuana as part of its treatment plan for people who are addicted to opioid painkillers. According to ABC15 TV news, which broke the story, Blue Door Therapeutics is believed to be the first medical clinic in the world, and possibly the only one as well, to combine herbal treatment using marijuana with traditional allopathic treatment methods to help patients detox from opioid painkillers.

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Judges Denies Arizona Patients’ Latest Request to Reduce Medical Marijuana Fees

A judge in Arizona has turned down the most recent request by medical marijuana patients in the state to reduce the steep $150 fee the Arizona Department of Health Services (ADHS) charges annually for a valid medical marijuana card.

In a May report by Howard Fischer of Capitol Media Services, it was revealed that, in the last fiscal year, which ends in June, the agency took in fees totaling $19.9 million, while operating expenses for the program over that term totaled under $7.8 million. That puts the fund’s balance at over $31 million going into the next fiscal year. That would essentially equate to over three years of operating expenses covered without the need for taking in any new fees.

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Arizona Attorneys Scramble for Clarity Amid Workplace Medical Marijuana Concerns

Attorneys in Arizona are finding that, despite the state’s legalization of marijuana for medical use, there is still great uncertainty and a lack of clarity when it comes to medical cannabis in the workplace. The conclusion most have drawn, according to an ABC15 news report, is that there are no objective, definitive rules for employers regarding their employees using medical marijuana in the workplace or being under the influence of medical marijuana while at work. Rather, these determinations are still subjective and based mostly on the type of work being performed.

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Medical Marijuana Now Legal on Arizona College Campuses

Despite that the Arizona Medical Marijuana Act (AMMA) permits legal medical marijuana use in the state, it still forbids possession of marijuana in prisons, schools and on school buses. As originally written in 2010 when voters approved the law, it said nothing about prohibitions against possession of medical marijuana on university and college campuses. When, in 2012, Arizona lawmakers added college and university campuses to the list of places where marijuana would remain prohibited, a legal battle ensued. In early April of 2017, in the latest decision in this battle, an appeals court overturned this addition to the law. In the court’s decision, it determined that lawmakers could not amend the law in this manner because doing so would not “further the purpose” of the law as voters originally approved it.

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Medical Marijuana Prices at Arizona Dispensaries Finally Lowering

Medical marijuana prices in Arizona have finally started to drop, after the recent failure of Proposition 205 to legalize marijuana for all adult use, including recreational, and a simultaneous proliferation of medical cannabis growers and dispensaries throughout the state. If Proposition 205 had passed, the number of prospective consumers for the marijuana industry would presumably skyrocket, maintaining high prices as long as demand outpaced production and availability. But, in the face of the proposition’s defeat, the recent combination of increased competition, cultivation and consolidation of dispensary license-holders has finally started driving medical marijuana prices down in the state.

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