Check out this prescription for whiskey written in 1928, during the Prohibition Era, which I stumbled across last week in the New Orleans Pharmacy Museum. The patient was directed to take a “tablespoonful 3 times daily”. Although alcohol was outlawed for general use, the exhibition explained that “it was still available for medicinal use by prescription… In fact, many Prohibition-era cartoons depict pharmacies as the new saloons, showing the pharmacist as barkeep.”

“Special prescription forms with duplicate copies were issued by the U.S. Treasury Department Bureau of Prohibition. The prescriptions, usually for whiskey, were void after three days from issuance; pharmacists were required to file the duplicate copies for possible inspection by Federal Officers. Prescribing physicians and pharmacists were required to verify the patient’s identity, address and other personal information and were to be held liable…”

History repeating itself?

As the medical cannabis scene grows in Montana and throughout the country, more and more citizens are being recognized by the state as being legally allowed to consume cannabis because of their conditions. While NORML does not specifically exist for furthering the cause of medical cannabis, it is hard to ignore the growing population of individuals that are able to partake in the programs that states provide for them.

These programs, laws, or regulations, allow individuals to have access to cannabis in order to provide them with feelings, relief, and compassion that can not be found in any prescribed drug. With all of this: we still find ourselves at the mercy of laws which govern what could possibly be the most incredible and versatile plant on Earth.

While this population of “users” grows, there comes a challenge in finding the provider of medical cannabis, or marijuana, that is right for you. In Montana, there are a large number of caretakers. Of those caretakers, the DPHHS has said there are only 27 caregivers in the state that have over 20 patients. Does this mean one of them is who you want to seek out? Maybe… maybe not.

An unfortunate product of the slight release of prohibition from a substance is the abundance of individuals and organizations willing to exploit it. As such, it becomes very easy to be caught up in the newspaper advertisements or handouts that may paint particular cannabis providers in a beautiful light. There is only a certain amount of truth in advertising, so it’s necessary to provide a guide to figuring out who should be your medical cannabis caregiver.

How do you find a caregiver that is right for you?

There are so many questions that should be considered when trying to identify a good caregiver for your cannabis needs.

The following has been adapted from questions and suggestions compiled by Vaporgirl, who participates in the Montana medical marijuana program. She provided a very good list of considerations from the point of view of a new patient. She was also kind enough to allow me to use it as a basis for this post in order to help share information with other new patients who aren’t sure what they should be looking for when seeking out their first medical cannabis caregiver.

First, we’ll start with 10 rules that every patient should have when it comes to finding their caregiver.

10 Rules for Finding a Good Caregiver

1. Ask to meet with the person before making any commitment.

Be suspect if the person says you have to accept them as your caregiver before they will meet with you. Be suspect if you are asked to pay in advance or to put up a large amount of money for an even larger return. This is a sure sign of a thriving illegal business.

2. Consider meeting in a public place the first time.

If you do not feel comfortable with this person, be polite, but do not feel like you have to accept them as your caregiver if you are uncomfortable in anyway. Rely on your instinct; a bad vibe goes a long way. A good vibe is what you are feeling for. You will have to be working with this person for quite some time so if your first impression throws you off, you might want to listen to yourself.

3. A good caregiver should return your calls/emails within 24hr.

There should be no forgetfulness. If they are not organized enough to return a phone call, they probably aren’t organized enough to make sure you’re getting the care you deserve.

4. A good caregiver keeps all your information confidential.

If you find out your caregiver has been talking about you, your plants, your treatment, or anything related to you without your permission: they’re not providing good care for you.

5. A good caregiver should be able to give you all the details of the entire process, from getting your card to helping you grow your own MMJ.

If your caregiver is just there to sell you medicine: they aren’t a caregiver, they’re a medical cannabis distributor. Your caregiver should be able to offer you advice on growing your own medicine, provide you with resources to help you grow your own medicine, and be a resource to provide assistance or answers to questions in regards to your medicine. They should be able to provide you with seeds or clones at a low cost or free.

6. A good caregiver will even suggest other caregivers if they feel that someone might suit you better.

This is not just about money; it is about care giving after all. Despite what a few caregivers in the state are trying to do: this is not about making money. This is about helping people. If your caregiver doesn’t have the strains you need, the prices you need, the locations you need, they should be able to recommend someone else to you.

7. A good caregiver should advise you to consider a vaporizer and she/he should be able to recommend products in a price range you can afford.

If you have never used cannabis before, a caregiver should be able to show you how and walk you through your first experience. This responsibility of a caregiver is bound to become more important as the medical community begins to recommend cannabis to patients who would benefit from this drug but are hesitant to try it. A recommendation that every caregiver should carry is that of vaporization. Vaporization offers many benefits, particularly health benefits, and your caregiver should be open and knowledgeable enough to talk with you about it.

8. A good caregiver makes you feel they are concerned for your health; you are not just a druggie and they are not just dope dealers.

You should feel like this is more than just about money and getting high. If your caregiver doesn’t make you feel this way, chances are it is just about money and getting high for them.

9. A good caregiver will not provide for you until you have your card.

There are some caregivers out there who feel they are above the law or understand the laws better than those who wrote them. They are not lawmakers or lawyers and so you should have your own best interest in mind. If your caregiver is asking you to break the law or does things that you are unsure about when it comes to the law, they have obviously made up their mind on how to interpret the law. Until a precedent has been set or a law is on the books, you should understand that you are trusting their opinion or the opinion of their legal team in these matters.

Until you receive your medical cannabis card in the mail, you are not receiving the fullest protection that can be provided to you by the law. By suggesting you should be purchasing or possessing cannabis before you receive your card, your caregiver is suggesting that you should make yourself vulnerable to possible arrest by law enforcement officers. While you may later present an affirmative defense, you may find yourself arrested, processed and possibly even jailed. You should consider doing yourself a favor and wait until you have the fullest protection of the law.

A good caregiver should not provide you with legal worries or grey areas.

10. High quality medical cannabis every time, without question or consideration.
If you start to hear any of the following excuses or phrases from your caregiver, consider looking elsewhere:
• “We’ve only got this right now.”

If your caregiver is relying on other caregivers to provide medicine to you, they are not a caregiver, they are a distributor. You sign them on so that they can grow six plants for you. Six, well grown plants, provides a lot of medicine. You should never have to “settle.”

• “Well, just some of the buds had a little mold.”

The ramifications of smoking moldy bud are documented and well known. It is not good for you, it does not taste good, and you may not know the terrible things it is doing to your body until it’s too late.

• “I’m not really sure, I think it’s organic. Maybe it’s hydro?”

Your caregiver should be honest and know about everything they are selling to you. If they don’t know whether it was organic or not or whether it’s this strain or that: they didn’t grow it. If they didn’t grow it, they probably don’t know much about it. If they don’t know much about it, why are they selling it to you to take care of yourself?

• “Well, it’s only been curing for a couple of days.”

High quality medicine includes a vigorous drying and curing process. The cannabis should be properly dried, cured, manicured and look very nice. It should have visible trichomes, a pleasant smell (or good stink), be absent of fan leaves that lack the trichome density of the sugar leaves and calyxes, and be of a good, firm texture that doesn’t disintegrate or feel squishy and damp. This process not only to make the herb more pleasant to consume, it actually aids in the decarboxylation process that allows all the acid forms of the chemicals we enjoy (THC-A, CBD-A, etc.) to turn into the form we want (THC, CBD, etc.).

• “I think we got all of the spider mites off of that clone for you.”

Don’t give me any plants you aren’t 100% sure of. Especially if they have had anything to do with spider mites. They will ruin grows, relationships, friendships, houses, plants. Spider mites are a very serious problem for growers and can be extremely hard to get rid of. Other pests/diseases should not be tolerated on clones/plants you receive from your caregiver such as powdery mildew, white flies, and so on.

Cost?
It is important to say something about the prices you should expect to pay. In a perfect world, caregivers would love to provide free, or close to free, medicine to their patients and let everyone receive all the care they need. Since we don’t live in a perfect world, there are real costs associated with growing quality cannabis. Depending on the size of the caregiver, it may be quite a costly personal endeavor to try and provide care. With that said, what price should you expect to pay for medical cannabis?

A good rule of thumb to start with: don’t pay as much as you did before you got a caregiver. In other words: don’t pay street prices. If your caregiver is trying to charge $350.00 or $400.00 an ounce (or more), they are probably not providing you with care; they are turning a profit. If your caregiver is trying to charge you $50.00 per 1/8 or more, they are not providing you with care. Very high quality medicine can be had for $250-$300 per ounce or even cheaper. Many caregivers will work with you on a sliding scale depending on your income so you might find prices even lower or caregivers willing to provide some medicine for free in some cases. If your caregiver is unable to grow or provide cannabis in this price range for you then you should question your choice of caregiver.

If your caregiver tries to charge you more for “the good stuff” then they are not providing you with care, they are ripping you off. You should be receiving the highest quality medicine they have at all times and it should be available at a reliable price. If they want to charge you less because it’s not up to the high quality they normally provide you with, that’s one thing; to admit they aren’t normally providing you with the best medicine they can produce by charging you more for “the good stuff” is not a good practice and shouldn’t be tolerated. You are the one who should be cared for, not their wallets. If they are producing their own medicine, as they should be, it all costs the same to grow. While the argument could be made that potentially more powerful, lesser yielding strains, could cost more money to produce, this should be a choice your caregiver should make on their own and they should not be looking to pass that cost on to you.

Edibles and processed cannabis such as hash, oils, butter, etc. should be fairly priced and you should follow the same general rules that you would for regular cannabis: don’t pay street price and don’t accept that there is “the good stuff” that should cost more.

I Think I’ve Found a Few to Consider: What Now?
So, you’ve got a good understanding of what you should be expecting from your caregiver, you arrange some meetings and you get a chance to sit down and chat with them. What do you do now? You should start asking questions and have some good ideas as to what you would like to hear as a response for those questions. Don’t be afraid to have a list with you when you go. Here are some good questions to ask that should get your list started.

Questions to Ask

• How long have you been a caregiver?

If they aren’t sure or new to being a caregiver, ask about their experience growing cannabis to see if you can get a good idea as to whether they will be able to provide you with the quality of medicine you deserve.

• How many patients do you have?

If you are looking for just a place to purchase medicine, this may not be as important. If, however, you are looking for a caregiver to be a resource for questions, to help you grow, to listen to your feedback or to help you figure out the best strains for your conditions by patiently listening to your ailments and your responses to different strains, you should find out if your caregiver will have time for you.

Vaporgirl, provided her own comment on this particular question:

“I don’t like being one of the pack so I prefer a caregiver who has a small group of patients. I don’t want anyone flipping my card out with 60 others and bragging about how many patients they have. This is very disrespectful.”

• Is the MMJ grown indoors or out and what kind of conditions is it grown in?

This can be especially important for those with breathing problems, allergies, or those susceptible to molds. If they can’t answer this question confidently, they probably aren’t closely involved with the medicine creation process. This should be a red flag.

• Is the MMJ organic or grown with good practices in mind?

Knowing that cannabis has been grown organically or with good practices such as recycling soil, using local ingredients, etc. can help you to be assured you’re receiving a high quality product from growers who have the plant and the environment in mind.

• What happens if crop production is down and you are in need?

This is a very important question to ask. If your caregiver has a problem with their plants or has a supply problem, where do they turn to? Can they guarantee the quality of the alternatives? Will the prices remain the same if this situation arises? If they don’t have a backup plan, they probably haven’t been growing medicine very long. It doesn’t take but a single spider mite or a few mold spores to cause serious problems for even the most seasoned growers.

• What sort of ailments do your strains address and how do they address them better than other strains?

If your caregiver doesn’t know what kind of relief their individual strains provide, they don’t know enough about their medicine and will not be able to provide you with the care you deserve. Basic descriptions of flavor and “strong” or “not so strong” is helpful, but not enough information. They should know which of their strains provides the best pain relief, which of their strains provides the best appetite stimulation, which of their strains help most with sleep, etc.

• How many different strains are usually available?

It’s well known that building up a tolerance for strains can be a problem. Be sure your caregiver offers many strains that offer the same kind of relief so that you can switch your medicine if the need arises.

• What form of payment is accepted?

If your caregiver only accepts cash, this is good information to know.

• Do they offer delivery services in case of inclement weather or the inability to pick up medicine?

This can be especially important for those with mobility issues or troubles with the extreme weather conditions that we can experience.

What Patients Should Not Expect

• Your caregiver is not a bud party buddy.

Do not expect to hang out with your caregiver or be invited to see the crop. This is obviously for security reasons. Some caregivers and patients become friends and that is fine.

• Your caregiver is not a bank, so do not expect them to be okay with loaning or fronting you MMJ.

While some caregivers may be understanding to the needs or situations of their patients, you should not expect that they should be okay with providing you with MMJ without payment. If you feel like this may be a situation you will find yourself in, be polite, ask them about it, and try to give notice. If they aren’t comfortable with it: don’t push it.

• Your caregiver has a life of their own, so do not expect them to be on-call 24/7 for you to just be a friend.

While your caregiver should be someone you can talk to or discuss your problems with while you are visiting with them, it does not mean that your caregiver is your personal friend so you should not expect them to just chat on the phone with you when you feel like talking. You need to respect their privacy and personal lives.

Lastly, we’ll finish up with some clear signs that should raise red flags for you when it comes to medical cannabis or marijuana caregiving.

Warning Signs of Bad Caregivers

• Charging money to meet with them or join their “co-op” or “group” or “club.”

It should not cost you any more than a postage stamp, an envelope and the ink and paper to print your Change Request Form to sign up for a caregiver.

• Watch out for phrases such as: “When we get going” or “When we get more patients”

There are enough established caregivers providing excellent care in this state. If your caregiver isn’t quite ready to provide you with the care you are looking for, tell them kindly and politely that you’d be happy to check out their services “when they get going” or “when they get more patients.”

• Listen for incorrect vocabulary or inaccurate information.

If your caregiver is not even knowledgeable enough to use correct vocabulary or speak with confidence about growing cannabis or the strains they provide, they may not be the right caregiver for you.

• Inconsistency in prices or availability.

If your caregiver says you will pay $40.00 per 1/8 and a month later they sound like this:

“Oh well, y’know, normally it’s like that but things are tight right now so it’s gonna be $45.00. I promise it won’t be like that next time. We got a bunch more coming in soon…”

…you can expect this to happen regularly.

• Your caregiver cannot provide you with enough resources or education to allow you to grow your own medicine.

Your caregiver should be able to answer any question you may have about growing your own quality cannabis. If they cannot answer your questions, they should be able to point you to good resources that can.

Remember, you do not have to keep your caregiver for the rest of your life. If you start with a good head on your shoulders going into your selection process, you will already be a step ahead when it comes to finding the right caregiver for your needs. If you sign up with a caregiver: do give them a chance to provide you with care. Caregivers occasionally communicate with each other and patients who constantly look for reasons to switch caregivers, switch caregivers often, or do not respect the privacy and personal life of a caregiver may find themselves having troubles looking for a caregiver to help them. If you have given your caregiver a chance and they are not adequate, be polite and let them know. Preferably give them some notice as they may have to alter their growing practices due to the loss of your 6 plants and 1 oz provided to them by law. If you can provide constructive feedback, don’t be afraid to do so.

Conclusion
You are the patient and they are the giver of care. You should not feel at the whim of your caregiver. There are many excellent options throughout the state and many more options showing up every day. Just because you see an advertisement in a newspaper or a caregiver has a store front, does not mean they will be a good caregiver. You deserve to be taken care of so be sure you find a caregiver who addresses your needs and is right for you.

Resources

• Frequently Asked Questions About the Montana Medical Marijuana Act – from the Department of Public Health and Human Services
• Patients and Families United – excellent resource for new patients
• Montana NORML – a good place to go to meet other patients or to find caregivers
• Montana Medical Marijuana Information – good information and a good list of caregivers put together and maintained by the Montana NORML folks
• Montana Medical Marijuana Program – official DPHHS site for information about the Montana Medical Marijuana program including a link to the necessary “Change Request Form” to sign up with a caregiver

Thanks again to Vaporgirl for the inspiration for this post.