HIPAA Compliant Marijuana Certification and Document Storage

Physician Marijuana Certification Software and Document Storage to issue medical marijuana certificates to patients via video or phone telehealth. Storage of patient questionnaire information, patient identification supplied, physician attachments, & notes that’s HIPAA compliant.

 

  • HIPAA compliant Hosted system
  • Responsive design
  • Configurable patient questionnaires
  • Storage of patient questionnaires, patient identification, physician attachments, & notes
  • Ease of use for client to access data stored within telehealth system
  • Payment flexibility
  • Physician video chat with telephone interview backup when video chat is not available
  • Support for multiple physicians to simultaneously chat with patients
  • Email notification to client of patients and status (approved or rejected), including physician and physician’s license number
  • Electronic Document Signing
  • California state medical marijuana database
  • Private Branding

About Medical Marijuana

Researching Marijuana for Therapeutic Purposes

The Potential Promise of Cannabidiol (CBD)

Three weeks ago I had the opportunity to testify before the Senate on cannabidiol, or CBD—one of the main active ingredients in the marijuana plant, and a compound around which there is a growing amount of interest from the public as well as the scientific and medical communities. The intent of the hearing was to explore ways we can reduce obstacles to research on CBD, given that all chemicals in the marijuana plant are currently in the most restricted category of the Drug Enforcement Administration’s schedule of controlled substances—schedule I. This category is reserved for substances that have a high potential for abuse and no scientifically supported medical use. Medical research can and is being done with schedule I substances; however, there are strict regulations and administrative hurdles associated with this status.

The chemical in marijuana that causes the high (and many of its other effects) is delta-9 tetrahydrocannabinol, or THC. But there are over 100 other cannabinoid chemicals in the plant; CBD is one of those. Different cannabinoids can have very different biological effects; CBD, for example, does not make people high and is not intoxicating. And, there is reason to believe it may have a range of uses in medicine, including in the treatment of seizures and other neurological disorders. In the impassioned, often emotional debates these days over medical marijuana, CBD is often cited as one of the main reasons restrictions on marijuana should be loosened.

A basic understanding of the way cannabinoids affect the body and the brain is helpful to making sense of some of the confusing and contradictory claims made by partisans on either side of those debates. Most cannabinoids (including THC) interact with specific targets on cells in the body, the CB1 and CB2 receptors. CB1 receptors are found mainly in the brain and are important for learning, coordination, sleep, pain, brain development, and other functions; CB2 receptors are found mostly in the immune system. The fact that chemicals in marijuana can speak the body’s chemical language (and cause both beneficial and harmful effects) is not surprising and does not make marijuana special. Many plants, including the opium poppy, tobacco, and coca are similar in that regard. Extracting and amplifying the medicinal benefits of such plants and minimizing their potential harms can lead the way to effective medications, but are also a major scientific challenge.

In marijuana’s case, future medicinal uses will most likely lie in drugs based on cannabinoid chemicals or extracts with defined concentrations that can be reliably produced. There are very few precedents for a whole plant being approved as a drug (only two ”botanical drugs” are currently approved in the U.S.). This is because creating a standardized plant medicine poses major difficulties—especially in a case like marijuana where there are countless, widely varying strains and large numbers of chemical components about which little is yet known. Marijuana has over 500 chemicals in total, including the 100 or so cannabinoids, so we will still be learning about this plant for years to come. However, we are quickly learning a lot about THC and CBD, and because of its unique properties, CBD, especially, may be poised to make great inroads into our pharmacopoeia.

CBD has very little effect on CB1 and CB2 receptors. This is probably why it does not make people high and is not mind-altering; in fact it may even blunt some of THC’s psychotropic effects. Most marijuana grown for recreational use is very low in CBD content (and high in THC). CBD’s actions in the body are not well understood, but they appear to involve several signaling systems besides the CB receptors, including a serotonin receptor.

Although CBD first rose to public prominence two years ago as a result of a CNN piece on medical marijuana, CBD has been considered as a potential therapeutic agent since the 1970s, when its anti-seizure properties were first examined in animal studies. A few very small randomized clinical trials were also conducted in adults with epilepsy, some showing positive results. But what has generated the renewed interest and excitement are the anecdotal reports that some children with otherwise untreatable severe epilepsies respond well to CBD extracts and oils. A followup to the CNN piece depicted the struggles of parents of children with a seizure condition called Dravet syndrome, who moved their families to Colorado in order to get CBD-rich marijuana legally. Several drug companies have recently developed CBD-based medications, and one of these, called Epidiolex, is now being tested in clinical trials. Epidiolex was developed by GW Pharmaceuticals and has been given to more than 400 children under the FDA’s expanded access (“compassionate use”) program.

While the existing data show promise, it is still too soon to tell whether and for whom CBD will be effective. Like most medical treatments, it doesn’t seem to work for everyone. Much more research needs to be done, but it should be done quickly. Parents can’t wait—their children are growing; their children’s brains are actively developing; and the repeated seizures may be damaging this growth. Parents currently must navigate states’ medical marijuana laws or defy the law to obtain CBD extracts—which, in the current unregulated market, may be of questionable quality and content.

Besides the trials of Epidiolex, there are already many studies of CBD for other disorders being conducted, including at NIH. Studies related to its possible use in the treatment of substance use disorders are being funded by NIDA, while other NIH Institutes are funding work on the potential of CBD and other cannabinoids in treating neurological and psychiatric disorders, disorders of the immune system and metabolism, and cancer.

In short, CBD appears to be a safe drug with no addictive effects, and the preliminary data suggest that it may have therapeutic value for a number of medical conditions. Addressing barriers that slow clinical research with CBD would accelerate progress. NIDA will do what we can to address such barriers and expedite the study of this potentially valuable compound, as well as other components of the marijuana plant.

By The National Institute on Drug Abuse

Dr. Jeffrey Ditzell is a Psychiatrist in New York City and specializes in issues involving anxiety depression and adult ADHD. Medical Marijuana is one of the many treatments Dr. Ditzell offers to treat a variety of mental health issues.


Ketamine for Depression

Ketamine for Depression is it a Miracle Drug?

A team of researchers funded by the National Institutes of Health (NIH) recently discovered why the drug ketamine may act as a rapid antidepressant.

Ketamine is best known as an illicit, psychedelic club drug. Often referred to as “Special K” or a “horse tranquilizer” by the media, it has been around since the 1960s and is a staple anesthetic in emergency rooms and burn centers. In the last 10 years, studies have shown that it can reverse — sometimes within hours or even minutes — the kind of severe, suicidal depression that traditional antidepressants can’t treat.

Researchers writing in the August 2010 issue of Archives of General Psychiatry reported that people in a small study who had treatment-resistant bipolar disorder experienced relief from depression symptoms in as little as 40 minutes after getting an intravenous dose of ketamine. Eighteen of these people had previously been unsuccessfully treated with at least one antidepressant medication and a mood stabilizer; the average number of medications they had tried unsuccessfully was seven. Within 40 minutes, 9 of 16 (56 percent) of the participants receiving ketamine had at least a 50 percent reduction in symptoms, and 2 of 16 (13 percent) had full remission and became symptom-free. The response lasted an average of about a week.

In a small 2006 NIMH study, one of the first to look at ketamine for depression, 18 treatment-resistant, depressed (unipolar) patients were randomly selected to receive either a single intravenous dose of ketamine or a placebo. Depression symptoms improved within one day in 71 percent of those who were given ketamine, and 29 percent of the patients became nearly symptom-free in a day. Thirty-five percent of patients who received ketamine still showed benefits seven days later.

In the most recent study published online in the journal Nature in May 2016, researchers discovered that a chemical byproduct, or metabolite, is created as the body breaks down ketamine. The metabolite reversed depression-like behaviors in mice without triggering any of the anesthetic, dissociative, or addictive side effects associated with ketamine.

“This discovery fundamentally changes our understanding of how this rapid antidepressant mechanism works, and holds promise for development of more robust and safer treatments,” said Carlos Zarate, MD, of the National Institute of Mental Health (NIMH), and a study coauthor and pioneer of research using ketamine to treat depression. “By using a team approach, researchers were able to reverse-engineer ketamine’s workings from the clinic to the lab to pinpoint what makes it so unique.”

In response to the Nature report, Sara Solovitch of The Washington Post wrote that “experts are calling [ketamine] the most significant advance in mental health in more than half a century.” She reported that many academic medical centers, including Yale University, the University of California in San Diego, the Mayo Clinic, and the Cleveland Clinic, have all begun offering ketamine treatments off-label for severe depression.

Therese Borchard, Associate Editor Psych Central. She is the founder of Project Hope & Beyond, an online community for persons with treatment-resistant depression and other chronic mood disorders. She blogs for Everyday Health and is the author of Beyond Blue: Surviving Depression & Anxiety and Making the Most of Bad Genes.

NYC psychiatrist Dr. Jeffrey Ditzell provides treatment such as Ketamine for Depression using ketamine infusion therapy, Dr. Ditzell also specializes in adult ADHD, Psychiatric Consultations. New York City Psychiatrist.


About Marijuana’s Medicinal Benefits

Obtaining a prescription for medical cannabis can be the first step toward relief for consumers suffering from debilitating symptoms, but many are challenged to navigate the sometimes-unfamiliar terrain of dispensaries and then find the best product to suit their needs.

Now nursing organizations are stepping in to help them serve as educators and advocates for patients who seek to integrate cannabis into their medical treatment.

The San Diego-based Cannabis Nurses Network formed in 2015 as a professional development organization that offers its domestic and international members access to education, networking, professional recognition, and legal and medical advocacy.

According to Heather Manus, a nurse and founding member of the network, the group educates nurses on the science behind medical cannabis and supports them in their careers

Group members appear at various cannabis conferences and will be staging its fourth annual Cannabis Nurses Network Conference from Feb. 28 to March 2, 2019, in San Diego. Manus said conference participants will learn about the latest science, research, and clinical applications relating to the human endocannabinoid system and cannabinoid therapeutics.

The organization’s website also lists educational resources and a member directory to help locate trained cannabis nurses.
A Washington, D.C. Group with Similar Aims

A similar group, the American Cannabis Nursing Association (ACNA), formed on the East Coast in 2012. Denise Foster, a nurse for more than 30 years in Chesapeake, Va., is director of the ACNA in Washington, D.C. The organization develops nursing standards, credentials, and certifications in an effort to reduce the stigma and knowledge gap surrounding cannabis.

Foster and the ACNA are working to train nurses in the safe use of cannabis products.

“Patients are using cannabis as medicine, and it’s important for nurses to be educated on the medical risks and legal implications of cannabis use,” Foster told Marijuana.com. “In addition, it’s important for nurses to know about the scientific evidence related to cannabis and symptom management.”

Foster said the ACNA ultimately hopes to see trained cannabis nurses employed in hospitals, doctor’s offices and dispensaries across the U.S. In these roles, nurses can counsel patients and help them determine the right cannabis product and dosage to manage their health condition.

“Depending on the state in which a patient resides, they may be able to choose from a number of different routes of cannabis administration,” said Sarah Cohen, a cannabis nurse in Chicago and secretary for the ACNA. “Each route has a different duration and time to efficacy. The type of symptom a patient is trying to control – chronic pain versus breakthrough pain, for example – can also help determine the optimal route.”

Cohen worked as a nurse for two years at a medical cannabis dispensary in Illinois. During that time, she saw patients with numerous conditions, including cancer, multiple sclerosis, fibromyalgia, and Crohn’s disease, who found relief from pain, spasms, and insomnia.

“I twice heard from patients whose opioid use was spiraling out of control, that cannabis saved their life,” Cohen said. “In general, consumers are starved for information so, as a nurse, my primary role was education about the different types of cannabis routes of administration.”

Currently, Foster said many patients receive prescriptions for Medical Marijuana from their health-care provider, but are then left with questions such as where to go, what to ask for and how to use the herb.

Foster said she remembers “one woman who was given an inappropriate dosage of medical cannabis and experienced some unwanted side effects,” which can include anxiety, shortness of breath and increased heart rate. “The experience left her nervous about giving cannabis a second chance.”

Cohen said nurses and other clinicians also should receive education about the endocannabinoid system (ECS), a network of receptors that affect appetite, mood, memory, pain, and other physiological functions. Since its discovery, the ECS’s role isn’t adequately covered in most clinical education curricula.

“Cannabis plant material can be smoked, vaped, ingested raw, and incorporated into food and beverages,” Cohen said. “Extracted cannabis oils can be vaped, applied under the tongue, ingested directly, applied topically, and incorporated into food and beverages. Cannabinoids can also be delivered through transdermal patches and gels and via suppositories.”
Preparing Nurses to Meet Needs of Patients

Regardless of whether a state is legal for medical or adult-use cannabis, Cohen said data shows that patients are using cannabis as medicine.

“This means that nurses and healthcare providers in all states, should have a working knowledge of cannabis therapeutics,” she said. “Only with accurate information can we best serve patients.”

Currently, the ACNA is the only professional nursing organization working toward having cannabis nursing recognized by the American Nurses Association (ANA) as a certified nursing sub-specialty. In conjunction with the Medical Cannabis Institute, ACNA offers an online course for nurses, as well as resources for nurses who want to learn more about how medical cannabis and how it can be safely and effectively used to manage a patient’s health condition. While becoming certified as a cannabis nurse is something the ACNA hopes to offer in the future, nurses who pass the ACNA’s Core Curriculum class and pass the subsequent test receive a certificate of competency in cannabis nursing from ACNA.

“While having cannabis nursing recognized as a sub-specialty is still a work in progress, we’re encouraged by a recent announcement from the National Council on State Boards of Nursing (NCSBN) that calls for all nurses to be educated about the mammalian endocannabinoid system and the scientific evidence base related to cannabis and symptom management,” Cohen said. “Additionally, nurses will be required to understand their states’ cannabis policies and how these may impact patient care and well-being.”

https://www.marijuana.com/news/2018/10/nurses-learn-and-educate-about-marijuanas-health-benefits/


What health conditions qualify for medical cannabis in New York?

Only a handful of “severe, debilitating or life threatening” health conditions are currently eligible for medical marijuana treatment in New York.

You are potentially eligible for Medical Marijuana if you have been diagnosed with a specific severe, debilitating or life threatening condition that is accompanied by an associated or complicating condition. By law, those conditions are: cancer, HIV infection or AIDS, amyotrophic lateral sclerosis (ALS), Parkinson's disease, multiple sclerosis, spinal cord injury with spasticity, epilepsy, inflammatory bowel disease, neuropathy, and Huntington's disease. The associated or complicating conditions are cachexia or wasting syndrome, severe or chronic pain, severe nausea, seizures, or severe or persistent muscle spasms.

In January 2016, Health Commissioner Dr. Howard Zucker announced that he would not allow patients with Post Traumatic Stress Disorder, Alzheimer’s disease, muscular dystrophy, dystonia, and rheumatoid arthritis to participate in the medical marijuana program because he does not believe there is enough scientific evidence to prove that cannabis can be an effective treatment for these conditions.

In accordance with state law, the New York Health Department was given a year and a half to consider the five proposed qualified conditions and make a determination as to whether patients with these ailments should be given access to medical marijuana. Officials reportedly pulled in a legion of health and science experts to examine several pieces of research pertaining to marijuana as a viable treatment option, but ultimately they concluded that more evidence was needed before they would be willing to move forward.

The New York Times recently reported that only 51 patients were currently registered to participate in the medical marijuana program, mostly because there are only about 150 physicians in the entire state that have been certified to provide their patients with medical marijuana recommendations. Furthermore, the Times indicates that dispensaries located in highly populated New York City have only seen “a trickle of patients” since opening their doors last week, indicating that dispensaries servicing other parts of the state likely aren’t seeing much action.

Keith Stroup, the founder of the National Organization for the Reform of Marijuana Laws, recently told Vice News that changes to New York’s medical marijuana program will take some time because lawmakers are still suspicious that patients are simply searching for a way to get stoned without legal ramifications. Unfortunately, due to the New York’s impact on national policy, Stroup thinks more states will follow in its footsteps when it comes time to create their respective medical marijuana programs – providing patients with no raw cannabis, no edibles, and no fun.

High Times

Medical Marijuana NYC Psychiatrist Jeff Ditzell Medical Cannabis.

Dr. Ditzell has the training and expertise to certify patients for medical marijuana (medical cannabis) to help guide cases and manage this treatment modality NYC Psychiatrist Jeff Ditzell.


Why is it so hard to find a medical marijuana doctor in New York?

New York doctors are signing up to recommend medical marijuana more quickly than some had anticipated. As of Jan. 28, 306 physicians had registered with the state, and they had helped 465 patients get certified for the program.

But cannabis medicine remains out of reach for many who are eligible, including those with epilepsy, cancer and the handful of other serious conditions approved for treatment.

Read more on Crain's.

There are also some handy fringe benefits to keeping your card current, like the tax-exempt status of medical marijuana. Under Prop 64, recreational cannabis retailers will be taxed by the state, and that’s before considering local city or county taxes that could drive prices up further. Recreational consumers are poised to pay more than Medical Marijuana patients, with the possibility of even higher taxes down the line.


About Marijuana

According to Norml.org, Marijuana is the third most popular recreational drug in America (behind only alcohol and tobacco), and has been used by nearly 100 million Americans. According to government surveys, some 25 million Americans have smoked marijuana in the past year, and more than 14 million do so regularly despite harsh laws against its use. Our public policies should reflect this reality, not deny it.

Marijuana is far less dangerous than alcohol or tobacco. Around 50,000 people die each year from alcohol poisoning. Similarly, more than 400,000 deaths each year are attributed to tobacco smoking. By comparison, marijuana is nontoxic and cannot cause death by overdose.

Recreational Legalization Won’t Make Medical Marijuana Cards Obsolete. Despite the continuing evolution of adult-use laws across the United States, a medical marijuana card can still come in handy and ensure your access to cannabis for any qualifying condition. That’s important, because the wheels of legislation turn slowly.


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