To Be A Medical Marijuana Patient Or Not To Be? That’s The Question!


Jack Rikess
Toke of the Town Northern California Correspondent Jack Rikess always tokes up before making a big decision

Or, Should Jack Renew His Medical Marijuana Card?

​​By Jack Rikess
Toke of the Town

Northern California Correspondent

I suffer from debilitating migraines that leave me temporarily blinded followed by a headache that feels like someone has taken a rusty blade to my brain with the full intent of whittling on it for the next couple of hours. Cannabis relieves the pain and lessens the thumping bombardments associated with the war games being played in my cerebellum. 
In another lifetime, I worked in a Navajo Old Folks home in Arizona. I wrenched my back lifting an overweight person who had passed out, which snared me in a dead weight death trap. My vertebrae have never recovered. 

Without acupuncture and yoga treatments, I would be in constant pain. Plus, a nice Indica blend with a high CBD count also reduces the back spasms and the overall discomfort. The additional benefit of cannabis for the migraines is that it relieves the nausea that comes after the headache. Because of this medical history and the auspicious Proposition 215, or the Compassionate Use Act of 1996, I am entitled to carry a medical marijuana card.  


​At various times in my traditional treatments I’ve been prescribed Percocet, Vicodin and Naprosyn for my back and a daily regime of migraine medication that is unable to prevent migraines but keeps me feeling dull and that if I sit too long, I may fall asleep. To be honest, as much as I wake and bake on occasion, nothing compares to the effects of these drugs weighing you down. If I was on the regime that my doctor prescribed, I’d barely be able to get off the couch… plus, these pills keep you depressed and distant from the stimuli and the beauty of the world around you. 
And sometimes, in balancing between good days and bad days, you can get a little edgy and pissed off from the pain and become short and prickly with friends. Nobody likes an angry hippie. After awhile you stop apologizing for being short-tempered. Soon you’re a cranky old man yelling at kids to get off of your lawn.
That’s why I was at this clinic, checking in once again to renew the doctor’s rec, in order to get my medical marijuana card. After five years of doing this, I wondered if it was worth it. I knew why it is worth it for me in the past. But with dispensaries closing all over the state, is it still worth it? 
But what, really, is a medical marijuana card? Why have one? Shouldn’t we support the good folks, the black market dealer who has been there for us, decade in, decade out? 

Contra Costa Health Services

​Up until recently I knew why I carried a medical marijuana card.
Beyond the medicinal relief, I was legal. After spending limited time in jails and county cells throughout this great country of ours for the curse of having grams and specks of cannabis on me that would allow for indefinite periods of incarceration depending on the mood of the local judge, I no longer feared the Man or the shame of being locked up.
That is why I have I a card. But beyond being a patient and holder of said valuable document, I really didn’t know much of the medical marijuana card, itself. 
Luckily, Roy — the intake resident at my clinic — was not only helpful and informative, but his honesty and plain talk inspired this writer to highlight those heroes in the movement who work and live in a world that is part industry, part political movement, yet never get the due they deserve for being part of paradigmal shift that could change the world. 
This is what I learned from a guy in the front lines.

SF Weekly

Toke: Let’s start at the very beginning.  When I applied for my first medical marijuana card in 2006, I had no idea what I was doing or even if I would receive one. That first time, I came here for my doctor’s recommendation, and then proceeded to San Francisco County General Hospital, where I applied for my state medical marijuana ID card. To clarify, that means when I was approved in your office I attained my doctor’s recommendation. That is the first document proving my legitimacy in the eyes of the State of California. Also from your office, I received a laminated card with your business information on it that I can also use to get into the dispensaries and to show the police if I have to prove that I am a certified legal medical marijuana patient. After the waiting period at County General, I received my state medical marijuana card in the mail.
Am I doing it right? Do I need all those documents? Do I need to have a state medical marijuana card? And, remember — I’m neurotic.
Roy: Let’s first clarify your two main points, or in essence — What kind of card or document do you need to get into the clubs? 

Marijuana Lawyer Blog

​To be clear, the doctor’s recommendation, which we all know is not a prescription, but a recommendation, is sufficient enough to get you into most of the clubs in the Bay Area. That is also true with the card that we issue with our name. Basically having our card means we’ve checked out your medical history, partially vetted the patient verifying who they are, and because we’ve been around since 2004, our name is good enough for most of the clubs. In the East Bay, they have a slightly different process, but most of them still accept our card
Toke: How about outside the Bay Area? Will your card work there?
Roy: It depends. Some will honor it, others don’t. We always tell our patients to bring a copy of the doctor’s recommendation with them. Between those two documents, the patient shouldn’t have a problem.
Toke: What about the state medical marijuana card?
Roy: In my opinion. Let’s just say you’re the neurotic type…
Toke: …Just saying…
Roy: The state card gives you peace of mind. You really don’t need it, but there are some definite advantages. I know there were dispensaries in San Diego and other points south that recognize the state card but may still ask for the doc’s rec. Then you also have to check with each county to be sure. Some counties prefer the State ID over the clinic-issued card like ours. To some, the State ID looks more official. 
Toke: You, Sir, seem very honest and forthright. Can I ask you some questions I’ve always wondered?

Free Press Release

Roy: I’m at my job and I’m not the boss but I’ll try.
Toke: Have you ever been raided by the Feds or the police?
Roy: No.
Toke: Have you had to go to court for any reason for what you do here? 
Roy: Oh yeah. We’ve been subpoenaed to testify for patients.
Toke: What’s that like?
Roy: We have all the paperwork, the medical records, our licenses and the rest of that stuff ready for the court. What we say is, “Cannabis would help with this condition for this patient.”
Toke: That’s it?
Roy: We’ve never lost a case. 
Toke: Do you ever encounter law enforcement or deal with the police much?
Roy: Nope, we’re not a dispensary. We do not have any cannabis here. We have absolutely no problems with law enforcement or the local police. What we get much of the time is cops or other members of law enforcement calling us for a clarification about medical marijuana. 
Toke: Huh?


Roy: Oh yeah, we get calls from cops who’ve stopped someone and they have our card or doctor’s rec, and they want to know if it’s good. Most of the time, it not even our card. Or they might have a question about growing rights or how much a patient can legally carry. You would be surprised. The other question we get a lot of the time is my card good outside California? Or more to the point, people say, “I’m going to Alabama, how much cannabis can I bring with me?” And of course, we tell them that their card is only good in the state of California. 
Toke: Do you ever turn people away? The misguided perception is anyone who enters, will walk away with a medical marijuana card. I think you know what I mean.
Roy: The truth, we turn away very few people, if they have their medical history with them and if they have a legitimate cause to receive a doctor’s rec. But we do turn people away — more than you think… but most people, who are coming here, are serious and legitimate. To be clear, we never turn people away. Say for example, someone comes in unfamiliar with the process or unsure what they need, the doctor sees everyone and goes over with them exactly what documentation they need in order to get a card. 

​Without getting into too many specifics, I’ll answer the perception that anyone can get a card. Last week a 19-year-old kid, I mean, young man, came in. He didn’t bring in any medical history with him. After taking his vitals, blood pressure, pulse and weight, he went in to see the doctor. In the waiting room, sometimes a patient doesn’t want or doesn’t feel comfortable disclosing their ailment to us, and only wants to confine in with the doctor. When he saw the doctor and was asked why he was here he said he was lazy. He thought cannabis would help with that. We said no.
We also turn people away who do not have a legitimate claim or proper paperwork; we tell them, “I’m sorry, this might not be the right place for you.”
But what I can tell you what we do is if a vet or someone else comes in with an amputation of some kind; we do not need to see their medical history to make a recommendation. Same thing goes for a person who is here and suffering from chronic pain from scoliosis or osteoporosis. We know they’re in pain. 
Also many terminally ill people walk through our doors without any other kind of assistance or hope. I met a gentleman that was dying from alcoholism. His liver was gone. He wanted some respite. We actually have terminally patients that if left to their primary care doctor, they’d be juiced, filled with pills and numbed out with a variety of drugs; and maybe even forgotten. We give them a quality of life for their last months.  

The Raw Story

​But to go to the heart of what you’re talking about, one thing we’ll do is if we’re unsure…wait, that’s not a correct choice of words. Let’s say a patient comes in complaining of back pain. Their records show that. But say we’re not sure that it is only back pain and this patient needs to go back to their primary care doctor and be reevaluated before we issue a full-year rec. What we might do on rare occasions is, only release a two-month recommendation, and then encourage the patient to seek further medical attention. Someone might complain about of back pain when it is really their kidneys. If we’re unsure of the patient’s history or maybe something has changed with the patient since the last visit to their primary care doctor, we will not issue a year’s rec until we can verify the exact nature of their ailment.
Toke: When I first went for my card, there were only a few clinics such as this that did doctor recommendations. Now, it seems like there is an explosion of clinics all over the place. The first thing I like about your place was the doctor did a full verbal review of my history as well as my family. Then the doctor made me vow to quit smoking cigarettes, which I did. 
What’s the deal? Did I luck out with you guys and find a reputable clinic on my first go-round? I mean, now there are hot chicks in scantily clad white smocks begging for my entrance to their establishment. Plus, I’m paying around a hundred bucks for my rec here. I know there are cheaper places out there. How do you pick the right clinic to get your doc’s rec from?


Roy: (Laughs) Easy rule of thumb, the hotter the chicks, the less certified the doctor is. Not always, but case in point. Before we go any farther, I just want to say that one of the chief reasons people or patients come here for our doctor’s recommendation, as opposed to their very own primary-care doctor, is that those doctors are afraid of issuing recommendations and having their license revoked. Our doctor didn’t start as a cannabis recommending doctor, but was in the field already…
Toke: …As it were…
Roy: (Laughs) …And developed a practice that issued doctor’s recommendations. We charge a fair amount, and this isn’t to support the cost but we spend a good amount of time with each prospective patient. They get a small comprehensive physical. We test reflexes and other vital signs to make sure the patient is all there. 
Now, if a doctor is charging $30-40 per visit, how can they afford to do that? That would barely cover office expenses. They get away with that kind of business because of the old axiom, volume, volume, volume. I would imagine that there are shady money people behind the 30-buck places. 

Steve Elliott ~alapoet~

​You’re going to think I’m crazy, but with my own money, I’ll go check out the competition to see what they’re like. There are some clinics out there that charge for something called a “Grower’s Permit.” For $299, you pay for this permit. The trouble is, there’s no such thing. There is some paperwork a farmer who grows for a collective or a dispensary fills out that is different, but as far as I know, there is no such thing as a ‘Medical Marijuana Grower’s Card.’ But someone out there is selling them. 
The women in skimpy outfits? That’s marketing and how the market works. I went to one of the clinics that had a hottie in their advertisement. I’m not going to say the name of the doctor… I’ll tell why in a second. It is right down the block from here. The doctor who saw me didn’t ask for any documentation or medical history records. He asked me what my problem was. I said, “Insomnia.”   
Without looking up, he filled out the doctor’s rec. I started to say something like, “Um, do you want to know anything else?”
The doctor basically said, “Our time is over.” It was like, “Next!”
So I called the California State Medical Board on him. He’s the guy people complain about. Long story short, the Board didn’t have the resources to go after him. Then I heard he closed up and then opened up under a new name.
Toke: What can we do about that?

Roy: I don’t know. I’m proud of where I work. We’re very professional with strong regard for customer service. We’re not some hippie-dippy business. I can’t believe that there are some clinics that don’t take vitals or do an examination. I think by what we’re doing, people see it and we get a very good word of mouth. 
Toke: Will, you’re here most every day. You’ve been around the scene for a while now. Not speaking for the clinic, but for you. What do you think about everything that is going on? 
Roy: I see all walks of life. Rich, poor, old, young. And I should say that I don’t smoke that much pot any more. I have a card for my insomnia. I don’t smoke to medicate but take an edible or the ‘Green Pill.’ (The nickname of a heavy dose of Indica used in pill form for insomnia.)
One thing I see is so many poor people that need medicine. What I don’t get is why can’t these guys just find a dime bag? They qualify as patients but it is very expensive for them. Dispensaries are not cheap. A black market dealer is still cheaper t
han the dispensaries. I have a card but when I need a little bit, I’ll probably see a friend before spending 60 bucks for an eighth at a dispensary.
My dream? My dream would be that all the dispensaries were gone and cannabis was legal. That everyone would have access and the price would come down. There wouldn’t be the crime that comes with prohibition. Cannabis shouldn’t be illegal.
More and more, we’re treating alcoholics with cannabis. People say we’re replacing one drug with another, but it’s not like that. Cannabis works. If it was legal, I think it would just be better. Right now, the black market is more stable than what’s happening with the recent crackdown. If cannabis was legal, we wouldn’t have the kind of confusion we’re experiencing now.

Jack Rikess
Toke of the Town correspondent Jack Rikess blogs from the Haight in San Francisco

Jack Rikess, a former stand-up comic, writes a regular column most directly found at

Jack delivers real-time coverage following the cannabis community, focusing on politics and culture.

His beat includes San Francisco, the Bay Area and Mendocino-Humboldt counties.

He has been quoted by the national media and is known for his unique view with thoughtful, insightful perspective.