MCC is your expert leader every step of the way!
Since Medical Cannabis is new to Missouri, you are likely to have some questions. Midwest Cannabinoid Clinics has assembled a comprehensive guide to Cannabis, CBD, Medical Marijuana and how to obtain your Physician Authorization to apply for your State Identification card.
MCC And Physician Authorization
Why should I choose Midwest Cannabinoid Clinics? When you choose to receive your care through Midwest Cannabinoid Clinics (MCC), you will be seen by a medical doctor (MD or DO) with decades of medical experience in the St. Louis and surrounding areas who specializes in providing safe, affordable, and reliable access to patients seeking a medical marijuana evaluation. MCC advocates for our patients, and care deeply about providing secure, compassionate, professional, and expert medical services. Most importantly, every MCC team member is considered a patient advocate that possesses extensive knowledge of Missouri medical cannabis laws, as well as a scientific understanding of medical cannabis, and cannabinoids. We adhere to all state policies and guidelines. We conform to the highest level of security to ensure your privacy both on-line and in office. MCC is passionate and committed to being the most trusted gateway for patients seeking authorizations. MCC is here solely to facilitate the process and to make your experience as easy and convenient as possible!
Why won’t my current physician provide authorization? Any patient may ask his or her current physician about receiving a medical marijuana certification. Because medical cannabis is a new concept to many physicians, they may not feel qualified or may be apprehensive to discuss cannabis with you. Your physician may also decline discussing and recommending cannabis due to the following:
- Not understanding contraindicators and possible restrictions with reference to your current medications
- Feel as though there is a lack of available information. Only 13% of medical schools offer courses regarding the Endocannabinoid System (ES). Only 9% have medical marijuana documented in their curriculum. ES is the largest receptor system in the body
- Lack of time to research dispensaries, products and which will work best for you
- Fear of DEA or legal involvement
- Not wishing to increase malpractice insurance
- Even though there is scientific evidence proving the benefits of cannabis, some physicians would like to have more access to documentation and studies
- They may feel more comfortable prescribing medications they understand
What if my family does not support my decision to choose medical cannabis? Historically, marijuana has been a controversial substance which has been painted in an intensely negative light by decades of moral condemnation, punitive legislation, and fear-mongering media coverage and public service announcements. For many patients, asking their doctor about medical marijuana just isn’t as easy as inquiring about the benefits of “normal” medications produced by pharmaceutical manufacturers. It can be even more difficult broaching the subject with your family members.
It’s perfectly understandable that discussing this approach initially makes you feel uncomfortable. Ultimately, however, your health and well-being are what matters most. Managing your symptoms and improving your quality of life absolutely takes precedence. At MCC, we respect your concerns and focus not on bias and belief, but on sound medical judgement. We can help you through various resources on being proactive about your health while educating your family on how this unique medication scientifically works.
When can I apply for a medicinal cannabis card? NOW! Simply follow our convenient and easy application process found on our website, www.DR420Midwest.com. Our premier MCC office is here to help YOU!
What will take place at my first MCC visit? A registered Missouri Physician (MD or DO) will review your medical records, assess your medical history, and discuss with you your condition and the uses of medical cannabis. He or she will document your condition and maintain your patient records.
What will I need for my first appointment?
- A valid, unexpired Missouri state photo identification card
- The identification card must prove that the patient must be over the eighteen (18) years of age. If the patient is under eighteen (18) years old, an authorized caregiver must accompany patient. (see caregiver section)
- Missouri proof of residency. Must supply our office with two Missouri identifiers. Examples include your Missouri Driver’s License, your mortgage bill, your insurance card, a current library card
- Medical records regarding the diagnosis for your qualifying condition(s)
- Prescription History from your pharmacy
- Verification for veteran status or first responder status to obtain our MCC discount
FIRST RESPONDER DEFINITION: As part of MCC’s commitment to support the men and women who serve our communities, we offer discounts to state and local first responders who are active, retired or volunteer, including:
- Firefighters, Emergency Medical Technicians (EMT) and Emergency Medical Services (EMS)
- Law enforcement including State Troopers, Sheriffs, Sheriff’s Deputies and Local Police
VETERAN VERIFICATION REQUIRED: An official copy of your DD Form 214/215, or NGB 22/22A.
Will the patient registration list/status be made available to the public? No. The law prohibits the DHSS authorizing providers or Missouri licensed dispensaries, from making personal identifying information public.
Is my personal information disclosed to MCC kept private? The privacy of our patients is a top priority of ours, so we make sure all patient information is kept confidential in our HIPAA compliant Electronic Medical Records (EMR) system. In order to prevent our patients’ medical records from being compromised, MCC has implemented a state-of-the-art cyber-security system.
Am I guaranteed to get approved for medical cannabis at my MCC appointment? The only person legally able to make that recommendation is a state and board-certified physician that makes the determination whether or not a patient qualifies. To make it more likely that you receive approval from the doctor, we recommend that you bring as much information as possible to your appointment regarding your medical condition and past treatments. However, you do not have to worry as the entire cost of an appointment will be a nominal flat fee if you, for whatever reason, are not approved by the doctor. Our comprehensive exam is only $50 and we can help you with understanding your diagnoses and what other holistic options may be available to you.
What do I do if I want medical advice but I am not ready to apply for medical marijuana or I need additional information on what CBD or other cannabinoids can do for my diagnoses? Some patients may not wish to explore the pharmacologic benefits of marijuana but want to consult with an authoritative source of medical expertise with regards to other Cannabinoids and how they may help both chronic or acute ailments. Because of this, we also can schedule a consultation to develop a targeted treatment plan tailored to lifestyle of the patient and their condition. We can then provide recommendations to other amazing products that we have researched, believe in and stand behind! Products we use for our own families! In addition, if you wish to discuss other holistic options, specifically full spectrum CBD products, we offer a comprehensive exam and consultation for only $50.00.
What do I need a medical cannabis card? A Missouri medical marijuana card shows that your name has been added to the Missouri Medical Marijuana Registry by a licensed Missouri physician. With this card, you can:
- Buy marijuana from dispensaries in the State of Missouri
- Possess marijuana and marijuana products in the State of Missouri
- Consume marijuana and marijuana products in the State of Missouri
A Missouri medical marijuana card is a personal identification card that shows the patient is a legal Missouri registered medical marijuana patient.
How do I obtain a medical cannabis card in Missouri? To obtain your Missouri medical cannabis card, you must have a Missouri board-certified physician review your medical records and provide an inperson consultation to determine if your qualifying conditions and current medications are appropriate for treatment with prescribed medicinal cannabis.
MCC specializes in only helping patients across the state of Missouri obtain their medical cannabis cards. Please call our Patient Care Representative today to see how to start with the process!
What credentials must the physicians authorizing medicinal cannabis in Missouri possess? Only MD or DO Physicians licensed to practice medicine in Missouri who are following state’s medical cannabis laws.
I cannot purchase medicinal cannabis until January of 2020, so why should I get certified now? Typically, once dispensaries are approved and open their doors, there becomes a massive influx of requests for patient registrations. Therefore, it is likely that patients will experience a significant delay due to a lack of physician appointment. We encourage patients to make an appointment now as the state is currently taking applications. This will ensure that once dispensaries are opened, our patients can immediately access their medicine.
What is the cost to get an expert medical consultation with a trained medical cannabis physician? Some offices charge a great deal of money just for an initial examination. We feel strongly that if you qualify for medical marijuana, you shouldn’t have trouble accessing it due to cost. As such, we offer a variety of payment methods and discounts for veterans, first responders and patients diagnosed with cancer, as well as referral discounts to those who spread the word about our services. Our fee for a simple, 15-minute consultation to review whether CBD or medical cannabis is even an option and only costs our patients $50.00. If it is decided that an authorization for medical cannabis is needed, then the authorization will cost an additional $149.00.
Is medical marijuana a prescription drug? No. Medical marijuana is not regulated by the FDA and therefore cannot be considered a prescription drug. There are currently three cannabinoid based medicines approved by the FDA.
- Marinol (dronabinol) Marinol is the brand name for an oral form of dronabinol indicated for treatment of anorexia associated with weight loss in patients with AIDS, and nausea and vomiting associated with cancer chemotherapy in patients who have failed to respond adequately to conventional antiemetic treatments
- Syndros – (liquified dronabinol) Last year, the FDA approved a new liquid formulation of dronabinol Indications are the same for Syndros as they are for Marinol: anorexia associated with weight loss in patients with AIDS, and nausea and vomiting associated with cancer chemotherapy in patients who have failed to respond adequately to conventional treatment
- Cesamet (nabilone) is the brand name for nabilone help prevent or treat chemotherapy-induced nausea and vomiting (CINV). Cesamet is to be prescribed to people who continue to experience these symptoms after trying other traditional medications, specifically antiemetics, to find relief
Missouri Qualifying Conditions
Who qualifies for medical cannabis in the state of Missouri? The Missouri Department of Health and Senior Services (“DHSS”) has approved a number of qualifying conditions that will allow patients to access Medical Cannabis in Missouri. The qualifying conditions identified by the DHSS include any chronic or debilitating condition that, in the professional judgment of a physician, might be helped by the use of medical cannabis.
What conditions make a patient eligible for medicinal cannabis in the state of Missouri? A “qualifying patient” must have a condition or symptom of, or side effect related to the treatment of:
- Intractable migraines unresponsive to other treatment
- Chronic medical conditions that cause severe, persistent pain or persistent muscle spasms, including but not limited to those associated with multiple sclerosis, seizures, Parkinson’s disease, and Tourette’s syndrome
- Debilitating psychiatric disorders, including but not limited to, post-traumatic stress disorder, if diagnosed by a state-licensed psychiatrist
- Human immunodeficiency virus (“HIV”) or acquired immune deficiency syndrome (“AIDS”)
- Chronic medical conditions that have been or normally are treated with a prescription medication that could lead to physical or psychological dependence, which a physician determines that medical use of marijuana could be effective in treating that condition and would serve as a safer alternative to the prescription medication
- Any terminal illness. In the professional judgment of a physician, other chronic, debilitating or other medical conditions, including but not limited to, hepatitis C, amyotrophic lateral sclerosis, inflammatory bowel disease, Crohn’s disease, Huntington’s disease, autism, neuropathies, sickle cell anemia, agitation of Alzheimer’s disease, cachexia, and wasting syndrome.
Am I allowed to mail in my documents to the Missouri Department Of Health And Senior Services? No. These must be completed on-line. They have indicated that mailed in applications or payments will not be accepted.
What is the cost for a medical cannabis card in Missouri? The State of Missouri charges a $25.00 application fee to apply on-line for the card after your appointment and granted authorization.
When will I receive my identification card? Your card should be received within 30 days of application, if your application is approved. Please contact The Missouri Medical Department of Health and Senior Services if you suspect there is a delay.
If my registry identification card is lost, stolen or damaged, what do I do? Is there a card replacement fee? You may print a replacement card. Simply return to the Missouri Medical Marijuana system account and reprint your card. Please note that once a replacement card is issued the old card is no longer valid. In addition, there is a registry change form available here for requesting a change/replacement card.
I received my registry identification card but it has other incorrect information. What should I do? You may complete the change form and submit online. Again, please be aware that once a replacement card is issued, the prior card is no longer valid.
If my registry identification card expired and I did not submit my renewal application before the deadline, am I still eligible to purchase and possess medicinal cannabis? No. When your card expires, the legal protection offered by the Missouri Medical Marijuana Act is expired. You may still submit your renewal application.
How much does it cost to register as a medical marijuana patient or caregiver in Missouri? The registration with the DHSS (to be completed within 30 days on-line if/when permission or authorization from our physician is provided) will be $25.
How long will my Missouri medical cannabis card be valid? A patient or caregiver registration will be valid from the date of issuance and expire one year later. You may request that we send you a reminder or you can go ahead and schedule an appointment for your re-evaluation next year!
The Science Behind Cannabis
Can you explain the science behind cannabis and hemp plants? When you eat an orange, how much of the orange do you eat? Of course, the juicy part, but what about the peel? The stem from which it hangs? The branch from which it dangles? The tree from which it grows?
Whenever we consume plants, we often target a specific part of the plant for consumption. In the case of cannabis, we most often target the seeds, leaves, and flowers. Seeds can be eaten or turned into oils, flowers can be made into a variety of food products, and we all know how cannabis buds can be used for neuropathy and other acute and chronic pain conditions.
But not every part of the plant contains the same chemical profile.
Each of us has a receptor system in our bodies called the endocannabinoid system (ECS). There are 113 known cannabinoids found in the cannabis plant. Cannabinoid receptors are located throughout the brain and body. The cannabinoid receptors are involved in a variety of physiological processes including appetite, pain-sensation, mood and memory. Cannabinoids attach to receptors in these cells. They often mimic our internal cannabinoids: anandamide and 2-arachidonoylglycerol.
What is THC? THC is one of at least 114 cannabinoids identified in the cannabis plant. THC is the principal psychoactive constituent in cannabis.
What is CBD? CBD is a cannabis compound that has significant medical benefits but without the psychoactive effect of THC. People have found CBD to help with inflammation, pain, anxiety, psychosis, seizers, spasms and other conditions.
What is the difference between CBD and THC? CBD and THC are both cannabinoids present in the cannabis plant. However, their roles are very different. CBD is non-psychoactive and is responsible for the analgesic, anti-inflammatory, and anti-anxiety properties present in cannabis. Alternatively, THC is the cannabinoid in cannabis that creates the feeling of intoxication (or “high”).
Why are cannabinoids so crucial to medical cannabis treatment? Despite facing decades of negative propaganda and criminalization, the world is pushing ahead on cannabis science. That science has shown us that cannabinoids offer novel therapeutic models where conventional therapies sometimes fail. For example, the opioid crisis has led to the deaths of tens of thousands of Americans every year, according to the CDC. Cannabis may be able to replace some opioid treatments that lead to those deaths.
All cannabinoids, including CBD, produce effects in the body by attaching to certain receptors. The human body produces certain cannabinoids on its own too. The two receptors for cannabinoids are called the CB1 receptors and CB2 receptors. These receptors are present throughout the body, but many are in the brain as well. As a matter of fact, there are more than 65 molecular targets of CBD in the body! They receive transmissions signals from cannabinoids found in CBD to produce many beneficial effects on the human molecular pathway, including acting as natural anti-inflammatory. A CBD rich product with little THC can convey therapeutic benefits without having a euphoric or dysphoric effect. Meaning you’re not going to feel high. In fact, this helps those who are on a combined CBD/THC regimen but don’t want to experience the “high” effect, as CBD dilutes the strength, but lengthens the duration of THC when combined, making it appealing to an even larger patient population. Using Whole Plant or Full Spectrum based oils and products help ensure you are getting all this powerful plant can produce.
What are terpenes and their importance? Terpenes are, in a sense, the essential oils of the plant, providing delicious flavor profiles, aromatic qualities, and therapeutic effects. Terpenes aren’t just present in the Cannabis plant, either. They are present in many other plants worldwide. Some terpenes taste and smell like citrus, while others may give off an earthy scent or flavor. Perhaps you have heard that Lavender can help calm anxiety, or relieve insomnia. This is largely attributed to the terpenes present in the Lavender plant. Some common terpenes include Myrcene, Linalool, Limonene, and Pinene. The Cannabis plant contains a combination of many different terpenes, THC, CBD, and other cannabinoids. Together, these different parts work to bring the consumer a greater sense of well-being than when used independently of each other.
What is the difference between industrial hemp and marijuana? Though both industrial hemp and marijuana are variants of the cannabis plant, the similarities end there. Industrial hemp is specially cultivated to have high concentrations of cannabidiol, or CBD for short, while maintaining very low levels of THC. Conversely, marijuana is cultivated to have high levels of THC to produce a psychoactive effect. Unlike marijuana, industrial hemp does not produce any psychoactive effects. In fact, CBD is classified as an anti-psychoactive and has been shown to help those suffering from existing psychoactive disorders.
What is the entourage effect? The Entourage Effect results when the many components within the cannabis plant interact with the human body to produce a stronger influence that any one of those components alone. It’s also called a synergistic effect.
Where and when will I be able to purchase medical cannabis? In order to legally purchase and possess medical marijuana in the State of Missouri, you must have a Medical Marijuana Card issued by the Missouri Department of Health and Senior Services. Medical marijuana will be available from a Missouri licensed dispensary facility licensed by DHSS. The state of Missouri currently estimates that Missouri residents with a valid Medical Marijuana Card will be able to legally purchase marijuana from licensed Missouri dispensaries as early as January 2020! Traditional pharmacies will not dispense medical marijuana. By law, medical marijuana sold to Missouri patients must be grown in the state of Missouri. However, the state has not yet issued any permits for growing marijuana. Once the DHSS has completed the dispensary licensing process, we will update our Missouri dispensary map online.
Do I have to purchase my cannabis from one of the dispensaries? Yes. To be protected under the Missouri Medical Marijuana Act, your products must be labeled from one of the Missouri dispensaries.
Will I be charged taxes for my medical cannabis products? Yes. Just as you pay taxes for pharmaceuticals, dispensaries are required to charge four percent of the retail price in addition to any other applicable state or local taxes.
Where will the dispensaries be located in Missouri? We do not know the exact number of approved dispensaries. Once approved, we will have a detailed link on our webpage, www.DR420MIDWEST.com, to help you find a trusted dispensary.
How much medical cannabis can be purchased from an approved dispensary? The Missouri Department of Health and Senior Services Medical Marijuana Program has set caps on the amount of marijuana that can be purchased by a patient. Patients can purchase up to 4 four ounces of dried, unprocessed marijuana or its equivalent in a thirty-day (30) period. If there is a compelling reason why the qualifying patient needs a greater amount, then the Department requires two independent physician certifications specifying what other amount the qualifying patient needs. See 19 CSR 3095.030(5)(E) of the Missouri Department of Health and Senior Services for further.
Will insurance or medicaid cover costs of cannabis? We encourage you to contact your insurance provider or Medicaid official for an answer; however, we are not aware of any insurance providers that cover the costs of medical marijuana at present.
How much will medical cannabis cost? The cost of medical marijuana will be set by each dispensary. At this point, it isn’t clear what those prices will be exactly. We hope that the prices will be competitive, therefore, low and affordable.
Will I be able to grow my own cannabis? Yes, Missouri approved patients will be allowed to grow six (6) flowering plants in their home. (It must be an enclosed, locked facility that is equipped with security devices that permit access only to the patient/caregiver.) Patients will be allowed to purchase up to 4 ounces of dried medical marijuana or equivalent. The law requires one not possess more than a 60-day supply of dried cannabis or equivalent unless permitted with written certification from two independent state-licensed physicians. The fee for the grower card is $100. Please see section 19 CSR 30-95.030(4) under the Missouri Department of Health and Senior Services for further.
How do I decide what product and method of ingestion is best for me? Education is key. We can help refer you to a trusted medical approved dispensary who will help with advice on specific dosing questions. Oftentimes, it is a trial and error process. If you are seeking help with CBD specific products, our Patient Care Representative through a consultation can discuss the ingestion methods and basic risks and benefits of using CBD oil, buccal strips, vape pen, suppositories or cream.
What is a designated caregiver? A designated caregiver is a person who is selected by a qualifying patient as the person authorized, on the qualifying patient’s behalf, to possess, obtain from a certified medical marijuana dispensary, dispense and assist in the administration of medical marijuana. Caregivers must apply for a registry card. It is not legal for caregivers to consume, by any means, medical marijuana that has been dispensed on behalf of a registered qualifying patient. Further, a designated caregiver is not prohibited from receiving compensation or reimbursement of expenses from a qualifying patient for assisting a qualifying patient with the medical use of marijuana. Someone who is:
- Twenty-one (21) years of age or older;
- Responsible for managing the well-being of a qualified patient
- Designated on the primary caregiver application for an identification card or in other written notification to the Department.
Medical marijuana caregivers cannot have more then three patients.
Do I need a caregiver card to purchase medical cannabis for my child? Yes. Qualified patients under 18 years of age cannot purchase medical marijuana from a dispensary. The legal guardian or parent is required to register as a caregiver to buy medical marijuana for a minor.
Can a caregiver have more than one patient? Yes. An individual may serve as a caregiver for up to three (3) patients. A caregiver must apply for a registry card for each patient and pay $25 for each registry card.
How do I apply to be a designated caregiver? Online registration is located on the Missouri Department of Health & Senior Services website.
Yes. A caregiver may be a registered qualifying patient. Yes. A caregiver may be a registered qualifying patient.
How much does it cost me to register as a medical marijuana patient or caregiver in Missouri? The registration with the DHSS (to be completed within 30 days on-line if/when permission or authorization from our physician is provided) is $25.00. The cost for the designated caregiver application is $25.00.
Cannabis And Missouri Law
If I have a past conviction for possession, can I still receive a patient license for purchase? Yes. Previous convictions do not disqualify an individual from obtaining an identification card. However, a qualifying patient’s identification may be revoked for certain criminal conduct that occurs after the card is issued. See 19 CSR 30-95.030(3)(B) for more information.
Can I consume medical marijuana and drive? The patient identification card does not offer individuals protection from violating laws pertaining to operating a motorized vehicle while under the influence. Nothing in Article XIV permits a person to operate, navigate or be in actual physical control of any dangerous device or motor vehicle, aircraft or motorboat while under the influence of marijuana.
Where can I publicly consume medical marijuana? Per 19 CSR 30-95.030, no qualifying patient shall consume marijuana for medical use in a public place, unless provided by law. 19 CSR 30-95.010 defines a public place as any public or private property, or portion of public or private property, that is open to the general public, including but not limited to, sidewalks, streets, bridges, parks, schools and businesses. See 19 CSR 30-95.010(33) for more information.
What happens if I encounter law enforcement? You must be in possession of an approved Missouri Medicinal Marijuana Identification card. Products in possession must be in the appropriate amount granted by the state AND in original packaging from a state approved dispensary. You may always contact an attorney for recommendations or advice.
Will the state of Missouri accept medical cards from other states? No. At this time, you must be a patient in the Missouri Medical Marijuana Program to access Medical Marijuana in Missouri.
Can you own a gun and medical marijuana card? The use or possession of marijuana remains unlawful under Federal law, regardless of whether it has been legalized or decriminalized for medical or recreational purposes in the state where you reside.
Can my employer still drug test me for marijuana if I am a registered patient? Yes, they can. Missouri does not provide protection to medical marijuana patients from employee drug testing. It will be left to the discretion of each employer whether they wish to recognize an employee’s medical marijuana approval as an exemption to company drug testing policies. However, employers are prohibited from discriminating against an individual in hiring, termination, or any term or condition of employment based on an individual’s past or present status as a caregiver or a qualifying patient. Certain “safety sensitive” positions are exempted from this protection which includes professions that require carrying a firearm, performing lifethreatening procedures, working with hazardous or flammable materials and others listed in Missouri Act 593.
Full Spectrum CBD products can contain no more than 0.3% THC as allowed per Missouri state regulations. Because of this, some drug tests may test or show positive findings for THC. If this is a concern, we are happy to explore CBD Isolate products, which contain no THC, with you.
Will I fail a drug test if I used CBD products? A consumer who uses a high-quality, scientifically vetted hemp-based product at the standard serving size is highly unlikely to test positive for THC and/or THC-COOH**. However, it’s important to note that extremely high doses may result in a positive urine screen and that genetic differences in the CYP450 enzyme system may cause variation in results.
Ultimately, consumers need to be fully informed of the specific regulations proposed by their employers and adjust their consumption of cannabinoid products accordingly.