A D.C. doctor makes medical marijuana a specialty

Takoma Wellness Center is a family-run medical marijuana dispensary in Washington. Stephanie Kahn sets up the dispensary room before business hours. (Sarah L. Voisin/The Washington Post)

 

By Steve Hendrix 

Twice a week at the office of Patrick Fasusi, District residents line up to ask the pain specialist to approve their use of medical marijuana. For most, the brief wait in the lobby is longer than their consultation.
As marijuana, which became legal for recreational use in the nation’s capital in February, continues to morph from contraband to commonplace, Fasusi’s clinic is a window into the ease with which some residents have been buying officially sanctioned pot for more than two years.

More than 2,700 people have registered for the city’s medical marijuana program, a number that has more than tripled since summer, when the D.C. Council relaxed the rules for participation. And many observers predict that the interest spurred by legalization will lead even more people to jump through the minor hoops required to obtain an official medical marijuana card from the city’s Department of Health.

[Getting medical marijuana in D.C. will become much easier]

The first step is a stop at a sympathetic doctor’s office. More than 240 D.C. physicians have applied to participate in the Department of Health’s online system that lets them recommend patients for medical cannabis.

But fewer doctors are busier, or more open about their work with medical marijuana patients, than Fasusi, a pain specialist and neurologist in Northwest Washington. At a clinic, two patients agreed in March to let a reporter sit in on their consultation as long as they were not identified.
The first, an unemployed man in his mid-30s, complained of pain following knee surgery — in 1995 — and loss of appetite.

Fasusi took his temperature and blood pressure and asked him a series of questions. The patient had no other major medical problems, was not on any medication, did not drink and smoked only marijuana. About 18 minutes later, after examining the knee, the doctor filled out the health department’s electronic application for the card and told the man to return for a follow-up in four months.

The second patient, a 20-year-old student from the District’s Takoma neighborhood, said she had been battling insomnia for a year and a half. The sleeplessness was creating anxiety, she said. She had tried over-the-counter melatonin but had not seen a doctor.
“Do you smoke?”
“Actually, I tried marijuana, and that was calming.”
He approved her application, as well.

Afterward, the doctor said the two consultations were fairly typical, although he said most of his patients have seen other doctors about their medical conditions before they come to him.
Fasusi, a strong advocate of medicinal marijuana, wrote more than 1,000 cannabis recommendations in 2014. City regulations call for an audit of any physician who writes more than 250, and the doctor said he was called before a Department of Health panel last year.

They asked questions but did not tell him to change his practice, and they noted that the 250 number was not meant as a limit, he said. The department said it could not comment on a specific physician’s prescribing habits.
“They were very, very supportive,” Fasusi said. “They wanted more information about how the program works.”

A dizzying display of pot

 

Now that it is legal for any District resident to smoke marijuana in the home, some pot professionals say more recreational users will take notice of the availability of medical cannabis. Indeed, Fasusi said he has seen a slight uptick in interest since legalization took effect.
“It’s really not difficult to register and get your cannabis card,” said Vanessa West, general manager of the Metropolitan Wellness Center, in remarks to a downtown marijuana expo in February. “The Department of Health has made it, in my mind, rather easy.”

[D.C.’s pot expo: Less Cheech and Chong, more Berkshire Hathaway]

For those who obtain a physician’s recommendation, the next stop is a visit to one of the city’s three official medical cannabis dispensaries. Each participant is assigned a dispensary, and there are no better places to observe the dizzying makeover of marijuana than in these shops, where a brisk and lawful trade has been going on for more than a year.

Chris Minar works the front desk of the Takoma Wellness Center, the largest of the three. Minar was a D.C. police officer for 28 years, including eight years running “buy-and-bust” stings against small-time pot dealers. Now, when people show up to buy marijuana, he greets them by name and offers them coffee.
“Tarik, how you doing?” he asked one afternoon not long ago as Tarik Davis, a 33-year-old musician who uses cannabis for back spasms, entered the waiting room. “How’s your mother?”

Minar took a part-time job in security here after retiring from the force. So did Darrell Green, the 6-foot-4 former D.C. police officer selling grams of Blue Dream and Sativa Afghani at the rear counter (debit cards accepted).
The decor at Takoma Wellness is a blend of spa lobby and head shop, and the place proudly reeks with a pungency that was once the mark of locked dorm rooms and dark rock concerts.

The rear sales room offers a glimpse of what a retail pot market might look like: well-lighted cases lined with fat green buds. Blue Dream sells for $21 a gram; Merry ’n’ Berryfor $22. A small pre-rolled joint of Blue Kush goes for $13.
“It’s still a little mind-numbing when they walk into a place like this,” said Jeffrey Kahn, a rabbi who served four congregations from Australia to New Jersey before opening Takoma Wellness with his wife, Stephanie, their two sons and a daughter-in-law. “It’s just a total paradigm shift.”

In the first months of medical marijuana, the enterprise was clouded by the suspicion and reticence that has long marked pot’s black-market status. Neighbors were wary. One early participant came in with his hat pulled low over dark glasses, suspecting a sting. When a documentary film crew came by in early 2014, the staff could not find a single participant willing to go on camera.
But the Kahns hired former police officers to reassure neighbors and coached them to make clients feel welcome.

(“At first, when they would answer the phone, we’d have to tell them, ‘Not your cop voice,’ ” Stephanie said.) And slowly, as more than 1,000 D.C. residents have registered with the city’s Department of Health to buy cannabis at Takoma Wellness — out of about 2,600 registered citywide — retail pot has begun to feel more routine to those on both sides of the transaction.

For clients, a ‘blessing’

 

During a visit to Takoma Wellness in March, customers came and went — and more than a dozen were willing to give their names and talk openly about their marijuana use.

[With marijuana legalization, green rush is on in D.C.]

“Just being on the legal side of things makes for huge peace of mind,” said Spencer Thompson, 26, a salesman at an H&M store in Friendship Heights. He had been smoking marijuana for years and found that it greatly eased his nearly crippling social anxiety.

When he got his first job with medical coverage, he asked his doctor about the anti-anxiety drug Xanax. She recommended medical cannabis instead. “She said if the pot was working, it was probably better.”
The customers filing in and out of the dispensary represented a cross-section of the District. Some were young and fit and practiced pot smokers. Others said they had never tried the drug, or had not done so for years, before a health concern led them to sign up. Their complaints ranged from phantom pain from an amputation to cluster migraines to muscle spasms from a years-ago motorcycle accident.

Breast cancer survivor Anna Hall, 39, said a few drops of sativa oil under her tongue is the only thing that has eased the nerve pain she feels from Tamoxifin, a cancer drug she will be taking for another nine years.
Jeremy Douglas, 39, a former deep-sea diver for the Navy, said the herb helped him kick the opioid painkillers he had been popping since he was blown out of a Humvee in an explosion in Bahrain in 2004.
Sydney Buffalow said two small hits of marijuana a day — sometimes inhaled from a steam vaporizer, sometimes in oil-infused tea — ease the pain of endometriosis. “I was so glad to tell my dealer I would no longer be coming to see him,” she said. “This place is a blessing.”

Insurance companies will not cover pot, the Kahns said, making it an out-of pocket expense. But low-income customers get a city-mandated 20 percent discount. The health department charges $100 for the marijuana card, or $25 for the poor.
The dispensary is housed in a small suite of freshly redecorated offices in a tiny shopping center a few blocks from the Takoma Metro station. The waiting room is a dentist-lobby haven of pastel walls, subtle art and trim leather chairs.

The bell on the always-locked front door rings every few minutes and, like a speakeasy, Minar asks each customer for their official D.C. Department of Health marijuana card and a second photo ID before he lets him or her in.
Traffic is brisk, thanks to an ongoing shortage of the cannabis supplied by the District’s three official growers. Dispensaries often limit how much each participant can buy to a gram or so per visit, so some customers come back every few days.

[D.C.’s medical marijuana shortage: A little noticed crisis]

If anything deters recreational users from trying to access the medical marijuana network, it may be this shortage, and the resulting jump in dispensary prices. One ounce of a strain called BerryO costs $552 at Takoma Wellness. A similar quantity of premium pot is available on the black market for as low as $350, according to several local dealers interviewed recently who spoke on the condition of anonymity to avoid legal scrutiny.

In the center’s dispensary room, where cardholders are called by name, Green works the register and talks with clients about the THC and CBD levels of the various strains. Packets of rolling papers fill one shelf, and glass pipes, another. But most of the space is devoted to smoke-free methods of imbibing: Volcano Vaporizers; Magical Butter machines that distill it to oil; a lone box of Duncan Hines brownie mix.
“We advise people that anything is healthier than smoking,” Stephanie said.

The Kahns view their bustling enterprise as part business and part mission. Stephanie’s father was diagnosed with multiple sclerosis in the 1960s. He tried a range of treatments, including snake venom, but found the most relief from marijuana. A huge honeymoon portrait of her smiling parents hangs in the dispensary lobby, and Stephanie tells the story to almost every new client.
“This is very personal for us,” she said.