A New Leaf
Medical marijuana dispensaries are sprouting up all over the Bethesda area. Who’s using them—and will full legalization be next?
Dr. Matthew Mintz, a Bethesda internist approved by the Maryland Medical Cannabis Commission to certify patients to participate in the program, wandered into the field of medical marijuana largely by happenstance. Mintz, who lives in Rockville, spent 20 years teaching and treating patients at the George Washington University School of Medicine & Health. Weary of his commute, he opened a private concierge practice last year in the Wildwood Medical Center on Old Georgetown Road in Bethesda. Mintz’s patients pay $1,500 upfront annually in exchange for the luxury of same-day or next-day appointments, longer than standard appointments and 24/7 emergency access. Although many longtime patients followed him to his new practice, the start-up was slow, he says. He had time on his hands. One day, he walked down to check out RISE Bethesda, the new medical cannabis dispensary that was opening on the first floor of the same medical building.
Intrigued, Mintz began reading about the medicinal uses of cannabis. He applied to participate in the Maryland Medical Cannabis Commission’s program. In Maryland, people hoping to buy medical marijuana can register online with the commission and receive a patient identification number. Then they visit a participating medical practitioner, such as Mintz, who interviews and examines them, reviews their medical records and assesses whether they fit Maryland’s legal criteria for buying medical cannabis. That criteria includes patients suffering from several listed conditions: chronic pain, severe pain, seizures, post-traumatic stress disorder, glaucoma, muscle spasms, severe nausea, anorexia and wasting syndrome. There’s also a broader, less specific provision for patients who have a severe medical condition, have tried conventional remedies and have a reasonable expectation that medical cannabis will help them, Mintz says. That allows willing practitioners to certify patients with problems not specified by the state, such as severe anxiety or insomnia, to buy medical cannabis.
Mintz says his practice tends to attract sicker people who legitimately need help, and because of that he’s never refused to certify a patient. Mintz charges $250 for those visits if the patient is not a member of his regular practice. “The way it works in Maryland is that I’m not prescribing marijuana,” he says. “All I’m doing is giving a medical opinion that the patient meets the medical requirements. That’s essentially what my job is. Now, in my practice, I try to do a lot more than that. I try to provide medical advice.”
Mintz has observed that the judicious use of medical cannabis has especially helped some of his elderly patients, he says. Those patients often suffer chronic pain, anxiety and insomnia. Traditionally they end up on a cocktail of prescription medications—all of which have potential side effects that can be compounded when taken together. In contrast, medicinal cannabis often eases their symptoms without a lot of side effects or negative interactions with other medications that they must take, Mintz says.
Debbie Mazia, 71, of North Bethesda, who is terminally ill with metastatic breast cancer, asked Mintz to certify her to buy medical cannabis. “It’s been the best thing,” Mazia says. “It’s kept the pain level under control, which is good. It’s not getting worse. I feel calm. …It takes the hamster-cage thing totally away. That’s when you go over and over things in your head and worry. I don’t do that so much anymore.”
Mintz has become a public advocate for medicinal cannabis. He seeks out and shares the limited available research. He’s created a PowerPoint presentation on the topic that he shares with other doctors. Mintz estimates that 25 percent of his workday is now spent seeing patients who hope to be certified to buy medical marijuana. “It’s been fascinating,” he says. “It’s not something that I ever thought, that I would be an advocate for cannabis. I think as a medicine it’s not a panacea, but given its safety and efficacy profile it’s a valuable tool in any physician’s toolbox.”
Darlene Jessup, 56, is in her Potomac garden on a summer afternoon, mixing concrete. She wants to point up the mortar on some stonework. Her father, who was a stonemason, taught her a bit of his craft. If someone had asked her in the summer of 2017 if she’d ever again mix concrete she might have laughed or cried. Even walking the family’s golden retriever around the block back then was painful and required steely determination.
She’s not easily defeated. She served in the Air Force as a cryptologic linguist, a job that involves, among other things, identifying and analyzing foreign communications. After leaving the service she became a contract manager for an engineering company. In her spare time she became a licensed massage therapist and earned a master’s certificate in Spanish translation. She already had an undergraduate degree in Spanish literature. Jessup was accustomed to being fit and productive.
Then the pain struck.
More than a decade ago she started feeling constantly tired. Her joints hurt. Her doctor ran tests, ruled out Lyme disease and was stumped. She grew sicker. Eventually she was diagnosed with rheumatoid arthritis. “By then, I was in bad shape,” she says. “I couldn’t walk.” Even the joints of her rib cage were so inflamed that it hurt to breathe deeply. Chronic pain, she says, turned her into a “shuffling, grumpy old woman.” She was only 45.
Some drugs her doctor prescribed to combat her arthritis were toxic; Jessup needed regular blood tests to determine if they were damaging her liver. “They all have side effects,” Jessup says. “Some give you headaches. Some give you diarrhea. Some make your hair fall out. I said to my doctor, ‘Sometimes I wonder if this cure isn’t worse than the disease.’ ”
She kept taking her meds, but researched alternatives. She changed to a whole foods, plant-based diet. “That helped tremendously,” she says. “I was able to do more and move better. But I still suffered every day with pain.”