By Michael Hartwell
mhartwell@sentinel andenterprise.com
FITCHBURG — Jokers who want to make Cheech and Chong references about the planned medical marijuana growing operation in Fitchburg haven’t met Dr. Karen Munkacy, the anesthesiologist-turned-advocate behind the business.
“We don’t recommend people smoke it,” said Munkacy, founding director of Garden Remedies Inc. She stresses the word “medicine” when speaking about the attention-grabbing product she plans to grow, process and distribute in the coming year.
This is about stopping chronic pain and getting kids with epilepsy out of wheelchairs, not celebrating stoner culture, she said.
She said although there is no medical evidence showing smoking medical marijuana causes cancer, she said it’s a reasonable precaution to avoid it just in case. Instead, she recommends patients get it into their system by using a tincture, in which liquid droplets are applied under the tongue; a vaporizer, which uses a heating element like an E-cigarette; or eating it in prepared products called “edibles.”
She’s also considering offering a medical marijuana skin lotion, but said more research needs to be conducted first.
Munkacy has a medical career going back more than 30 years. She’s licensed to practice anesthesiology in California, taught at UCLA and USC Medical Centers in Los Angeles and has been a medical researcher and consultant.
In 2004 she was diagnosed with breast cancer and faced down a 50 percent mortality rate. At its worst, her cancer was at stage 3B and she had a tumor the size of a chicken egg. She suffered through six surgeries and 28 radiation treatments and is now cancer-free.
She said she never used medical marijuana while in treatment, but heard from other patients that it helped with the gut-stomping nausea that follows cancer treatment.
“There was no way I was going to break the law. I just suffered through it,” said Munkacy. “But the thought of other people going through this was just heartbreaking.”
She left the workforce to become a medical marijuana advocate. She is now a board member of the dedicated medical marijuana advocacy group Americans for Safe Access and lives in Newton. In 2012 she testified in favor of medical marijuana on Beacon Hill, calling it the opposite of a gateway drug and saying it keeps people from taking addictive painkillers. She said it can help with patients treated for conditions such as ALS, neuropathic pain, paraplegia, multiple sclerosis, ulcerative colitis, allodynia and HIV/AIDS.
Massachusetts voters passed a ballot initiative in 2012 that legalized medical marijuana.
It’s not clear when Munkacy’s activism led her to want to start her own dispensary; she said it evolved over time and her motivation has always been to help make sure medical marijuana patients get the “best quality medicine” they can.
“I want to make this as close to any other medicine as possible,” she said. “And I wanted to work with people who follow the law.”
She contacted medical marijuana growers in Colorado, a state where medical marijuana has been legal since 2001, and is attempting to open a single dispensary in Newton.
The city of Newton has approved her dispensary, but she’s waiting for the state Department of Public Health to give her business state approval. Commonwealth regulations require medical marijuana businesses to use a vertical integration structure: They have to grow their own marijuana, process it themselves and distribute it to patients themselves.
“That’s the only way you can do it in Massachusetts,” said Munkacy.
Medical marijuana can’t be sold out of state, and for the most part can’t be sold to other companies. In rare exceptions, like a massive crop failure, a Massachusetts company could buy medical marijuana from another one, but only up to 30 percent of its supply and not as an ongoing business structure.
“The entire program has been designed with safe patient access in mind,” said DPH spokesman Scott Zoback. He said this closed approach not only keeps medical marijuana from being “diverted” into the illegal recreational drug market, it also ensures that patients know what they are getting.
The regulation process is a slow one. Munkacy’s dispensary was approved by the Newton in early 2014. She said her Fitchburg application for a growing operation is going smoothly, and she is currently submitting a site plan to the Planning Board. Fitchburg’s ordinances treat marijuana growing as any other industrial activity, and the business does not require special approval.
Her operation will be located along Airport Road in the 81,000-square-foot complex that previously housed New England Wire Products. Munkacy said the business will only use 20,000 square feet initially but will expand into more of the building if approved by the board of directors of Garden Remedies.
This past week workers were removing New England Wire Products equipment from the building. Munkacy said she can’t start construction until she gets state approval, but when it’s ready the Fitchburg growing location won’t require knocking down any walls or major work.
There will be indoor lamps to help grow the marijuana plants, space to dry and cure the plants, laboratory space to process it and a kitchen to make the edibles.
“It’s complicated to do this indoors and make the medicine under very precise conditions,” said Munkacy. Temperature and humidity need to be carefully controlled, and mold and bacteria must be kept in check. She said she will voluntarily use organic farming methods as well.
Security is a big issue. She declined to go into details on the security measures, but said they are carefully regulated and her head of security is a former state trooper.
She said the company will hire and train people from Fitchburg, who must pass an extensive background check.
Garden Remedies is primarily funded by Munkacy and her husband, who works in real estate. She plans to join the North Central Massachusetts Chamber of Commerce.
She said she hopes to have products ready to ship in Newton by mid January 2016. There is no plan to open a dispensary in Fitchburg.
One of the strangest parts behind selling a medical product that patients were once forced to buy off drug dealers is deciding what to write on the package.
Munkacy said many patients know particular marijuana strains by street names like Super Silver Haze, Australian Blue and Caribbean Dream. They have preferences for these “brands” and have been using them for a long time.
She said she and her staff are going to come up with more medical sounding names but will write “also known as” on the packages so patients with preferences will know what they’re getting.
The company hasn’t decided how it will make its edible offerings, which often come in the form of baked goods and prioritize proper dosage over taste and variety. Munkacy said the packages can’t be bright or inviting as that could cause children who find them to eat them like Oreos. She said they will be sold in plain, opaque containers.
Munkacy plans to offer the strain known as Charlotte’s Web, which has been shown to help some children with epilepsy. Developed through crossbreeding in 2011, the strain was originally called “Hippie’s Disappointment” because it can’t be used for a recreational high. It contains a minuscule amount of THC, the psychoactive component that gets people high, and instead has massive amounts of CBD, a chemical valued for pharmaceutical uses.
She stresses that for child patients, medical marijuana should be a last resort. That’s because their brains are still developing and there isn’t a body of evidence showing long-term effects. The strain Charlotte’s Web was famously named after a patient with severe epileptic conditions that was in hospice and had to use a wheelchair and feeding tube. In that case, the family had exhausted every other medical option and had the child on a “do not resuscitate” order.
In order to get treatment at Garden Remedies in Newton, patients will have to get a Medical Marijuana ID card from the commonwealth, which requires approval of two physicians, a medical history check and if under 18, parental consent. The patient will bring that card with a photo ID to the Newton clinic and be admitted to a holding area. The rest of the clinic will be behind frosted glass and out of view of the potential patient.
Once Garden Remedies staff verifies the legitimacy of the card with the commonwealth, they can arrange an initial appointment. That appointment will last about 20 minutes and afterward the patient is eligible to enter the full clinic.
The clinic has a pharmacist on staff, and Munkacy said staff will help patients determine what form of medical marijuana they should take. Regular doctors often have little knowledge on medical marijuana and do no prescribe particular strains or application methods.
For example, the vaporizer is a fast way to get the drug to act in the patient’s system, but the effect is short-lived. Edibles take longer to take effect, perhaps an hour or two, but last longer.
“You don’t want someone to go with the vaporizer then go to sleep and wake up in pain three or four hours later,” said Munkacy. She said with someone with a severe nausea problem, she would recommend they use a vaporizer for fast relief and that will also allow them to take an edible without vomiting.
Patients will have to take their medical marijuana doses at home, and are told not to drive afterward.
When asked about the legalization of recreational marijuana, Munkacy said it’s not relevant to what she does.
“We’re making medicine for people,” she said. She also rejected notions that legalizing recreational marijuana would relax the heavy regulations in the medical marijuana field. She said following Colorado’s recreational marijuana legalization, medical marijuana regulations have actually increased, not diminished.
Jen Bernstein is the managing editor at “High Times” and the pro-pot publication’s business writer. She’s been pushing the idea that Colorado’s legalization has been great for that state’s economy and said their medical marijuana laws are “very strict.”
“Each plant is attributed to a patient,” she said. “It has a tracking number that can be scanned or coded from a clone or a cutting, so that plant is automatically associated with a patient.
Technically, medical marijuana is illegal in all 50 states under federal law. Bernstein said President Barack Obama has said he will not make stopping medical dispensaries a priority and that it should be up to the states to decide.
“That hasn’t stopped the government or the DEA from raiding some dispensaries,” she said.
However, Bernstein said those dispensaries were actually fronts for illegal drug operations. She said to her knowledge, the federal government isn’t going after law-abiding dispensaries and is not putting the boot down on companies that make accidental paperwork errors either. It is targeting fronts for criminal enterprises.
“For the most part we’ve seen that businesses have complied with the laws,” she added.
Follow Michael Hartwell at facebook.com/michaelhartwell or on Twitter or Tout @Sehartwell.
