Right now, I should be savoring the fall of the Sackler family, righteous head-rolling for the sales-based damage the opioid crisis did and does to my state, Massachusetts. Unfortunately, I also have a chronic pain condition that all the schadenfreude in the world couldn’t hope to quash, and I feel proud of our tenacious Attorney General Maura Healey, and disgusted by our state’s clear antipathy for pain patients. Governor Baker just made it clear with his four-month vape ban that pain patients are not prioritized or considered by healthy, intergenerationally-wealthy, fully-enfranchised legislators like himself.
I have Interstitial cystitis, a life-altering bladder condition with no cure. It causes excruciating pain that fluctuates. I have a renowned, pioneering urogynecologist and have worked with the top experts in pelvic pain management. I pursued opioid pain medication for emergencies, never consistent use, and was pelted with antidepressants, nerve drugs, nerve injections, et al and “do you meditate?”
In 2014, Massachusetts feigned positive vibes around medical marijuana legalization, lauding itself for being so humane though the ballot initiative was supported as a mere pretext to enabling large, out-of-state cannabis holding companies to profit from a legitimized recreational market. Championing weed legalization as an alternative to opioid pain medication was a moment of crass punditry. It pushed our would-be healers to grip tighter to their DEA numbers, refusing to risk their licensure to help pain patients achieve higher quality of life. The CDC only recently retracted the guidelines that resulted in patients being cut off, leading to agony for some, suicide for others.
I have to crawl to a foul little weekends-only shop to obtain medical certification for cannabis use from a doctor who has the clinical experience of an egg because the institution where I receive care is too nervous about their federal funding to engage. I go to dispensaries where some “budtender” tries to up-sell me rather than inform me like a pharmacist.
I am under no illusions that “why don’t you go consume cannabis about it” was sound medical advice or a pain solution, understanding the risk I take by combusting cannabis products. My risk balances higher quality of life now, and while I’ve made my peace, I’m exceptionally fortunate. Others are not so abled, don’t have as many good days, and don’t have access to the socioeconomic context I do. I’d prefer outright hostility to this paternalistic state urge to be involved in a contract they have broken with their citizens.
For insipid, ineffectual Governor Baker to take decisive action like this for the first time in his tenure reflects how woefully ignorant regulators often are. For starters, he banned vape cartridges, not concentrates or even concentrate oil. It’s early, but many vape deaths can be ascribed to counterfeit vapes with poor lab oversight; of course fungus that turns into cyanide when combusted is a problem. This is a counterfeit/supply-chain issue. People are pushed to purchase counterfeits because $65-70 vape cartridges are comically unaffordable and unsustainable—not to mention the lack of insurance coverage. However, cartridges which labs report to have 70-90% THC (as opposed to “flower” at more like 15-25%) are suddenly unavailable, so people are scrambling to learn how to dab, increase their dosage to even *touch* their symptoms, or experimenting with the psychedelia of edibles. None of these options are 1:1 for the accessibility, ease of use, and efficacy vaped cannabis offers.
This is another entry in apathetic state incompetence. Boston holds what we like to think are the most internationally prominent and enlightened higher education and medical institutions within a small 5-mile radius. How do we continue to fall so terrifically short for people with disabilities, chronic illnesses, and incurable pain?
Massachusetts is usually a leader in legislation, regulation, and industry. As more recently legal states such as Illinois contemplate the nascent industry and formulate public health perspectives, attending to Massachusetts as a case study in using compassionate cannabis as mere pretext for out-of-state industry will be essential. Financial incentive is an essential lens for critically evaluating policy. It should not be omitted, and citizens of all physical ability and health should be given the chance to have their voice heard.
Chaya Rusk is a writer living in Cambridge with her partner and their polydactyl cat. She focuses on chronic illness and public health.