The first dispensary to open under Pennsylvania's new medical marijuana program, Keystone Canna Remedies (KCR) operates with a focus on patient engagement and community outreach, offering educational workshops and person-to-person care. Founder Victor Guadagnino, Jr., along with his aunt, father and a family friend, opened the airy Stefko Boulevard location this past February, and they've already made a positive impact on thousands of lives.
How Does It Work?
The human body already contains an endocannabinoid system that regulates our health toward a homeostatic, balanced state. The molecules in medicinal cannabis bind to receptors in this system, both in the brain and body, to affect a number of physiological and cognitive processes such as pain, mood and appetite. “THC is the molecule that gets all the attention,” says Guadagnino, “but CBD is another main medicinal driver in cannabis, and the synergy between THC and CBD is really where the medicinal benefit shines.”
There's no difference between the cannabis that has been a federally illegal, stigmatized substance since the 1930s and the cannabis that's now being administered medicinally. It's all in how it's used. At KCR, cannabis is available in the form of tinctures, lotions, capsules, patches, vaporization cartridges and, most recently, finished flower (the actual dried plant).
Who's Eligible?
The Pennsylvania Department of Health has developed a list of 21 conditions with symptoms that cannabis can alleviate, including autism, cancer, epilepsy, HIV/AIDS, PTSD, MS, neurodegenerative diseases, such as dementia and Parkinson's, and opiate use disorder.
Anyone suffering from these conditions can register online in a simple process and make an appointment with a physician certified to recommend cannabis treatment. The physician can then certify the patient to receive an ID card, which can be presented at a dispensary to buy the product. In most cases, physicians charge between $115 and $200 for this evaluation, equivalent to a self-paid visit.
What Happens at the Dispensary?
At KCR, initial consults determine what medicines the patient is already taking, what experience with cannabis they have, whether they have a history of anxiety and what kind of regimen will be most helpful.
Products at KCR are sorted by A.M. and P.M., depending on what time of day they'll be most useful. Whether symptoms are worse first thing in the morning or after a long day of work, whether sleep issues are a factor and what level of tolerance the patient has, all determine what's prescribed.
In a limited-access part of the building, there is an open counter where patient-care representatives demo the options and where the purchases, follow-up and often camaraderie between patients takes place. The atmosphere is comfortable and not overly clinical, setting the stage for a positive, professional experience.
Patients receive instruction on how to experiment within safe parameters to find the dose that gives relief from symptoms without compromising functionality, and it can improve functionality as well. “We're interested in this realm primarily because it does reinvigorate the patient into their own health care,” says Guadagnino.
Are There Risks?
You can't overdose on cannabis, but as Guadagnino says, “We wouldn't have a dispensary where we're taking a health-care-led approach if it wasn't a powerful substance.”
Misuse and overuse are potential issues with cannabis as with many substances, but when using it according to KCR's recommendations with a micro-dose approach, it's unlikely to present these problems.
Generally, if use is decreasing functionality rather than increasing it, increasing sluggishness or anxiety instead of doing the opposite, that's a case of overuse. “That's why you need to approach it in an educational and effective, safe manner,” Guadagnino says. “And that's what we're here for.”
What Are the Benefits?
Guadagnino lights up when he talks about patient improvement. “We're seeing tremendous success,” he says. “They eat better, they move better, they sleep better, they feel better.” Chronic-pain patients have taken their one-to-ten pain-scale rating from a nine to a three. Autistic children have evened out, sparing their families at least some tantrums. One brain injury patient who had receded into himself, losing his personality, became able to do things independently and feel like himself again.
Whether it's the focusing effect that can help stabilize and lift mood, or the anti-inflammatory effect easing pain and discomfort, or sensation returning to neuropathic extremities, or patients working with their pain management physicians to reduce their opiate intake in conjunction with a cannabis regimen, this powerful plant is improving quality of life for 2,000 patients at KCR, and counting.
And for people who have been suffering from stubborn, debilitating symptoms for years, KCR has given them a place to celebrate and share in the relief that comes with effective treatment freed from the shadows of illegality. Even Guadagnino is impressed with the results: “I'm just blown away sometimes.”
