This is a first in a series of bonus episodes. I’ll record and release randomly. Today, I’m joined by Courtney. She’s a nurse practitioner in the Commonwealth of Virginia. Courtney’s recently opened a business focused on medical marijuana certificates here in Virginia. 

https://www.moreaumed.com/

Courtney

Stack: Thank you for joining me for another episode of the things we all carry. Today’s episode is a deviation from the norm. I’ve identified a few people or groups I think would bring benefit to the audience. This is a first in a series of bonus episodes. I’ll record and release randomly.

Today, I’m joined by Courtney. She’s a nurse practitioner in the Commonwealth of Virginia. Courtney’s recently opened a business focused on medical marijuana certificates here in Virginia. She was also the wife of one of the good guys in my department. It was a pleasure talking to Courtney and picking her brain. Please remember to check the laws.

And statutes in your own state before considering cannabis as an option. A quick reminder to please help us build a community which not only recognizes, but supports each other through the struggles and recovery. Reach out through instagram @thethingsweallcarry or email mystoryatthethingsweallcarry.com to offer support and share your story.

Please remember to leave a review on iTunes and give a shout out to any first responder, you know, love or care about. You all enjoy the show. Is that what you’re calling it?

yes. Okay. I just wanna make sure I don’t fuck it up cuz I will. All right. So join us today is Courtney. She’s a nurse practitioner and she just started getting into the business of medical marijuana cards. And she’s gonna answer some of our questions and I’ll let her, tell you a little bit about herself as we go, and then we’ll get the questions going.

How you doing Courtney?

Courtney: I’m doing pretty good. Thanks for having me today. So like he said, I’m Courtney, I’m a nurse practitioner. I’m coming up on my sixth year of practice primarily in the primary care setting. And then more recently into palliative care and hospice, which really led me into obtaining my license to be able to write the medical certification for medical cannabis.

I saw such a growing need for medical cannabis, especially since insurances were not approving. Common prescription medications for things such as anorexia that you see with cancer patients, Caria, the wasting that just happens from the disease. As well as appetite stimulant they really are only approved for AIDS patients.

And so we kept heading into these roadblocks, but I had my patient suffering as well as the pain associated with cancer. I decided to go ahead and get my license to be able to write the medical certifications.

Stack: And what’s the process for that for the license.

Courtney: Prior to July 1st 20, 22 you would meet with a practitioner and it there’s qualifying conditions, but they’re based on what the medical provider chooses.

It’s not set by Virginia. You would meet with them and they would provide you the medical certificate. And then you used to have to go register with the board of pharmacy after July 1st, you no longer have to register with the board of pharmacy, which I know a lot of people were fearful about as far as tracking.

Stack: And I guess my question was more like how what certifications did you need to get on top of your, everything else you already had?

Courtney: Okay. Obviously you have to be a practitioner. So either a physician assistant do, or a nurse practitioner. And then I had to apply through the board of pharmacy for my license.

So it’s an additional license to prescribe that I hold on top of my nurse practitioner, my registered nurse, my Virginia license to prescribe as well as my DEA license.

Stack: So not horrible then for you to get that?

Courtney: No, honestly it literally was just an application, the same system, same website you would go to prior to July 1st of this year to get your medical cannabis

Stack: card.

Oh yeah. I’m familiar with the website. Yeah. Do you wanna tell us what your business is named and how you’re doing?

Courtney: Sure. Absolutely. So after getting the license to prescribe the medical cannabis certificate I really saw a need in the community. I’m really big on trying to support my community and the access to mental health services is just absolutely atrocious.

The opioid epidemic is just getting worse and we’re seeing. A mass amount of overdoses and deaths related to opioid overdoses. So this is just really showing and screaming to the people that there is a huge pain problem and a huge mental health problem. And it’s just not being solved.

It’s just, we don’t have enough people. We don’t have enough people or here take this pill, take that pill and like any medication. Yeah. It might help one thing, but it might also cause other issues. Being a wife of a first responder. That’s where I’ve really seen one of the biggest needs. As in, as the mental health of first responders, I grew grew up in a family of first responders.

My cousin and my uncles were very active within the local community as volunteer firefighters. And so I actually became an EMT basic my senior year. That was one of the electives that I chose and. Now husband was actually my state partner. I went on to nursing of course, and he continued on the with his degree and his career path in the EMS world.

And went career. So my business name is Moreau Medical Associates nothing super fancy. So really knowing about the mental health and really struggling, watching the first responders struggle, watching the suicides the increase in alcoholism and divorce amongst first responders.

I just think it, I thought it was really important to try to reach out and provide another. To these people, to the brothers and sisters in the fire department world and to the police department because they, I’m, it’s just awful.

Stack: So how can Virginia listeners find you?

Courtney: We do advertise on VA normal word of mouth, of course.

Facebook. Our website’s pretty easy to find it’s meed.com. And you can easily make appointments. You can see my availabilities and since I do still work full-time with another company I tailored my hours to the working person. My hours will start at five and go all the way to almost 9:00 PM.

And I also have weekend mornings available. Again, access is my big push.

Stack: So when somebody reaches out to you what’s your first step with that person?

Courtney: If they just request an appointment, I confirm an appointment. Let ’em know that it’s confirmed. Of course. I also send them intake paperwork just like any other medical visit.

I need to know, your allergies. I need to know what medications you’re on. I need to know. What other past medical history, and obviously the reason why you’re coming to me medications are, it can be a big issue, unfortunately cannabis, like some of the same receptors as certain medications.

And so that’s why it’s really important to get those intake forms completed. So I can actually do a medical review. My I. Here to be a card mill for lack of better words, when you’re gonna come to me and you’re gonna see me for an evaluation for the medical cannabis or I’m really gonna check you out.

Yeah, I can’t be in person physically, . And I can’t listen to your heart and your lungs, but I can assess you in all the other ways. As well as just talk to you sometimes just listening is one of the biggest. Parts of an exam, the most therapeutic portion.

Stack: So initial exam, then you determined according to that interview, whether they qualify based on the illness or ailments,

Courtney: correct. Since it’s not recreationally legal on the state of Virginia, there has to be a medical condition associated. The medical cannabis or, but again, Virginia state leaves it up to the practitioner.

It could be anything from anxiety and depression, chronic pain nausea, vomiting associated with chemotherapy, poor appetite, migraines seizures, the list is endless. What cannabis can do for a person The only I’ve I think I’ve only turned away. Two people, one was due to age cuz he wasn’t 21.

And the other one was because there was a drug to cannabis interaction that I didn’t feel comfortable. I didn’t think it was appropriate to approve that person.

Stack: We’ve talked about first of all, I just wanna preface the rest of this conversation with the fact that we’re talking. And we’re speaking from the point of view from the state of Virginia that it’s good information for everybody, but if you’re listening to the conversation outside of Virginia, you need to check with your own state laws and localities, just to be sure what their regulations are.

Yes, correct. We have a list of questions and you had some time to go over the list of questions as well. And the first one was obviously, what is your connection with first responders? I think you covered that pretty well that your husband is a firefighter and a first responder and that it was in your family to begin with.

And you dabbled with it with the EMT stuff as well. Correct. And I think maybe you want to go a little more into what sparked your interest, but I think covered that as well. Sure. Yeah.

Courtney: I can definitely jump into that. So yeah. When I was 16 actually my, the month of my 17th birthday, I was diagnosed with multiple sclerosis.

Cannabis has been used in other countries for treatment of our management of symptoms of multiple sclerosis for years. Canada is one of the biggest ones and, it can help with anything such as pain, muscle spasms, and anxiety that are pretty common in Ms. so I’d say that’s probably where my interest first started.

And then again, my more recently, my focus has been on the poor mental health within the community and within the first responder I just felt that mental Health’s always been one of my big, hot buttons is trying to get it out there. Since the availability of mental health providers is so low.

As a primary care provider, I would definitely try to get my patients started. I never tried to push them off immediately to try to find a psychiatrist, because I know that, realistically that’s not an option. I You’re talking 6, 8, 9 months plus your waiting list to get in with a psychiatrist.

And so I I wanted to just be able to provide, yet another option .

Stack: so talking about medical marijuana, what are some pros and cons of using medicinal marijuana?

Courtney: Right off the top, the pros of course, would be the relief of the symptoms or complaints such as the chronic pain spasms anxiety, depression.

And that’s just the tip of the iceberg. As far as. It’s still a controlled substance. In most areas it’s not federally legalized. And you gotta be careful how much you have on, know, you can’t cross state lines cuz that’s federally illegal. And of course there’s, I had mentioned before with another patient there’s potential medical, inter our medication interactions between prescription medications and medical cannabis.

And they can vary anything from psych meds cardiac meds some antibiotics and anti fungals. And one that I ran into was actually an anti-rejection medication for an organ transplant. It can actually decrease the efficacy of it and cause that person to go into rejection. So that’s not good.

And then just like with anything that you consume, there’s the potential side effects, which, tachycardia or racing, heart rate, panic attacks vomiting. And one of the most fascinating things I found out because I’m a big believer for a cannabis for the use of mental health, is that it can actually worsen or exacerbate bipolar disorder.

So whenever I have a patient that comes to me and they have a history bipolar disorder, I really make sure that their psychiatrist is on. And that they understand that it can trigger both highs and lows within that. And so to monitor that,

Stack: going along with that, I, is it true that it possibly does the same thing with schizophrenia?

Courtney: Yeah. Yeah. That’s one that like, I would be a little hesitant about just because there’s just not enough research out. But if somebody came to me and they’re like, listen, my psychiatrist really, recommended it at least for X, Y, and Z. And they’re med compliant with their regular medication.

So it’s something that I would consider not, I haven’t come across someone with that yet. I’m not sure of its uses within schizophrenia.

Stack: I guess my question is more along the lines. I’ve heard that maybe exacerbates the symptoms of at.

Courtney: I can totally see that. Absolutely.

Stack: And I guess I would play into more of the, I, it probably feeds into some hallucinations.

Yeah, absolutely. That’s I from my layperson’s thinking on it at least.

Courtney: Yeah. AB absolutely. I could just thinking about it medically, I can see how that would trigger it or or exacerbate or make those symptoms more prominent or worse.

Stack: What are some of the ailments or conditions from the, from first responders?

What are you targeting in first responders other than sleep?

Courtney: Yeah, sleep is definitely a big one. I would say probably mental health stress just general unhappiness with the current day to day work burnout anxiety, agitation just being super irritable and then watching a lot of first responders really turn to alcohol and, the health side effects just from that alone is just really not good.

Stack: All right. Why don’t we get into some of the specifics about cannabis? One of the misnomers not misnomers, one of the biggest questions I hear day to day when I’m around the fire station is difference between CBD and THC. If you want to delve into that a little bit for us.

Courtney: Sure. Oh my gosh. I can never pronounce this word correctly. Cannabidiol commonly referred to as CBD. It’s just one of over a hundred cannabinoids found within the plant. So everybody just talks about THC and CBD. Those are just like drops in a bucket of what actually is the cannabis plant. Some early human studies in clinical trials have identified a host of therapeutic properties associated with CBD including anti-seizure antipsychotic pain, relief antidiabetic effects.

And in safety studies involving human studies, short term dosing with CBD has been shown to be safe and well tolerated. And unlike THC, the administration of CBD is generally not considered to be mood alter. Although the cannabinoid may be like help with anxiety and higher doses and then the THC.

Oh, and that’s also Le it’s legal, cuz it doesn’t contain the component of the cannabis plant THC. So THC is the chem chemical responsible for the psychological effects that people typically associate with marijuana. And it actually acts, we actually have cannabinoid chemicals within our body.

That’s why we have a cannabinoid system. So THC can mimic those NA more natural chemicals that we make in our body. And the cannabinoid receptors are concentrated in certain areas of the brain that are associated with thinking memory, pleasure, coordination, and time percept. The THC attaches to these receptors and activates them and affects a person’s memory, pleasure, movement, thinking, concentration, coordination, and sensory and time perception.

So because of where the cannabinoid system is linked in the brain, that’s where you get some of those therapeutic a relief for mental health, for pain as far as movement, not, like you see it with Parkinson’s disease, the shaking, the tremor, it can help relax that. So there, there are just a, the main difference is it’s just a different chemical within the cannabis plant, one’s legal, one’s not one can give you that high or that euphoric feeling.

And CBD does not. And a lot of times, like when you go to a dispensary and you look at product. You’re actually gonna see CBD a lot of times listed as one of the terpenes or one of the chemicals that’s actually in the product that you buy

Stack: with CBD another one of the questions and springing this on you.

And I apologize. One of the questions I hear is the difference between isolate full spectrum and broad spec spectrum. Can you speak to that at all? For.

Courtney: I will be completely honest with you. I cannot. Okay. I I didn’t know that there was a difference and that’s, I will say that my research on cannabis is I’m still very much a novice, a very early beginner as I’m learning more and more, and it’s just so complex, like I’m like two books in and I felt like I’ve.

Brushed off the top.

Stack: So what I’ll do is there know there’s some differences in the efficiency or efficacy of CBD, according to whether it’s broad or full or isolate. And I can just attach something to, to the show notes, to fill people in on that. That’s not an issue. Okay. Thank you.

And you covered, my next question was CBD and impairment and it doesn’t cause impairment. If you get. A clean CBD oil,

Courtney: correct. It’s not regulated by like the FDA, you don’t really ever know what’s actually in it. So if you do choose to get a go to an actual CBD store, maybe not a vape store, and that’s not saying that what vape stores have are crap, but just be very leery and do your research before you purchase this because you just.

No.

Stack: And at this point in the show, I’m gonna give a shout out to a friend of mine. He runs a CBD business out of Miami and it’s called rescue one CBD. And he provides the testing documents with his oils. And he also provides a test for a year analysis test as well. So just a quick shout out to rescue one CBD.

Courtney: Yeah, that’s awesome that you mentioned them. I actually had a patient who. Uses their products. And actually I told me about that. So I know thought his, the work and behind dish products is pretty amazing. Yeah. He

Stack: does a great job and he’s always available to answer questions. He’s always on doing little videos for himself and making sure that people are informed and aware.

So it’s great. It’s a good part of the community. Now back to THC, you want to, yes. What about differences between sativa in.

Courtney: It’s broad, when I was like, I knew the basics Sativa’s always, you’re more, you always hear it so more stimulating, almost like your daytime one and then and because better for relaxing or that full body higher for sleep and then I started reading about how it actually.

Kind of goes into like your broadleaf plants. And I was like that’s too crazy. That’s above me right this second. But those are your, those are your general guidelines, but that’s not to say that like you can, that you’ll use a sativa and not feel sleepy or feel invigorated by an indica, but that’s usually, generally sativa tends to be more stimulating versus endo, which would be better for chilling out sleep.

Stack: And the way you used cannabis and THC makes a difference from what I believe at least. And so can you Def I dunno, hit on some of the effects of the, on the body with dosages and routes.

Courtney: Yeah. So with any medication, especially cannabis low and slow, you should, your goal for any medication or anything that you put into your body should be the least amount or at.

The smallest dose possible. But reaching your goals of treatment so least effective dose. That’s what I was trying to say. And there’s different, methods, anything from smoking you hear about edibles all the time. There’s your tinctures that people put under their tongue resin.

Which I believe you still have to smoke cuz you have to heat it up. As far as your effects, edibles can take up to two hours to kick in and sometimes they’re a little bit more difficult to dose. Because what if you cut a piece in half and the half that you got actually has more cannabis than the other side.

So sometimes edibles can be a little bit trickier trying to find the. Amount. And then for the inhalation routes, like you’re smoking, you are vaping that onset for affects is the average six to eight minutes. And that’s not to say that you’re not feeling something within a few minutes.

Less than that six minute time. So some people like that better for like your more acute pain, say you get this headache and you need something more instant. So I think it’s just dependent on the person and what they’re comfortable doing as far as like smoking it or consuming it.

Stack: and a word of caution to firefighters out there, because I know that there’s some , know, cancer presumption acts and that smoking is a route that we’re advised to stay away from. And in some cases you’ve agreed to do, you’ve agreed to stay away from it as a condition of your employment.

Courtney: Yeah, absolutely.

Stack: What are oh, go ahead. No, go ahead. I was just gonna go into long term effects on the body. If there was anything out there that any studies out there that showed any long term effects.

Courtney: Yes, there is. I actually wrote them down because there is quite a few. There we go. So heavy, long term smokers can develop C O P D or chronic bronchitis.

There there are also limited studies proving one way or the other, as far as increasing cancers. What studies are out there are saying that there is not an increase in lung cancer for people that smoke I’ve also heard of the the like almost like a cyclic vomiting from like heavy cannabis users to where they just, they have this extreme, these extreme vomiting episodes and like a cold shower is actually what helps with the vomiting episodes.

It’s the wildest thing. And actually stopping. The cannabis will actually make those symptoms go away. There’s also of course, decrease in cognitive function with chronic heavy cannabis use. So not just when you’re using it, but it’ll long term affect you, but they seem to be reversible when a person quits cannabis.

Stack: The other part we talked about this being from the state of Virginia, we’re coming from the angle of the state of Virginia. What are. Legal ramifications in the state. Now I know we, we touched on it earlier and you mentioned getting the medical marijuana card would allow you to use recreational is legal in Virginia, but so is there, why is what’s the, why?

What would the reason be to obtain medical marijuana card?

Courtney: As far as I know Medical is the only, like recreational is not legal. So that’s the only way to be able to use it in the state of Virginia, at least legally. And then there’s the legal ramifications of public consumption.

It’s illegal in the state of Virginia without a medical cannabis certificate. And it only covers products purchased from an approved dispensary. So if your. Grows weed or has weed and you get it from them. It doesn’t cover you. And they just changed their laws. And by bay, Virginia changed their laws on July 1st of this year to where public possession of more than four ounces of marijuana will now be subject to CRI to a criminal misdemeanor.

And so in the case of edible products, four ounces could, that’s just a few pieces. And then you’re getting criminal charges. And then of course you can’t drive high. That’s illegal, that’s a DUI crossing state lines. That’s federally illegal. And you’re not supposed to smoke in public.

That’s the same as like drinking in public. When you do go to dispensary and you get product it needs to be in your trunk. It can’t be in the passenger compartment. It’s the same thing as. An open container of alcohol in your car.

Stack: not to step on your toes, but recreational it is legal in Virginia and oh, the one thing you don’t get from the recreational.

The one benefit from the medical card is employee protections as well, but recreational. Oh yeah. Recreational use in the state of Virginia is legal. There’s just no arm set up to, to buy recreationally.

Courtney: I’m sorry. That’s what I was referring to. It’s not, you can’t just go to a dispensary to get the product, I

Stack: just, I didn’t wanna confuse lists out there. So I that’s why I just wanna clarify. No apologies. Yeah. So they that’s the they failed to create an arm of sales in the state of Virginia. And then with the change of the governor’s house they kept it as their original date. So we didn’t get it moved up this year.

Courtney: Okay. Yeah, that was my confusion. I should have clarified that. Thank you for clarifying that cuz that makes sense. Cuz you can have, what is it up to four plants up to floor plants per household. Yeah. So that makes sense.

Stack: Talk about the database cuz I know that the everyone has breath, the sigh of relief.

When you, cuz you mentioned you don’t have to register now you just take the certificate to the dispensary. Yes. What was the database? What were the concerns.

Courtney: So I think the concern was that people could look you up or see it, or concerns about owning a firearm. And to be honest, like the information I couldn’t find a lot of good information about like how it’ss shared or how that information is shared or how to look it up.

I can tell you that on re-certifications of medical cannabis or it’s I. Find where to look anybody up to see their current like marijuana card numbers. It’s not like I could look it up. Like I could like a doctor based off of their name or their location in Virginia. Like I couldn’t do that for a cannabis patient.

So I think it’s a lot harder to do. It does show up on what’s called the prescription drug monitoring program or the PDMP and that’s for any controlled. Pops up for any patient, whether it be a pain medication anxiety, medication, such as Avan or Xanax it will actually pop up on, on that drug, the drug monitoring system.

And and as and I don’t know if honestly to be completely a hundred percent honest. I don’t know if police have access to. I think, and this is a very strong think that it’s a provider based system that it’s a more medical system. I know the medical examiner can access it, but again, they’re doctors.

So that would make sense that a medical examiner could I can, as a practitioner and I do utilize it for my patients and in there’s several. That participate in that. So I can even look up patients in Maryland or in DC.

Stack: And the next question we had was just about the process again and we covered that pretty well at the beginning.

And then obviously once you do have the prescription, then it’s going to one of the state approved dispensaries and I know they’re broken into to regions in Virginia and correct. You had to go there with the, with. Permission from your provider and then you can obtain product there. And like you said, that’s the only legal way to, to do that in the state of Virginia.

Courtney: Yeah. And not to, just to speak on that. There’s no prescriptions. I always hear that oh, you’re writing prescription. No. And I don’t make recommendations on strains. There’s some great resources out there, but the biggest resource would probably making an appoint. Are doing a walk in with the pharmacist on staff, they know their product, they’re familiar with the different terpenes, which is the chem, some of the chemical components within the cannabis plants and what they tend to be good to treat, whether it be anxiety or pain or whatever.

And so that’s I always recommend trying to get in with them, especially for. Who is new to cannabis. But it’s not. So when I write a certification, it’s not a prescription, but when you actually get the product from the dispensary, it actually does have a prescription label and it has the pharmacist’s name on

Stack: it.

So I can speak to that a little bit. When you go into a dispensary, you’re gonna sit down with a Pharmac or a provider there and they’re gonna go they’ll do a little interview themselves after you get your cert certifi. They’ll do their own little interview and they’ll poke in no prod to figure out why you’re there and what you need from it.

And then they’ll steer you in the right direction and they’ll steer you towards gummies or the vapes or now there’s flour in the dispensary. So they’ll, they do spend some time with you and they explain options. They explain the strains and they explained that the difference in cuz there’s a wide variety of.

Potency in the products that they sell. So they do a pretty good job of explaining that to a first time buyer in there.

Courtney: Yeah, absolutely. And I, and when I went to a dispensary for the first time, just to see the process and, at least meet with one of the groups I actually met with rise and Lynchburg, the Lynchburg.

and it was optional. And I asked and I was like, yeah, that’d be great. I’d love to, to pick, their brain. And it was awesome. I literally felt like I was sitting down and chatting with the person at the dispensary. I didn’t feel like I was being interrogated or judged. It was a very welcome open place.

And I think a lot of people are expecting, like to go into dispensary and it look. I don’t know, like a old rundown antique hippie shop. And it’s not, it’s very clean. I think they’re, they look nicer than a lot of doctor’s offices out there.

Stack: The one up here in, in Manasas is pretty clean.

Unfortunately, you’ve been in there in the middle of the night for a few times for fire alarms. So I’m tired of going there for that, but yeah, so I mentioned employee protections in the state of Virginia. Sure. And as I understand it, and it’s it protects from a, if you have a medical card, it protects you from retribution or excuse me, not retribution it D it protects.

From being fired for using not on the job necessarily, but being tested and coming up positive.

Courtney: Yeah, absolutely. So this was actually one of my favorite things to research for myself as well as for my patients. So there’s actually at least three solid codes in Virginia That you discipline for employees, me medicinal use of cannabis oil is prohibited.

And no employer shall discharge, discipline or discriminate against an employee for such employee’s lawful use of cannabis oil pursuant to a valid written certification issued by a practitioner for the treatment or to eliminate the symptoms of the employee’s diagnosed condition. And. Just a note on that.

That’s in that being said, you can’t show up to work high or impaired. That’s like showing up to work drunk or even buzz, like if you’re still hungover still drunk the next morning, you shouldn’t go to work, you shouldn’t drive. That’s not safe. And I, and the law will not protect you from that.

If you are impaired working especially in the EMS world, cuz you’re an, that’s an impaired. Technically and that could be grounds for being fired. Every I think with this being so new that I, I’m not a hundred percent sure that workplaces really know what to do with it because a lot of places have a zero tolerance for for a legal substances.

But then again, I guess it’s how you look at it. If you have a cannabis card and you went about it, the correct legal way you’re buy. From a legal dispensary then, is it really an illegal substance when you technically have done it the correct way and you have the right to have it for medical reasons?

I would say no.

Stack: And I think locally, we’ve seen that in the recent months where we have had a test case in the county and that person still has his job. And that’s a, that was a victory for everybody and it’d probably be forced to change it. That’s coming.

Courtney: I hope so. I really do.

And I’ve unfortunately seen some weird policy changes from some surrounding counties with for fire, the fire service, where they wanted like a letter from me saying, oh, like they, while they’re taking this, it’s not going to impair their. Judgment and impair their ability to work.

And I’m like no, practitioner’s gonna say that because that’s like saying, that’s saying that you can a hundred percent drive while you’re high and it not potentially impair your judgment or drive drunk and it not impair. We know that it impairs that we know that it’s increased car accidents.

We know that it can impair cognitive function and critical think. Just like pain medications. You’re not supposed to drive when you take a pain me or when you take an anti-anxiety meds such as Xanax or Atavan. So some, there, there is a local county that has tried to be a little sneaky by writing that in and said, yeah, that’s fine.

You can do it, but you need this letter from our practitioner and you’re not gonna find a practitioner. That’s gonna sign their name to something like.

Stack: wow. I hadn’t heard that story before. And so that’s it, it never ceases to amaze me the links they’ll go to, to stamp it out.

Courtney: Yeah, it was very disappointing

Stack: to hear.

I know when I listen to people around the county and outside the county I know that there’s a large number of people that already use and already have their medical card. And so if counties and jurisdictions realized how many people actually were using they, they would immediate. They would need to get on board immediately.

So the last question we had is is there a way to test for impairment?

Courtney: Okay. So yes and no. One of the things that I’ve been touching, like just starting to research on is like urine and blood test for it. Blood is going to be better, but just because your numbers so say you test positive and you get, what’s kind a, a quantitative number, which is an actual number of how much of a certain substances in your blood versus a, your general yes or no, or positive or negative that does not correlate with how high a person is.

So you can still have a number and they may think. It’s a higher number, but that doesn’t mean that person’s actually high. It just could be, maybe they ha they’re chronic smokers. Like it, it doesn’t correlate with actually how high a person is. And then if you’re thinking more like EMS, like not EMS, I’m sorry.

Police department wise since it is a DUI, if you drive high and you’re. Yeah, they can do a field sobriety test and if they have concerns for impairment, they can get a warrant for what’s called a legal blood draw and they will take you into custody and take you to a hospital. And the they’ll be a nurse there to obtain what they call legal blood draw in.

It’ll be sealed and mailed in. And they will get, that those quantitative levels of your, of of your blood.

Stack: So the answer is yes and no there’s a method, but it’s not really not very at the field level. It’s not very scientific.

Courtney: No, but then even again, even the blood say somebody pops positive at work during their Workday and their number.

And these are just making up numbers because I don’t know the numbers, but say the cutoff for the department, they say your number shouldn’t be higher than 10. And that person’s number comes up as 15, but they’re not impaired. It just because their number’s 15 and it’s above this magic number that the department has created.

That doesn’t mean that person’s impaired or that they smoked an hour ago or even a day ago. It just is everybody metabolize, like everybody metabolizes differently. And one person could smoke and then take a drug test in two weeks and be clearer. And another person can.

And take a drug test in two weeks and test positive. So it’s just different. And so it’s not a really great measurement of really considering, like seeing if somebody’s truly impaired or not.

Stack: So have you listened to my episodes? I’m curious.

Courtney: I haven’t, I’ll be honest. Okay. I think I started one and I just haven’t don’t

Stack: I work three jobs.

I know. And it wasn’t asking if you had listened. Oh, cuz I was gonna ask you the typical questions. I ask people at the end of a episode. But since you it’d be a complete surprise to you. So I won’t do that. I won’t throw that. No, go ahead.

Courtney: Let’s swing it.

Stack: All right. So the last two questions I like to ask everybody, the first one is about an everyday Carrie, since.

Term. Alright. Titled to show the things we all carry and Uhhuh. The reason for that is because we all carry something into a call, and your husband can attest to this and you can attest to it. We, carry set of irons. We carry an aid bag, whatever the call. requires we carry it in, but every call, we take something out with us and whether it was a bad call or just a, it could just be something is significant.

Something leaves that, that house with us. Is there something you carry with you every day that you would feel naked without

Courtney: this is a toughie? I, you. This sounds cheesy. And I don’t know if it actually answers the question, but don’t hate anybody. You never know what somebody’s going through. Don’t compare yourself to other people because they have a completely different set of circumstances than you do. And just because they’re handling it one way and you’re handling it another doesn’t make

either one of you wrong, we’re just very different. But the hate is probably the biggest thing that will eat you alive. And talk to somebody communication. You have to talk about the things that you see. I worked in the ER, I work on call for the medical examiner’s office. I see things now.

That you guys see things that don’t make it to the hospital. And we don’t talk about that and we need to talk about that and nobody talks about kids dying and just the bad shit we see. And and we need to be more open especially in such a manly man kind of profession, it’s a man’s world. And that stigma that men don’t cry or men are not supposed to have emotions like that’s, I guess acceptance and love for everybody is what I carry.

Stack: I was gonna say, you can ask my therapist, men do cry. yeah. I’m not ashamed to say it. So

Courtney: yeah, they should. That’s the problem. Exactly. We, I grew up in a military family and my family never shamed me for it, but I grew up in a military family and it was get up, brush it off mentality.

And trying to get away from that from my own kids, not that they weren’t, my parents weren’t compassionate, just was very different. And I know people, they don’t talk about problems and you hear about that and you’re like, who knew that your family was so messed up and you’re just finding this out because nobody talks about anything.

So you just never. And just, don’t be hard on yourself for it. So

Stack: the last question, and I’d just like to ask everybody for a book suggestion, something that you think people should read or person to follow or music to listen to.

Courtney: Slipknot, and honestly, since we’re on the topic of cannabis, I freaking love the book cannabis pharmacy

and I love it even more because Amazon has it for 20 bucks and it is on prime, so you can get it next day. And I thought it was super fascinating cuz they go into the history of where it really came from when the crackdown really happened. The fact that it was re really. Mariana like with an H instead of a J and they put the J in to bring race or racism into it.

It just was, it was absolutely fascinating. But yeah, cannabis pharmacy, the practical guide to medical marijuana.

Stack: I’m going to I’ll link to that in the show notes, and I’m gonna link to your website and the show notes as well.

Courtney: I appreciate that. I hope I was able. At least semi answer

Stack: all your questions.

Oh no, I think it was great. And obviously this is gonna benefit most, mostly people in Virginia, but maybe it, it spurs conversation in other states and maybe someone reaches out to me from another state that has a similar setup and we can talk to them and share that with those listeners.

So I, I appreciate you coming on and I think it’s been a fascinating.

Courtney: Yeah I appreciate you bringing me on. And of course, if anybody, has any questions, the contact information is on there. I’m very open about talking about anything they can email, they can call at least on the medical side I feel like I’ve done half, half more than half the visit.

Sometimes just chatting with someone. Who’s a prospective patient who has questions, who is just completely going into this line. And then finally we get to do our video visit and it’s like seeing an old friend again. So I’m always available for any questions or anything like

Stack: that. That’s perfect.

Like I said I’ll link to your website and link to your Instagram and Facebook get your information out there. And hopefully you’ll hear for some people and get some help there for some.

Courtney: yeah, that’s my goal. I appreciate it. Awesome. We’ll

Stack: tell Rob. I said hi.

Courtney: I will. Thank you so much. All right.

Enjoy your evening. All right, bye. Bye. Bye.