Licensed to ill

A down and dirty guide to getting a medical marijuana card in Nevada

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by Brad Bynum

It took me a grand total of about two hours and less than $70 to get my medical marijuana card. And then I was able to go to a dispensary, buy pot, and smoke it—fully compliant with Nevada law.

The part of my brain that regularly corresponds with my inner teenager checked in with 15-year-old me, and, between spins of Nirvana's In Utero, the young dude confirmed he was stoked.

Wishing well

Last year, Sierra Wellness Connection was the first medical marijuana dispensary to open in Reno. A couple of weeks ago, I met with Deane Albright, founder and treasurer of Sierra Wellness, and Eva Grossman, who was, until very recently, the director of marketing and community outreach director for Sierra Wellness. Her husband, Jeff Grossman, is still the cultivation facility manager.

Eva Grossman is also a patient. She uses cannabis to manage chronic pain and prevent seizures. She’s passionate about medical marijuana, which she describes as the best solution to the “prescription medication epidemic.”

“I’m one of the people who has been thrown into pain management and stuck on these addictive narcotic medications—and didn’t want to be,” she said. “And this is the only thing that has worked. I was able to get off of them. You put people on these medications and, obviously, they’re going to get addicted. They’re physically addictive.”

But how is developing a marijuana habit any different? Aren’t you trading reliance on one substance for reliance on another?

Grossman says no. First of all, marijuana is not physically addictive.

“With narcotic medications, no matter who you are, you start taking them, take them for a period of time, then you stop, you’ll start getting runny eyes, goosebumps, runny nose, vomiting, diarrhea, all kinds of symptoms of withdrawal,” she said. “With marijuana, you can use marijuana, and if you stop, nothing is going to happen except that maybe whatever you’re taking it for—say you’re taking it for nausea, the nausea will probably return and it may seem exacerbated at first because you haven’t had it in a while.”

Opioid pain medications, like hydrocodone and oxycodone, have a long list of possible side effects, some of which are potentially fatal. On the other hand, no one has every overdosed from cannabis.

Marijuana is, of course, already very popular on the black market, and many people who use it habitually are already self-medicating—even if they don’t call it that. However, it’s shrouded by the stigma of illegality, which might preclude things like total honesty with medical professionals. But even with the widespread popularity of cannabis, above-board medical marijuana consumption in Nevada hasn’t reached some people’s expectations.

“We’ve been scratching our heads and scratching our heads—why aren’t more young people getting cards?” said Grossman. “Why aren’t people getting cards? And we go out and talk to people, and either they don’t know we’re open, or they think you have to be gravely ill—which is not the case. Or when they do find out, it’s this effort to do it—and people are busy. It’s time and effort. But, if it’s 30 minutes? Then, it’s a no-brainer.”

Like I said, it took me a little longer than that, but saying yes to a two-hour process is still an easy decision.

In the cards

Here in Nevada, medical marijuana cards are issued by the Nevada Division of Public and Behavioral Health. Another reason that some people might be shying away from getting a medical marijuana card is that there's often a fear that the application process is bait used to get marijuana users to reveal themselves to law enforcement.

“When we first opened, a lot of people came in, and they were like, Is this a trap?” said Grossman. “People are certain that the cops are targeting them.”

But considering how widespread medical marijuana use has become across a broad spectrum of different demographics in the state and across the nation, the idea that law enforcement is using medical marijuana applications as a way to target users is a bit impractical. It might sound odd, but marijuana use is now totally mainstream.

Still, the process for applying for a medical marijuana card in Nevada might seem daunting. Some potential patients might even have trouble tracking down the right state agency, even though many local medical facilities, like Nevada Medical Marijuana Consultants and Elements Cannabis Center, specialize in helping guide prospective patients through the process.

Currently—although the process has changed several times and probably will again soon—the first step is to go to the Department of Public and Behavioral Health’s website ( and download the application request form. This form, completed and accompanied by a $25 fee, can be sent in exchange for the application packet, which must be completed with a physician, who will likely charge a fee. The completed packet must be notarized—another fee.

And of course, there’s the issue of what ailment qualifies for a medical condition. Although many patients have had success easing symptoms for very serious diseases, like cancer and HIV, it might sometimes seem like applying for a medical marijuana card is like choosing a cure before detecting a symptom.

“People are already self-medicating with cannabis,” said Grossman. “Maybe they’re using it recreationally to relax, and they’re self-medicating for anxiety. They’re using it anyway.”

Some recreational users might use cannabis to help them sleep. “Why are you having trouble sleeping?” asked Grossman, hypothetically. “Are you having trouble sleeping because your back hurts?”

Even those who use marijuana as a social lubricant might be self-medicating for a medical condition—social anxiety. Chronic pain, difficult to detect or diagnose, is the number-one condition for which marijuana is recommended. And what’s required by law, in Nevada and elsewhere, is not a prescription, but a recommendation.

“It’s the same as, ’take two aspirin and call me in the morning,’” said Grossman.

After completing and submitting the notarized, doctor-signed application packet, patients are then subject to a background check and waiting period that could take as long as three months. (The state is working to streamline the waiting process and background check to make it faster.)

“It takes longer for people to get a card here in the state of Nevada,” said Grossman. “In California, you can get a card in about 20 minutes.”

And here’s where it gets interesting: You don’t have to be a California resident to get a California medical marijuana card. Cards there are administered by medical professionals, not a state agency. And Nevada has reciprocity with California, which means that a California card can be used at a Nevada dispensary. You can’t get a Nevada card as a California resident, but getting a California card as a Nevada resident is actually much faster than getting a Nevada card.

Additionally, the Nevada card isn’t honored in some other states that have medical marijuana, including California, and Nevada cardholders can’t have concealed weapons permits. Also, California cardholders aren’t subjected to background checks.

Now, if you only have a Nevada-issued ID, like a driver’s license, you must use a Nevada medical marijuana card to make purchases in the state. However, if you have a federally issued ID, like a U.S. passport, you can use that to obtain a California medical marijuana card, and then you can use that ID to make purchases at Nevada dispensaries.

In other words, you can spend potentially hundreds of dollars and several months to get a Nevada card—or, as long as you have a federally issued ID, like a passport or a military ID, you can easily get a California card, which can be used at Nevada dispensaries.

“Here’s the options: you can travel through the desert for 100 miles without any water—or you can fly there,” said Albright.

So, I decided to get a California card. I could have driven to a nearby California city, like Truckee, to meet with a physician, but I decided to risk the internet.

Pain and gain

In his 1970 song “God,” John Lennon sings, “God is a concept by which we measure our pain.” It stands to reason then that pain is something we measure by our concept of god. In other words, pain is subjective, personal and private. Some have a very high tolerance for pain. Others need a little help.

I have bad knees, digestive issues that cause nausea, back pain, and stresses that give me aches and make it tough for me to relax. Jessica Knox, M.D., was sympathetic to these pains when we met virtually through the website, and she recommended I use cannabis. We talked for half an hour or so, and she asked me some detailed questions. She also described some of the different options for cannabis consumption—smoking, edibles, tinctures and more. She explained that marijuana has two different molecules that can be used to treat pain—THC, which is psychoactive, and CBD, which is not. (A medical marijuana card isn’t required to purchase CBD-only items.)

I received an email with a PDF of a recommendation signed by Knox within a few minutes after our video consultation, and then a hard copy and my medical marijuana card came in the mail two days later. The whole thing cost $69 and took less than two hours, and a big chunk of that time was just me trying to figure out how to use the webcam on my computer. More technologically literate people who keep better track of their personal information might be able to get the process done in less than half the time it took me. Before my card had even arrived in the mail, I was able to go to Sierra Wellness, and using just a print-out of the PDF and my passport, I was able to buy marijuana legally. I had to show my ID and recommendation letter at the front desk before being allowed into the actual retail area. I half expected the inside of the place to look like some ’70s hesher living room, with black light posters of Bob Marley and complimentary Mountain Dew, but it was more like half pharmacy, half health spa.

I met Michelle Autry, the dispensary manager, and she told me that the process was going to change again soon, and if I were to have waited a month, it might have been even easier. The state of Nevada is going to make things easier by not forcing patients to wait for the background checks to be completed. However, they’ll soon require that California patients show an actual medical marijuana card, and not just the simple printed-out PDF that I used. This will eliminate the ability to buy cannabis the very same day as receiving a recommendation, but will also eliminate the long wait.

“The state is trying to do right by everybody,” said Autry. “The state is awesome. They do change stuff, but they change it because they’re trying to streamline it and make it better. They’re changing it because people are taking advantage of it. They’re changing it because it needs to be changed.”

One wild thing about the presence of medical marijuana is that potheads—ahem, patients—can easily turn into snobs. There’s a cognoscenti culture around cannabis that rivals the wine world. The different strains of marijuana are very reminiscent of different wine varietals. In cannabis, the basic dividing line—the red versus white, if you will—is sativa versus indica. Sativa is more heady, energetic and psychedelic. Indica is mellower and more relaxing.

“If you’re looking to treat, say, ADD, you want a sativa,” said Autry. “If you’re looking to treat back pain, you would want an indica.”

I decided to buy a little of both. I bought a gram of LA Confidential, an indica, and a gram of Green Crunch, a sativa. Grams are usually $16 apiece, but the two grams of house strains were $25. (As part of promotion they were running, they also threw in a free Juju Joint, a disposable e-cigarette preloaded with cannabis vapor and wrapped in a ton of packaging. It seemed like one of the most wasteful products on the planet to me.) A full ounce costs $300, which—my sources tell me—is about $100 more than street prices. Patients can buy up to 2.5 ounces every 14 days, which seems like a lot to me, but I’m not one to judge anybody else’s needs.

Sierra Wellness has a bunch of other cannabis products—face creams, olive oils, and “intimate arousal creams”—even CBD dog treats.

“Us here at the dispensary are like the first line,” said Andrew Koetting, an assistant manager of the dispensary. “The state doesn’t have anywhere you get any information—if you’re someone who wants to get a card, or someone who just got a card and wants to learn more about cannabis. So a lot of our job has become educating the public.”

He said people often just come in asking about cannabis as a treatment for various ailments, from chronic pain to neurological diseases, cancer and HIV.

“I was surprised by the amount of truly sick people coming in, using cannabis as a therapy and a relief for something that otherwise they’re only option is hard opiates,” said Koetting. “It’s been really eye-opening in that sense. And there is no demographic. … We have people coming in who are 18, and we have people coming in who are 85.”

The laws, regulations and processes keep changing, but the bottom line is that it was surprisingly simple and accessible for me to become a medical marijuana card-holder. Of course, there’s a ballot measure this November to legalize recreational marijuana in Nevada. If that passes, then the process will become even simpler. You’ll just walk into a store and buy what you want.