Exeter City Council open to cannabis consultation clinic


Exeter City Council directs staff to investigate ways to allow medical cannabis consulting company BioLife Solutions to locate in town

By Paul Myers @PaulM_SGN

EXETER– The City of Exeter made a strict decision early on to buck the overwhelming trend of local cannabis that has swept California, including some nearby cities. Good thing, too, as the State Assembly has recently tried to remove local controls promised by Prop 64. But now the Exeter City Council is faced with a different kind of canna-business, and they decided two weeks ago that they want to know more.

BioLife presenters explained the differences between their products and traditional medical cannabis products. Slide from BioLife presentation to Exeter City Council

After a lengthy presentation and Q-and-A from local pediatrician Dr. David Sine, during their May 14 meeting, the Council told staff they would like to know what they need to do if they want to allow a medical cannabis consultation clinic in town.

The topic first came up when Dr. Sine spoke with first term councilman Frankie Alves in February. Alves and the Council decided they wanted to hear out Dr. Sine. Since then, a typically reserved community isn’t saying no, instead they’re asking questions.

“We’ve had a few folks come by and ask us about it. They aren’t mad about it. They just want to know more,” City manager Adam Ennis said.

Quality of BioLife

While Dr. Sine is known for his pediatric work in Exeter, a significant number of his patients are referrals from UC San Francisco and Stanford. He treats patients who suffer from pain management, seizures and children with behavioral disorders like autism. But not all of his patients are children. Dr. Sine also treats adults with terminal illnesses like cancer or Parkinson’s and those with chronic pain. But legitimate medical grade cannabis is not available to him.

Because universities like UCSF and Stanford receive federal funding, they are not able to consult patients on the use of medicinal cannabis, and for that matter, neither is Dr. Sine. But when he thinks a patient can benefit from it, he trusts BioLife Solutions.

According to their presentation at the Council’s May 14 meeting, BioLife is a group of health care practitioners who developed a specific, limited application of medical cannabis for their unique patient populations. They are pharmacists, nurses, therapists and patient care advocates who have served medically fragile children in the Valley for the last five years.

Doctor of pharmacy Lee Thai and registered nurse Sean Hunt, who both presented at the meeting, said 60 to 80 percent of their clientele are from the Valley and, more specifically, Tulare County.

Dr. Sine said the majority of his patients trying to manage pain get all the wrong products, from all the wrong places, with all the wrong advice.

“People don’t know what to do. They look it up on the internet and they say that it didn’t work or they get high and they aren’t treating it like a medication,” Dr. Sine said in an interview with the Sun-Gazette in March.

At the meeting he admitted that patients using medical cannabis have gotten better. But he did say that the progress has been inconsistent. After some additional investigation on his part, he found out that patients were going down to Los Angeles or driving up to Oakland for marijuana.

“I found roundup, arsenic, poo, bacteria or just some coconut oil with nothing in it, some [oils] said there was no TCH in it and there was. There was zero consistency,” Dr. Sine said. “By that point when I started treating kids with cancer that were using it for pain, I said they cannot have this. There is bacteria in there, it will kill them.”

Dr. Sine says he trusts BioLife because they engage in the biomechanics of cannabis and not just the recreational or medical marijuana products.

“People behind the counter aren’t qualified to give any kind of medical advice what so ever, parents that have tried everything, they finally get a card to be able to do that but then they go and are left on their own to make these kind of medical decisions that they may not be comfortable with,” Thai said.

He added that the history of medical marijuana has jaded parents and patients because they have received bad advice with inconsistent products.

All of Biolife’s products come in a liquid form that are compatible with various feeding tubes, which 70% of their patients have. During their presentation they made explicit that they do not provide traditional cannabis products since they cannot control dosing accurately enough for true medical applications. They added that they do not supply, support or work with any products that are commonly associated with marijuana or cannabis.

Specifically, there is no smoking, no paraphernalia, no “pot” and no getting “high.”

With BioLife’s effort to legitimize cannabis, the problem has not been their results. Instead it has been access. Part of the problem with treatment is the proximity of the nearest BioLife consultation office and pharmacy. The closest in the Valley is in Clovis—a good hour drive from Exeter or perhaps farther for some patients. Dr. Sine said he has patients referred to him who live as far as Bakersfield. Having an office in Exeter would help mitigate travel time for his sickest patients.

Treating with Solutions

Fitting with several categories of Dr. Sine’s patients, BioLife has crafted treatments for patients suffering from pain management, refractory seizures and severe behavioral disorders. During their presentation Thai said that pain management patient group is mixed with moderate-to-severe chronic pain as well as more severe end-of-life pain. Their treatment focuses on reducing or eliminating opiate analgesics with equal or greater pain control. They noted that even the most potent narcotic regimen seems eligible for cannabis replacement if transitioned appropriately.

Most patients with refractory seizures, sometimes referred to as uncontrolled or drug resistant seizures, have had more success with BioLife’s cannabis products where traditional medicines have failed.

Thai said that patients with severe behavioral disorders can be in danger of self-mutilation or cause physical harm to family members and care givers. He noted as well that they are sometimes misdiagnosed and on multiple medications to control their behaviors. The side effects of their medications tend to grow in numbers with limited results. In their cases, patient outbursts decreased in severity and number, they had improved in following directions and responding to behavior modifications and had improved sleep.

Hunt added three different cases where children were able to have an improved quality of life using BioLife’s course of treatment.

A since passed 14-year-old girl named Trenity was diagnosed with acute lymphocytic leukemia. Her prognosis was classified as “grim.” Before treatment she was 48 pounds and wheelchair bound. She took a handful of medications to help manage her pain. Trenity started treatment in November 2015 and gained more than 20 pounds. Before her death in November 2016 she was eventually able to walk on her own.

A 2-year-old name Zane was diagnosed with hypoxic ischemic encephalopathy and complex seizures. His prognosis was also classified as “grim.” He frequently suffered from seizures stating at 5 months old and had multiple complications affecting his quality of life. Hunt said after a course of treatment was identified Zane was seizure free after 4 days of moderate dosing, and he is now able to stand and use a walker, he is gaining function and growing rapidly.

Brody, a 12-year-old with autism, oppositional defiant disorder and reactive affective disorder, had a prognosis of “poor.” When BioLife took on the case an institutional placement was pending due to self-harm and extreme instability. Hunt said that he was becoming a danger to his petite mother. To help mitigate his autism Brody was taking Abilify, Depakote and Prozac. As a result he gained 60 pounds and developed fatty liver disease and hypertension.

Because of his behavior he was sent home from school often and missed half of the last school year. Hunt said that since his treatment with BioLife, Brody lost 15 pounds, and his liver enzymes have reached a normal level. He has been able to get off of his previous medications and has not missed school.

“These are three different kind of stories…these are the three arms we have been really good at finding success,” Hunt said.

“It’s weird for me to be 52 years old, 20 years as a doctor, and the thing that brings me the most joy is medical cannabis,” Sine said. “Eight years ago I would have never thought I’d be prescribing medical cannabis but it is an incredibly powerful plant.”

Council on Cannabis

While the Council has decided they would like to move forward with a narrow path of allowing a medical cannabis consulting office, their stance hasn’t softened on commercial marijuana.

“I don’t mind putting it on the record that I’m in agreement with the doctor. I’m not a big fan of bringing any recreational dispensary in here or any medicinal dispensary as the current image of medicale dispensaries are you just go get your card and go in,” Alves said.

The Council asked about how treatment works with schools. Dr. Sine said that nurses cannot administer the medications because of the federal funding they receive. He added that parents have become accustomed to giving their kids medication before or after school.

Councilwoman Barbara Sally said most of her questions were answered during the presentation and that she is glad Alves had introduced it to the Council.

“Frankie did an outstanding job bringing it to us. We had a lot of questions,” Sally said.

“I’m happy about the open mind the council has had on this, including [Councilman] Jeremy [Petty],” Alves said.

Mostly the Council agreed that they are doing something against the grain when it comes to cannabis. While Farmersville is clamoring for dispensaries, Exeter is carving out their niche in the emerging cannabis market.

“Exeter could be one of the places that people look at to change their perspective on the differences between what is medical and recreational,” Sine said.

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