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Former Gov. Kathleen Blanco and her daughter Karmen Blanco

Medical marijuana became available in Louisiana almost a month ago, and the 1,500 legal consumers of the drug since then have included attorneys, war veterans, teachers — and former Gov. Kathleen Blanco.

Blanco’s family sought a prescription on Aug. 6, when she was suffering excruciating pain and appeared to be on the verge of death from a rare type of cancer known as ocular melanoma.

Drops of medical marijuana mixed with methadone not only kept Blanco alive for nearly two more weeks, but they dramatically improved her quality of life over that time, said Karmen Blanco-Hartfield, who is the former governor’s oldest child.

“It was a game-changer,” she said.

Blanco died on Aug. 18.

It took a long, complicated process to make marijuana available to Blanco and others in Louisiana.

The Legislature legalized medical marijuana in the 1970s, but no one could obtain it because none of the necessary rules and regulations existed.

Fred Mills, a pharmacist in the Lafayette area, was the executive director of the state Board of Pharmacy in the late 1990s. From then on, Mills received calls from folks asking if they could obtain medical marijuana. He had to say no.

In 2015, while serving as a Republican state senator from Park, Mills sponsored a bill approved by the Legislature and signed into law by then-Gov. Bobby Jindal that created the legal framework to actually distribute the drug.

In 2016, Mills sponsored a second law, signed into law by Gov. John Bel Edwards, that laid out the specifics. Over the next three years, the Department of Agriculture wrote the rules overseeing the growing of medical marijuana; the Board of Medical Examiners established the regulations for doctors; and the Board of Pharmacy set the rules for the pharmacies.

The law allowed LSU to contract with a private company, GB Sciences Louisiana, to begin growing the marijuana under strict controls in a warehouse in a Baton Rouge industrial park. Southern University has also partnered with a private company to grow the legal weed but has yet to produce its first crop.

State law permits authorized doctors to “recommend” marijuana to patients suffering from specific forms of disease — including cancer — and from intractable pain. Nine specialized pharmacies throughout the state are now authorized to dispense the drug as a flavored oil.

Medical marijuana remains legal only until 2025 unless the Legislature extends its life.

Blanco was the state’s first female governor, from 2004-08, but Jimmy Clarke, who served as Blanco’s chief of staff, said neither he nor several other former senior aides could recall the governor being asked to take a stand on the legalization of medical marijuana or recreational marijuana.

Blanco didn’t come easily to the decision to begin consuming medical marijuana, said several of her children. The former governor never consumed recreational drugs and drank nothing more than the occasional beer or glass of wine.

But over the years, Blanco heard testimonials from friends who had benefited from medical marijuana obtained elsewhere. The 2015 bill that created the framework for medical marijuana in Louisiana is named the Alison Neustrom Act; Neustrom had been a close friend of the governor’s in Lafayette.

By 2015, Blanco had been diagnosed with ocular melanoma four years earlier. In December 2017, she announced that it had advanced to a terminal stage.

Blanco entered St. Joseph’s Hospice Carpenter House in Lafayette on July 25 this year.

Two days beforehand, Dr. Geoffrey Mire visited Blanco and “recommended” that she begin taking a type of medical marijuana that was half CBD and half THC, when it became available two weeks later.

Mire had become one of the 100 or so doctors in Louisiana who were authorized to recommend medical marijuana. (Under state law, doctors may only “recommend” the drug, not prescribe it.)

Mire, a nursing home medical director, thought that it might benefit older patients who were wasting away, not eating and enduring pain.

“I didn’t care if this made them high or not,” he said. “I wanted to make them comfortable.”

By Aug. 4, the former governor was receiving injections of morphine and Zofran to reduce the pain, but the drugs came with a major downside.

“She had terrible reactions to morphine,” said Blanco-Hartfield. “She’d go into a blackout. It destroyed her quality of life. It made her want to die.”

By the next day, Blanco could no longer swallow and was grimacing with pain.

“It was the end,” said Blanco-Hartfield.

On Aug. 6, the first day it became legal, one of the Blancos picked up the prescription at the Apothecary Shoppe, the lone pharmacy in Lafayette authorized to dispense medical marijuana.

A 30-milliliter bottle costs $80 to $200. Mire estimates that a bottle can last between 10 days and two months, depending on a patient’s dosage.

Lori Maraist, a pharmacist at the Apothecary Shoppe, said the public remains wary of medical marijuana. “There’s such a stigma still there,” she said.

Blanco, too, had qualms. But with no other options on Aug. 6, Blanco-Hartfield asked her mother whether she wanted to try medical marijuana.

“Hurry,” was the one-word reply.

Blanco-Hartfield put half a milliliter of oil under her mother’s tongue.

“Within 60 seconds, her whole body relaxed,” Blanco-Hartfield said. “She smiled and a peacefulness came over her. It was amazing.”

The following day, Blanco-Hartfield gave her mother a mixture of two milligrams of crushed methadone that had been dissolved with a peppermint into water and half a milliliter of marijuana oil.

“All she had to do was let it go down her throat,” Blanco-Hartfield said. “By that night, she was smiling, eating, laughing and drinking. She could speak one-word commands. We never imagined we’d see that again. It made all the difference in the world that she no longer had to take the morphine.”

A day later, Aug. 8, was the 55th wedding anniversary for Blanco and her husband Raymond.

He gave her roses and a Chantilly cake, her favorite.

“She was fully verbal, telling jokes, laughing,” Blanco-Hartfield said. “She ate cake. She drank a root beer. She drank Coke. She ate cookies. She got up and walked across the room. She took a shower. It was unbelievable. We went over the funeral plans with her. She said how she wanted to be remembered.”

Two days later, Blanco’s daughter Nicole showed off her engagement ring to her mother.

That same day, Mills ran into Blanco-Hartfield at a Lafayette grocery store. She told him about her mother’s turnaround.

“We both got teary-eyed,” Mills said. “I’ve always loved and respected the governor, so to hear that was incredible. We all knew it wasn’t a cure, but it gave her a better quality of end-of-life.”

Two days later, on Aug. 12, Blanco began to decline again. She could no longer keep anything down.

Blanco-Hartfield tried something new. She rubbed the marijuana oil on her mother’s wrists followed by Phenergan, an anti-vomiting gel.

“She began to have solid sleep,” Blanco-Hartfield said. “The sleep gave her the ability to fight the nausea and pain. She went out on a beautiful, peaceful journey with her family, without us having to watch her fight and struggle. She didn’t slip into a coma. She never wanted to be sedated from heavy narcotics.”

Blanco communicated verbally until two hours before she died.

Mire said that medical marijuana has not worked for all of his patients.

“But overall, the response has been positive,” he said. “I’ve had some life-changing situations for some people. Gov. Blanco was one of them. I thought it would just be about getting people to feel good at the end of their life, but it’s done a lot more.”

Mills said he is hearing good things.

“Yesterday I got a call from a veteran with PTSD,” the senator said. “He was crying. He said, ‘I think I have my life back.’ So far, so good.”

Pilar Eble, another of Blanco’s five children, said she only wishes her mother could have received the drug months earlier.

“All of those months when she was losing pounds, if we had had it, I think she’d still be here,” Eble said. “As soon as she got the marijuana, her appetite came back.”

Email Tyler Bridges at tbridges@theadvocate.com.