Editorial - NJ Medical Marijuana Bill Restrictions

Marijuana bill restrictions

Published in the Times of Trenton

Tuesday, June 23, 2009

BY KEN WOLSKI

Ken Wolski, R.N., MPA, is executive director of the Coalition for Medical Marijuana New Jersey Inc. (cmmnj.org).

The Coalition for Medical Marijuana-New Jersey Inc. (CMMNJ) is grateful to the Assembly health committee for passing the New Jersey Compassionate Use Medical Marijuana Act (A804/S119) on to the entire Assembly for a vote. However, CMMNJ objects to the substitutions added by the committee. The bill already proposed the most conservative medical marijuana program in the country. No state has a lower plant limit or possession amount than New Jersey's bill would allow. The committee's substitutions to the bill are overly restrictive and they possibly render the bill unworkable.

The Assembly health committee's substitutions:

remove the provision for qualified patients to grow their own supply of marijuana;

place severe and unnecessary restriction physician recommendations; and

deny access to the largest population of patients, those suffering from chronic pain.

Having qualified patients or their caregivers grow a limited supply of marijuana when a physician recommends it is part of the program of all13 states that have passed these laws. Nor does this patient access result in greater recreational use of marijuana -- one of the fears the committee was apparently addressing. Substance Abuse and Mental Health Services Administration studies show that teenage marijuana use has declined in eight of 10 medical marijuana states between 1999 and 2006.

Marijuana use by AIDS patients, cancer patients, multiple sclerosis patients and chronic pain patients deglamorizes its use for teenagers. It is not something they want to emulate. Moreover, for the past 30 years, the Monitoring the Future surveys have shown that more than 80 percent of high school seniors in New Jersey have said that marijuana is "very easy to obtain" or "fairly easy to obtain." This is without a medical marijuana program. Instituting such a program almost certainly cannot increase availability to teens and almost certainly will result in decreased teen use.

Another study by Texas A&M University shows that adult use of marijuana has remained steady in medical marijuana states. As further proof that these programs are working well, 12 other states besides New Jersey have legislation or ballot initiatives pending that will allow qualified patients to grow their own medical marijuana.

It is a wonderful advance in American health care to allow patients to produce their own medicine and individually titrate it -- that is, adjust the dosage to control their symptoms -- safely, under medical supervision. It will produce tremendous savings both to the patient and to the state. It will also refocus the health care industry away from the pharmaceutical industry and the health insurance industry and back toward the patient. This is where the focus of health care belongs -- on the patient.

The restrictions that the Assembly health committee placed on which physicians may recommend marijuana are at odds with current medical practices in America and may well render the law unworkable. Physicians specialize. If you break an ankle, your doctor sends you to the ankle doctor. But if you need marijuana therapy, your treating physician is unable to send you to a doctor who specializes in marijuana therapy, according to the health committee. Physicians are wisely reluctant to recommend a treatment unless they have had specialized training or experience in that treatment. Yet this is what the committee's substitutions expect them to do.

It would not be without precedent for the New Jersey Legislature to pass an unworkable medical marijuana bill. In 1981, the Dangerous Substances Therapeutic Research Act was made into law here. The law was written to protect patients who engaged in clinical trials of marijuana. To this day, not a single patient has ever been able to take advantage of the law. Let's make sure that the intent of A804 is not undone by undue restrictions.

The Assembly substitutions acknowledge that "marijuana may alleviate pain or other symptoms associated with certain debilitating medical conditions." But then it turns around and eliminates chronic pain as a qualifying condition for marijuana therapy, except in the cases of HIV/AIDS and cancer. Nearly half of all current physician recommendations for marijuana therapy are for chronic pain. About one in five Americans suffers from chronic pain from a wide variety of diseases such as arthritis and degenerative disc disease and conditions such as burns and other accidents and injuries. Some of the most rigorous studies establishing the safety and efficacy of medical marijuana in pain management have been done. These studies used the gold standard of scientific research: the double-blind, placebo-controlled clinical trial. Marijuana has proved its worth and will continue to prove its worth as a pain management tool. It is simply unfair to restrict the greatest number of New Jersey patients from access to medical marijuana.

CMMNJ recommends that the Senate version of the New Jersey Compassionate Use Medical Marijuana Act, which does not contain the Assembly health committee's substitutions, pass into law without delay. This will ensure that patients who are suffering from debilitating medical conditions can quickly begin to relieve their suffering and no longer need fear arrest and imprisonment for following the advice of their physicians.

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Harborside Health Center THC Expo Video

Harborside Health Center THC Expo Video


Video link From James Anthony who says, " Harborside Health Center: Oakland's premier medical cannabis dispensing collective--watch the video on youtube. See how it's done. (My client and one of the successful operating models for Harborside Management Associates, a separate and independent entity.)" This from the THCExpo in LA this week.



Comment generated on Facebook about this link:

Kevin Long - "WOW Where is that place? How about that coming to NJ?"

Kevin Long - "After watching that video, how can one not want to help people? That place really looks like it would do WONDERS for LOTS of people... I like the acupuncture and such to help with the therapy... Thanks for posting... Imagine this really spreading across our country to help anyone who needs it... Sincere Thanks for all you do...."

Peter Rosenfeld - "This seems to be basically what the NJ Assembly Health and Senior Services committee wants. I can't disagree with that."

Kevin Long - Are you kidding Peter...??? Is this what you get out of it? Ya... well I DISAGREE... with the limitations they put forth on what stipulates acceptable Medical use.... Lets stop kidding ourselves with the restrictions they put on AFTER the Senate vote... I have cervical myelopathy and cervical disk damage. I am EXCLUDED from the new bill put forth... BULLSHIT as I have avoided surgery to date cause of Medical Marijuana. Yet,,, I will be excluded from this... ITS BULL!!! Tell me I am wrong???

Peter Rosenfeld - "I was referring to the non-profit Alternative Treatment Centers (ATCs). They want all patients to get their medicine from these. There's nothing in the Assembly version that says NJ's ATC's can't be like there.

Yes, I agree, the other restrictions are ridiculous. That's the irony. They have much more restrictions, by far, than any other MM state, they appear very afraid of letting anything here in NJ that might resemble California, yet they want state sponsored distribution centers, something no other state has.

btw - even though your condition is excluded, the Health Department could easily add it in soon after the bill is passed. But I suggest you write to your assemblyman and especially members of the health committee asking why they excluded conditions such as yours. Also write letters to the editor. I'm sorry I sounded flip. I'm in exactly the same boat as you, same medical condition and all.

Oh - minus the clones, of course, since the Assembly version doesn't allow home growing but requires you to pay out of pocket ( since insurance doesn't cover it) for expensive ATC medicine. But maybe we could do it cheaper here than in California. I hope, at least. I was looking at Harborside Health's price list when I was out at Oakland last year... Read More and it's $60+ per 1/8th of an ounce for their "top self". Since many patients here tell me they use 2 ounces a month, that would be nearly $1000 per month. The Assembly restricts distribution by the ATCs to 1 ounce per month, so that's a cost saver, I guess :-("


Kevin Long - "Hello Peter, Thanks for the reply. I hope we can somehow convince these lunatics how safe MMJ really is when used responsibly. I do write letters but always using the templates that Norml, DPA, MPP, etc. send out. I DO need to work on a PROFESSIONAL letter geared toward my specific ailments. MMJ has so many uses... I guess its going to take a ... Read Morelittle more time to convince people that we are NOT just trying to be STONERS... EVEN THOUGH I DO AGREE, that Marijuana should ALSO be available for recreation use (minus the stoner stereotype). I do not mean ABUSE. I mean at the end of the day if one wants to indulge in a little cannabis, similiar in fashion to a glass of wine or beer, they should be allowed to without any FEAR. I am the first to admit I used MJ recreationally BEFORE I realized how much it was actually helping me medically. I wondered why my pain threshold was so high. It was the MJ. Anyway... I just added you as a friend... Will talk more soon... Have a great day friend! :-)

Kevin Long - " Hey Peter, isn't it funny how the authorities put all these street prices on MJ. They sure know how much money is being made ON THE BLACK MARKET... You think they would want to change that??? I once said, even though you could allow people to grow there own, not everyone would want too. I mean think about this. We all can currently grow tomatoes in... Read More our back yards, but we still go to the store to buy them. I mean if they allowed people to have say 6 of there own plants, not everyone would want it. They would still need to purchase it from a caregiver or whatever. Well from all I am reading, the dominoes are falling. Be sure to watch Anderson Cooper all week at 10 pm. Gonna have special on MJ. CYA...:-) Sorry to go off on tangents as I try to communicate everything in one post ;-P (it can't be done) hahaha"

Peter Rosenfeld- "The ATCs are important for other reasons. If you just got diagnosed with cancer and expect to undergo chemo in a couple of weeks, you don't have 3 months or more to wait to grow your own. Or you may simply have no place to grow your own. Plus ATCs could be a great place to organize medical care and support for people beyond just MM"

NJ Assembly Hearing Videos now online!

You can now watch videos of the 6-4-09 Assembly health and Human Services committee hearing that passed A804 forward!

http://www.youtube.com/NJmedicalmarijuana

Medical Cannabis: In 90 Seconds or Less

Medical Cannabis: In 90 Seconds or Less

Chris Goldstein - CMMNJ

On June 4, 2009 the New Jersey Assembly Health and Senior Services committee met to consider medical marijuana legislation for the Garden State and one thing was for sure: The bill would pass committee.

Assemblyman Herb Conaway MD got the proceedings underway by telling the room packed with cannabis supporters : “We have heard this bill at length before. We’re not going to have extensive testimony on various portions of the bill …the bill has I will tell you… there is a favorable opinion of the bill on this committee and this legislation will be moving here today.”

This commitment to medical marijuana on the part of these legislators in NJ was rather refreshing and unique. And all this was generally good news to the crowded committee room.

But the bill everyone on the committee was supporting was one that had changed dramatically. The new version of A804 was something none of the advocates or opponents in the room had a chance to read yet.

"Substitutions” were made by the committee just that morning that took away home cultivation, removed Chronic Pain from the list of qualifying conditions, put forth the new idea of just 6 Alternative Treatment Centers to grow medical marijuana along with a courier delivery system to serve patients and further restricted physician recommendations.

So, to those packed in like sardines sweating away to testify there was an atmosphere of a tempered victory for medical cannabis. But because of the pre-announced conclusion, testimony was then limited to just 90 seconds per person.

Advocates and opposition scrambled to cut down speeches and adapt to the situation. Still some new patient testimony was very compelling like that of Diane Riportella who is dying of ALS or Lou Gehrig’s disease, “ It saddens me and enrages me that I have to spend my last days fighting for the right to use and have access to the medicine that relives my suffering.”

Five of us had planned to testify on behalf of the Coalition for Medical Marijuana New Jersey CMM-NJ. But the committee allowed just one of us to come forward and it ended up being me. It wasn’t easy to fairly represent our constituency of medical marijuana patients or the issue overall with such limited time. Here's that testimony.



The New Jersey Compassionate Use Medical Marijuana Act now goes to the full Assembly for a floor vote this fall. If it passes, the Senate must have a vote of concurrence. Governor Corzine said he will sign it into law, should it pass. www.cmmnj.org

More Analysis of Assembly Committee Changes to Medical Marijuana Bill

I finally read the actual text of the "substitutions" the Assembly Health and Senior Services committee put in NJ's medical marijuana bill and it is somewhat worst than I first though.

But the overriding problem is the requirements for setting up the Alternative Treatment Centers (ATCs), the only venue they allow for growing and delivering marijuana to patients, combined with the difficult hoops a patient has to go though to get a recommendation.

The ATCs are required to be set up as full formal non-profits, with a board of directors, a manager, etc., plus criminal background checks for everybody working at them. The complete set of requirements is pretty large and means there is going to be a lot of expensive costs in setting up one of these non-profits.

Meanwhile, very few patients have conditions that qualify, few doctors who are providing treatment to these patients are going to want to recommend and even fewer patients are going to want to go through the difficult process of getting a recommendation. It will just be easier to go to the black market and hope they can find same clean marijuana and not get busted.

So we have expensive ATCs with few patients. That means the ATCs are going to have to charge a lot of money for the medicine. Oh, and they can only give out what I estimate to be half the amount of medicine a typical patient uses.

The high cost of medicine means even fewer patients will use the ATCs, which means more costs passed on to the remaining patients raising the price of medicine, etc. You get a death spiral and the ATCs shut down because they have no patients and are hemorrhaging money.

Anybody analyzing this situation would refuse to get involved in setting up an ATC and the whole system will never get off the ground.

So this bill needs to be changed to a functional bill before the Assembly votes on it. The Senate version, S119, was pretty reasonable.

Call your Assembly person and get them on board for the original bill.

Analysis of Assembly Committee Changes to NJ Medical Marijuana Bill

The New Jersey Assembly Health and Senior Services Committee finally voted to release the A804/S119 bill to the general Assembly for a vote, but with significant modifications.

These modifications include:

1)Removing any allowance for home growing, instead requiring patients to purchase their cannabis from at least 6 non-profit "Alternative Health Centers" to be set up around the state;

2)Removing "severe or chronic pain" as a qualifying condition except when associated with cancer;

3)Requiring that patient recommendations come ONLY from the doctor who is directly treating the qualifying condition.

The first modification will put NJ at much greater risk of federal crack downs as well as cost many patients more money for medicine than they can afford. The second modification eliminates the largest group who could benefit from the act and for whom some of the best medical science exists supporting the use of cannabis. But the final change worries me the most. It will make it almost impossible for anybody to receive a cannabis recommendation. So this last change will make it unlikely that the program will ever get off the ground after it is signed into law.

Why? Because most doctors simply will not write recommendations for cannabis use. Their reason is two-fold:

First, doctors fear repercussions from their own certification professional societies and also fear losing their DEA scheduled-drug prescription license. Even though the act explicitly forbids professional societies from taking negative actions against doctors who recommend marfijuana, and a Supreme Court decision protects doctors' free speech rights to make a recommendation, most doctors are not going to realize the existence of these protections. Even if they are educated to be aware of them, they will not or trust these protections, fearing controversy with negative impact on their practice if they do make a cannabis recommendation.

Secondly, most doctors, quite rightly in my opinion, will not write prescriptions for drugs with which they do not have training and experience. Zero doctors in our state currently have experience with cannabis.

Even though California has had a medical marijuana law since 1996, only a few doctors there will make recommendations for the above reasons. Obviously, by this point most doctors in California should know the law and its protections. Many, perhaps the majority of doctors in California say they believe there are benefits to medical marijuana. So the reason is fear of reprisal and unwillingness to prescribe drugs with which they are unfamiliar.


So almost no New Jersey doctors treating patients with AIDS, MS, etc. will be writing marijuana recommendations. And the bill apparently also has a provision to prevent a patient from switching to one of these few doctors who might make a recommendation as it will require a long term doctor/patient relationship before the doctor can write a recommendation.

In general, doctors prefer to refer patients to specialists for treatment with scheduled drugs, especially if a patient needs long-term or strong pain relief. For example, a doctor will refer a patient with severe or chronic pain to a pain specialist. The pain specialist has superior knowledge of treatment with pain drugs and also knows how to go through the regulatory hoops to best protect himself and keep his patients within the law.

I had expected a similar situation to develop in New Jersey for cannabis recommendations. I know that a number of doctors with cannabis experience were considering setting up clinics here for exactly that purpose.

I realize that the Assembly committee was worried about abuses of the law. They put in the amendment regarding who can recommend because they feared that "pot clinics" would be set up where people can walk in with a hang-nail and walk out with a recommendation.

But the original bill already had strict definitions of qualifying conditions. And I'm sure a more subtle change could have been made to achieve the same level of protection from abuse that the Health and Senior Service committee desired. One method could be to require a note from the primary care doctor documenting the medical condition of their patient. There would be no need for the primary care doctor to make an actual recommendation The patient could then take this note to a cannabis doctor clinic to get a recommendation.

I believe that the Health and Senior Service committee does want to get this act in place and that they do want to help patients. But I fear that they have unknowingly gutted this act.

It will probably take at least a year to set up the regulation committees and get the Alternative Treatment Centers going. Hopefully in that time we can talk to committee members and get them to loosen some of these overly-restrictive provisions.

LISTEN: June 4, 2009 Medical Marijuana Testimony

The complete audio of the Assembly Health & Senior Services Committee hearing on medical marijuna is now online!

Advocates and CMM-NJ are within the first hour of the recording.

Of patricular note in the audio:

- Testimony was limited to 90 seconds spoken plus written submissions

- Assemblyman Reed Guiscora, Assemblywoman Joan Voss and Senator Nicholas Scutari strongly champion the cause of medical marijuana and the bill they sponsor

- New patients testified on behalf of the bill with compelling and heartbreaking stories

- The Committee Chair Asm. Dr. Herb Conaway repeating that the committee will pass the bill

- Committee's well educated and even terse responses to the opposition's tangential arguments

CLICK TO LISTEN: 6/4/09 NJ MEDICAL MARIJUANA HEARING

Please listen to the committee hearing and let us know what you think by posting a comment on this blog!

A804/S119 PASSES ASSEMBLY HEALTH AND SENIOR SERVICES COMMITTEE!

FOR IMMEDIATE RELEASE 6-4-09

The New Jersey Assembly Health and Senior Services Committee passed the Compassionate Use Medical Marijuana Act, forwarding the bill to the full Assembly for a vote this fall.

The Senate version passed a floor vote this February.

The Assembly did offer some substitutions that made some serious changes to the bill that would not serve patients well.

Ken Wolski, a registered nurse and Director of the Coalition for Medical Marijuana - New Jersey said, “I am pleased that the bill passed and this committee vote represents significant progress on medical marijuana in New Jersey. I do have some serious concerns about the amendments and substitutions made to the bill. We at CMM-NJ hope that our legislators will pass a final version bill that is not overly restrictive to help the most amount of suffering patients in our state.”

Chris Goldstein testified on behalf of CMM-NJ and asked that the committee to pass the bill in 2009 without trying to perfect the language. Instead NJ should follow the example of New Mexico. The NM legislation allowed the NM Department of Health to decide the rules on distribution and the registry card system rather than have it defined in the legislation.

Several committee members abstained form voting. The Committee Chairman, Dr. Herb Conaway, showed that he was very well educated on all topics related to medical marijuana. The Chair himself easily countered many of the baseless opposition arguments, including from law enforcement.

Several medical marijuana patients testified before the committee including those suffering from MS, ALS and Chronic Pain.

Audio from the hearing will be available on the NJ Legislature website tomorrow.

For more information please visit www.cmmnj.org

For more info, or Media please contact: Ken @ (609) 394-2137