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.