Wednesday, September 2, 2009

The New Jersey Compassionate Use Medical Marijuana Act

July 21, 2009

The "New Jersey Compassionate Use Medical Marijuana Act" was introduced in 2005 by Senator Scutari (D-Linden) and Assemblymen Gusciora (D-Princeton) and Carroll (R-Morris). This bill would remove the statewide penalties for possession, use and cultivation of a small amount of marijuana when it is recommended by a doctor. New Jersey patients would still be subject to federal laws against marijuana, but this bill would protect the vast majority of legitimate New Jersey medical marijuana users. The bill had informational hearings in the Senate in June 2006, and in the Assembly in May 2008. Every major newspaper in New Jersey had editorially endorsed this bill. The bill also picked up key endorsements from health care organizations such as the New Jersey Academy of Family Physicians, the New Jersey League for Nursing, the New Jersey chapters of the Leukemia and Lymphoma Society, the New Jersey Hospice and Palliative Care Organization and the New Jersey State Nurses Association. Polls showed the New Jersey public supported this bill with approval ratings between 70% and 86%. The bill picked up a total of 11 co-sponsors in the Assembly and 8 in the Senate.

On December 15, 2008, the New Jersey Senate Health Committee conducted a hearing and then voted 6 – 1 in favor of “The New Jersey Compassionate Use Medical Marijuana Act” (S119) as amended. The amendments established Alternative Treatment Centers that resembled collective gardens, where patients owned the marijuana plants and reimbursed the Centers for the cost of producing the medicine. The favorable committee vote allowed the bill to be released to the full senate for a vote.

On February 23, 2009, the New Jersey State Senate approved the New Jersey Compassionate Use Medical Marijuana Act" (S119) by a vote of 22 – 16 in the State House Senate Chambers in Trenton, NJ. Many supporters of the bill attended the voting session. The senate vote was a significant step in the legislative process to protect patients who use marijuana on the recommendation of a physician. Qualifying medical conditions included chronic pain, cancer, AIDS, multiple sclerosis, Crohn’s disease, etc. Patients would be issued ID cards in a program run by the New Jersey Department of Health and Senior Services (DHSS). Patients would be permitted to grow up to six plants and possess one ounce of marijuana, but they would not be permitted to use their therapeutic marijuana in public or while operating motor vehicles. Patients were given the option to designate a caregiver or an Alternative Treatment Center to grow the plants for them, but the caregiver/center must also register with DHSS. The bill was very conservative. None of the 13 medical marijuana states had a smaller plant limit or possession amount. Still, supporters were convinced that the bill would help a tremendous number of patients here and they applauded the senators who supported this bill.

The bill would next go to the New Jersey Assembly, the lower house, for votes in the health committee and then the entire assembly. Governor Jon Corzine had said on several occasions that he supports medical marijuana and that he would sign the bill when it got to his desk. New Jersey would become the 14th state in the nation to legalize medical marijuana when it passed this legislation into law.

On June 4, 2009 the New Jersey Assembly Health and Senior Services Committee passed the Compassionate Use Medical Marijuana Act 8 - 1, forwarding the bill to the full Assembly for a vote in the fall of 2009. The Coalition for Medical Marijuana—New Jersey, Inc. is grateful to the assembly health committee for passing the "New Jersey Compassionate Use Medical Marijuana Act” A804/S119 on to the entire assembly, however, CMMNJ objects to the substitutions added by the committee. The committee’s substitutions to this 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 restrictions on physician recommendations;
· Deny access to the largest population of patients, those suffering from chronic pain; and,
· Arbitrarily limit patient access to one ounce of marijuana per month.

Home cultivation:
Having qualified patients or their caregivers grow a limited supply of marijuana on a physician’s recommendation is part of the program of all thirteen 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 ten medical marijuana states between 1999 and 2006. Marijuana use by AIDS patients and cancer 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 over 80% of high school seniors in New Jersey have said that marijuana is “very easy to obtain” or “fairly easy to obtain.” Instituting a medical marijuana program simply 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, twelve 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 healthcare to allow patients to produce their own medicine and individually adjust the dosage to control their symptoms, safely, under medical supervision. This will produce tremendous savings both to the patient and to the state. This will also refocus the healthcare industry away from the pharmaceutical industry and the health insurance industry and a back towards the patient, where the focus of healthcare belongs.

Physician restrictions:
The restrictions the assembly health committee placed on physicians 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 would be 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. Because of this, even otherwise qualified patients will do without proper treatment. 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” passed into law here. This 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 this law. The assembly health committee also said that only New Jersey licensed physicians could recommend marijuana to their patients. If a New Jersey patient sought treatment in New York City or Philadelphia, that patient would not be protected. Nor could out-of-state medical marijuana patients safely visit friends or relatives, or even vacation in New Jersey.

Chronic pain:
The assembly substitutions acknowledge that “marijuana may alleviate pain or other symptoms associated with certain debilitating medical conditions.” But then it eliminates chronic pain as a qualifying condition for marijuana therapy except in rare cases. Nearly half of all current physician recommendations for marijuana therapy are for chronic pain. About one in five Americans suffer from chronic pain from a wide variety of diseases like arthritis and conditions like accidents and injuries. Some of the most rigorous studies, studies using the gold standard of scientific research (the double-blind, placebo-controlled clinical trial) have established the safety and efficacy of medical marijuana in pain management. It is simply unfair to restrict the greatest number of New Jersey patients from access to medical marijuana.

Arbitrary limitations:
The Assembly Health Committee also arbitrarily determined that every qualified patient should be limited to only one ounce of marijuana a month. There is no scientific basis for this limitation. In fact, the federal government, in its Investigational New Drug (IND) program provides patients with two ounces of marijuana per week. The National Institute on Drug Abuse (NIDA) sends this standard dose of marijuana, about a half-pound a month, to the patients enrolled in this program in canisters of 300 pre-rolled cigarettes that may be consumed at a rate of ten or more a day. NIDA has been doing this for up to 27 years. This long-term dosage has proven to be safe and effective, with no unacceptable side effects. For legislators to set this arbitrary one ounce limit is akin to saying, “We know you need antibiotics, but we’re only going to let you have one pill a day. Never mind what your doctor says, never mind what community standards are, and never mind how you are responding to this therapy.”

The senate version of the "New Jersey Compassionate Use Medical Marijuana Act” A804/S119 does not contain the assembly health committee’s substitutions. CMMNJ recommends that this version of the bill should pass into law. This will ensure a workable, cost-effective, and proven program for qualified patients, that is, at the same time, extremely conservative. Let’s make sure that the intent of this bill is not undone by undue restrictions.

Ken Wolski, RN, MPA
Executive Director
Coalition for Medical Marijuana New Jersey, Inc.

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