Thursday, October 15, 2009

Assemblyman, doctors support medical marijuana

Assemblyman Carroll backs medical pot law
By PHIL GARBER, Staff Writer, Randolph Reporter
Published: Oct. 9, 2009

Assemblyman Michael Patrick Carroll, R-Morris, remembers when a family member was suffering from debilitating nausea and extreme pain for months after her surgery for ovarian cancer.

Carroll knew that something as simple as marijuana could significantly limit his relative’s discomfort. He also knew it was illegal to use marijuana for any reason, including medical reasons.

The Assemblyman said the experience three years ago reinforced his belief that it is wrong to bar people like his relative from smoking marijuana if it could ease their suffering. It wasn't long thereafter that Carroll joined in co-sponsoring an Assembly bill to legalize use of marijuana for medical reasons.

Various studies have shown that marijuana can lessen debilitating pain and nausea commonly experienced by people with cancer, HIV/AIDS and other chronic and crippling diseases. Officials in New Jersey have been considering medical marijuana legislation for at lest five years but Carroll said on Sunday that this year the proposal may finally become law.

A Senate version of the medical marijuana bill, S-119, has passed while the Assembly version, A-804, is awaiting action. Gov. Jon Corzine has said he will sign the bill if it is passed by the Legislature. New Jersey would then be the 14th state to allow medical use of marijuana.

The bill is sponsored by Assemblyman Reed Gusciora, D-Mercer, and Carroll is the only Republican among a number of co-sponsors.

"I'm a great believer that physicians should be freed from the restrictions drawn by people who are not physicians," Carroll said on Sunday in a program at the Skylands Unitarian Universalist fellowship in Mansfield Township.

The Unitarian fellowship draws its membership largely from Long Valley, Budd Lake and sections of Warren County.

"The government should not stand between a patient and his doctor," said Carroll, who is considered one of the state's most conservative legislators. "I see people in wheelchairs who say marijuana is their only way to get help."

Carroll represents the 25th legislative district which includes Mendham Township, Mine Hill, Boonton and Boonton Township, Denville, Dover, Jefferson, Morris Township, Morristown, Mount Arlington, Randolph, Rockaway, Rockaway Township, Roxbury, Victory Gardens and Wharton.

Personal Experiences

The legislator said another personal situation further spurred him to support the legalization of pot for medical reasons. He said his grandmother had been diagnosed with lung cancer and that doctors had given her six months to live.

"Six years later, she was still trucking on but she suffered from horrible pain," Carroll said.

The doctors prescribed a derivative of heroin and cocaine to help ease the pain. It was an irony that did not get past Carroll.

"But marijuana is considered a problem?" he said.

Carroll said he has had his own painful, medical ailments which further illustrated why a prohibition on the use of medical marijuana makes no sense.

He said he was suffering from a recurrence of gout and found it very painful to walk. A physician prescribed large doses of Motrin but it was not helpful. Another doctor prescribed Vicodin and Percoset and the two powerful pain relievers worked.

Both drugs also are considered widely abused by young people and opponents of the medical marijuana law say it would make it even easier for youths to abuse pot.

"I have six kids who could get in the medicine cabinet," Carroll said. "The potential for abuse exists but it doesn't mean marijuana should be illegal."

Opponents of legalizing pot for medical reasons often claim that the doses can't be determined or managed because pot is smoked and not taken as an easily-monitored liquid or solid. Opponents also say that there is no scientific data showing marijuana reduces pain but that it only makes the person feel euphoric.

Carroll said the arguments are empty when compared with his own and medical observations.

"Based on my observations, if a doctor says it's effective, we should pay attention," Carroll said. "I can't get exorcised that some MS (multiple sclerosis) patient might also get high."

He said the only scientific studies show that THC, a component of marijuana, is effective in reducing eye pressure for glaucoma sufferers. But he said it doesn't really matter whether the use of marijuana provides relief because it attacks the cause or because of the euphoric effect.

Others argue that pot smoking can damage the lungs, a claim that makes little sense to someone who has a terminal illness and is in great pain, Carroll said.

Opponents also cite the experience in California where medical pot has been legalized and the state has "essentially permitted head shops" to open, he said.

Those opposing the bill argue that it is just a foot in the door toward eventual legalization of marijuana for recreational use. They say that legalizing pot for medicinal use will only make it easier to obtain for recreational use.

"I find it impossible to believe that it may be easier to get if you legalized it," said Carroll who said marijuana is the largest cash crop in the nation, because it is illegal and in demand.

Carroll said legalization of pot for medical reasons will eventually lead to consideration of further legalizing recreational marijuana. And he has no problem with such an eventuality. He said the discussion should focus on the society's failure to control illicit drug use, the disproportionate costs of law enforcement and the courts to punish people for possession of marijuana.

"Any rational dispassionate society will entertain that discussion," he said. "It's the first step toward a realization that there is no such thing as an evil plant."

A key to the success of a medical marijuana bill would be the federal government's agreement not to raid and prosecute those who grow marijuana for medical reasons, he said.

Carroll predicted the bill will eventually be passed but that won't likely be up for a vote until after the November elections. He said in legislative districts with close contests, it will undoubtedly either become a "demagogic" issue or the candidates will not discuss it at all.

"In close elections, the instantaneous desire is to hide your head and lay low," he said.

The Senate bill, S-119, would provide registry cards, authorized by the state Department of Health and Senior Services, to anyone diagnosed by a physician as having a "debilitating medical condition." The conditions are defined as cancer, glaucoma, HIV/AIDS or other chronic debilitating diseases or medical conditions that produce or the treatment produces wasting syndrome, severe or chronic pain, severe nausea, seizures or severe and persistent muscle spasms. The state could include other medical conditions if officials saw fit.

A patient or caregiver with a registry card could collectively possess no more than six marijuana plants and one ounce of usable marijuana.

Assembly bill, A-804, is more restrictive. It would allow marijuana use for seizure disorders including epilepsy, intractable skeletal muscular spasticity or glaucoma that is resistant to conventional therapy; HIV/AIDS or cancer patients experiencing severe or chronic pain, severe nausea or vomiting, cachexia or wasting syndrome; amyotrophic lateral sclerosis (ALS) or terminal cancer; and any other condition approved by the state.

The Assembly bill also would prohibit patients and caregivers from growing marijuana. Qualified patients would have to acquire the marijuana from alternative treatment centers as established by the state.

Copyright © 2009 - Recorder Community Newspapers

Dear Esteemed Assemblman,

I am a physician practicing in New Jersey since 1982. I'm writing to ask you to help me, and other like minded physicians, to help in the care of certain seriously ill patients in New Jersey.

On June 4, members of the Assembly Committee on Health and Senior Services approved substitute language for Assembly Bill 804, New Jersey Compassionate Use Medical Marijuana Act.

However, as amended by the Committee, the appropriate indications for medical marijuana was severely limited by not including the control of refractory pain and neuropathic pain. I also object to language that indicates that medical cannabis should essentially be a treatment of last resort.

I believe there is growing evidence-based findings that marijuana has a role in compassionate pain control. Medical pain management is a complex matter and the care is best individually tailored to the specific patient based on many factors. Having medical marijuana as an option, and not necessarily as the last resort option, would be a welcome 'tool' in the armaments of the prescriptive medical doctor. I also would note that marijuana may be the drug of choice in refractory anorexia from any cause. There is probably no drug alternative to this condition. Lastly, as a physician, I object to the position of having non-physicians dictate to me and my patients what can or cannot be used in a given circumstance. Legitimize the medical use of marijuana, or not, but please don't intrude into how I, or my fellow physicians prescribe it for patients.

Yet, I understand the concern and controversy that surrounds the legislature's courageous decision to allow the compassionate medical use of marijuana. And no drug is without potential side effects, nor do I decry the monitoring of its use to keep it a legitimate option rather than an abusable one. I often prescribe opiates for pain management, and the use is carefully controlled. Likewise I occasionally prescribe to treat opiate addiction; so the potential for abuse, misuse and diversion is not lost on me. I agree with restricting the supply only to a system that allows checks and controls on appropriate/inappropriate use.

As substituted, most patients diagnosed with severe chronic or neuropathic pain would no longer receive legal protection under the law.

And that is why I am urging you to SUPPORT THE SENATE VERSION of the New Jersey Compassionate Use Medical Marijuana Act, which does not contain the assembly health committee’s substitution restricting the use of medical marijuana to a very, very limited number of patients.

Jeffrey S. Pollack M.D.
Mays Landing, NJ

Marianne Bays, Ph.D.
Montclair, NJ 07043

September 28, 2009

Assemblyman Herb Conaway, Jr.
Delran Professional Center
Suite 125
8008 Rt. 130 North
Delran, NJ 08075

Dear Assemblyman Conaway:

On June 4, 2009, the New Jersey legislature took another step towards providing its citizens with safe access to medical marijuana. I am writing to communicate my passionate support for this initiative and my personal request that you continue to help to move NJ’s compassionate use medical marijuana bill forward during the current legislative session.

Who am I? I am a 57 year old life long resident of New Jersey; and a corporate management consultant, professionally. I have family and friends who suffer needlessly under current state and federal law prohibiting them from obtaining the medicine they need, or putting them at risk of arrest if they ignore current law. I am a member of the Coalition for Medical Marijuana - New Jersey because of this. I have been tracking the NJ State Legislature’s actions on medical marijuana very closely this year and have studied the course of similar legislation nationally. I listened on-line to the NJ Assembly Committee on Health and Senior Services hearing on A804 on June 4 and have a high positive regard for the capable manner in which you managed the public discussions on this bill.

The substitute text adopted by the Assembly Health and Senior Services Committee in A804 reflects an understandably cautious approach to the change in NJ’s existing law. Controls are needed. I believe that the added provision for a formal one-year later evaluation of the enacted bill is excellent. In fact, I think that annual review should be an on-going responsibility of the NJ Department of Health and Senior Services. However, I believe that the restrictions in the amended bill go too far and that the result is not what was intended or what we need.

A truly “compassionate use” medical marijuana bill would recognize that patients are already unreasonably suffering under existing law and would immediately decriminalize possession and use of medical doses of marijuana as prescribed by patients’ physicians.

• It would not push out the effective date of the legislation for 15 months (12 months after enactment, for no good reason, and then 90 days for administrative implementation).

• It would not presume to substitute political judgment for medical, by qualifying the situation under which a patient with a covered illness might have medical marijuana (e.g., only when the illness is “resistant to conventional medical therapy”). There are well documented cases where side effects of conventional therapy are negative, degrading the quality of life for patients, and other cases where conventional therapy is simply too expensive. Where medical marijuana is in any way better than conventional therapy for a patient, his or her physician should be able to qualify the patient for its use.

• It would not arbitrarily restrict the amount of usable marijuana available to a patient during a month to one ounce. Marijuana’s efficacy as medical treatment for an illness depends upon its potency and particular biochemical make up as well as the specific ailment(s) it is being used to treat. Different plants and curing methods yield different results and different disabilities require different dosages. While a one ounce sale and possession restriction at any given point in time is reasonable, expecting that “one size will fit all” in dosage is not. This rule will simply force patients who need more to continue to obtain their medical marijuana illegally.

• It would recognize that those with covered illnesses are often among the poorest and least mobile of our citizens and would provide them with a simple home growing alternative. The restriction against home growing will work to prevent NJ patients from obtaining the medicine they need at the lowest cost possible.

• It would not burden patients with the additional doctor and travel costs that would result from a required quarterly renewal of registry identification cards. Once annual renewal should be sufficient. It would also instruct the NJ Department of Health and Senior Services to find ways to streamline the issuance of registry identification cards to patients. A possible thirty-five day wait for needed medication would not be considered acceptable in treatment of illness in any other case, would it?

When I read through proposed legislation and listen to debates about medical marijuana, I have a mind set that I think you, as a legislator, would also find useful in evaluating proposals for providing safe access to medical marijuana for qualified patients. I ask myself: Does this help Sandy, and what about hospice patients?

Sandy is a friend who has suffered from multiple sclerosis for thirty years. She can no longer work; she is living at the poverty level on disability benefits. She has chronic pain and degenerating mobility. She walks slowly and painfully with a cane. She can no longer climb more than a few stairs. Most outings require use of a wheelchair. Additionally, her dependence on steroids has taken its toll, leaving her with a very fragile immune system, so that she suffers from infections of all sorts constantly. Sandy cannot afford a car and her condition has ruined her night vision, so that she is limited to day time driving if someone is kind enough to loan her a car. She is dependant on friends to get her where she needs to go.

Without medical marijuana, Sandy would be unable to coordinate her muscles, overcoming her pain and spasms sufficiently to enable her to walk. She would suffer from chronic nausea from traditional anti-spasm medicines, and would find it even more difficult to sleep than she already does. Her only alternative for pain management would be morphine, which she can obtain easily, but which is much harder on her body and negatively affects her ability to perform life functions.

At prevailing street prices, Sandy cannot afford the amount of medical marijuana she needs. One and a half to two ounces per month would meet her current needs. She tells me that other medical marijuana patients that she knows consume even more than this amount to alleviate their pain – “up to 10 joints a day”. Sandy would, with education and resources from an “Alternative Treatment Center” have the capability to grow her own medical marijuana. The revised bill does not give her that option, however.

And, what about hospice patients?

They’re likely to be even less mobile. And, they may need family or friends to even figure out how to obtain and use medical marijuana. How is this system of application, review and approval going to help hospice patients? Clearly, these are cases where the patient is unlikely to be able to obtain authorization or medicine without assistance.

However, the substitution bill approved by the Committee on June 2nd, envisions the use of another “designated individual” to obtain medical marijuana for a patient as an “emergency” measure only. How could anything about getting medicine to alleviate a dying patient’s pain ever be considered anything but an “emergency” by loved ones and the patients themselves?

The envisioned lengthy application review and approval process and special exception needed to authorize someone other than the qualifying patient to obtain the medicine both place unnecessary obstacles in the way of getting medical marijuana to patients who need it. With the way this bill has been redrawn, these patients will be dead before they can obtain authorization to acquire and use medical marijuana.

I understand that there will never be a “perfect” compassionate use medical marijuana law in NJ; one that everyone agrees upon. I urge you to support basic legislation this year that immediately:

• Decriminalizes doctor approved use of medical marijuana for patients that are likely to benefit from its use

• Sets only broad limits on the quantities of medical marijuana that may be legally sold to or possessed by a patient at any given point in time

• Establishes a no more than 90 day planning period for enactment of this law

• Establishes a process that streamlines the certification of licenses for patients who obtain doctors recommendations (and for patients’ caregivers where a doctor certifies that the patient will need assistance)

• Provides for establishment of licensed Alternative Treatment Centers to legally grow and dispense medical marijuana to qualified patients

• Permits licensed patients to grow their own cannabis plants as an alternative to purchasing from a licensed Alternative Treatment Center

Thank you for your consideration.

Yours truly,

Marianne Bays

P.S. There is one other aspect of the amended A804 that troubles me. It seems to suggest that the NJ State Legislature expects the Department of Health and Senior Services to be able to regulate/administer some aspects of the growing and dispensing of cannabis to patients that are well outside of the purview of this agency. Basic knowledge of what strains of cannabis are most effective for what different conditions already exists in the medical marijuana community. More knowledge and more strains will continue to develop as time passes. Medical and bio-chemistry professionals should be relied upon for this knowledge; involvement by state administrators makes no sense.

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