Sunday, January 24, 2010

How do I become a medical marijuana patient in New Jersey?

Now that the New Jersey Compassionate Use Medical Marijuana Act (CUMMA) has passed into law, patients are asking when and how they can start using medical marijuana. This is a quick review of the law, timeline and other issues. Remember, this is our understanding of the bill. We will all have to wait until the Department of Health and Human Services (DHSS) puts out explicit rules and regulations associated with the CUMMA to have a full understanding of the medical marijuana process. We will post updates as we get more information.


What conditions are eligible for medical marijuana?
1) One of the following conditions, if resistant to conventional medical therapy: seizure disorder, including epilepsy, intractable skeletal muscular spasticity or glaucoma;
2) one of the following, if severe or chronic pain, severe nausea or vomiting, cachexia, or wasting syndrome results from the condition or treatment thereof: positive status for human immunodeficiency virus, acquired immune deficiency syndrome, or cancer;
3) amyotrophic lateral sclerosis, multiple sclerosis, terminal cancer, muscular dystrophy, or inflammatory bowel disease, including Crohn’s disease ;
4) terminal illness, if the physician has determined a prognosis of less than 12 months of life; or
5) any other medical condition or its treatment that is approved by the DHSS by regulation.

Note the last provision. Even if your serious medical condition is not yet covered, it can be added by the DHSS.

When can I get medical marijuana?
This is our current understanding of the timeline for patient ID cards and the formation of Alternative Treatment Centers (ATCs):
CUMMA passed into law 1/18/10. Usually reliable State House sources say regs will be out in 3 mos. (April) and the program running in 6 (July). No real info before that.
So the earliest possible time to be able to go to an ATC is July. However, if the ATCs have to start growing marijuana on that date, it may be another three months or so before the medicine is ready.

Where do I get medical marijuana?
The CUMMA does not allow patients to cultivate marijuana. Instead they will have to register with an Alternative Treatment Center (ATC) and receive it there. Initially there will be 6 non-profit ATCs. Patients will likely have to compensate the ATC for the cost of production of the marijuana.

How do I get a medical marijuana “prescription”?
When the program is running, you must apply for and receive a “registry identity card” from DHSS for your qualifying condition. Your doctor writes a “certification”. You take your registry card and the certification to an ATC to receive the medical marijuana.

Begin a discussion with your doctor NOW
Have as much in place as possible before the law takes effect. Begin a dialogue with your physician now. Discuss why you think you need marijuana for your condition. See what your doctor says. If he agrees, fine. Ask him/her if he would please make note of that in your chart.

If he disagrees, ask him why? Is it his unfamiliarity with marijuana? Or his belief that the risks outweigh the benefits? Ask him if you can present him with some research findings that support your belief (See ASA and NORML links at http://cmmnj.org/ and the Patients Out of Time link below), then do so. Discuss this with any specialist you might be involved with. Ask him/her if he would please make note of that in your chart. Perhaps get a second opinion.

If he says he has to wait for the law, remember, the law is only partially the issue. The real issue is your need for marijuana as part of your therapy, and a physician agreeing to that. The law is very restrictive and many patients who could benefit will find themselves not qualified under the law. But they may become qualified as doctors and patients request the addition of new conditions to the DHSS regulations.


Info for Docs and nurses: The law offers significant protection to doctors who make medical marijuana “certifications” (recommendations) . There are numerous scientific papers available showing the utility of medical marijuana that many doctors may want to review. We will be putting up links to these papers. Doctors and nurses can also receive information at the upcoming Patients Out of Time Clinical Conference April 15-17 http://www.medicalcannabis.com/Clinical-Conferences/2010-upcoming-conference and the NJ State Nurses Association INPAC Breakfast on Feb. 4 http://www.njsna.org/


41 comments:

  1. this is the greatest thing that could have happened ive suffered for many years with pain my whole family knows i smoke marijuana including my doctors and they know why finally we can get some help all them pain killers did were ruin my life and my stomach their is a god

    ReplyDelete
  2. While waiting for this bill to finally pass I would joke with my wife that if it passes I should have little trouble being certified since I hit the medical marijuana "trifecta" -- I've been suffering extreme pain due to intractable skeletal muscular spacticity due to an accident at work years ago, I am on my opthamologist's glaucoma watch list with elevated pressure in both eyes, and in 2008 I underwent cancer surgery.

    It's a trifecta I would much rather have not hit.

    The accident finally led to an unsuccessful cervical spinal fusion and afterward began getting severe migraine headaches. My doctors prescribed narcotic pain killers to relive the pain. I never had migraines prior to the surgery. My doctor prescribed Imitrex. It worked as long as I took it as soon as I saw the aura at the onset of a migraine. Otherwise I was in for at least a full day of intense migraine headache.

    A good friend suggested I try marijuana not only for the migraine headaches but for the pain I was suffering from the spinal fusion. It was like a miracle. Not only did marijuana relieve my muscle spasms but after using it I've never had another migraine headache -- ever.

    I never had a means to obtain marijuana on a regular basis. I'd stumble into some now and then through friends and acquaintances but even though it provided such incredible relief for my pain and migraines the illegality of possession and the draconian laws being enforced made me generally steer clear except for those times when I could find some through friends I could trust.

    After several bouts of what I can only describe as withdrawal from dependence on the narcotic pain killers my doctors prescribed I decided to stop using them. I'd rather suffer than go through that every few months. Then I read a report in the newspaper about the liver damage associated with prescription pain killers that include acetaminophen. The report said these prescription pain killers are the number one cause of liver failure in America. Another reason I refuse to use them any longer.

    Then in 2008 I got the news -- I had cancer. I underwent surgery in November 2008 and so far it looks like I've beaten it. I also learned that I had early stage glaucoma shortly after I learned about the cancer diagnosis. 2008 was quite a memorable year.

    I mentioned marijuana to my doctors and they were generally supportive but afterward they refused to discuss it any further. I never mentioned it to my opthamologist so he still doesn't realize that the two times when my intraocular pressure was normal were when I had used marijuana within the past day or two.

    So I've been waiting patiently, suffering, hoping that this bill would pass. I was afraid to get involved because of the legal ramifications and the stigma. I feel guilty now for not getting involved but at the same time I'm so happy this bill passed. It is going to make a world of difference for so many people.

    I'm going to bring up the subject of certification at my next visit to each of my doctors. I'm going to print out all the information I can find to present to them. I'm certain at least one of them will cooperate.

    I want to thank everyone who was brave enough to take up this fight for people like me who didn't have your courage to do so but will benefit immensely from your efforts.

    Thank you. May God bless you.

    ReplyDelete
  3. I am an alcoholic. I can tell you that I don't like marijuana; but if it can be used to stop my craving for alcohol, I would like to try it during the times when the cravings hit me. Alcohol has destroyed my life and I will try any thing to stop drinking. The cravings are just too strong at times.

    Will a doctor prescribe marijuana to treat my alcoholism?

    ReplyDelete
  4. webmaster - Doctors can only recommend cannabis for the allowed conditions shown in this post. Alcoholism is not currently one.

    Bob - non-terminal cancer and pain not related to AIDs or cancer actually aren't on the current list. Intractable spasticity and glaucoma are, if resistant to standard treatments.

    Hopefully, new conditions will be added by the DHSS over time. The best thing to do if you have a serious condition not covered is to write and to get your doctor to write to DHSS about the need for coverage.

    ReplyDelete
  5. As someone who suffers with severe spasticity and Central Pain Syndrome (an incurable continual agonizing sensation of burning crushing cold) as the result of a stroke, I have found that NONE of the available medications give me true relief.

    The idea that there may be an option for me is a cause of tremendous hope. September cannot come some enough.

    One major problem that I see with this bill, however, is that it forbids home propagation (in NJ, The Garden State, no less!). As a person with both a green thumb and limited income, I would much prefer to grow my own, just as I do with tomatoes or other herbs.

    Is there any chance that home propagation may evcentually be added to this law, once it's apparent that medical users aren't peddling nickel bags outside of middle schools?

    ReplyDelete
  6. I think it's wonderful that my lame home state of NJ has finally got it's head out of it's butt and taken off the blinders and is actually doing good for people that really need it. I reside in Denver Colorado and the medical Marijuana industry has taken off, but it's being handled responsibly and there has been no ill effects from the growth of this new industry. Unfortunately for NJ, patients can't grow there own....for now...Good luck guys!!!

    ReplyDelete
  7. i have a severe anxiety problem and ive tried all types of so called meds my doctor knows i smoke marijuana and encourages me to continue, so far its the only think that works...would anxiety problems be something the dhss might look into for it helping there as well marinuana is truly the only medicine that calms me enough to be able to eat or sleep and when im without im awake for days on end obsessing over things and having severe panic attacks...please help me nj

    ReplyDelete
  8. NJ has made a very small step forward. Every state that has an open policy has shown that Marijuana related crime is decreased and there have been zero detrimental effects from it's use.

    Check Denver as well.

    These moron parents actually feel that making medical marijuana available will lead to more children using it. MORONS. Complete morons. If everyone over 40 wanted to smoke or use marijuana then you can be assured that much less young adults would have any interest at all.

    My wife has Muscular Dystrophy. She cannot travel. I wonder what grief they will give me when I attempt to pick up her meds for her since I am sure they are too dumb to deliver. I mean how many doctors make house calls today (OURS DOES and he is wonderful to do it for my wife)

    SOme people are still nice.

    ReplyDelete
  9. I'm confused. One article states chronic pain is included, another says it's not. Please verify this for me. Thanks

    ReplyDelete
  10. Hello my name is Shawn. I am 20 years old and live in the Philadelphia area. I will tell you my problem, then ask you my question. Since the 4th grade(about 9 years old) I have been seeing specialists and family doctors for severe Head and Abdominal Migraines. Right now I am on pain relievers, Oxycodone, for the pain which gets very bad. Now my question is would I be a candidate for the marijuana program? I do it already and it does help take them away, and I have also notice prevention also. And if so, my family has a summer house in New Jersey and if I registered to live there would I be able to enter the program? Any information would help greatly or someone who would point me in the right direction. Thank you for your time!

    ReplyDelete
  11. Shawn - I also notice that THC helps prevent migraines in addition to helping relieve an active migraine. Without routine use of this, I would be incapacitated by them. So I truly appreciate your position.

    But migraines do not qualify. The qualifying conditions are as stated above.

    This doesn't mean new conditions won't be added by the Dept. of Health in the future.

    You must be a legal resident of the state to be a medical marijuana patient. I do not know the details of how you establish residency, but I'm sure you can do an internet search and find out.

    ReplyDelete
  12. Karen - the original NJ senate version of the bill had chronic/severe pain as a qualifying condition. We and others reported on that version last year when the senate passed it. But the NJ Assembly removed that condition and that is the version that actually passed both houses of the legislature this month and was signed into law.

    ReplyDelete
  13. dcohn9999 - the bill has a provision for a designated caretaker to pick up the medicine. But the caretaker has to apply and be approved for this position. The Alternative Treatment Centers can also deliver if they choose.

    The Dept. of Health will be making regulations as to how this will all work.

    ReplyDelete
  14. I'm an OIF Vet, and I suffer tremendously from several conditions. PTSD and 2 herniated discs, and at times makes my legs spasm up so bad, that it balls me up in excruciating pain! The PTSD makes me so hyped up, that I stay up for days. When I go to places like Wal-Mart I get nervous and have bad anxiety. I get so focused at looking at peoples hands, that it makes me so wirey and jumpy to be there. After that it's so hard to calm myself down, that it takes days at times. I go to the VA Medical Center in Lyons, N.J. and they treat me for my conditions with handfuls of different meds. The oxycodone for pain works, but it only last for 3 or 4 hours, and it doesn't stop the leg spasms. The Klononapin really doesn't work at all, as far as calming me down, before any mall trips! I spent 45 days in the PTSD unit, and it's well documented. So, to make a long story short, am I qualified for Medical Marijuana instead of handfuls of different meds that only works for the 3 to 4 hours of little pain, but alot more bearable than without them. I don't smoke marijuana right now, but if it would work I'd much rather smoke that, then taking handfuls of different meds!

    ReplyDelete
  15. I'm an OIF Vet, and I suffer tremendously from several conditions. PTSD and 2 herniated discs, and at times makes my legs spasm up so bad, that it balls me up in excruciating pain! The PTSD makes me so hyped up, that I stay up for days. When I go to places like Wal-Mart I get nervous and have bad anxiety. I get so focused at looking at peoples hands, that it makes me so wirey and jumpy to be there. After that it's so hard to calm myself down, that it takes days at times. I go to the VA Medical Center in Lyons, N.J. and they treat me for my conditions with handfuls of different meds. The oxycodone for pain works, but it only last for 3 or 4 hours, and it doesn't stop the leg spasms. The Klononapin really doesn't work at all, as far as calming me down, before any mall trips! I spent 45 days in the PTSD unit, and it's well documented. So, to make a long story short, am I qualified for Medical Marijuana instead of handfuls of different meds that only works for the 3 to 4 hours of little pain, but alot more bearable than without them. I don't smoke marijuana right now, but if it would work I'd much rather smoke that, then taking handfuls of different meds!

    ReplyDelete
  16. I have to say I am kind of peeved. I went to my doctor last night and asked him if he was going to change my antispasmotics (jokingly) to MM. He said 'hell no' I am not applying for a certificate and it's federal law that mj is illegal so you can still get busted. Now it's time to start working on the de-criminalization

    ReplyDelete
  17. People I still don't belive its going to happen here in NJ but lets hope it works out. My wife has MS and the meds cost a ton of money. If she can get relife from smoking pot Then so be it. Maybe in the long run it will help get her off the expensive meds we buy each month.

    ReplyDelete
  18. I'm already Medirol patient for chronic pain. Will that allow me to recieve MM since I am already on perscribed THC, though it's not for cancer? My Insurance company has oked it for treatment, and is paying $2,700 a month to cover me. I wrote to Gov. Christie about this insanity for what good it will do.

    ReplyDelete
  19. Richard,

    I suffer from a herniated L5-S1 disc and am wondering if i can apply for a card. I'm very curious because the pain i suffer from is there all day, and i can do little to take away the pain. Oxycodone and flexeril help slightly but i hate taking medication. I would rather deal with the horrible pain then to take those medicines,call me insane but I feel that if I take these meds then i will become dependent on them and become addicted to them.

    I know marijuana isn't addictive and its a more natural healing option then oxycodones and all other pain meds.

    I'll be 18 when the law takes effect and really want to try it.

    I do smoke weed now but it is only to help my severe chronic back pain. Im worried if i mention this to my doctor that he will think that im so marijuana feign and taking advantage of the new law, im not.

    Bottom line: Is/will chronic pain by added to the list of conditions that can be solved by medical marijuana

    ReplyDelete
  20. akashawolfe,
    2oz mo. (assuming you even needed that much) from an ATC would run you less then 1/2 that amount. about ~1000$. Believe me it's not going to be cheap, though product will be high quaility. An ATC built out with the needed redundencies and operated professionally dotting all the i's, crossing all the t's in the state of NJ is quite the costly undertaking. Given such and ATC will have to recoupe said investment costs as well as their ongoing burn rate. I've run some basic numbers and am highly interested in opening an ATC but I'll need 180-220 monthly patients (at 1oz) before break even, and inital $ in the 600k range, maybe more depending on regs and doing things top of the line professionally.

    Does anyone have an idea of what the initial market numbers may be, ie how many people do you think the docs and state will approve in the first 12 months as well as number of ATC licenses they may issue, I see in the law they are required to license at least 3 (of the non-profit types).

    ReplyDelete
  21. I suffer from a condition called Monomelic Amyotrophy. This conditions is very similar to ALS but "Plateaus" after about 2 years. now i suffer from twitching and cramping (thank god that is all, could be ALS). Marijuana is the only way to treat the symptoms without other medications which make have side effects for me that I cant deal with. I also have the onset of Fatty Liver Disease.

    Would i candidate for Medical Marijuana?

    tom

    ReplyDelete
  22. It's a step foward but much more has to be done...

    ReplyDelete
  23. I have epilepsy. I have been taking meds for 42 years, but my seizures have been controlled for about 20 years. However, I have gradually reduced the quantity of seizure medications in part I believe because I smoke pot once every night. Two questions: If I have been seizure free do you think the state would reject my request for a MM card? And second, I believe the original Senate bill had a cultivation option. Do you think that there is a chance that cultivation may eventually be added. Purchasing med grade is very expensive.

    ReplyDelete
  24. Don't kid yourself self cultivation will not be wildly cheaper unless you can just do a summer crop, though yes it will be cheaper.

    I doubt they are going to add self cultivation any time soon, in fact once a few ATC's are up they will likely be privately lobbying againt it. Self cultivation creates and even further management nightmare from the state's perspective.

    ReplyDelete
  25. I have Scleroderma that has effected my inner organs and my skin dramamtically. I have found a off label treatment that has slowed the progress dramatically but I have the joint damage and pain. Is Sclerodema on the list, it is pretty rare, so I don't see much about it but marajuana definately calms me and helps the pain, but due to it being illegal I only used it when things were horrible. I will discuss with my doctor next week,thank God for these little helpers - there are such few things that help!

    ReplyDelete
  26. In regards to the above post, I also have epilepsy and have been on medication for roughly 3 years. My seizures occur at night while i'm sleeping so I dont always know if my seizures are under control, I stopped 'self-medicating' with marijuana about 6 months ago out of fear of breaking the law, but I have insomnia due to my condition and almost fear sleep since I quit using, afraid I might wake up in the hospital again with a $5,000 medical bill. I'm just curious on how they might approach epilepsy because of all the medications that are out there. I would really prefer to get rid of the pills all together, as they make me depressed. Do you think I have a case that would qualify if I discussed MM as an option to my doctor?

    ReplyDelete
  27. Control of seizures from epilepsy is one of the covered conditions. Your doctor would have to decide if you needed more control. But even if the conventional treatments were working, if you feel the side effects are severe enough that you need to try alternative treatments like medical marijuana, I expect you would qualify in a legal sense.

    But I'm no lawyer and this is one of the areas that need working out. I expect this side effects issue is going to be an "interesting" area with NJ's strict medical marijuana law. From what I know at this point, if your doctor agrees, you are OK.

    ReplyDelete
  28. Please publish information on the excellent research that shows that marijuana relieves treatment-resistant nightmares of post-traumatic stress disorder. http://www.ncbi.nlm.nih.gov/pubmed/19228182

    ReplyDelete
  29. Anyone help me plz?
    My son's stepsister was just diagnosed with nueroblastoma and just had her first chemo treament. I live in new Jersey and cant find permit info or medicine to help her. Gotta get her the treatments asap! She goes back for chemo in two weeks.

    ReplyDelete
  30. Russ - It is unlikely that any medicine will be available until early Fall. If you think her treatment will still be ongoing at that time, you should talk to her physicians and ask if they will be willing to make a cannabis recommendation at that time.

    ReplyDelete
  31. I live in constant pain from day to day from SC disease, a derivitave of Sickle Cell - A condition of the blood in which the hemoglobin will crystalize in situations of low oxygen, and so far I've lost my right eye from this and can't see too well out of it, which is also a problem because SC is known for that -- I could lose both eyes, and not to mention I suffer from constant pain with every waking second I'm alive with this bloody mess. I've been hospitalized for my condition far more times than I care to remember, starting at the age of two and spanning throughout my lifetime to which I'm now twenty-seven years of age.

    My doctor could only do so much for me as far as pain narcotics is concerned. They could not continually keep perscribing pain medication because it would go so fast and finally they slapped an "addict" sticker on my condition and said I'd developed a physical dependency for the meds (though, in most cases what was given just did not work, but you can't blame them after the huge Micheal Jackson case -- I understand) and after a while they cut me off meds completely. It has been sheer terror my whole life through for me. This pain is like no other and will happen totally at random. It also does not care how inconvenient to you it is when it strikes.

    When I finally heard that they were doing research on medical marijuana in conjunction with pain medication for chronic pain from a friend in Australia I thought my prayers had been answered. I've always advocated the responsible use of marijuana, but as it stands, it looks like there's a long road ahead for me and no reason to celebrate yet as far as my condition is concerned. What can I possibly do in my situation? Should I plead with my skeptical hematologist and see a doctor then explain to them why this condition should be listed? I don't quite know how to go about this, and I'm fearful that I may not even be listened to.

    ReplyDelete
  32. Magus - if you can, find a NJ doctor who supports the use of medical marijuana for your condition and have him write a letter about this. Then petition the NJ Department of Health and Senior Services to add your condition. http://www.state.nj.us/health/med_marijuana.shtml

    I think severe and chronic pain will be added to the conditions after the system gets going, the science is very good for this, but the more people who petition, the better.

    ReplyDelete
  33. not any person is going to prescribe marijuana ... must have a history which reflects that neceiste a soothing ... and is prescribed in small amounts ... If I take generic viagra there is a problem with the recipe

    ReplyDelete
  34. cant find an answer..plz help! due to a nasty accident i am disabled and in constant pain/anxiety for the past four 1/2 yrs. problem is i live in suburbs of philly. am i legally permitted to get medical help in nj..any advice or suggesstions to dr's would be gratefully accepted as i live in pain 24/7 despite a plethora of medications..nan

    ReplyDelete
  35. Honestly I am so glad for all the people who are able to get treatment, but does anyone think they should add some more diseases to the list like depression and anxiety. Those are very common and the pills that treat them are just as harmful. If i could smoke marijuana legally I wouldn't have to get the pills

    ReplyDelete
  36. Hey
    Every one linke good health so come and know about better health
    medical marijuana doctor

    ReplyDelete
  37. Nice content, I trust this is a nice blog. Wish to see fresh content next time. Thanks for sharing this post with us. Keep it up. legal marijuana

    ReplyDelete
  38. I'm someone who being dealing with pain, nausea, depression,& mential issues since I was 14. I'm now 28 this year and been a user since 16. I'm truely greatful for this product to be legal. Which, I'm trying to do it legally but my doc. don't like marijuana, and been knowing me for 3 years. I think I need to change doc.

    ReplyDelete
  39. I am not going to say my age but know that I am not a adult I am suffering with migraines. They are the not the worst thing possible I am being tested on because they still do not know what is the matter with me. I got put on a preventative but it is useless. I have try'd pot and it does go away. I am not a "pot head" I use it for a legitimate reason. I think that they should widen the illness and disorder range. I use it in moderation and do not abuse it.

    ReplyDelete
  40. to know a little more pertaining to laser mole removal gurgaon visit to http://www.skindelhi.com/moleswarts.html

    ReplyDelete