Friday, March 6, 2015

Maryanne Boniello's Legislative Testimony, 3/2/15

Assembly Regulatory Oversight Committee
Committee Room 14, 4th Floor
State House Annex
Trenton, NJ 08625

Re:  NJ Compassionate Use Medical Marijuana Act

I would like to thank the Committee for this opportunity to express my views on the NJ Compassionate Use Medical Marijuana Act.

I have been a NJ Medical Marijuana patient since May of 2014. I have Stage 4 advanced metastatic thyroid cancer. I have also had breast cancer. In May of 2013, with my 3rd cancer operation in 7 month’s time to remove my remaining sternum pending, I made the decision to apply and got approval for Social Security Disability benefits. I had been a self-employed freelance Certified Court Reporter for 31 years. I was out of work since October 2012, when I had an operation to remove the upper part of my sternum for thyroid cancer. I will not elaborate on my medical treatment here other than to say it has been extensive and debilitating at times. The decision to apply for SSD benefits reduced my income by more than half.

When I decided to apply for my Medical Marijuana card, I was glad to see the State offer reduced fees for low-income and disabled patients. This does not apply to the dispensaries or the physicians on the registry who can charge whatever they like. This puts an undue burden on those that are struggling on fixed incomes and disability benefits, on top of having severe medical conditions. Unfortunately, the Compassionate Use Medical Marijuana Act is anything but compassionate. It is hurting the very patients who need it the most. I do not believe this was the intent of the original legislation.

NJ patients are held hostage to the ATCs because we are not allowed to grow our own plants, although that was allowed in the original legislation. The ATCs have no competition or reason to have fair pricing. I would like to see a fee schedule imposed on the ATCs and physicians for patients who are on SSD and low-income patients similar to what the State offers for the MM program. This would take a huge financial burden off patients who are already dealing with a great amount of pain, stress, suffering and anxiety due to their illnesses and do not need the extra worries of whether they can afford their medicine. Patients should also be allowed to grow a certain number of plants for their own use, as was originally intended.

I also feel medical marijuana patients should not be taxed on their medicine. I do not pay taxes on my pharmaceutical medicines. This compounds the financial burden of the high-priced product and the extra tax. Are our legislators really okay with taxing the sick and suffering medical marijuana patients?  Not compassionate at all.

Physician Registry:

I do not understand why there is a physician registry. All licensed physicians in the State of New Jersey should have the opportunity to prescribe medical marijuana as they do prescription drugs. I should not be prevented from using my primary care physician who I have been going to for more than 15 years because she is not on the registry. I also should not be precluded from using my cancer doctors, all of whom are in New York City, just because there is no provision for out-of-state doctors to certify patients.

I had a lengthy discussion with my PCP about this program. She is very interested in it. When I asked her if she would consider joining the registry, she said she didn’t have a problem doing that, but she would want to know more about dosing and interaction of other drugs before she felt comfortable as a physician to prescribe medical marijuana. The required course for the registry is Addiction Medicine & Pain Management. I am not a doctor, but even I can figure out that courses on medical marijuana, strains, dosing, interactions with other drugs would be more effective for the physicians to gain the knowledge they need for their patients. I am on my own to figure out dosing and interactions. This is not right.

Recently, I looked into changing physicians for the program to one that accepted my insurance. I first called the DOH to ask the procedure for that and it was a simple one - the new doctor had to sign-on to the online website and a few clicks and information changes and it was done. I called 3 local doctors on the registry:

Dr. #1 wanted to charge me $150 administrative fee not refundable through my insurance and then would take my insurance for visits.

Dr. #2 wanted to charge a $300 consultation fee not billable to my insurance.

Dr. #3 wanted to charge $275 and the manager I spoke with said I had to be completely re-certified again with all the paperwork I submitted in May. This was totally inaccurate as I had gotten specific instructions from the DOH on how to transfer a patient.

There needs to be oversight and fee schedules for the physicians also.


These need to be allowed and made available for all patients, not just children. I find it very offensive and discriminatory that the way I choose to medicate is being directed by politicians. Whether  one believes that cannabis cures cancer, helps with seizures and other diseases or not, patients should have full access to the various forms of medical marijuana which have different uses. I should not have to make my own cannabis oil. There is no valid reason why whole plant-based cannabis oil is not available in NJ. I fight every day for my life and am committed to doing everything within my means to fight cancer. Why am I being denied a possible treatment option? How many of you can say that given the same situation I am in, you would not want ALL available options of treatment for yourself or a loved one?

I truly hope that these changes will be implemented very soon. As with anything new, there’s tweaking to be done with the program. There are a lot of people out here that have severe, life-threatening conditions who are depending on this program. We don’t have the time to wait.  

Maryanne Boniello
Nutley, NJ 07110

VANESSA WALTZ: Testimony to Assembly Regulatory Oversight Committee March 2, 2015

My name is Vanessa Waltz, and in 2011 I was treated for Stage III breast cancer in New Jersey. I moved to New Jersey for cancer treatment both because my family lived there, and because I believed the physicians and hospitals in New Jersey were superior to those in New Mexico, where I was living at the time of my diagnosis. I had also read that New Jersey had recently passed a Medical Marijuana law, and I was looking forward to becoming a legal cannabis patient.

Little did I know at the time of my move that more than a year after the passage of the Compassionate Use Medical Marijuana Act, there was still no legal access for patients in New Jersey, nor would there be legal access through my months of chemotherapy, radiation, five surgeries, and multiple hospitalizations. I was forced to find cannabis on the black market to alleviate my suffering, rather than making use of the program that should have already been in place.

Four years later, I realize to my great disappointment that the situation for critically ill patients in New Jersey is not much better than it was during my cancer treatment. Despite the fact that New Jersey’s compassionate use program is now active, and there are 3 dispensaries open, the most vulnerable patients are still unable to access cannabis medicine for a variety of reasons.

While I was being treated for cancer, I had regular visits with a primary care physician, an oncologist, a radiologist, a neurologist, a cardiologist, a pain management specialist, a gastroenterologist, a physical therapist, a neuropsychologist, a speech therapist, an occupational therapist, and an orthopedist. In addition to being extremely ill, at times bedridden and or in a wheelchair, as you can imagine, my appointments with these physicians and rehabilitation specialists took up a lot of my time and a staggering amount of money, which I believe is typical for patients with a life-threatening illness like mine. None of my physicians signed up for the physician registry, and therefore, even when the program became active toward the end of my treatment, none of them were legally able to recommend me for a medical marijuana card.

How are patients who are experiencing similar illnesses – or worse – supposed to find the time or the money to develop a “bona fide” relationship with yet another physician in order to access the program? When New Jersey’s program was being developed, “doctor shopping” was a big concern among many legislators. Originally conceived in a misguided
attempt to validate the legitimacy of the program, the physician registry in New Jersey has itself created the need for “doctor shopping”.

As a Board Member and Social Media Administrator for the Coalition for Medical Marijuana – New Jersey, I am regularly contacted by critically ill patients facing these obstacles. I called all the doctors in my area in the physician registry, they often tell me, and they require a two year relationship to recommend me for a card...Or, they are not accepting new patients…Or, they require four visits at $250 each before I can get my medical marijuana card.

When I was going through treatment, my days were filled with nausea, migraines, heart arrhythmias, and regular visits to the emergency room. I was unable to work. I was often bedridden. There is no way that I could have found the energy, time, or money required to jump through the hoops that are still TO THIS DAY the average struggle of a critically ill patient attempting to get legal access.

Until the physician registry is removed, the most critically ill patients will continue to face the unnecessary barriers of excessive time, money, and energy needed to join the program.

The lack of patient participation in New Jersey’s program is compounded by the fact that even if patients do jump through the hoops and become a registered card holder, they find that the cannabis available in dispensaries is far more expensive than what can be found on the black market, and that edible products cannot be purchased by adults, and are still not even available for children despite changes in the regulations allowing for their sale. Not to mention the fact that many patients must travel a significant distance to a dispensary, or designate a caregiver at significant financial cost.

Considering this, it is no wonder to me that the number of patients in New Jersey’s program is a mere fraction of what it is in other medical states.  It is no wonder that the dispensaries are struggling financially, or that New Jersey patients only purchased 17 pounds of cannabis in New Jersey dispensaries over a year.

Governor Christie claims that lack of participation in the program proves that there is not a legitimate need for medical marijuana in New Jersey. This is clearly not the case; rather, the need for medical cannabis is not being met for critically ill patients due to the cumbersome and unnecessary red tape and expense involved in becoming a cardholder.

Other states with more active programs are not simply providing patients with medicine for a mild headache, as Governor Christie is fond of claiming. Rather, other more compassionate states are allowing critically ill patients access through their own established physicians without any kind of registry or unnecessary training requirement. Critically ill patients are able to purchase cannabis for fair market prices, and in all kinds of preparations best suited for their individual health issues. Many states allow delivery services for registered patients. And in more compassionate states, patients are able to grow their own cannabis at home, or designate a caregiver to do so for them.

Until New Jersey changes the regulations to make cannabis medicine more affordable and accessible for critically ill patients, the program will continue to operate ineffectively, forcing the most vulnerable patients to choose between spending an inordinate amount of time and money to achieve legal access, suffering without medication, or breaking the law to access black market products. And none of these options are compassionate for patients in New Jersey.

Thursday, March 5, 2015

CMMNJ Meeting Agenda for March 10, 2015

Monthly Public Meeting Agenda 
Lawrence Township Library, Room #3
Tuesday, March 10, 2015, 7:00 PM -- 9:00 PM

Approve February 2015 minutes. Discuss:

NJ United for Marijuana Reform (NJUMR) Press Conference, 2/18 in Newark, NJ with NJ ACLU, LEAP, Municipal Prosecutors Assn., & NAACP; CMMNJ endorsed.

CMMNJ testifies at Assembly Regulatory Oversight Committee Hearing, 3/2/15.

“CMMNJ TV”--two episodes taped 2/24: Roger & Lora (Genny) Barbour & Hugh Giordano.  Shows air Tues., 10 pm & Fri., 10:30 am on Comcast Ch. 30 & Verizon FIOS Ch. 45.  Next taping: 3/31, noon to 4 pm. New HD equipment at the Princeton Community TV studio!

“Petition for Rulemaking,” for MMP reg changes; media reports DOH will respond 3/15.

Current NJ marijuana bills: A3525/S2312 (comprehensive MMP fix); S1896/A3094 (legalize, tax and regulate marijuana); A3726 (adds PTSD); A218 (decrim).

Upcoming Events:
NLRB Hearing 3/16, 6th & Chestnut, Philly 10 am: UFCW v. CCF.

NJ SPRING SMOKE-OUT Sat., March 21, 2:00pm march to Trenton State House.

“Medical Marijuana: Myths & Medicine,” PA State Nurses Assn., 3/26/15 Millersville Univ.

ASA’s National Medical Cannabis Unity Conference, March 27-31st in Washington, DC.

"Patients Out of Time" conference, W. Palm Beach, Florida, 5/21-23/15.

Trial of Jon Peditto, Toms River; jury selection to start. Jury nullification attempt.

PA joint House committee hearing on SB3, 3/24/15, 800 Spruce St., Philadelphia, 10 am.

CMMNJ Patient Handbook being printed.

Recent events: Grand Rounds: “Medical Marijuana” at Princeton House, 2/23/15 Dr. Marcu.
March for the Love of Cannabis, 101 S. Market Street, Wilmington, De 2/14/15.
“Cannabis & the Endocannabinoid System” webinar, Dr. Aggarwal, 2/21 & 3/7.
AAP endorsed limited pediatric use, rescheduling, & decrim for minors and young adults.
PA Medical cannabis bill, SB 3 hearing 2/25, Harrisburg.

Treasury report: Checking: $3651; PayPal: $3526.

CMMNJ's meetings are the second Tuesday of each month from 7 - 9 PM at the Lawrence Twp. Library, 2751 Brunswick Pike, Lawrence Twp., 08648 Tel. #609.882.9246.  All are welcome.  (Meeting at the library does not imply Mercer County’s endorsement of our issue.)

More info:  Ken Wolski, RN
(609) 394-2137
Facebook: Friends of CMMNJ:

CMMNJ, a 501(c)(3) public charity, is a non-profit educational organization.

Monthly Public Meeting Minutes 
February 10, 2015

January 2015 minutes approved.  Discuss:

NLRB Hearing 3/16 in Philly: UFCW v. CCF ATC: discussion by Hugh Giordano, union rep. UFCW supports marijuana reform to help patients, union & industry.  TV interview scheduled for UFCW union rep  for 2/24.

“CMMNJ TV” Princeton TV wants two shows edited and handed in this week.

PA SB3 medical marijuana bill, not better yet; needs many amendments.  Gov. Wolf supportive.

Trial of Jon Peditto, Toms River; jury selection/nullification starts in three weeks for 17 plants.

Jim Miller discusses Op Ed re: opiate addiction; Jim plans to respond to this.

Fully Baked Radio” interview, 1/19 with Ken & Jim M. "Cannabis Frontier" interview, 1/24.

CMMNJ awaits action on “Petition for Rulemaking” requesting MMP regulatory changes; write letters of support to DOH.

Support NJ marijuana bills: A3726 (PTSD); A3525/S2312 (MMP fix); S1896/A3094 (legalize); A218 (decrim).

Treasury report: Checking: $3696; PayPal: $3526. CMMNJ is selling hand-rolled hemp bracelets/necklaces from Romania @ $3 each or 2/$5.

CMMNJ, a 501(c)(3) public charity, is a non-profit educational organization.

Recent Media Coverage and Blogs:

Marijuana legal in New Jersey?
This new coalition launches effort to legalize it, tax it

Endorse NJUMR (New Jersey United for Marijuana Reform)

Daily Marijuana Use Is Not Associated with Brain Morphometric Measures in Adolescents or Adults

Cannabis and the Endocannabinoid System

NJ Weedman’s Passing the Joint: The cure for what ails you

U.S.: Pot use doesn't increase crash risk

Le’Or aims to put marijuana legalization on the Jewish agenda

Christie on the issues: Marijuana

Group Launches Campaign to Legalize Marijuana in New Jersey

Is it Time to Legalize, Tax and Regulate Marijuana in N.J.?

NJ Weedman’s Passing the Joint: If you don’t know your history, you can’t guide your future

NJ Weedman’s Passing the Joint: The butthurt is high over being snubbed by new marijuana coalition

NCNORML at the Moral March February 14, 2015 in Raleigh, NC

Philly420: Marijuana goes legal in D.C. and Alaska

Did Smoking Pot Mess Up Your Brain?
Actually, research suggests that the chemicals in marijuana might protect against Alzheimer’s.

Philly420: Privatizing Pa. liquor shows marijuana hypocrisy

Freedom Leaf

Is the grass greener? The highs and lows of marijuana decriminalization in Philly

Trenton’s Biggest Buzzkill

N.J. medical marijuana program stagnating
because state limits illnesses, bars edibles, critics say

How New Jersey could legalize pot: Letter

Philly420: The DEA's stoner rabbits

NORML Debunks Latest Smear Campaign Against Cannabis

CMMNJ TV: Genny's Mom & Dad

Coalition Pushes for Legalization of Marijuana in New Jersey

Monday, March 2, 2015

Oral Testimony to the New Jersey Assembly Regulatory Oversight Committee, March 2, 2015, by Kenneth R. Wolski, RN

Chairman Gusciora and members of the Assembly Regulatory Oversight Committee, thank you for the opportunity to again address this committee.

My name is Ken Wolski.  I am Executive Director of the Coalition for Medical Marijuana—New Jersey, Inc.  (CMMNJ)   I am a registered nurse with 39 years experience in New Jersey & Pennsylvania.

In 2003, I co-founded CMMNJ.  We are the only statewide organization in NJ that is solely dedicated to bringing about safe and legal access to medical marijuana.  We incorporated in 2006 and became a 501(c)(3) in 2007.  Our mission is to educate the public about the benefits of medical marijuana.
Last year I presented to this committee my resume, some Op Eds I had published on the importance of home cultivation, some testimony from patients who are having a great deal of difficulty with the medical marijuana program, and a Compact Disc (CD) containing the revisions to the Regulations that enact the Compassionate Use Medical Marijuana Act (CUMMA) that we feel are necessary in order to make this a successful program.

In looking at where we were a year ago and where we are today, not much has changed.

3 ATCs were open then; 3 ATCs are open now (it's like having three pharmacies in the entire state);
About 250 doctors were in the program then; about 350 doctors are in it now--out of over 30,000 licensed physicians in the state;
About 1700 patients were registered a year ago; about 3700 patients are registered now, in a state with almost 9 million people.

When the CUMMA passed into law in Jan., 2010, The Legislature found and declared that:
there was “beneficial use for marijuana in treating or alleviating the pain or other symptoms associated with certain debilitating medical conditions” and,
this “law will have the practical effect of protecting from arrest the vast majority of seriously ill people who have a medical need to use marijuana.”

That has simply not happened in the 5 years since this bill became law.

Marijuana has enormous therapeutic potential, but,
Most people who could benefit from marijuana therapy do not have one of the severely limited qualifying conditions;
Those who do have a qualifying condition find the application process too difficult, or too time-consuming to manage; and,
Even those who manage to get an ID card find the program too expensive to afford.

Limited qualifying conditions:
There is no valid medical or scientific reason to limit marijuana therapy for pain management to only two diseases, cancer and HIV/AIDS.

Marijuana is effective for pain management for any disease, injury or medical condition that causes chronic pain, and, for conditions that cause neuropathic pain, marijuana works better than any other drug on the market.  Last year there was some question about what constitutes chronic pain and I want to offer a definition so that we are clear on this. Chronic pain is unrelieved pain in a major disabling condition that continues for six months or more. Marijuana therapy is appropriate for any chronic condition that a doctor might prescribe a narcotic for
and, in fact, marijuana is significantly safer than narcotics.  There is a 25% reduction in opiate overdose deaths in states that have robust medical marijuana programs.  See that article from “Science Daily” that I provided to members of this committee.

There is no reason to limit marijuana therapy for only three neurological conditions.  Marijuana is neuroprotective according to the Expert Opinion Paper of the National MS Society published in 2008. That means that marijuana can delay or even stop the progression of these incurable neurological conditions, but it continues to be nearly impossible for patients to legally access.

Twenty-two veterans commit suicide every day in the U.S. because Post Traumatic Stress Disorder (PTSD) is so poorly managed by traditional pharmaceuticals. We give parades and platitudes to veterans for their
service, but we deny them access to appropriate health care—marijuana therapy—which shows great promise in the management of PTSD in the states and foreign countries where it is allowed.

The DOH is empowered to add qualifying conditions at any time.  But the DOH has created an overly burdensome process that we believe is designed to fail.  The process has not even started yet due to self-imposed restrictions by the DOH.

Application process too difficult:
Finding a doctor who participates in the MMP is difficult when only about 1% of NJ physicians are signed up to take part. The Regulations created the very thing the statute wanted to avoid—patients going to a small list of doctors specifically for marijuana recommendations.  The statute wanted to ensure that there was a bona fide doctor/patient relationship but instead, patients have to abandon their family doctors and specialists and find a doctor on the DOH’s list.

The application process is too lengthy for nearly all hospice patients who die before they ever get access, and for many cancer patients who get a cancer diagnosis and have to endure chemotherapy before they can ever get an ID card.

Medical marijuana too expensive:
The marijuana from New Jersey’s ATCs is the most expensive in the nation.  It is just not an option for the many patients who have been impoverished by their illness.

The DOH justified this high price by saying in its Biennial Report that NJ is an expensive state to live in.  There was no sympathy at all from the DOH, no attempt at accommodating the poor—the DOH just seemed to say, “If you want cheaper medical marijuana, go find yourself another state to live in.”

In the packet of material I have provided to Committee members, there is:
Testimony from two patients, Maryanne Boniello and Vanessa Waltz who could not be here today.  Their testimony explains in detail some of the problems they have had with the medical marijuana program;
A Petition for Rulemaking that CMMNJ submitted to DOH in Oct., 2014.  CMMNJ made a formal application through the Regulatory process to the DOH for modifications to some of the more egregious regulations. Namely:
1. Eliminate the $200 fee for all volunteer caregivers and eliminate the illegal sales tax on medical marijuana.
2. Delete the registration requirement for doctors as well as the unwarranted course requirement in pain management in order for licensed physicians to recommend medical marijuana.
3. Eliminate the regulatory requirement for physicians to violate patient confidentiality and that section which interferes with the physician’s professional judgment.
4. Eliminate the regulatory requirement that requires physicians to provide warnings to patients that directly contradicts the law.
5. Add as an additional qualifying debilitating condition Post Traumatic Stress Disorder (PTSD) to accommodate the influx of recent military service veterans inasmuch as the DOH failed to establish the panel as required by N.J.A.C 8:64-5.1 to add new conditions.
6. Eliminate the requirement for parents to seek the approval of three licensed physicians in order to obtain medical marijuana for their child.
The packet of material also contains a summary of the changes A3525/S2312 will bring to the NJ Medicinal Marijuana Program. This is a much more comprehensive legislative fix of the MMP, that:
1. Eliminates the physician registry;
2. Expands qualifying conditions—includes PTSD, Alzheimer’s, Lyme or Parkinson’s Disease, hepatitis, nail patella & any condition causing severe or chronic pain, severe nausea or cachexia;
3. Restores limited home cultivation (five plants plus one or more mother plants) for patients--patients may grow themselves, use a registered grower, or use an Alternative Treatment Center;
4. Protects organ transplant patients from disqualification simply for the use of medical marijuana;
5. Eliminates the tax on the sale, use, cultivation and possession of marijuana;
6. Includes explicit employee protection—makes it unlawful to take adverse employment action simply for medical marijuana use;
7. Eliminates background check and fee for caregiver ID card;
8. Reduces ID card fee to $50 with no automatic expiration;
9. Eliminates requirement for psychiatric clearance for minors—keeps pediatrician requirement;
10. Requires initial and ongoing training for all state, county and local Law Enforcement Officers (LEOs) on the rights of patients, growers and caregivers and trains LEOs in Field Sobriety Tests who may not simply rely on blood or urine tests for DUIs;
11. Includes explicit immunity from civil liability and criminal prosecution for the authorized use of medical marijuana;
12. Requires physicians to determine the form, strain and amount of marijuana for their patients and eliminates the two ounce/month limit, as the amount required is determined by patient need;
13. Allows patients to obtain medical marijuana from out-of-state if necessary and out-of–state ID cards are honored in New Jersey;
14. Cuts permit fees for Alternative Treatment Centers (ATCs) from $20,000 to $5000 and imposes no upper limit on the number of ATCs permitted;
15. Removes strain or potency limits imposed on marijuana cultivated;
16. Allows ATCs to dispense a 60-day supply of marijuana instead of current 30-day limit;
17. Permits any edible form of marijuana for any age;
18. Establishes dosage units for all forms in conjunction with Department of Health (DOH);
19. Requires testing in licensed laboratories on each batch of marijuana (and on request) for chemical composition, biologic contaminants, pesticides, solvents and foreign material with results of testing available on request;
20. Forbids the DOH to issue overly restrictive or unduly burdensome regulations for this law.

In summary, the MMP fails the vast majority of patients in NJ who:
Who know they can benefit from marijuana therapy;
Who see patients in other states obtaining relief with marijuana therapy for the same debilitating medical conditions that they have;
Thought they would be protected by having safe and legal access to marijuana therapy; and,
Who continue to suffer needlessly—and even die--in NJ, or who break the law and risk serious civil and criminal penalties for their use of an unauthorized medicine.

CMMNJ believes that the MMP is a case of Failure to Thrive.  This Failure to Thrive is not the result of a lack of ability on the part of the Health Department, but a lack of political will to create a meaningful program, and this is directly a result of Governor Chris Christie.

This governor has said that he is “done” expanding the medical marijuana program, apparently regardless of whatever evidence is presented to him. He has questioned the legitimacy of this program, and all 23 state programs like it, by saying these programs are just a “front” for legalization.

I worked in state government here in NJ for 25 years, all, or part of, five decades, actually. I know how the system works.  The governor appoints the commissioner of the Department of Health and that commissioner serves at the pleasure of the governor.  If the commissioner does not carry out the wishes of the governor, that commissioner is replaced.

I believe that public health is too important to be run this way.  The Commissioner of the Department of Health needs independence from the political whims of governors (especially those with presidential ambitions whose decisions may well not be based on the best interests of the people of the State of New Jersey).  A Health Commissioner in New Jersey could perhaps be independently elected, or else be given lifetime tenure after vetting.  Some solution must exist to ensure that public health decisions in NJ are based on sound science and not political whims or worse yet, delusions.