Tuesday, December 12, 2017

CMMNJ: Proposed improvements for the NJ Medical Marijuana Program

The Coalition for Medical Marijuana New Jersey, Inc. (CMMNJ) has identified issues to make the NJ Medicinal Marijuana Program (MMP) more effective.

The amendments CMMNJ proposes to NJ’s Compassionate Use Medical Marijuana Act would bring comprehensive changes to the MMP. These needed improvements to the MMP would:


Eliminate the physician registry (This is a major stumbling block to an effective program, and it was not called for in the law.  A voluntary registry would be OK to help patients find physicians who will recommend medical marijuana in the event a patient cannot locate a doctor, but any licensed NJ healthcare professional with prescriptive privileges, including Advanced Practice Nurses, should be allowed to recommend marijuana for patients);

Expand qualifying conditions (Immediately add to the NJ MMP the 43 petitions to add qualifying conditions that were given final approval by the NJ DOH MMP Review Panel);

Restore home cultivation of 6 (six) plants for qualified patients with a NJ MMP ID card;

Eliminate the tax on medical marijuana;

Include explicit employee workplace protections;

• Eliminate background check and fee for caregiver ID card, and reduce ID card fees;

• Eliminate the requirement for psychiatric clearance for minors;

• Require initial and ongoing training for all state, county and local Law Enforcement Officers;

Eliminate the two ounce/month limit;

Honor out-of–state ID cards and allow patients to obtain medical marijuana from out-of-state, if necessary;

• Cut permit fees for ATCs and impose no upper limit on the number of ATCs;

Permit any edible form of marijuana for any age and establish dosage units for all forms (The current prohibition on edibles for adults while allowing them for minors is simply absurd);

Require testing in licensed laboratories on each batch of marijuana (and on request);

• Forbid the DOH to issue overly restrictive or unduly burdensome regulations for this law;

• Eliminate the need for marijuana to be the last resort drug and establish it as a potential treatment of first resort;

• Broaden the definition of caregiver to allow for more than one child and eliminate the background check for the Primary Caregiver;

• Establish secondary caregivers who will be permitted to assist qualifying patients with the use of medical marijuana at schools, facilities for the developmentally disabled and LTC facilities. These secondary caregivers can be adult employees of the patient’s school or facility, and a person may serve as secondary caregiver to more than one qualifying patient at the school or facility at a time. Eliminate the fees for both caregivers.

(Ideally, nurses at the facilities would automatically qualify as secondary caregivers. Nurses should have no problem administering standardized doses of medical marijuana, as long as the typical prescribing information accompanies the drug—side effects, adverse effects, usual dosage, precautions, drug interactions, etc.  This info is already available. While the federal government still considers marijuana a Schedule I drug, the feds have promised not to interfere with the state medical marijuana programs, and indeed they have not.  Besides, the federal government has no power over the actions of nurses in NJ.  NJ determines what appropriate actions for nurses to perform are.)

Deschedule marijuana in NJ—remove it entirely as a Scheduled Drug since marijuana will soon be legalized in the state;

• Consider medical marijuana the same as any other medication used at the direction of a physician, and a patient may not be disqualified from receiving any medical care, including an organ transplant, based on the authorized use of medical marijuana;

• Block local governmental units of this state from enacting or enforcing any ordinance or other local law or regulation conflicting with, or preempted by, any provision of this law;

• Establish no upper limits on the number of ATCs in the state;

• Get the Board of Medical Examiners (BME) actively involved in educating physicians about the Endocannabinoid System and advising physicians of the availability of the standardized dosage unit information;

(The BME should insist that every physician in the state be required to take 1 – 3 hours of Continuing Medical Education on the Endocannabinoid System (ECS) as a condition for continued licensure in the state.  The ECS is an important emerging science, developed within the last 25 years, that explains how marijuana works in the human body and how it can be effective for so many diverse diseases, symptoms and conditions.  Even today, the ECS is only mentioned in about 13% of medical schools, despite its many implications for healthcare. Moreover, the DOH has an MMP which many physicians are completely ignorant of, and have no incentive to learn about.  These physicians refuse appropriate care to qualified patients in NJ, and often belittle and insult attempts by patients to receive this care.)

• Complete prescribing information, developed by the NJ DOH, should be available to NJ physicians when standardized doses of edible marijuana are available (currently lozenges and oils are available at one of the ATCs in NJ);

• Expand the time period that physicians may provide written instructions for to 60 days, which may include multiple written instructions up to 6 months.

(Once a patient with a chronic condition is established on medical marijuana, it should not be necessary to be routinely seen more frequently than this.)

• Allow edible medical marijuana products for qualified patients in all state institutions including psychiatric hospitals and state prisons.


Ken Wolski, RN, MPA

Executive Director

Coalition for Medical Marijuana--New Jersey, Inc.

609.394.2137

www.cmmnj.org

December 12, 2017


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