[img-wide:/assets/18/0417/2152]New Jersey residents could enjoy easier access to medical marijuana, thanks to a proposal to increase their options for doctors that could prescribe the drug. Other changes under consideration could make it easier for some patients to use pot, while also easing the path to further clinical studies on cannabis.
Both efforts are independent of ongoing efforts to decriminalize or even legalize recreational use of the substance. And each process involves public input and a state review.
Staff for the State Board of Medical Examiners, which regulates physicians, is finalizing language about a regulatory proposal that would allow patients to receive medical marijuana prescriptions from participating physicians who treat either their disease, like cancer, or symptoms of that disease, such as pain and nausea.
Under the current law, which permits patients with nearly 30 specific conditions to legally purchase the controlled substance at distinct state-licensed facilities, only the doctor treating the underlying disease can write a prescription for medical marijuana. Patient advocates have said the present system leaves far too many patients without access to relief.
Public hearings on pot
In addition, the state Division of Consumer Affairs, which oversees the board, has scheduled public hearings — starting Thursday, April 19 in Newark — to help it determine if New Jersey should revise how it classifies marijuana.
Cannabis is currently considered a Schedule I drug, defined as the most dangerous and without medical value, along with substances like heroin and LSD. That status creates challenges for medical research and can make it hard for some medical marijuana patients, like schoolchildren, to access their medicine at all times.
The revisions now under consideration by the board and the agency, both of which fall under the New Jersey attorney general’s office, reflect Democratic Gov. Phil Murphy’s ongoing push to create what he calls a “more compassionate” medical marijuana program. The law — the Compassionate Use Medical Marijuana Act — was adopted in 2010 and implemented slowly, with some resistance under former Gov. Chris Christie, a Republican, and is widely considered one of the most restrictive in the nation.
“We’ve been failed by a system that has been prevented from delivering the compassionate care that you were promised,” Murphy said last month, when announcing an initial round of changes to the program. Patients, he said, “have struggled through the bureaucratic nonsense for too long.”
Those reforms, based on a report from experts at the state Department of Health, which oversees the initiative, added five new qualifying conditions — including various kinds of pain and anxiety — and called for cutting in half the $200 program fee, encouraging the production of more diverse and powerful strains, and improving the enrollment process. The program includes six licensed production and retail centers statewide, five of which are operating, more than 500 participating physicians, and nearly 18,600 patients.
AG on marijuana
The regulatory proposal — which the attorney general’s office announced late last week and will soon be published and available for comment — builds on Murphy’s initial announcement. According to draft language reviewed by NJ Spotlight, the measure outlines several changes to the marijuana law to ensure physicians treating the symptoms of qualified conditions would also be eligible to sign up and prescribe marijuana — not just those doctors who are dealing with the underlying condition.
The move prompted praise from Ken Wolski, a nurse who is executive director for the Coalition for Medical Marijuana, New Jersey. “This is another step moving marijuana into mainstream medical treatment,” he said.
The current restrictions cost patients time and money, since many of the current prescribers require cash only, he said. “Now the visits to recommend marijuana will be part of the regular management of a diagnosed debilitating disease, medical condition, or symptoms associated with its treatment, Wolski added.
Another change proposed would codify a reform Murphy mentioned in March by eliminating the requirement that medical marijuana patients under age 18 receive written clearance from both a pediatrician and from a psychiatrist, in addition to the standard physician’s prescription. Advocates said, given the shortage of child psychiatrists, this presented an unreasonable barrier.
The reforms proposed would actually add one requirement: that the prescribing physician should consult the state’s prescription-monitoring program, a database designed to track the use of addictive drugs and reduce so-called doctor shopping, at least every three months. In addition, the doctor prescribing the marijuana would need to enter into a contract with the patient, similar to those used for pain care, stipulating that they discussed the potential and consequences of abuse.
Putting marijuana on a different schedule
The state’s review of marijuana’s legal classification was prompted by a Superior Court decision in November, which raised questions about the current Schedule I status; under state law, which dates back to 1971, substances in this category are considered highly addictive and have no medical value. (The system involves Schedule I through IV, with IV being the least dangerous, and least controlled.)
The judges found that to state cannabis has no role in healthcare, in this day and age, “strains credulity beyond acceptable boundaries” and they urged state officials to revisit the distinction.
The attorney general’s office declined to appeal the November ruling and has, under Murphy, instead begun to review the current schedule for marijuana. A statement from the office earlier this month said the Division of Consumer Affairs “found that that the time is ‘certainly ripe’ to do so.”
“More recent scientific research suggests that marijuana has “potential therapeutic value” for pain relief, control of nausea and vomiting, and appetite stimulation, among other medicinal benefits,” the division noted. Any changes in state classification would not impact legalization and would have no bearing on the federal system, which still considers marijuana a Schedule I substance — meaning those charged with federal crimes would still face stiff penalties.
Catching the kingpin
The court decision stemmed from a challenge filed by Steven Kadonsky, who was convicted in 2014 and sentenced to life in prison for marijuana trafficking under New Jersey’s “drug kingpin” statute, which requires strict punishment for Schedule I substances.
But the case also attracted support from the family of Genny Barbour, a Maple Shade teenager who suffers from autism and a seizure disorder, but had struggled to regularly access her medical marijuana treatment because its status as a Schedule I made it illegal for her to use at school.
Among other things, the Consumer Affair’s review will consider marijuana’s potential for abuse and other public health threats; the scientific knowledge about the drug’s impact; the potential for psychological or physical dependence; and its status as a gateway drug to other controlled substances. The process involves a review of any written comments, as well as input shared during the two public sessions.