Dr. Janis Enzenbacher discusses certifying patients for medical marijuana use John Meore, email@example.com
The failed push to legalize recreational pot this year has solidified medical marijuana’s ongoing expansion in New York.
Instead of bracing to compete with legal weed, medical marijuana advocates are reinforcing plans to improve everything from patient access and affordability to manufacturing and clinical research.
The move comes after legislation that sought to legalize pot for adults and overhaul medical marijuana couldn’t gain enough support. Similarly, a bill that would’ve only reformed medical marijuana stalled, leaving backers to regroup for next year.
Yet despite the legislative deadlock, some medical marijuana companies are poised to produce more cannabis-based drugs to meet growing demand, which recently surpassed 102,000 certified patients.
Further, New York’s medical marijuana marketplace no longer faces the imminent threat of losing patients to less expensive recreational pot, an outcome in other legal weed states that has raised concerns among some New York doctors supporting medical uses for cannabis.
What follows is an analysis of the next steps for medical marijuana in New York as part of the ongoing investigation by the USA TODAY Network in New York of marijuana legalization.
Treating more patients
Some New York doctors described expanding medical marijuana eligibility as an overdue fix for a program that could benefit thousands of additional patients.
“Medical marijuana has very little risk and potentially high reward for results, and from what I’ve seen so far that’s the case,” said Dr. Charles Glassman. “The people who have been put on medical marijuana have gotten great results.”
Glassman, whose office is in Pomona, Rockland County, has treated conditions such as seizures and inflammatory bowel disease with medical marijuana, but mostly he recommends it for pain-related cases.
“People who have used it for chronic pain have seen great relief, which is terrific because of the opioid epidemic that we have,” he said.
Dr. Stuart Reiber in Suffern, Rockland County, said about 80% of the 150 patients he treats with medical marijuana are pain related and seeing dramatic improvements, especially in replacing opioids like Percocet.
“I had one patient consuming six to eight Percocets per day, and since starting medical marijuana she’s taking at most two Percocet per month and was able to get her job back and care for her children,” Reiber said.
Reiber and Glassman both support plans to allow medical professionals to use their clinical judgement to certify patients, a significant change from the current law that limits patient eligibility to a list of state-approved health conditions.
Initially, the list of 10 eligible diseases consisted of cancer, epilepsy and other serious illnesses as diagnosed by doctors registered in the program.
Then, as criticism mounted over limited patient access, regulators began expanding eligibility of conditions, such as chronic pain and post-traumatic stress disorder.
As a result, the tally of certified patients has increased steadily to 102,000, which is up from a couple thousand in the early stages after New York’s medical marijuana law passed in 2014.
Allowing clinical discretion to certify patients was one of the reforms in the standalone medical marijuana bill supported by Sen. Diane Savino, D-Staten Island.
While unable to pass it this year, Savino said Gov. Andrew Cuomo and lawmakers agree that the medical marijuana program needs to be retooled and broadened to encourage more customers and prescribers, which currently totaled about 2,400 statewide.
“It’s been five years since we’ve wrote the bill. We were pushed into creating a very narrow program and as a result of that we have spent the last five years working on it, improving it step by step. But we still have a lot more work to do,” Savino said.
She said the bill she is sponsoring with Assembly Health Committee chairman Richard Gottfried, D-Manhattan, largely mirrors what Cuomo has proposed, such as expanding who could prescribe marijuana, making home deliveries more accessible and increasing the types of ailments that would be eligible for the drug.
“Even he recognized that the program he created in 2014 is insufficient to satisfy the needs of patients,” Savino said.
Ari Hoffnung, CEO of Vireo Health of New York, one of 10 licensed medical marijuana companies in New York, described the failure to pass Savino’s legislation this year as a huge loss for low-income and rural patients unable to afford higher-cost, extract-based medicine or to access a dispensary.
“Going forward, our physician-led team will continue to advocate for policies designed to make medical marijuana more affordable by reducing the economic barriers through the sale of dried flower, and more accessible by increasing the number of dispensaries,” he said.
Remedy, Rockland’s first medical marijuana dispensary, opened its doors to customers at its new location in Bardonia. Seth Harrison/Lohud, The Journal News/Lohud
Medical versus recreational
Several doctors noted New York is also positioned to build its medical marijuana program without the risks tied to introducing recreational pot.
They noted other states that legalized recreational pot saw medical marijuana programs decline because cannabis companies chased profits and patients abandoned costly pharmaceutical-grade marijuana products.
Oregon’s medical marijuana program, for instance, saw a 55% decline in patients between its recreational use legalization in 2015 and 2018, state records show. That reflected a drop to 35,000 patients from 78,000.
During that span, Oregon’s medical marijuana caregivers and growers declined 61% and 66%, respectively, records show.
The Rockland County doctors described the trend as troubling considering the potential need to return to non-cannabis drugs with more side effects and addictive risks, like opioids.
“That would be a problem because I don’t really feel that the options for pain medicine are really great,” said Glassman, who has about 30 medical marijuana patients.
But with recreational pot legislation in limbo, the New York state Department of Health, which oversees medical marijuana, is poised to expand its reforms that have already expanded access greatly since 2017.
The reforms include programs seeking to improve clinical research of cannabis in medicine and reduce the cost, such as by promoting insurance coverage of the drugs that can cost up to $200 per month, according to state records and agency officials.
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