Pubdate: Sun, 15 Jun 2014
Source: Star-Ledger (Newark, NJ)
Copyright: 2014 Newark Morning Ledger Co
Author: Susan K. Livio


TRENTON - After predictions that New Jersey's medical marijuana
program could serve tens of thousands of patients with severe and
painful illnesses, only 2,342 have signed up - a participation rate so
small some worry the very future of the program could be at stake.

Lawmakers, some dispensary operators and patients blame the sluggish
enrollment on the program's rigid rules, exorbitant costs for patients
and growers, and Gov. Chris Christie's contention that he does not
need to do anything more to enhance participation.

And they say one major roadblock is that so few New Jersey doctors are
willing to recommend patients for medical marijuana.

"We have a dysfunctional program, and I think it's going to take some
sort of 'pot summit' bringing together patients, doctors and
legislators to really make this a success," said Assemblyman Reed
Gusciora (D-Mercer), one of the lead sponsors of the law.

"We are hearing more and more anecdotal evidence that dispensaries are
not sustaining themselves, the quality (of the marijuana) is not
always there, and it's difficult for doctors and patients to get into
the program," Gusciora said.

The lawmaker said while he has "every faith" in state Health
Commissioner Mary O'Dowd, "there is so much reticence on the
administration's part, I don't know how you break that logjam. All
they have to do is open their eyes."

Enrollment in the program has more than doubled in the last year as
two of the state's three medical marijuana dispensaries opened their
doors. But it's nowhere near the 5,000 to 30,000 medical marijuana
patients advocates anticipated when the law was passed. Dispensary
owners looked at disease statistics in New Jersey and expected at
least 50,000 patients. The state's first dispensary opened in December

"We thought we would have 10,000 patients by now," said Yale Galanter,
attorney and spokesman for Garden State Dispensary in Woodbridge,
which has served 1,700 since opening six months ago.

The Compassionate Care Foundation center in Egg Harbor Township, which
opened with great fanfare in October after securing a state-backed
loan, says it needs 2,000 patients to break even and has served 600.
The owners report bagfuls of cannabis are going to waste, and
expansion plans are on hold.

Chief operating officer Bill Thomas quit last week, saying he could no
longer work without getting paid.

"It's failing," Thomas said in an interview days before he resigned
Monday. "From a business standpoint and from a patient standpoint,
it's not successful. The governor says why change anything if
(patients) haven't shown up. Is there really no demand, or is it so
hard to get access that it is easier to buy it from the high school
kid down the street? It's not like the people don't get it another

Woodbridge's Galanter said the problem can be fixed, based on owner
Michael Weisser's experience operating dispensaries in Colorado.


"We know the key to this program being viable is getting doctors
involved," he said.

Patients must be referred by a doctor in order to participate. Just
296 of New Jersey's 21,000 licensed physicians have signed up.

Many doctors don't want their name on the state's website, according
to Gusciora, and dispensary officials from Woodbridge and Egg Harbor
Township. They said doctors who are in the program report that they
get calls from people diagnosed with illnesses they don't treat, as
well as others who don't qualify for the program. As that word
spreads, other doctors are wary about joining the program, the
officials say.

And given the stigma surrounding marijuana, which is still illegal
under federal law, some doctors fear they will lose patients or
alienate their practice partners.

"They are not saying (their names) should be a secret," said David
Knowlton, a founder and board member of Compassionate Care Foundation.
"But having it on the website implies to patients they can walk in and
be seen."

In New Mexico, a state Christie officials studied when modeling the
program's rules, doctors' names are not publicly disclosed "due to
confidentiality and legal issues," according to the state program's
website. Physician names are accessible by consulting the many
commercial websites that have sprung up promoting the program.

O'Dowd's spokeswoman Donna Leusner defended the state's cautious
approach to the program, noting New Jersey was the first state to
enact the law that adopted "a medical model" rather than the business
blueprint forged in states like Colorado and California.

"Physicians' names were posted on the department's website to assist
patients in finding doctors, just as health insurers list physicians
participating in their networks," Leusner said.

"The model of a medically based program was well-known and established
by the Legislature and former Governor (Jon) Corzine when the law was
passed," she said. "Advocates may have overstated the demand based on
the experience of other states that do not have a medical model. But
that's a question best directed to (the dispensaries), their boards
and investors."


Larry Downs, executive director for the Medical Society of New Jersey,
said he found the lack of doctor involvement a "convenient excuse" for
the program's struggles.

"If dispensary owners have overestimated the market, then that is not
the concern of the medical field," Downs said.

"If doctors believe it is a legitimate therapy, being published on a
website is not going to stop them," he added. "A lot of doctors do not
believe it is a good therapy and that it does not meet standards of
efficacy and safety."

The slow enrollment rate and struggling dispensaries have had a ripple
effect on some patients.

Betty Rand, an 89-year-old homebound stroke patient from Millburn,
says medical marijuana eases her pain and muscle spasms, but it would
be far easier if she could get it in the form of a lozenge. Smoking
makes her cough and adds to her suffering from the host of other
illnesses she's battling.

Dispensaries, however, don't offer lozenges or any edible product yet.
The health department is reviewing manufacturing plans from the
Woodbridge dispensary. With lagging enrollment, Egg Harbor officials
have said they can't afford the expense of developing a new product.

Rand describes the program as "a job they've half-done and are not
finishing right, They are not making an effort, and as long as
Christie is there, he is not going to do it."

Knowlton, a former deputy health commissioner, says he's far from
giving up on the program. He is talking with O'Dowd and program
director John O'Brien about changes that could make it more
accessible, such as allowing hospice centers and nursing homes to act
as couriers for registered patients in their care. People who cannot
obtain their own marijuana may identify a caregiver to retrieve it for
them, but a caregiver can only serve one patient.

"I recognize that with a program that has this much scrutiny, the
state has to move slowly," Knowlton said. "I think the department is
trying to be helpful but cautious. They have to think 'How could this
go bad?' I am confident this is going to work out. This is just a
trying time."
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