Pubdate: Fri, 30 Oct 2015
Source: Honolulu Star-Advertiser (HI)
Copyright: 2015 Associated Press
Author: David Klepper, Associated Press


ALBANY, N.Y. (AP) - New York state will require physicians to 
complete an educational course before they can authorize medical 
marijuana for patients - an unusual mandate not applied to other new 
drugs or seen in other states with medical marijuana programs.

State officials say the 4-1/2-hour, $250 online course will inform 
doctors about a complex drug treatment not covered in medical school. 
But while the investment of time and money is modest, some patient 
advocates worry the inconvenience could discourage physicians from 
participating, ultimately limiting patient access.

Medical marijuana is expected to be available beginning in January, 
18 months after lawmakers and Gov. Andrew Cuomo approved what they 
intended to be a cautious program balancing patient need with 
concerns about abuse.

While many of the other 22 states with comprehensive medical 
marijuana programs offer physicians free, voluntary resources about 
the drug, they haven't required physicians to pay for training before 
they can authorize cannabis.

Only one other drug is subject to a similar training requirement - a 
potent narcotic used to treat opiate addiction - and those rules come 
from the federal government.

"Doctors recommend medications all the time for which they are not 
required to undergo special training," said Julie Netherland, deputy 
state director for the Drug Policy Alliance, a group that supports 
medical marijuana. "Obviously, it is good for doctors to be educated 
about medical cannabis, but the concern is whether this will serve as 
a deterrent. How many doctors will choose to go through this training?"

Under the state's law, cannabis will be made available to patients 
with certain qualifying conditions such as cancer, AIDS, Parkinson's 
and epilepsy if approved by a physician. In addition to the training, 
physicians must register with the state's health department. Only 
tinctures, oils and other nonsmokable forms of cannabis will be available.

Craig Blinderman, a physician who directs adult palliative care at 
Columbia University Medical Center, predicted that only "the most 
motivated" physicians will sign up for the training.

"The vast majority of doctors are not going to do it until their 
patients start asking about it," said Blinderman, who supports 
medical marijuana. "If you live in upstate New York and there is a 
handful of doctors, this is going to be an issue. It may have been a 
little too much to mandate."

Eric Voth disagrees. The Topeka, Kan., physician and chairman of the 
Institute on Global Drug Policy opposes widespread use of marijuana 
as a medicine and said too many states have approved programs with 
few controls.

"We are totally bypassing the FDA. It's just the Wild West," he said, 
adding that he supports mandatory training for physicians interested 
in authorizing the drug for patients. "It needs to go beyond that. 
There should also be ongoing oversight of their practices."

Voluntary training courses are available in many states, where 
medical marijuana classes are offered as part of a physician's normal 
continuing education requirements.

Florida's limited medical cannabis program includes the regulation 
perhaps closest to the New York training requirement. A 2014 Florida 
law that has yet to be implemented will allow certain patients to 
obtain marijuana with low levels of tetrahydrocannabinol, or THC, one 
of the drug's active ingredients. That law will require physicians to 
complete a training course offered by the state's medical 
association. The program is so constrained that the National 
Conference of State Legislatures does not include it in its list of 
the 23 states with comprehensive laws.

In New York the training requirement was added by Cuomo during 
negotiations with lawmakers, according to the bill's sponsor, 
Assemblyman Richard Gottfried, D-Manhattan.

"I would have been comfortable without such a requirement," Gottfried 
said. "We generally trust physicians to learn about medications they 
haven't prescribed before without special legal requirements. But I 
don't see it as a problem, and I think it could be helpful."

Meanwhile, patients and their loved ones are growing tired of waiting 
1-1/2 years after the program was approved. Maryanne Houser's 
daughter Amanda, 11, has a form of epilepsy she hopes can be treated 
with cannabis. Houser said she's not opposed to the training 
requirement, but believes the state has delayed for long enough.

"My daughter is suffering," Houser said. "I want my daughter better."
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MAP posted-by: Jay Bergstrom