Long Road From Medical Marijuana Legalization To Access - Lessons From New Jersey

Katelyn Baker

Well-Known Member
Jay Lassiter is, like so many AIDS patients, a survivor. He contracted the disease nearly 25 years ago, yet there's still plenty of vitality left in the 44-year-old.

A cocktail of more than 50 pills each week keeps his HIV in check, but they run roughshod on his digestive organs. Severe bouts of nausea wake Lassiter in the middle of the night, coming so fast he sometimes can't make it to the bathroom in time. This happens two or three times a month.

His weight and blood pressure, however, were healthy just hours after a recent vomiting-diarrhea session. His T-cell count is the highest it's been since his diagnosis.

He needs medicine to help settle his stomach and keep his appetite in check, so he turns to medical marijuana, which he smokes twice a day. He goes to a dispensary about once every month. He checks in with his doctor every 60 days, per state regulations. He's been doing that for nearly four years.

It took time to establish that routine. Lassiter lives in Cherry Hill, New Jersey, and his state's medical marijuana program took years to launch after the bill became law. Lassiter admits he acquired marijuana illegally when he was waiting for the state to implement its program.

As of July 1, it will be legal for children in Pennsylvania with conditions such as epilepsy to use medical marijuana, although specifics of the new law are unclear.Adults who have diseases such as cancer and sickle-cell anemia will be able to use the drug once the state's Department of Health launches its program.

The program for adults is expected to take at least 18 months, possibly two years or longer. A new government agency must be created. Policies are being crafted. Applications for prospective patients and their caregivers are expected to be available by the end of the year, allowing them to seek proper permission to receive medical marijuana.

Now, Pennsylvanians who want to use medical marijuana are where Lassiter was six years ago - waiting. Waiting for clarity on finding a doctor. Waiting for answers to legal questions. Waiting for a program heavy on hope and bureaucracy.

In order to get his medical marijuana, Lassiter sees Dr. Marshall Lauer in Collingswood, New Jersey. He found him on the state's medical marijuana program website. Lauer is one of more than 300 physicians registered to sign off on marijuana use under New Jersey's program. The state's program has more than 8,000 patients and about 460 caregivers registered.

Lassiter's first trip to see a new doctor was initially an annoyance, but it has become routine. You need every tool you can get to manage a terminal disease for multiple decades, he said.

Before doctors can recommend medical marijuana in Pennsylvania, the state's health department has to implement a program. In New Jersey, a similar program took nearly three years to launch. Doctors in Pennsylvania will have to register with the state's health department and take classes to stay educated on the drug.

Several multiple sclerosis patients urged Lauer to sign up before New Jersey's bill had passed. After it was approved, Lauer said, his phone started ringing off the hook.

Lauer has been working under the state's program for nearly four years, but he's not afraid to say he's still learning.

"I look toward the dispensaries, because they have the in-the-trenches experiences," Lauer said. "For me, in New Jersey, it's pretty clear cut. I don't have a lot of decision-making. I have (boxes) to check. If I can't check one of those boxes, I can't prescribe it."

Pennsylvania health officials have been in touch with other states about their programs, but won't disclose which ones. Officials have said they have been targeting states with similar laws, gathering information on best practices and communicating with other states since last summer.

No one from Pennsylvania's health department has reached out to New Jersey's, according to Donna Leusner, communications director for New Jersey's health department. The department established its program after a new governor took office, which is believed to have encumbered the process. Some are still critical of the state's program, with a nonprofit that lobbies for marijuana patients giving it a C.

The health department made a permit process, marijuana testing protocols and an identification system for patients among other intricate layers of program development, Leusner said.

The department developed ways to grow, package, test, inspect, dispense and dispose of the drug to provide patients with safe and secure access, health officials in New Jersey said. And some of the dispensaries had difficulty finding a community that would host them, causing more delays. No dispensary could open in a community without the appropriate municipal approval or community support.

Dr. Karen Murphy, Pennsylvania's health secretary, said she has learned that early engagement of potential stakeholders is critical to developing a new program. There is an online survey for the health department to gather public input on dispensaries and laboratories. It's the second such survey. One was circulated specific to growers and processors a few weeks ago.

Another survey is forthcoming as health officials create what they are calling "temporary regulations," according to the department. These will explain the medical marijuana program's operation and will be in place for two years from the date they are published.

The department on Friday unveiled temporary guidelines for parents or caregivers to follow when applying to obtain medical marijuana to administer to their children, which they can do in July. Adults have to wait until the program's full implementation because of the program's complex nature, Murphy said.

Pennsylvania's program is not expected to be operational until November 2017 at the earliest, based on an 18-month timeline from when Gov. Tom Wolf signed the bill into law. If it takes two years, May 2018 would be the earliest patients here could be treated with marijuana grown, processed and distributed in the Keystone state.

Buying marijuana in another state isn't like buying cigarettes or lottery tickets. Federal laws prohibit transporting the drug across state lines. New Jersey, like most other states with medical marijuana programs, requires residency for participation.

Pennsylvania's forthcoming medical marijuana program will not protect against federal prosecution, according to the health department's FAQs.

For that reason, some parents of sick children in Pennsylvania - the same ones who lobbied legislators for years - are not comfortable speaking publicly about getting medical marijuana from other states.

The entire act the governor signed in April is against federal law, said Steve Hoenstine, press secretary for a senator behind the bill's legislative push. "Something being against federal law doesn't preclude us from legalizing it under state law," he said.

One marijuana activist said in a perfect world, someone found with medical marijuana in Pennsylvania should be able to use his medical access card to defend himself against the federal law.

If a parent buys marijuana in Colorado and is caught with it in Lancaster, he should be able to avoid charges, said Chris Goldstein, board member of PhillyNORML. But since the state's program is not a defense to federal law, there's no guarantee the person could avoid prosecution.

The Justice Department said in 2013 that it won't challenge state laws allowing for medical and recreational use of marijuana as long as the sales don't conflict with federal enforcement priorities. President Barack Obama's administration asked the Supreme Court to stay out of a lawsuit seeking to block Colorado's voter-approved law legalizing recreational marijuana use. In March, the court declined to hear the case.

Lassiter, a political activist and columnist who commonly travels to Pennsylvania for work, doesn't believe crossing the Delaware River should make his liberties fade. Even when Pennsylvania doctors can recommend the drug, he would be violating federal law for using New Jersey medical marijuana in Pennsylvania. His driver's license works across state lines, but his medical marijuana access card does not.

Lassiter used to drive almost two hours to a Montclair dispensary before one opened just outside Atlantic City, about an hour away from his home. When Compassionate Sciences Alternative Treatment Center set up shop nearby, he had Lauer switch where his prescription was sent. Quality and price varied at the three dispensaries, he said.

Lassiter's dispensary, located less than a mile from a state police office, has served more than 1,300 patients in the seven months it's been operating. It sells about 50 pounds of marijuana each month from its building in Bellmawr, New Jersey, said Gretchen McCarthy, dispensary director.

Patients are allowed two ounces every month, according to state law. And they all pay cash. Banks won't touch the transactions because of federal regulations.

The seed-to-sale dispensary is one of five operating in New Jersey. A sixth is pending.

When Lassiter buys his marijuana from the center, he knows exactly what he's smoking.

Compassionate Sciences tracks marijuana strains, their cannabinoids and how to most effectively use each one. The educational process is what makes Compassionate Sciences stand out, McCarthy said.

New customers undergo a 30-minute consultation with an employee to go over the patient's condition, she said.

When someone walks into a dispensary, staff will verify the person's registration with the program through a state-maintained system. There is a portal for patients, physicians and dispensaries.

That tracking deters fraud, since patients commonly switch dispensaries. If Lassiter got marijuana at another dispensary, he'd have to first register there. And McCarthy's computer would let her know where and when he filled a prescription.

An impromptu tour of Compassionate Sciences' facility during a harvest nearly puts Lassiter in tears. "It's hard not to get emotional when you think about how much relief this room is bringing to my neighbors," he says with a finger pointing to a room where a half-dozen employees are sifting through marijuana buds and examining them carefully.

"Pennsylvania deserves this," Lassiter says.

Lassiter is on his sofa after a 9-mile drive from the dispensary that was serving veterans and senior citizens during his visit. Gliding patio doors overlook a spacious and secluded back yard from the mid-century modern living room that boasts stylish furniture and a brick fireplace.

He breaks up and grinds his marijuana as he starts to roll a joint. Lassiter says he likes to "pack it like a musket," as he uses a rod to prepare it while describing the stark details of nausea, constipation and diarrhea.

His condition - even with 25 years of HIV coursing through his blood - suggests he's doing it right. Part of that strategy, he insists, is smoking marijuana every day. He doesn't have a life expectancy, but he doesn't care. At this point, he figures he's playing with house money.

He's keeping an eye on what develops in Pennsylvania, hoping his state's neighbor to the west doesn't reinvent the wheel over the next two years.

The health department's Safe Harbor guidelines require:

Photo ID

Background check

Safe Harbor letter physician form from the minor's Pennsylvania-licensed doctor

Once approved, state health secretary Dr. Karen Murphy advises the letter be carried whenever medical marijuana is being transported outside of an individual's home.

The temporary regulations will explain the medical marijuana program's operation and will be in place for two years from the date they are published. The health department plans to issue temporary regulations sequentially for growers/processors, dispensaries/laboratories, physicians, patients and caregivers, as well as research institutions, according to a department news release. Officials anticipate these regulations will be completed by the end of the year.

- News release from the Pennsylvania Department of Health

New Jersey's program

The New Jersey Medicinal Marijuana Program was built from the ground up. Below is the program's path from bill passage and signing to having five operational dispensaries serving more than 6,000 patients.

  • Created a permitting process to vet the financial and personal backgrounds of those associated with dispensaries, known as Alternative Treatment Centers.
  • Established sampling and testing protocols to screen the product for mold, fungus, heavy metal and pesticides and other contaminants, which can be dangerous to patients with compromised immune systems. The protocol was developed after researching marijuana testing protocols in the United States, Canada and Europe.
  • Developed online registration system for patients, caregivers and physicians.
  • Developed ID card system with security protections against counterfeiting and features allowing for cards to be validated by law enforcement through an online search.
  • Developed guidelines for law enforcement to be able to check patients with authorized cards.
  • Worked with the state's Drug Policy Alliance, Medical Society and Board of Medical Examiners to establish an e-library of scholarly articles and research materials for program participants.
  • Developed manufacturing standards designed to ensure that the manufacturing process used by the alternative treatment centers is sanitary and safe and produces products with consistent strength, quality, purity and packaging. All ingredients and the amounts of each ingredient will be listed on the package labeling.
  • Before dispensing edibles, treatment centers have to demonstrate to the program that they have put the manufacturing standards into operation.

- Donna Leusner, communications director for the New Jersey Department of Health

Medical marijuana in Pennsylvania

This story is part of an occasional series on how Pennsylvania will create its medical marijuana program.

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News Moderator: Katelyn Baker 420 MAGAZINE ®
Full Article: Long Road From Medical Marijuana Legalization To Access - Lessons From New Jersey
Author: Mark Walters
Contact: York Daily Record
Photo Credit: Jeff Lautenberger
Website: York Daily Record
 
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