Robert Celt
New Member
It took Paul Ellis of Sugar Loaf over five weeks to get medical marijuana for a close family member with cancer - but it wasn't cheap, and it wasn't covered by insurance.
"It's a very secretive kind of thing," Ellis said. "I'm hoping that's only because it's so new, that it's only three months old, and that they're going to find out that the system is really screwy and they're going to fix it."
Access and affordability are just some of the reasons why state legislators are calling for numerous changes to the New York State Medical Marijuana Program (MMP). Signed by Gov. Andrew Cuomo on July 5, 2014, The Compassionate Care Act allows medical marijuana to be manufactured and dispensed to patients in the state of New York that qualify under a list of eligible medical conditions.
Currently 23 states, plus Washington, D.C., and Guam, allow medical marijuana. Under the New York law, which has some of the strictest restrictions in the country, the health commissioner registered five organizations to manufacture medical marijuana, each of which may own up to four dispensing sites, putting a cap on dispensaries of up to 20 statewide.
The process
But before patients can step foot into a dispensary, there is a process they must go through in order to receive a registry ID card. Patients must first have an eligible condition, then have a doctor, who is registered with the medical marijuana program, certify them.
Once certified, patients can then apply online for a registry ID card. Upon approval, a registry ID card will come in the mail, allowing them to buy medical marijuana from a dispensary.
The biggest problem patients are experiencing is with gaining access to medical marijuana due to a number of restrictions, according to Mischa Sogut, legislative aide to Assemblyman Richard N. Gottfried, who is chairman of the Assembly Health Committee and was instrumental in legalizing medical marijuana.
"The issues that we've seen include access, basic geographic access for example, conditions restrictions, the list of conditions and statutes, and finding doctors and providers able to prescribe," Sogut said. "So it's access, but access as a few elements."
Can't find a doctor
One issue, and one Ellis had to deal with himself, is that there is no list of registered doctors available to patients. According to Sogut, the executive argued that under the Freedom of Information laws, the list of certified doctors cannot be made public, something Gottfried disagrees with.
To become registered, doctors must complete a state Department of Health four-hour online course, which costs $249. If the patient's current doctor is not registered and does not wish to register, the doctor can then use a database to find a physician who is registered and make a referral.
Patients must find a doctor who is willing to either become registered or take the time to help them find one who is. According to Ellis, this was the hardest part.
When Ellis first asked about medical marijuana to a Crystal Run Healthcare oncologist, he was told, "I know nothing about that," and the doctor walked out of the room. About two weeks later, when confronted again, the oncologist said, "well, we have someone in our practice who does that ... you can see him in three weeks."
Ellis doesn't know why the oncologist was hesitant to tell him about the certified doctor, but suggested that it could be due to his hippie appearance. He said there is one doctor in Middletown and two in Newburgh that are certified. Calls to Crystal Run Healthcare were not immediately answered.
"At my (family member's) last treatment last week, the nurse, and thank God for nurses, she looked at my (family member) and said 'did you ever get that thing straightened out with the medical marijuana because you're clearly suffering.' She said, 'well this will not do' and she walked across the hall, brought the doctor back to the chemo treatment room and he filled out the form there, two weeks earlier than our appointment."
Once certified by the doctor, Ellis went online to register through what he described as a convoluted series of questions. The fee was $50 for registering the patient and $50 for registering the doctor as their designated caregiver.
According to Gina Moreno, a tow policy fellow at the New York Drug Policy Alliance, "the state has created a certification process that is expensive and complicated." She also said that the low number of doctors who've registered has greatly hampered patient access.
As of March 31, 494 physicians have registered with the Medical Marijuana program, and 2,390 patients have been certified by their doctors, according to state health officials. There are 79,000 doctors within the state (although some estimate there are upwards of 90,000) so less than one percent of New York doctors have registered, Moreno said.
To address this issue, there is a bill that has been introduced in both the Assembly and the Senate that would authorize nurse practitioners and physician assistants to recommend medical marijuana.
"Nurse practitioners and physician assistants are fully authorized to write prescriptions," Sogut said. "In a lot of areas, especially upstate, they play a central role in health care delivery. So we think one way to address an issue with a shortage of doctors, you can train more doctors, or you can authorize PAs and NPs."
Can't get to a dispensary
Another issue is that patients can't get to a dispensary near them that carries the form of medical marijuana they need. With a limit of five manufacturing companies and a cap of only 20 dispensaries, patients are finding it difficult to get the treatment prescribed to them.
The closest dispensaries to Orange County are ones in Kingston and White Plains. However, there is a manufacturing site owned by Pharmacannis opening in Hamptonburgh.
According to Sogut, it was put in regulation by the executive that no registered manufacturing organization can produce more than five "brands," or products. Since they can only produce five products, and, for example, one of those products is more prescribed than another, the company is more likely to produce the more popular product.
"We heard one story from a patient in Buffalo, who was a teenage girl with a major, major seizure disorder," Sogut said. "And her family had been taking her to Kingston, which is six and a half hours each way driving, to get a product. And the issue wasn't that there weren't any dispensaries closer; there were several. And the issue wasn't even that the company that made the product didn't have dispensaries closer to Buffalo."
The problem was that since dispensaries only offer five products, the dispensaries closer to Buffalo didn't have a market for that product in the area. Plus, under regulation, production sites are only allowed to transport to their dispensaries, so the company couldn't even send a truck from Kingston to Buffalo with a product, Sogut explained.
One of the proposed Assembly bills would aim to fix these regulations, which essentially is creating a forced vertical integration model, Sogut said.
"So there's a whole systemic problem here, both in the number of dispensaries and production sites, and in the ability to ship product to sell product to other dispensaries," he said. "And this is how you end up with a situation where you have someone who has to go 13 hours round trip to get the product."
More forms and conditions
Another issue patients run into is that in New York State, only smoke-free forms of medical marijuana are available, such as capsules, liquids, oils and vaporization. Out of the 25 places in the country that allow medical marijuana, only two states do not permit smoking.
"Smoking was in the original bill; smoking was taken out," Sogut said. "And smoking is, for many patients, a good way to control dosage. It's also much cheaper than a lot of other forms and we know that health insurance doesn't cover this product, so for a lot people you're talking hundreds of dollars every time they go."
According to Moreno, a month's supply ranges anywhere from $150 to $2,000.
Another proposed bill aims to increase the number of eligible conditions, adding those that were included in the original bill. Currently there are 10 conditions that qualify, including cancer, HIV/AIDS, Parkinson's disease, multiple sclerosis and epilepsy.
Along with one of these conditions, the patient must also be experiencing an associated condition, such as cachexia or wasting syndrome, severe or chronic pain, severe nausea, seizures or severe muscle spasms. If passed, the bill would authorize other patients to be eligible, for example, those with severe chronic pain not associated with another listed condition.
Ellis was finally able to go to the dispensary in White Plains and purchase medical marijuana. He said that his family member with cancer took had taken the marijuana pills for two days, and was able to sit down and eat, something he said they hadn't been able to do in weeks.
"Now it's just a matter of seeing if the prescription starts to work," he said, "and if it works, how well it works." -
News Moderator: Robert Celt 420 MAGAZINE ®
Full Article: Patients Are Struggling To Get Medical Marijuana In New York
Author: Ericka Norton
Photo Credit: Allison Dunne
Website: The Photo News
"It's a very secretive kind of thing," Ellis said. "I'm hoping that's only because it's so new, that it's only three months old, and that they're going to find out that the system is really screwy and they're going to fix it."
Access and affordability are just some of the reasons why state legislators are calling for numerous changes to the New York State Medical Marijuana Program (MMP). Signed by Gov. Andrew Cuomo on July 5, 2014, The Compassionate Care Act allows medical marijuana to be manufactured and dispensed to patients in the state of New York that qualify under a list of eligible medical conditions.
Currently 23 states, plus Washington, D.C., and Guam, allow medical marijuana. Under the New York law, which has some of the strictest restrictions in the country, the health commissioner registered five organizations to manufacture medical marijuana, each of which may own up to four dispensing sites, putting a cap on dispensaries of up to 20 statewide.
The process
But before patients can step foot into a dispensary, there is a process they must go through in order to receive a registry ID card. Patients must first have an eligible condition, then have a doctor, who is registered with the medical marijuana program, certify them.
Once certified, patients can then apply online for a registry ID card. Upon approval, a registry ID card will come in the mail, allowing them to buy medical marijuana from a dispensary.
The biggest problem patients are experiencing is with gaining access to medical marijuana due to a number of restrictions, according to Mischa Sogut, legislative aide to Assemblyman Richard N. Gottfried, who is chairman of the Assembly Health Committee and was instrumental in legalizing medical marijuana.
"The issues that we've seen include access, basic geographic access for example, conditions restrictions, the list of conditions and statutes, and finding doctors and providers able to prescribe," Sogut said. "So it's access, but access as a few elements."
Can't find a doctor
One issue, and one Ellis had to deal with himself, is that there is no list of registered doctors available to patients. According to Sogut, the executive argued that under the Freedom of Information laws, the list of certified doctors cannot be made public, something Gottfried disagrees with.
To become registered, doctors must complete a state Department of Health four-hour online course, which costs $249. If the patient's current doctor is not registered and does not wish to register, the doctor can then use a database to find a physician who is registered and make a referral.
Patients must find a doctor who is willing to either become registered or take the time to help them find one who is. According to Ellis, this was the hardest part.
When Ellis first asked about medical marijuana to a Crystal Run Healthcare oncologist, he was told, "I know nothing about that," and the doctor walked out of the room. About two weeks later, when confronted again, the oncologist said, "well, we have someone in our practice who does that ... you can see him in three weeks."
Ellis doesn't know why the oncologist was hesitant to tell him about the certified doctor, but suggested that it could be due to his hippie appearance. He said there is one doctor in Middletown and two in Newburgh that are certified. Calls to Crystal Run Healthcare were not immediately answered.
"At my (family member's) last treatment last week, the nurse, and thank God for nurses, she looked at my (family member) and said 'did you ever get that thing straightened out with the medical marijuana because you're clearly suffering.' She said, 'well this will not do' and she walked across the hall, brought the doctor back to the chemo treatment room and he filled out the form there, two weeks earlier than our appointment."
Once certified by the doctor, Ellis went online to register through what he described as a convoluted series of questions. The fee was $50 for registering the patient and $50 for registering the doctor as their designated caregiver.
According to Gina Moreno, a tow policy fellow at the New York Drug Policy Alliance, "the state has created a certification process that is expensive and complicated." She also said that the low number of doctors who've registered has greatly hampered patient access.
As of March 31, 494 physicians have registered with the Medical Marijuana program, and 2,390 patients have been certified by their doctors, according to state health officials. There are 79,000 doctors within the state (although some estimate there are upwards of 90,000) so less than one percent of New York doctors have registered, Moreno said.
To address this issue, there is a bill that has been introduced in both the Assembly and the Senate that would authorize nurse practitioners and physician assistants to recommend medical marijuana.
"Nurse practitioners and physician assistants are fully authorized to write prescriptions," Sogut said. "In a lot of areas, especially upstate, they play a central role in health care delivery. So we think one way to address an issue with a shortage of doctors, you can train more doctors, or you can authorize PAs and NPs."
Can't get to a dispensary
Another issue is that patients can't get to a dispensary near them that carries the form of medical marijuana they need. With a limit of five manufacturing companies and a cap of only 20 dispensaries, patients are finding it difficult to get the treatment prescribed to them.
The closest dispensaries to Orange County are ones in Kingston and White Plains. However, there is a manufacturing site owned by Pharmacannis opening in Hamptonburgh.
According to Sogut, it was put in regulation by the executive that no registered manufacturing organization can produce more than five "brands," or products. Since they can only produce five products, and, for example, one of those products is more prescribed than another, the company is more likely to produce the more popular product.
"We heard one story from a patient in Buffalo, who was a teenage girl with a major, major seizure disorder," Sogut said. "And her family had been taking her to Kingston, which is six and a half hours each way driving, to get a product. And the issue wasn't that there weren't any dispensaries closer; there were several. And the issue wasn't even that the company that made the product didn't have dispensaries closer to Buffalo."
The problem was that since dispensaries only offer five products, the dispensaries closer to Buffalo didn't have a market for that product in the area. Plus, under regulation, production sites are only allowed to transport to their dispensaries, so the company couldn't even send a truck from Kingston to Buffalo with a product, Sogut explained.
One of the proposed Assembly bills would aim to fix these regulations, which essentially is creating a forced vertical integration model, Sogut said.
"So there's a whole systemic problem here, both in the number of dispensaries and production sites, and in the ability to ship product to sell product to other dispensaries," he said. "And this is how you end up with a situation where you have someone who has to go 13 hours round trip to get the product."
More forms and conditions
Another issue patients run into is that in New York State, only smoke-free forms of medical marijuana are available, such as capsules, liquids, oils and vaporization. Out of the 25 places in the country that allow medical marijuana, only two states do not permit smoking.
"Smoking was in the original bill; smoking was taken out," Sogut said. "And smoking is, for many patients, a good way to control dosage. It's also much cheaper than a lot of other forms and we know that health insurance doesn't cover this product, so for a lot people you're talking hundreds of dollars every time they go."
According to Moreno, a month's supply ranges anywhere from $150 to $2,000.
Another proposed bill aims to increase the number of eligible conditions, adding those that were included in the original bill. Currently there are 10 conditions that qualify, including cancer, HIV/AIDS, Parkinson's disease, multiple sclerosis and epilepsy.
Along with one of these conditions, the patient must also be experiencing an associated condition, such as cachexia or wasting syndrome, severe or chronic pain, severe nausea, seizures or severe muscle spasms. If passed, the bill would authorize other patients to be eligible, for example, those with severe chronic pain not associated with another listed condition.
Ellis was finally able to go to the dispensary in White Plains and purchase medical marijuana. He said that his family member with cancer took had taken the marijuana pills for two days, and was able to sit down and eat, something he said they hadn't been able to do in weeks.
"Now it's just a matter of seeing if the prescription starts to work," he said, "and if it works, how well it works." -
News Moderator: Robert Celt 420 MAGAZINE ®
Full Article: Patients Are Struggling To Get Medical Marijuana In New York
Author: Ericka Norton
Photo Credit: Allison Dunne
Website: The Photo News
