This article was produced in collaboration with AlterNet and first appeared here.
New York's long-delayed medical marijuana program finally rolled out this month, not with a bang, but with a whimper. What looks to be the country's tightest medical marijuana program has an extremely limited number of producers and retailers, a tiny number of eligible patients, a dearth of doctors, and forbids both smoking marijuana and using edibles.
[image:1 align:left]For patients and advocates, the very limited arrival of medical marijuana in the Empire State is not the end point they hoped to achieve. Now, instead of resting on their laurels, they will have to continue to fight to make the program one that actually serves the needs of New Yorkers.
"It's a start," said the Drug Policy Alliance's Julie Netherland, until recently the deputy director of the group's New York Policy Office, where she was deeply involved in massaging the law through the legislature and past a reluctant governor. "It's the first time New Yorkers can legally purchase medical marijuana, and it's the result of the hard work of thousands of patients and family members across New York."
But, she was quick to grant, the program has some serious issues, immediate ones in the way the program has been rolled out and longer-term ones with the statute itself.
Here are seven ways New York's medical marijuana program falls short:
Not Enough Access to Doctors
Under the law, before doctors can recommend medical marijuana to patients, they must complete a $249 four-hour course on the drug and then register with the Health Department. As of Thursday, only 306 physicians had done so. Unlike neighboring New Jersey, the Health Department maintains no public registry of doctors certified to recommend medical marijuana, making it that much more difficult for potential patients to find doctors who might certify them to purchase it. So far, only 465 patients have been certified by the department to buy medical marijuana.
"This is the number one complaint of patients," said Netherland, sketching out an almost Kafkaesque process. "The Health Department is telling me if I'm a patient, I should go see my doctor and see if he participates in the program and if not, to encourage him to register," she said. "If the doctors says he's not going to register, then I'm supposed to ask him for a referral, but the doctor isn't going to know about any list of certified doctors to refer me to, and then it's incumbent on me to tell him. It's just another set of hoops for patients to jump through."
At least the Health Department has now agreed to make the list of certified physicians available to patients.
Not Enough Dispensaries
In a state of 20 million, only eight dispensaries opened January 7, and only another dozen are envisioned under the June 2014 medical marijuana law. Weedmaps lists only three for New York City -- one each in Manhattan, the Bronx, and Queens. By way of comparison, Los Angeles had 135 permitted dispensaries and probably three times as many actually operating.
New York is not only heavily populated, it's big. With only 20 dispensaries, large geographical swathes of the state will remain without access. Long Island, for instance, will have two dispensaries, but right now, it's a two-hour drive into the city.
"I'm disappointed that only eight dispensaries will open by the deadline," said Missy Miller from Atlantic Beach. "There are none opening on Long Island, which leaves my son Oliver, who suffers from life-threatening seizures, out of luck. This only highlights concerns we have had all along that the state has licensed way too few producers and dispensaries to serve a state as populous and geographically large as New York."
No Personal Cultivation
Unlike the majority of medical marijuana states, patients can't just grow their own. That means they are dependent on the dispensary system, with all its limitations.
Access Is Limited to Specified Qualifying Medical Conditions
The state law only allows medical marijuana for a list of specified medical conditions, including cancer, HIV/AIDS, Parkinson's disease, multiple sclerosis, and chronic pain. The law allows the Commissioner of Health to add other diseases and conditions, but just last week, he refused to add PTSD, Alzheimer's, muscular dystrophy, dystonia, rheumatoid arthritis.
"We're hearing every day from patients with all kinds of conditions," said Netherland. "The commissioner was directed by law to consider those five additional conditions, but he declined to add any. That was a huge blow to patients across the state hoping he would do the right thing. Half the medical marijuana states include PTSD; we thought there was strong scientific evidence to include it."
[image:2 align:right]Limitations on Forms of Ingestion
The law bans the sale of smokable marijuana. New York joins Minnesota as the only two medical marijuana states that ban smoking; 21 others do not. The state will only allow oils and capsules that can be administered orally, and liquid forms of marijuana may also be vaporized.
"The law prohibits any smoking, but regulations prohibit any access to the whole plant," said Netherland. "That means all the products will be extracts, oils, or tinctures. This is also an issue for a lot of our patients.
Limitations on Strains
The law only provides for five producers, and each producer can only grow five strains.
"We know there are dozens and dozens of therapeutic strains," said Netherland. "We'd like to have the flexibility to match symptoms with strains. One of the issues is that all of the products have to be approved by the Health Department."
Access for Limited Income Patients
Advocates sought unsuccessfully to get provisions to ensure access for low income patients. Medical marijuana is not covered by insurance, and could run between $200 and $1300 a month, depending on the product and the condition. Now it will be up to the charitable instincts of dispensaries.
"We had encouraged the state to create incentive programs for producers to have programs for low income access, and we also encouraged the state to set up a program itself. It chose to do neither," Netherland said. "Now, patients are basically waiting to see if dispensaries will step up."
"There's lots of room for improvement," she said. "We anticipated a lot of these problems when the law was passed, and we're looking at going back to the legislature. We'll be back in Albany in the coming months talking about the need to expand the program and make it work from the patient's standpoint."
It looks like there's plenty of work to be done.
Members of Congress urge the VA to get out of the way on medical marijuana, the Marijuana Policy Project eyes an Ohio initiative this year, Florida will vote on an initiative this year, California legislature is trying to fix a mess of its own making, and more.
[image:1 align:left caption:true]National
On Wednesday, federal lawmakers called on the Veterans Administration to let doctors recommend medical marijuna to vets. Twenty-one members of Congress have written to Veterans Administration (VA) Secretary Robert McDonald urging him to allow VA doctors to discuss medical marijuana as a possible treatment in states where it is legal. A VA policy that does not allow doctors to recommend it expires at the end of this month, and the lawmakers are calling on McDonald to not extend it. "You are in a position to make this change when the current directive expires at the end of this month," Sen. Kirsten Gillibrand (D-NY), Sen. Steve Daines (D-MT), and others wrote Wednesday to McDonald. "We ask that you act to ensure that our veterans' access to care is not compromised and that doctors and patients are allowed to have honest discussions about treatment options."
On Thursday, Americans for Safe Access released a report on state medical marijuana programs. The patient advocacy group graded each state and graded toughhly. No state earned an "A" and only 12 earned a "B." Read the report here.
On Monday, a GOP politician withdrew a bill that would have crippled the medical marijuana program. State Rep. Jay Lawrence (R-Fountain Hills) has withdrawn HCR 2019, which would have barred naturopaths and homeopaths from recommending medical marijuana. Nearly 90% of all recommendations in the state are written by those health care professionals. Lawrence said he withdrew his bill after his office "received so many calls" and he actually learned about how the program works.
On Monday, the Senate approved a bill to slow medical marijuana bans. The state Senate Monday approved Assembly Bill 21, designed to fix what lawmakers called a mistake in the state's comprehensive medical marijuana regulation laws. The bill had a paragraph that gave the state authority to license cultivation in localities that didn't have their own laws on the books by March 1, and many localities had responded by passing preemptive cultivation bans. The bill now goes to the Assembly.
On Wednesday, the Assembly approved the bill. After passing the Senate earlier this week, Assembly Bill 21, has now passed the Assembly and awaits a signature from Gov. Jerry Brown (D). The bill lifts a March 1 deadline for localities to regulate medical marijuana or lose control to the state. The deadline has prompted more than a hundred localtities to enact bans on various sorts in a bid to retain local control.
On Wednesday,the Florida medical marijuana initiative qualified for the ballot The group behind the effort, United for Care, said the Division of Elections has recorded 692,981 verified voter signatures, nearly 10,000 more than needed to qualify. A similar effort won 58% of the vote in 2014, but failed to pass because constitutional amendments require 60% of the vote to pass in Florida.
Last Thursday, a state representative admitted breaking the law to help families obtain CBD cannabis oil. Rep. Alan Peake (R-Macon) admitted that he has been going to other states to obtain the medicine and bring it back for patients. Under a law he sponsored last year, CBD cannabis oil is legal for people for certain diseases, but there is no provision for in-state cultivation or sales. "We made sure that families properly registered with the state got access to medical cannabis, including delivering it to them if that's the only way we can make that happen," Peake said. "Maybe at some point there is a need for civil disobedience. It comes down to, 'What would I do if it were my child?'" Peake said.
On Monday, a bill to ban patients from growing their own was filed. Now that dispensaries are set to open up in the state, Rep. Marcus Oshiro (D-Oahu) has filed a bill that would prohibit patients from growing their own, instead requiring them to use the dispensaries. The bill is House Bill 1680. Patient groups don't like it.
This week, a petition is seeking to prod the governor to expand qualifying medical conditions. The state Medical Cannabis Advisory Board has recommended adding eight new qualifying conditions to the state's medical marijuana program. The petition is directed at Gov. Bruce Rauner (R) and the head of the state Department of Public Health, who will make the final decision. The petition currently has more than 19,000 signatures and has been endorsed by Melissa Etheridge.
Last Thursday, medical marijuana bills were pronounced dead. State Sen. Jean Leising (R-Oldenburg) said Thursday that medical marijuana bills in the state legislature would not got a hearing this year. "They are all dead," she said. "There just isn't the appetite in the Senate for approving any kind of medical marijuana, not with the current makeup of the (50-member) Senate. You need 26 votes, and they're just not there." Parents of children suffering from epilepsy had pleaded with lawmakers to act, to no avail.
Last Wednesday, the Marijuana Policy Project announced plans for Ohio. MPP said Wednesday it plans to put a medical marijuana initiative on the 2016 ballot. The initiative would take the form of a constitutional amendment, but has not yet been drafted.
Last Friday, the attorney general rejected the wording on a medical marijuana initiative. State Attorney General Mike DeWine (R) has rejected a third petition for a medical marijuana constitutional amendment. He said there were five discrepancies between the language of the proposal and its summary language.
Last Wednesday, a "whole plant" medical marijuana bill was filed. Sen. Mark Madsen (R-Saratoga Springs) has introduced Senate Bill 73, which would create a full-fledged medical marijuana system in the state. The bill would only allow marijuana to be consumed in the forms of oils and gummies, not smoked. Another bill already filed would allow only cannabidiol.
Last Thursday, the Republican governor signaled support for medical marijuana. Gov. Bob Herbert (R) said Thursday that he is not familiar with two medical marijuana bills filed this session and that he doesn't want a "Dr. Feelgood" situation, but "if there's a medicine out there that will alleviate pain and conditions and health concerns for people, if there's a medicine out there that can do that, we ought to see if we can embrace it." He added that he would prefer that Congress legalize it federally rather than leaving it up to the states to act.
[For extensive information about the medical marijuana debate, presented in a neutral format, visit MedicalMarijuana.ProCon.org.]
Chronicle AM: FL MedMJ Init Qualifies for Ballot, VT Gov Endorses Pot Legalization Bill, More... (1/28/16)
Busy, busy. State legislatures are in full swing, and the bills just keep coming. Meanwhile, Florida's medical marijuana initiative has qualified for the ballot, Vermont's governor endorses legalization, and more.
[image:1 align:left caption:true]Marijuana Policy
Federal Judge Throws Out Lawsuit Against Colorado's Legalization. A Colorado US District Court judge has rejected a lawsuit challenging the legality of marijuana legalization in the state. The lawsuit was filed by a Washington, DC-based anti-marijuana group, the Safe Streets Alliance, and asked the court to find the state and Pueblo County guilty of violating the Racketeer Influenced and Corrupt Organizations (RICO) Act. The judge in the case rejected the claims, concluding that private parties have no standing to seek recourse for alleged violations of the Supremacy Clause, which makes federal law the supreme law of the land. Another lawsuit, filed by the states of Nebraska and Oklahoma, is still being decided.
New Mexico Poll Finds Strong Support for Legalization. Three out five (61%) adult New Mexicans support legalizing and regulating marijuana, according to a new poll from Research & Polling. The poll comes as the legislature ponders two bills, one that would amend the state constitution to let voters decide the issue, and one that is a straightforward legalization bill. The bills are Senate Joint Resolution 5 and House Bill 75, respectively.
Vermont Governor Endorses Legalization Bill. Gov. Peter Shumlin has endorsed the Senate Judiciary Committee's legalization bill, Senate Bill 137. "The War on Drugs has failed when it comes to marijuana prohibition," Gov. Shumlin said. "Under the status quo, marijuana use is widespread, Vermonters have little difficulty procuring it for personal use, and the shadows of prohibition make it nearly impossible to address key issues like prevention, keeping marijuana out of the hands of minors, and dealing with those driving under the influence who are already on Vermont's roads. The system has failed. The question for us is how do we deal with that failure. Vermont can take a smarter approach that regulates marijuana in a thoughtful way, and this bill provides a framework for us to do that."
DC Poll Finds Residents Want District to Move Ahead With Regulation -- Despite Congress. A substantial majority of District residents believe Mayor Bowser should move forward with taxation and regulation of marijuana despite Congressional prohibition, according to a survey conducted over the weekend by Public Policy Polling (PPP) for the Drug Policy Alliance, DC Vote, DC Working Families and the Washington City Paper. Two-thirds (66%) of respondents believe the mayor should pursue a legal method (such as use of reserve funds) to implement taxation and regulation of marijuana in the District. In light of congressional interference attempting to prevent such regulation, 63% of residents view marijuana legalization as a statehood issue for the District.
Americans for Safe Access Releases Report on State Medical Marijuana Programs. The patient advocacy group graded each state and graded harshly. No state earned an "A" and only 12 earned a "B." Read the report here.
California Bill to Halt Medical Marijuana Bans Heads to Governor's Desk. After passing the Senate earlier this week, Assembly Bill 21, has now passed the Assembly and awaits a signature from Gov. Jerry Brown (D). The bill lifts a March 1 deadline for localities to regulate medical marijuana or lose control to the state. The deadline has prompted more than a hundred localtities to enact bans on various sorts in a bid to retain local control.
Florida Medical Marijuana Initiative Qualifies for the November Ballot. The group behind the effort, United for Care, said Wednesday the Division of Elections has recorded 692,981 verified voter signatures, nearly 10,000 more than needed to qualify. A similar effort won 58% of the vote in 2014, but failed to pass because constitutional amendments require 60% of the vote to pass in Florida.
Heroin and Prescription Opiates
Injection Drug Use Driving Appalachian Hepatitis B Infections. The Centers for Disease Control and Prevention report that acute Hepatitis B was up 114% in Kentucky, Tennessee, and West Virginia between 2009 and 2013. The report found that injection drug was tied to 75% of the new cases. Unlike Hep C, Hep B can be prevented with a vaccine, but vaccine coverage is low among adults nationwide.
Maine Governor Wants Gunowners to Shoot Drug Dealers. Just days after saying Maine should revive the guillotine to execute drug dealers, Gov. Paul LePage suggested just shooting them instead. "I tell ya, everybody in Maine, we have constitutional carry," LePage said in an on-camera interview in Lewiston. "Load up and get rid of the drug dealers. Because, folks, they're killing our kids," the governor said. He then denied that he was encouraging vigilantism.
New York Assembly Minority Task Force Releases Report on Heroin Addiction. The task force has come out with suggestions for combating heroin and opiate addiction. The recommendations include earlier drug education, involuntary "emergency medical" detention of addicts, and a felony "death by dealer" statute. Now, the task force must work with Assembly Democrats to create legislation.
South Dakota Welfare Drug Testing Bill Killed in Committee. The Health and Human Services voted to kill a bill that would have required welfare applicants to undergo mandatory, suspicionless drug testing. Even the Republican governor had opposed the bill.
Producers of Prohibited Plants Issue Declaration Ahead of UNGASS. The Global Forum of Producers of Prohibited Plants (coca, opium, marijuana) is demanding that growers be heard at the UN General Assembly Special Session on Drugs in April. In a joint declaration from producers in 14 countries, the group urged an end to forced eradication of drug crops, the removal of the three plants from international drug control treaties, and sustainable rural economic development. Click the title link for a full list of participants and recommendations.