The state of New Jersey’s medicinal cannabis program: not patient-oriented, not medical and going very slow

    In this rebuttal to an op-ed statement by New Jersey Department of Health and Senior Service Commissioner Mary E. O’Dowd, a doctor states that New Jersey’s long-delayed medical marijuana plan has so far failed patients because it is not driven by medical professionals.

    The commissioner of the New Jersey Department of Health and Senior Service (DHSS), Mary E. O’Dowd, attempted to defend N.J.’s actions, or lack there of, in an op-ed statement in (Opinion: Medicinal pot program must be done right) on Jan. 24, 2012 with regard to the two-year-delayed Medical Marijuana Plan (MMP).

    However, the original plan, designed to be a serious and legitimate medically driven plan to benefit a narrow list of qualified patients, based on science and medical consensus, has so far has failed to deliver.

    While this writer wholeheartedly agrees with certain key points made by Commissioner O’Dowd, in that the essential problem has been and remains the Schedule I Controlled Dangerous Substance status of Marijuana by the federal government, the bureaucratic federal organizations, including Congress, that have prohibited cannabis for 40-plus years, continue to deny science in order to maintain the status quo.

    Nevertheless, recent data continue to define the safety profile of cannabis in long-term studies, published in peer-reviewed medical journals. Other studies have emerged showing a disease-focused medical utility of manipulating specific cannabinoid receptors.

    I agree the DHSS needs to proceed cautiously. While O’Dowd asks for patience as they carefully implement the MMP, not from the “ground up,” but with an eye to be more “medical” and more secure than the programs of California and Colorado. The “go slow” approach appears to be at last tiptoeing forward.

    However, the two-year delay is not “cautiously proceeding” with a new and controversial program from the ground up, but a serious case of the slows. Further delay continues to this day. Further impediment to the implementation of this law is unacceptable.

    In two full years, not one patient has benefitted from medicial cannabis. Not one patient has registered. Not one patient has even been able to apply to register. No physician has authorized a single prescription.

    Two years have passed, and a patient of mine is going to prison for five years for self medicating his documented multiple sclerosis.

    Two years after the law was signed into place, instead of a physician-driven medical act providing safe and legal access to medical cannabis, what the Compassionate Use Medical Marijuana Act has become is a law enforcement-led barrier to medical marijuana access.

    I do not belittle the capabilities, nor the esteemed careers in public service of Commissioner O’ Dowd or the director of the MMP, John O’ Brien, himself a retired N.J. State Police officer, but respectfully, neither of them are physicians. The key administrator of a medical cannabis program should be a physician, or a public health master, or some other qualified medical person, not a former state police officer.

    The DHSS’s original health-oriented program, authored by physicians, (then DHSS’ Deputy Commissioner Dr. Susan Walsh and former DHSS Commissioner Alaigh), has been replaced by a law enforcement-led organization. It has not been a physician-driven program.

    After all, this program is about the health of those who are caring for, or who are themselves, someone who is sick.

    Furthermore, the regulations have for two years stubbornly adhered to its original language without hardly a tweak of the essential flaws in the program.

    For instance, the state’s 10% THC strain limit, and limits on biodiversity, are themselves unscientific and unhealthy, as well as arbitrary, restrictions.

    The only thing the DHSS has done promptly was to select the six Alternative Treatment Centers (ATCs). Now the state is doing background checks. How long does that take? What has the DHSS found so far? Why weren’t the bona fides ascertained before the selection process? Transparency has been deficient.

    Only one ATC is “nearing completion.” But they haven’t started yet, and they have no plants, nor seedlings growing as of yet. They have no patients to serve.

    Had the DHSS originally chosen ATC applications from organizations more heavily vested in their community, then perhaps the vetting process would have been completed by now, and more ATC operators would be ready.

    And yes, it is up to the ATC organizations to find their niche, and on that point Commisioner O’Dowd is right.

    The overly narrow defined medical conditions, initially allowed in the original document known as the N.J. Compassionate Use Medical Marijuana Act, is arguably too restrictive in consideration of up-to-date science and a cautious medical consensus. The inclusion of additional indications was supposed to begin two years after the law was written, as per the original MMP document. Well, two years have passed.

    As a physician who treats patients, I see a small number of patients who are appropriate for cannabinoid therapy, because of a medical condition, but do not have the few clinical conditions that allow safe access. Some of these patients have serious, debilitating chronic pain. Others have psychiatric illness, such as PTSD. How does a physician-prescriber approach these patients? Are they to be helped? Or shall the state obstruct their care?

    Well the answer to that dilemma is straightforward.

    Who’s in charge of the program? A physician, or a master of public health? Or a police officer?

    Dr. Jeffrey Stuart Pollack, MD, practices internal medicine in Mays Landing, N.J.

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