Pubdate: Sun, 17 Oct 2010 Source: Philadelphia Inquirer, The (PA) Copyright: 2010 Philadelphia Newspapers Inc Contact: http://www.philly.com/inquirer/ Details: http://www.mapinc.org/media/340 Author: Chelsea Conaboy, Inquirer Staff Writer POT RULES PUT MANY ON EDGE Medical-marijuana Backers Call N.J.'s Draft Regulations Too Strict. The State Says It Just Wants To Be Careful. The wait for access to medical marijuana has been excruciating for Jennifer Lande. Long-untreated Lyme disease paired with genetic complications cause Lande chronic pain. Her muscles are wasting, and her digestive system doesn't work properly. On good days, the 28-year-old Medford woman, who once enjoyed camping and hiking, walks with a cane. On bad days, she's bedridden. Marijuana, she said, could ease the suffering and slow her weight loss. The New Jersey Department of Health and Senior Services' release this month of draft rules dictating who will have access to marijuana and how it is distributed might have been a moment to celebrate. Instead, Lande plans to attend a Statehouse protest Monday. The law that Trenton legislators passed in January already was the most conservative among the 14 states that have approved distribution of medical marijuana. It didn't, for example, allow patients to grow plants in small numbers at home, as other laws do. But the proposed rules would make the program even stricter, dropping the number of state-approved distribution centers from a potential six statewide to four and limiting the drug's potency. Advocates warn that the limit on the drug strength would drive patients to the underground market. Some, such as Lande, say there are so many hoops to jump through that they feel they are being treated as if "we've already done something wrong." State officials say their intention is simply to create a controlled "medical model" that ensures the drug will be available only to those who qualify under the law. Susan Walsh, a physician and the deputy health commissioner in charge of crafting the rules, said she believed her office had created "the best model in the nation." It has earned the endorsement of the Medical Society of New Jersey and the New Jersey Hospital Association. It also has the backing of Gov. Christie, who said he would not have signed the medical-marijuana bill had he been governor when it passed in January. At a town-hall meeting Tuesday in Ewing, N.J., the former prosecutor said he didn't want the state's program to "become a joke" like those in Colorado or California, where, he said, anyone can get a prescription. "I won't permit it," he said. Walsh said tens of thousands of people might eventually enroll in the program. To qualify, patients must prove that their recommendation for use comes from a physician with whom they have a "bona fide," ongoing relationship - one who has treated them repeatedly or over a full year's time, or who assumes official responsibility for the patient's care. Approved patients may have access to 2 ounces of marijuana a month, in the form of lozenges, lotions, or dry weed. They can pick up sealed packages from a not-for-profit dispensary or sign up for home delivery. Qualifying medical conditions are limited. They include HIV, AIDS, multiple sclerosis, inflammatory bowel disease, and cancer. Other conditions - such as glaucoma, epilepsy, seizures, and muscular spasticity - qualify if the patient has not responded to conventional treatment. That stipulation has Lande concerned: Who decides whether, in her years of treatment, she has exhausted every conventional option? The drug is to be distributed through four vendors. Two other facilities would be responsible for growing the marijuana, under the draft rules. Each facility may grow three strains of the plant, none containing more than 10 percent of the chemical tetrahydrocannabinol, known as THC, which is primarily responsible for marijuana's psychoactive effects. Plants containing a higher percentage must be destroyed. Opponents say the limit, plus the fact that patients receive only 2 ounces, is restrictive. Though the law didn't set a limit, 10 percent - low enough to limit the euphoric effects - is reasonable, Walsh said. She cited a federal program that distributes marijuana with lower THC content. The little-publicized program, administered by the National Institute on Drug Abuse, has supplied medical marijuana to a very small number of patients for years. Decades for some, such as Irvin Rosenfeld, 57, of Fort Lauderdale, Fla. He is a grandfathered participant in the program, which is now closed. Rosenfeld, the vice president of a brokerage firm, receives 8 to 9 ounces of marijuana, grown by the University of Mississippi, every 30 days. His pot has a 3.6 percent THC level and is delivered as rolled cigarettes to his pharmacy. "As far as I'm concerned, I have the best dealer in the country," he said, only half-joking. Rosenfeld, who says he was vehemently antidrug in high school, lobbied the federal government and threatened a lawsuit before he was permitted access to the program in 1982. He knew that marijuana significantly lessened pain from a genetic condition that caused aggressive growth of bone tumors. Today, he smokes 10 to 12 cigarettes a day and takes no other pain medication. He plays softball, works five days a week, and teaches sailing. Without the drug, he said, he would likely be on disability. "I have a fantastic, well-rounded life," he said, "all because I have the right medicine." There are things in New Jersey's law Rosenfeld doesn't believe make sense, such as limiting growing to two centers. But "it's a nice start," he said. That's a point that Walsh echoes frequently. Her office will provide annual reviews to the Legislature, and there will be opportunities to adjust the program according to patient need - though not many in the first two years. Critics say the rules are so demanding that a small-business owner seeking to be one of the four distributors doesn't stand a chance in the application process, which requires $20,000 to initiate. (All but $2,000 is refundable if the applicant is denied.) Under the proposed rules, distributors must have a relationship with an acute-care hospital, but Walsh said that might be revised. Other requirements involve insurance, packaging, background checks, inventory monitoring, and security measures. There is even a ban on delivery staff's engaging in "extraneous conversation" with those they serve. Jason Cogan of Brigantine, N.J., considered applying to become a vendor. Now, he said, "anybody would be a fool to want the license." Sen. Nick Scutari (D., Union), who sponsored the original bill, plans to submit a resolution contending that the rules run counter to the legislative intent. Most important, he said, there should be six distribution centers in a state of more than 8.7 million people. "They're treating medical marijuana like it's radioactive material," Scutari said, "and if it gets out - well, believe it or not, people are getting it anyway." The sharpest critics believe the state is trying to thwart the program altogether. "There's a patient belief that the Christie administration is trying to set up this program to fail," Anne Davis, executive director of the state chapter of the National Organization to Reform Marijuana Laws, told Walsh at last week's public meeting. Walsh adamantly disputed that idea. A failure would reflect on her office, she said. Even some conservative bloggers and columnists - a group that has praised Christie for his pro-business policies and aggressive government budget-cutting - have been critical of the rules, saying they would impede on individual rights established under the medical-marijuana law. Walsh acknowledged the frustration felt by many who were eager to see the program implemented. "I'm sorry," she said. "We're trying to be careful." The public may comment on the rules for 60 days starting in November. Vendors will be selected early next year. Walsh expects centers to begin distributing marijuana by summer. - --- MAP posted-by: Jo-D