Pubdate: Sun, 02 Jun 2013
Source: Courier-Post (Cherry Hill, NJ)
Copyright: 2013 Courier-Post
Contact:  http://www.courierpostonline.com/
Details: http://www.mapinc.org/media/826
Author: Kim Mulford

MEDICAL MARIJUANA IS HARD TO GET FOR LOCAL PATIENTS

When you think of medical marijuana patients, Richard Caporusso of 
Medford Lakes wants you to think of people like him.

A former corrections officer, the 33-year-old was forced to retire 
from his state job in 2010 due to neck injuries he sustained 
restraining an inmate. Caporusso compares his chronic pain to an 
intense electrical shock.

"It literally feels like lightning bolts coming down your hands," 
said the Medford Lakes resident. "There are times that I've been up 
for hours in agony."

A regimen of doctor-prescribed pain medications - Celebrex, Lyrica 
and Vicodin - made him feel like "garbage" and left him lethargic and 
sick. Eventually, the combination ulcerated his stomach and esophagus.

The best medicine for neurological pain, each doctor told him, is 
marijuana. Though at the time of his injury New Jersey had already 
legalized medical marijuana, Caporusso could not get the relief he 
sought until last December, when the state's first alternative 
treatment center opened in Montclair, Essex County.

He's one of the few.

"It's the only thing I use for pain," Caporusso noted. "It's the only 
thing that works."

Three and a half years after Gov. Jon Corzine signed the New Jersey 
Compassionate Use Medical Marijuana Act, only 124 people have been 
able to buy marijuana from a state-approved alternative treatment 
center. That accounts for about 13 percent of New Jersey's 946 
card-carrying medical marijuana patients.

Medical marijuana advocates blame Gov. Chris Christie's 
administration for the delays, and say strict regulations have made 
it too difficult and expensive for patients to get prescribed 
marijuana. The governor and former prosecutor opposes legalizing 
marijuana for medicinal use because the drug is still prohibited 
under federal law.

Patients and their supporters plan to air their complaints at a 
protest rally Friday in Trenton, said Ken Wolski, CEO of the 
Coalition for Medical Marijuana New Jersey.

The organization contends the state's own rules have caused the 
delay. Among them are rigorous background checks on alternative 
treatment center employees and restrictions on levels of the 
pain-relieving compound THC from cannibas plants grown inside tightly 
secured warehouses.

"We just say the program is absolutely dysfunctional," said Wolski, a 
registered nurse.

Indeed, "we're hearing stories every single day about patients all 
over the state that don't have access to (their) medicine," observed 
Evan Nison, executive director of New Jersey NORML, a nonprofit 
working to regulate marijuana like alcohol.

"This is a disaster of a program right now in New Jersey."

Both NORML and Caporusso are suing the state Department of Health 
over implementation of the law. The case is now before the Appellate Division.

Of the six alternative treatment centers initially approved to grow 
and dispense marijuana, five are still creeping through the 
regulatory process. Greenleaf Compassion Center, the state's lone 
center in operation, is no longer accepting new patients outside the 
seven counties surrounding it.

Permits needed

The Compassionate Care Foundation in Egg Harbor Township and 
Compassionate Care Centers of America Foundation, Inc. in Woodbridge 
expect to open in the fall, according to Donna Leusner, spokeswoman 
for the state Department of Health. Three others still don't have an 
estimated opening date.

William Thomas, CEO of the Egg Harbor Township center, did not return 
several calls or emails for comment. In an email, Leusner said the 
center still needs a permit to grow plants "and as soon as they tell 
the department they are ready to be inspected, we will send 
inspectors out. We have done several pre-inspection visits to 
streamline the process."

Compassionate Sciences is finalizing local approval for a facility in 
South Jersey; its spokesman, Andrei Bogolubov, would not yet say 
where. Earlier attempts to win favor in Maple Shade and Camden failed.

Bogolubov would not speculate on an opening date.

"It really depends on a lot of things, because at every stage, you're 
working with the state to make sure you're meeting everything you 
need to meet until you have that final permit issued," he explained. 
"These things take more time, because this is such a rigorous 
regulatory framework."

It's been hard for alternative treatment centers to find 
municipalities willing to host them, Leusner said in an email. The 
other top challenge? Building "a program that would withstand federal 
scrutiny because the federal government considers marijuana illegal," 
she added.

Caporusso's lawyer, William Buckman of Moorestown, called that 
response an excuse. One of the plaintiffs in the lawsuit died "in 
unnecessary agony" without getting access to marijuana, he said.

"The feds have pretty much said they're not going to unduly harass or 
interfere with legitimate medical marijuana schemes, and I don't 
think that's a valid explanation for what's been going on here," 
Buckman insisted of state regulations.

"They've simply been dragging their feet and literally doing nothing."

Eighteen states and the District of Columbia have legalized medical 
marijuana, and 11 more states have such legislation pending, 
according to the Marijuana Policy Project, a nonprofit based in 
Washington, D.C.

New Jersey's medical marijuana regulations are among the strictest in 
the nation, said Matt Simon, a legislative analyst for the project. 
The state was one of the first to legalize medical marijuana while 
maintaining criminal penalties against patients who grow their own 
cannabis. That restriction, among others, has contributed to the 
delay, he added.

"It was an experiment, and the early returns (show) it has not been 
successful in meeting the needs of patients. I hope other states will 
look at New Jersey and see an example of what happens if access and 
regulations are too burdensome and too restrictive."

The state's maximum penalties for illegally possessing two ounces of 
marijuana - the most an alternative treatment center can dispense to 
each patient for a month - remains an 18-month prison sentence and a 
$25,000 fine.

Pain relief

Caporusso was among the first patients to pay the $200 registration 
fee for his card. He waited for months for Greenleaf to call him in, 
then drove two hours north to get his prescription.

"When I finally got home and was able to use it, the amount of relief 
I was able to get out of it was amazing," said the father of a 
4-year-old daughter. "All of a sudden, the pain stopped shooting up 
and down my arms. The electrical shock feeling went away."

Caporusso said the cost for one ounce at Greenleaf is $600 cash, plus 
7 percent sales tax - nearly double the street value. He can't afford 
to buy more than that each month, so he usually suffers through the 
last week of the month in pain.

When he's medicated, Caporusso said, "I'm far more coherent. I can 
engage in conversation. When you're in pain constantly, it's hard to 
be yourself. When the pain goes away, you can be normal and not have 
to sit there in agony and have to pretend that everything is OK."

A marijuana prescription card must be approved by a doctor in the 
state's marijuana registry. Doctors are required to apply for the 
program. Only 221 doctors are enrolled in the state's database, and 
they must have a "bona fide" relationship with a patient before 
writing a prescription for marijuana.

Under current law, 14 medical conditions qualify, including multiple 
sclerosis, Crohn's disease or terminal illness. Doctors can also 
prescribe marijuana to treat cancer or AIDS patients suffering with 
severe or chronic pain, nausea or vomiting or wasting syndrome.

Dr. Mark Angelo, director of palliative medicine at Cooper University 
Health Care, said he has certified about 25 patients for the 
marijuana program, but only one has been able to obtain the drug. He 
called the program "very frustrating," and said his patients are 
distressed and angry.

"I think the restrictions that are in the law are very appropriate," 
Angelo explained. "My problem has been in the implementation of the 
law. The fact that there's only one center available for the entire 
state has been incredibly difficult for my patients. By the time they 
come to see me, they're very sick ...

"In terms of compassion, I certainly feel that's where we've been a 
little bit deficient."

Dr. Stephen Goldfine, chief medical officer for Samaritan Hospice in 
Marlton, called the law "well-written" and said it will ensure 
medical marijuana is used appropriately. He recently completed the 
state's registry requirements but has not yet issued a prescription 
card for any of his patients, partly because of the delay in opening 
alternative treatment centers.

Goldfine said pain makes it hard for terminally ill patients to get 
out of the house and participate in family life during their last months.

"Some of the narcotic meds make people feel nauseous and sick," 
Goldfine said. "I think marijuana can actually help with that, as 
well as relieve some of the pain and anxiety, too."

A parent's plea For some patients, marijuana may be a lifesaver.

Meghan Wilson of Scotch Plains recently made headlines for her fight 
to get medical marijuana for her 2-year-old daughter, Vivian. The 
toddler suffers from a rare and severe form of epilepsy called Dravet 
syndrome. Patterns and bright colors - even dappled sunlight filtered 
through trees - trigger multiple daily seizures.

The syndrome can also cause sudden unexplained death during sleep. 
Wilson said anecdotal evidence has shown a particular strain of 
marijuana that is low in psychoactiveTHC and high in cannabidiol can 
reduce seizures in Dravet syndrome patients to about one every 10 days.

Though she has a prescription card and recommendations from her 
pediatrician and neurologist, Vivian still needs approval from a 
psychiatrist, according to state regulations for pediatric marijuana patients.

"Vivian is 2 and doesn't even say 'Mama,' " said Wilson. "I mean, it's a joke."

The 34-year-old mother thinks Christie doesn't understand the issue 
and how it impacts patients.

"He just hears medical marijuana and minors and says, 'No, this will 
not look good when I'm running for president,' " Wilson lamented. 
"What I want to say to him is, 'Gov. Christie, what if this was your 
kid? What if this was your grandchild?'

"And I want to bring my iPad and show him a video I have of Vivian at 
8 months old seizing for 45 minutes, running out of air and being 
intubated, and say, 'Look at this. Wouldn't you do anything you could?'

"What is the harm in allowing this?"
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