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?" - --- MAP posted-by: Jay Bergstrom