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Buffalo Business First – New York acts to expand medical marijuana program

By Tracey Drury, 8/31/16

State officials said Tuesday morning they would expand New York’s medical marijuana program, with plans to implement all recommendations issued last weekend in a two-year report.

The state Department of Health cited a statewide needs assessment in its decision to enhance the program, including doubling the number of registered organizations in the next two years, improving access for patients, authorizing nurse practitioners to certify patients for the program and allowing for home delivery services.

The recommendations came as part of a report,“Medical Use of Marijuana Under the Compassionate Care Act,” released by the DOH two years after the medical marijuana law was signed into effect by Gov. Andrew Cuomo. Since the program launched in January, 677 physicians have registered for the program, while 7,005 patients have been certified by their doctors.

Most of the changes will begin immediately, with others requiring regulatory approvals. Others will include reviewing information already in hand: The department plans to phase-in five more organizations over the next two years to meet patient demand, including revisiting the 43 applications submitted during the initial application period.

Western New York physicians and caregivers welcomed the expansion, some expressing surprise at how quickly it followed the DOH report.

“I can’t believe the Cuomo administration actually responded to that so quickly. That’s really amazing they are taking very specific actions,” said Lisa Valle, whose eight-year-old daughter has been taking medical marijuana for a genetic seizure disorder and pain since January. She’s also the co-founder of the Medical Cannabis Connection, a nonprofit group that works to grow awareness and access to the treatment.

Since her daughter began taking cannabis, she’s gone from having 150 seizures daily to none at all. She’s also gaining strength, trying to crawl and ride a special needs bicycle and has been taken completely off medications for asthma, pain medications for neuropathy as well as medications for acid reflux and seizures.

Valle is hopeful the expansion of the program will lead to more consistency and greater variability in the types of medical marijuana available as well as greater access due to the delivery options, resulting in more patients registering for the treatments and helping solidify business for the organizations that make and distribute medical marijuana.

“These recommendations really open up access for a lot for patients who are struggling with different ailments,” she said.

Dr. Laszlo Mechtler, medical director of Dent Neurologic Institute and Roswell Park Cancer Institute’s chief of neuro-oncology, said once the provision to allow nurse practitioners to prescribe is finalized, he plans to have at least 10 complete the training from Dent.

“It’s a positive move,” he said. “I think New York state realizes they have a very rigid program that needs to be expanded. I’m very happy with these announcements.”

The Western New York region has seen limited participation by providers, with just 39 practitioners and 491 patients registered through June 15. The highest concentration locally is found in Erie County, where two of the state’s 20 planned dispensaries are located.

Some say they’re hopeful about the program expansion, but restrained as they wait for final rules on how the program will change. Christina Kelly’s daughter Mariah receives medical marijuana for seizures, but currently can’t get her third daily dose during the school day because of restrictions on where and by whom the drug can be administered.

In the eight months she has taken cannabis, Kelly’s 19-year-old daughter has seen her seizure activity reduced by 75 percent, plus she’s gaining muscle control and better balance, and walking for the first time in years. She’s also come off seizure medications and anti-epileptic drugs.

The DOH said it would assess possible regulatory amendments that would make it easier for healthcare facilities and schools to possess, secure and administer medical marijuana products under limited circumstances.

“I’m feeling hopeful, but I don’t want to be let down,” Kelly said. “To me, not giving it to her at school is akin to saying to a diabetic or an asthmatic you can’t get your meds at school. It infringes on her human rights, her dignity and her ability to attend school, so there’s a lot at stake.”

Dr. Howard Zucker, state health commissioner, said in a statement the department will continue to evaluate the program to make it more effective for patients and practitioners.

“We believe that the implementation of these recommendations will do just that,” he said.

Already, the DOH has begun the regulatory process necessary to authorize nurse practitioners and streamline manufacturing requirements. Proposed amendments for both will be published in the New York State Register on Sept. 14 and will be subject to a 45-day public comment period. Within the week, the department will begin issuing guidance to registered organizations about home delivery plans.

Also underway is a review of evidence and literature on how medical marijuana can be used for individuals with chronic pain, with a decision expected within 90 days. In the next 30 days, the department will assess steps necessary to utilize independent laboratories to test medical marijuana programs, which is now restricted to one state-owned lab.

A financial hardship waiver has been immediately expanded to help alleviate financial burdens for patients and caregivers, while the certification and registration system will be enhanced to be more user-friendly. The state is also exploring changing the way patients find practitioners registered to recommend medical marijuana. In the next 30 days, all currently registered practitioners will receive a letter asking if they are willing to be publicly listed on the DOH webpage.

Assemblyman Richard Gottfried, who heads the New York State Assembly’s health care committee, said the expansion is positive, but doesn’t go far enough. Gottfried has sponsored half a dozen bills aimed at changing the law, including expanding the medical conditions that would qualify a patient to receive medical marijuana.

“Certainly, I think the department’s report has highlighted the need for the legislature to more actively lead on this issue,” he said. “These changes are all in the right direction, but they leave a lot of important changes undone.”