The state health department’s plans to expand access to New York’s restrictive medical marijuana program is being greeted with mixed reaction from doctors. Dispensaries say growth of the program has been slow since the sale of cannabis began in January.
Syracuse internist Dr. Jeff Sneider is one of the few doctors in the area certified as a medical marijuana provider. He said he did it partly out of curiosity, and knowing he had patients who might be eligible.
"The patients I've spoken to about it have mostly already been using marijuana illegally, so they;ve been smoking it illegally," Sneider said. "They already knew the effects it would have on their condition, and wanted to switch over to medical marijuana."
The state sanctioned form of marijuana is administered in liquid of vapor form. Key changes to the program include authorizing nurse practitioners to certify patients, in addition to doctors. Sneider has some reservations.
"This is complicated enough, and we've messed up enough with drugs as physicians," Sneider said. "I'd like to make sure there's a collaboration between nurse practitioners and physicians, particularly a physician experienced in the areas of medical marijuana or addiction medicine."
The increased likelihood of addiction is what worries Dr. Brian Johnson as the Director of Addiction Medicine at SUNY Upstate. he says the more available the drugs are, the more people get hooked.
"Now we're starting to have alcohol available on Sunday," Johnson said. "So, we're going to have more alcoholism. The same is true of marijuana. The more available you make it, the more addiction you'll see."
SHOULD PATIENTS BE ALLOWED TO USE MARIJUANA TO TREAT CHRONIC PAIN?
The state is considering the addition of chronic pain to the short list of qualifying conditions for a patient to purchase medical marijuana. That possibility concerns Dr.Brian Johnson, who’s Director of Addiction Medicine at SUNY Upstate. He says while there’s been some evidence to support the efficacy of medical marijuana for chronic pain, he worries it’s a slippery slope.
“If you ask people with chronic pain, ‘gee, when you use marijuana, does it help?’ People tend to say it helps. Just like if you give people with chronic pain oxycodone, they’re going to tell you, ‘yea, I took the pill and I felt much better.’”
Johnson says just like opioids, studies show that cannabis may help chronic pain in the short term, but probably isn’t best for long-term use.
“What people don’t notice is that anytime you try to squash the pain system, the brain redoubles its effort to make pain awareness,” Johnson said. “It’s as if it’s a survival thing that we need to be able to feel pain to stay alive.”
Other physicians like internist Dr. Jeff Sneider has been more open to the medical marijuana program…he’s one of the few certified providers in the area. He wants to let evidence determine whether chronic pain should be added to the list of qualifying conditions.
“The evidence for some of the conditions on there now is kind of thin,” Sneider said. “It’s why they need to make marijuana a class 2 drug instead of class 1 so it can be used for clinical research. We need more research.”
Both Dr.'s Sneider and Johnson do not want to see marijuana made available for recreational use.
Those who operate medical marijuana dispensaries welcome the changes being implemented and considered by the health department to generate additional access to the drug. Hillary Peckham is Chief Operating Officer of Etain LLC, which opened a dispensary on Erie Boulevard East in Syracuse in February. She says increased volume is needed to reduce costs.
“Really, the inhibiting aspect for a lot of current patients is the price of the products, which is very high due to the amount of regulations and the restrictiveness of all the diseases,” Peckham said. “One way we can increase access is finding a way to create volume of patients so we can bring those prices down.”
Peckham says about 7,000 patients are registered in the program, but only about 2,000 are active and participating. She says restrictions on marketing their products also limit awareness and access among doctors and patients.
“A large portion of what we try to do is outreach and education for those who are interested,” Peckham said. “But we’re not allowed to solicit like a normal pharmaceutical representative or something like that. We’re limited in what we’re actually even allowed to discuss with doctors and the relationship we can have with them. It’s a prohibiting factor in educating them so they can get on board. I’d like to see that change.”
Peckham says there are still large numbers of eligible patients who don’t even know the medical marijuana program is up and running…nearly eight months after many dispensaries opened their doors.
