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Law expands providers of medicinal marijuana

Nurse practitioners may certify patients for medical marijuana

Nurse practitioners may certify patients for medical marijuana in New York starting Nov. 30 and a proposed measure would allow physician assistants to do the same, according to state health officials. A file taken on April 19, 2016 shows a marijuana plant and its buds at Alternative Solutions, a medical marijuana producer in Washington, D.C. Credit: AFP/Getty Images / BRENDAN SMIALOWSKI

Nurse practitioners may certify patients for medical marijuana in New York starting Nov. 30, and a proposed measure would allow physician assistants to do likewise, state health officials said.

The long-expected approval of nurse practitioners as providers who could authorize patients for the drug, required an amendment to state law and is part of an expansion effort to increase patient access, state health officials said last week.

To date, only physicians could certify patients for therapeutic cannabis, a drug approved medicinally in New York in tinctures, vaporizable oils, capsules and extracts. Smoking pot as a medication is not allowed under state law, and patients must be officially certified to use to the drug.

An estimated 740 doctors have registered with the state Health Department to certify patients, and about 10,500 authorized patients are in the medical marijuana program, official figures show.

State Health Commissioner Howard Zucker is calling the therapeutic marijuana effort — signed into New York law two years ago under the Compassionate Care Act — a success.

“Authorizing nurse practitioners and physician assistants to certify patients will only help to further strengthen the program and improve patient access,” Zucker said in a statement last week as he announced the new role for nurse practitioners.

He sees statewide medical cannabis use growing with additional health care providers coming onboard to provide certification of patients. There are nearly 19,000 nurse practitioners, according to state figures, and more than 11,000 physician assistants. All the providers are already licensed to prescribe opioids and other controlled substances.

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Empowering them to issue medical marijuana certifications will help patients with severe, debilitating or life-threatening conditions, Zucker said.

Pulse, a Wantagh-based organization that focuses on patient safety, advocacy and support, contends that desperately ill people need all the help they can get from as many health care providers possible.

“I do believe that if physicians can certify patients for medical marijuana then I think that nurse practitioners and physician assistants should have the same function,” said Ilene Corina, Pulse’s president.

“I am very nervous about medical marijuana,” added Corina “but I am very respectful of people who need it.”

Corina said she would like to see more scientific research on medical marijuana, an argument also made by many doctors. In New York, the drug’s therapeutic use is restricted to patients with serious medical conditions, such as epilepsy, multiple sclerosis, glaucoma and cancer.

As with physicians, nurse practitioners will have to complete an online course developed by the New York State Department of Health, called Medical Use of Marijuana.

Zucker’s department, meanwhile, has filed a proposal to allow physician assistants to certify patients for therapeutic cannabis, as long as their supervising doctors are registered to authorize them.

That proposal, to be submitted Nov. 30, will be subject to a 45-day public comment period. An amendment to state medical cannabis regulations would not take effect until after the public review period.

David Jackson, government affairs chairman of the New York State Society of Physician Assistants, said his organization lobbied the state to certify patients for medical marijuana.

“It would be an important role for P.A.’s to provide whatever care is medically appropriate for the patients they are caring for,” said Jackson, a physician assistant in Old Westbury and a vice president with the American Academy of Physician Assistants.

“Medical marijuana is certainly a pharmaceutical that is getting greater attention for the treatment of pain and nausea for certain patients,” he said.

The academy of physician assistants has taken several official positions on medical marijuana: One calls for additional clinical research on the therapeutic value, efficacy and safety of cannabis. Another recommends that in states where medical marijuana laws exist, physician assistants be included among providers able to authorize patients for the drug.

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