New York's approval of a medical-marijuana program ended a political debate. But the questions are just beginning.
Supporters were joyous after lawmakers struck a deal last week to make New York the 23rd state to legalize marijuana for medicinal purposes. Yet they also were anxious about the many details that still need to be addressed.
How will doctors be certified to prescribe medical marijuana? Where can you get it? Will every region have a dispensary? How much will it cost? Will the list of eligible diseases and conditions expand?
"It's going to be a long process to get this up and running," said Tracy Ofri, a Valley Stream resident and multiple sclerosis patient who uses a walker. She's one of many medical marijuana advocates who have been lobbying lawmakers at the State Capitol for months.
"At least, now, we're on the board," she said. "It's on its way."
Here are some of the key parameters of the program and issues to be resolved:
According to the Cuomo administration, the bill allows patients with the following conditions to qualify: cancer, HIV/AIDS, ALS (Lou Gehrig's disease), Parkinson's disease, multiple sclerosis, damage to the nervous tissue of the spinal cord with objective neurological indication on intractable spasticity, epilepsy, inflammatory bowel disease, neuropathies and Huntington's disease.
Regulations also will allow the state health commissioner to add to the list as he determines.
Legislators originally wanted no limit on treatable conditions, preferring to permit physicians to make case-by-case decisions. They reduced it to 20 conditions, then cut it even further at Gov. Andrew M. Cuomo's insistence.
One condition omitted: post-traumatic stress disorder.
Advocates said they would push to add it to the list. "With all the veterans out there suffering from PTSD, this is a real concern," said Gabriel Sayegh, state director of the Drug Policy Alliance.
The program could open for business no earlier than 18 months after Cuomo signs the bill. But it could be longer -- the state Health Department must certify that the program is ready before any patients could begin receiving treatment.
Further, interested doctors would have to receive training about doses and other issues to be certified to prescribe medical marijuana. It's unclear how soon training would begin, but lawmakers want it to start well before the program goes live.
State Sen. Diane Savino (D-Staten Island), a prime sponsor of the legislation, said setting a timeline was key to encouraging companies to compete. "We had to have a start date or the industry would take a pass on New York and we didn't want that to happen," she said.
No form of smoking would be allowed. Patients could receive the product through oil, edible forms and vaporizers.
The state Health Department will issue dosage guidelines and no patient can possess more than a 30-day supply. Patients must keep the product in its original packaging until used and may not share with other patients.
Approved patients would receive registration cards.
Only New York State residents may participate, as well as only physicians who are registered and practice in the state. The law also prohibits a patient from being discriminated against on the job solely for being a medical marijuana patient.
Prescriptions would be tracked with the state's I-Stop program for monitoring prescription narcotics. Physicians and pharmacists could be prosecuted for illegal prescriptions.
Authorization for the program would have to be renewed after seven years. Further, the governor could terminate it at any time.
The state would select a maximum of five manufacturers to produce medical marijuana. Each could operate up to four dispensaries, giving the state up to 20 dispensary locations.
Cuomo said "geographic diversity" would be a consideration in selecting sites.
Sayegh and others worry that's too few for the state. "Will 20 dispensaries be enough for a state with almost 20 million people?" he said.
Savino acknowledged "that is a concern" but said the legislation allows the Health Department to expand the number. Sayegh said New Jersey put "too many restrictions" on companies, resulting in the loss of two of its dispensaries.
The health department and State Police will set the price per dose. "We have to make sure the product is not more expensive than [marijuana] street value, so that patients don't go out and buy it from the black market," the senator said.
The state will apply a 7 percent excise tax on manufacturers. Counties that host manufacturers would get 22.5 percent of the revenue generated; counties that host dispensaries would get another 22.5 percent. Five percent would go to state substance abuse programs; 5 percent to criminal justice services and the rest to be appropriated by the governor and legislators.
Savino couldn't say exactly how many jobs would be created but said that in other states, each "grow operation" can employ "several dozen people."