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Widen access to medical cannabis

Medical marijuana plants at a medical cannabis cultivation

Medical marijuana plants at a medical cannabis cultivation and processing facility. Some LI towns have banned retail sales of pot. Credit: AP/Hans Pennink

Three years ago, my colleagues and I partnered with a local cannabis dispensary and surveyed older adults with chronic pain, and found an overwhelming number reported that medical cannabis significantly reduced their chronic pain and reliance on opioids.

Close to 30% reported they had been able to wean themselves completely off highly addictive and potentially deadly synthetic painkillers and improve their quality of life by introducing medical cannabis into their regimens. Ninety-one percent said they would recommend that others do the same.

As a specialist in geriatric and palliative medicine, my referral rate of patients interested in trying medical cannabis as an alternative to traditional pharmaceutical drugs is sky high — more than 50% of the new consults I see fall into this category. Yet, barriers remain that create a bottleneck to access of this highly effective drug for the patients who so desperately need it.

New York’s medical cannabis program is one of the most restrictive in the nation. The Marijuana Regulation and Taxation Act, or MRTA, which legalized cannabis for adult recreational use in late March, includes changes to improve both accessibility and affordability in the medical program, yet the state has thus far refused to implement them.

More New Yorkers are becoming savvy to the possibility of using cannabis as an alternative to pharmaceuticals to treat pain and mitigate the side effects of cancer treatment. But there is a lack of expertise on cannabis in the medical community, and most clinicians are self-taught.

The MRTA seeks to address this by reducing the number of training hours required for medical professionals to legally prescribe cannabis from four hours to two, and providing them with more discretion to prescribe this medication.

Another problem is the stigma cannabis continues to carry due to years of prohibition. This can be combated by improved education. Such efforts are hampered by the inability to conduct significant research into the benefits of cannabis, as it remains illegal at the federal level and classified as a highly controlled drug.

We need more verified and clinical cannabis research so medical professionals feel comfortable accepting its benefits. The MRTA includes a license that allows a holder to procure, produce, process and/or possess cannabis to "conduct research on the efficacy and safety of administering cannabis as part of medical treatment."

Because cannabis remains illegal at the federal level, it is not covered by insurance. Patients must pay out of pocket, so medical cannabis remains out of reach for many — particularly those in lower-income communities.

The MRTA allows the medical program to sell a form of cannabis that is less processed and more easily smokable, known as "whole flower." This is cheaper to produce and therefore would bring costs down. Many elderly patients prefer to take cannabis in a pill or oil form, but others who are younger might prefer to smoke it as a mode of administration.

Though it will likely take over a year to get an adult-use market up and running, state lawmakers made clear when they passed the MRTA that changes to the medical cannabis program could and should be made as soon as possible. New York should move expeditiously to do so. Too many patients have waited long enough.

This guest essay reflects the views of Dr. Diana Martins-Welch, a physician at Northwell Health’s Center for Advanced Medicine in New Hyde Park.

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