EDITOR’S NOTE: On March 10, NJ Cannabis Insider hosts its first semi-annual, daylong industry conference, featuring leaders in the medical marijuana, hemp and legal cannabis industries. Tickets are now on sale.
With roughly 2,000 people registering every month, New Jersey’s briskly growing medicinal marijuana program needs more participation from doctors, more product options and more information about which strains actually work for patients.
These are topics some of the experts serving on the medical cannabis panel, “The Next Frontier” will discuss at the March 10 New Jersey Cannabis Insider conference presented by Curaleaf NJ.
Even though the number of doctors participating in the program has doubled since Gov. Phil Murphy took office in January 2018, the 1,105 licensed physicians who recommend patients to the program are spread too thin in a state with 9 million people, panelists agree.
Attorney Sheila Mints of Capehart Scatchard in Mount Laurel said the physicians she counsels are interested yet reticent.
“The whole way it is set up in New Jersey is frustrating to doctors,” Mints said. “They are used to saying, ‘Here’s the medication, take it twice a day, it’s 20 milligrams.’ They understand how it interacts with other medicines.”
With cannabis, doctors they are saying, “ ‘I am going to register you and you will go to a dispensary where hopefully they are educated,’ “ and know what to suggest, Mints said. The doctor “can’t really tell patients what they may feel.”
Some doctors have been waiting for the number of cultivators to expand and the products to improve to the point where pharmaceutical-grade cannabis is widely available, she added.
Mints said one of the down-sides of incorporating cannabis into a medical practice is the challenge of finding insurance carriers and financial institutions that will likely remain skittish as long as marijuana is illegal under federal law.
“It’s not the kiss of death it used to be but it can still be difficult,” Mints said.
Former Health Commissioner Shereef Elnahal two years ago met with doctors and hospitals across the state to encourage them to demystify medical cannabis. More doctors signed up.
Panelist David Nathan, founder of Doctors for Cannabis Regulation, agrees physician education is very important to the program’s success. The state should be doing more to lead the effort.
The “knowledge gap” is most evident among general practitioners. Specialists like oncologists may fare better because cannabis is widely recognized for easing nausea and pain, Nathan said. But general practitioners who see a wider array of patients likely have the least experience working with cannabis.
When asked why doctors don’t participate, the most common answer is there is not enough research funded to determine the benefits versus the risks. While the federal government continues to classify marijuana as a schedule 1 drug, there are other ways to learn from the experiences of patients, Nathan said.
The Department of Health, perhaps in connection with a university, could be conducting patients surveys asking how cannabis helps them, which strains do they use, how much do they take and in what form do they ingest it, Nathan said. There is a lot that could be learned from the more than 70,000 registered patients in New Jersey, he said.
National research is happening in some places. Nathan noted that the Albert Einstein College of Medicine and Montefiore Health System in New York obtained a $3.8 million research grant from that National Institutes of Health in 2017 to study whether medical marijuana reduces opioid use among patients with chronic pain.
Nathan said he recommends doctors who want to do their own homework obtain a copy of the 2017 book by the National Academies of Sciences, Engineering, and Medicine, which identified the accepted therapeutic use and effects of cannabis, based on 10,000 studies.
“It’s a great work,” Nathan said.
Jackie Cornell, chief of Policy and Health Innovations at 1906, an edibles company, and the former principal deputy health commissioner, said she agreed that there should be an “observational study” of medical cannabis patients.
“There are a lot of patients who would be eager to do this. They want to have a better understanding of the benefits,” said Cornell, also a panelist.
Cornell suspects we will learn patients wants more non-smokable forms of cannabis, such as pressed tablets. “It’s the wave of the future. It is how we administer medicine,” she said.
The future Cannabis Regulatory Commission, which is supposed to be created this year and take control over the medicinal program, as well as the anticipated adult use market, should be spearheading this work.
There’s been no word on when the governor or the Legislature will appoint the commissioners and launch the new office.
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