As of November 30th, patients in New York are now able to receive medical marijuana recommendations not only from doctors, but from nurse practitioners as well. Nurse practitioners in New York can now register with the state Health Department to receive a certification in order to recommend medical marijuana to patients. This is a huge and potentially positive development for a state that has put up enormous hurdles for patients to obtain state issued medical recommendations for cannabis.
Nurses, just like doctors within NY, will be required to take an approved online course called “Medical Use of Marijuana” and submit their credentials of completion to the Health Department before being allowed to sign off on patient recommendations. The Health Department also started a 45-day comment period on another proposed amendment that would give Physician’s Assistants the ability to give medical marijuana recommendations to patients in addition to nurses. What is interesting in this development is that nurses, not doctors, are often more well informed regarding the efficacy of cannabis with patients.
Medical marijuana has experienced mixed reviews in the state, particularly with patients who believe that the implementation of the medical marijuana program was incomplete, making it incredibly difficult and expensive to obtain marijuana as a medicine. HelloMD talked with a New York dispensary that confirmed that the impediments to doing business mostly centered around the lack of patients. This dispensary was quoted as saying “We have been prepared to do business in a difficult market as we believe the state will eventually ease requirements to getting a medical recommendation. If this happens it will result in larger patient flow, increase overall business and ideally lower the costs reflected back to the patient.”
Officials from the New York Department of Health, however, have declared medical marijuana a success in the state. The health commissioner of the state, Dr. Howard Zucker, has expressed that adding nurses, and possibly physicians assistants, to the recommendation process will serve to help improve the program, especially in rural areas where doctors are limited.
The current program in the state involves roughly 10,500 patients and 740 doctors who have been approved to recommend medical marijuana to patients. The ratio of doctors to patients at about 14:1 isn't nearly as bad as the lack of dispensaries in the state. The state did not even reach its goal of having five dispensaries up and running by the time of medical marijuana roll out in the state. Still to this day, 27% of registered patients and caregivers have to travel one to five hours to reach a dispensary.
Not only are dispensaries costly to reach for over a quarter of the people enrolled in the program, but the cost of marijuana in the state is extremely expensive. In a survey of people enrolled in the medical cannabis program, 70% of respondents said that their monthly cost for medication would be $300 or more. All of these factors add to New York’s reputation as on of the hardest states to access medical marijuana. Previously, the state has also experienced some major problems within the Department of Health. The Department of Health previously mishandled regulations on how doctors could be certified, leaving many gravely ill patients unable to access medication that could have been truly life changing for them.
Another major problem was the faulty dispensary roll out, which is an issue that still has not been completely resolved. People having to drive over an hour to get their medication is a major problem that shows incomplete commitment to the program by the state. Medical marijuana should be viewed on the same plane as pharmaceutical medications, so accessing a dispensary should be as easy for patients as accessing a pharmacy.
New York has also had some problems getting doctors interested in enrolling in the program to recommend medical marijuana. Many doctors in the state are fearful of federal retribution for being involved in the marijuana program because it is still considered a federally illegal substance. Doctors across the country must register with the DEA in order to handle prescription drugs and many are worried that their right to prescribe pharmaceuticals could be revoked if there is backlash against medical marijuana in the future.
Many doctors in the state also feel under educated on cannabis, despite the fact that New York is one of the few states that requires doctors to take a course before being allowed to recommend medical marijuana. Unlike in other states, however, New York physicians are suppose to recommend doses to patients, rather than patients getting dosage information from dispensaries.
Many Doctors who do recommend medical marijuana in the state feel overwhelmed by the sheer number of people interested in medical marijuana for their various conditions. One of the conditions where medical marijuana has the most efficacy, chronic pain, is still not an approved condition in the state, leaving many people who could greatly benefit from cannabis to resort to harsher, and often addictive, pharmaceuticals like opioids.
New York is starting to turn the tide and potentially change their reputation on medical marijuana by giving patients more access to recommendations through nurses, but these improvements do not take away from the large changes the state still has to make to provide their patients with a consistent and affordable source of medication. The bottom line is that New York needs to keep moving in this direction and quickly. The state must improve overall education for medical providers as well as patients, make a significant effort to help licensed dispensaries to lower overall costs and license more dispensaries for those in more rural areas.