TRENTON — Suzette Roberts would rather not break the law.

But playing by the rules of New Jersey’s struggling medical marijuana program has gotten the 64-year-old Cliffside Park woman nothing but $500 in doctor bills and a $200 ID card she has yet to use. New Jersey’s only licensed dispensary told her in the spring they’ve been swamped and haven’t gotten to her name on the waiting list.

Roberts — who says marijuana "lessens the pain and gives me more of an appetite" as she undergoes treatment for stage 4 breast cancer — buys the drug illegally because she can’t afford to wait.

"This is a disgrace," Roberts said. "I am upset and angry that I laid out $700 and I am not getting any answers. I am upset with the state, too, and they don’t seem to care."

In the eight months since New Jersey’s first dispensary — Greenleaf Compassion Center in Montclair — opened, patients and providers have learned the nation’s most restrictive medical marijuana program is also the most expensive.

From registration fees and required multiple doctor visits that insurance won’t cover, to sales tax and the price of pot, New Jersey’s costs are generally higher than the 10 other states and Washington, D.C., that permit medical marijuana retail sales, according to a Star-Ledger analysis.

The review found:

• New Jersey is tied for second for the costliest registration fee ($200 for two years), has the third-highest sales tax (7 percent) and the steepest marijuana prices, according to state and dispensary websites.

• Greenleaf patients say they have spent from $440 to $560 for an ounce of marijuana, depending on the strain. Only Washington, D.C.’s sole dispensary, which opened last week, comes close, charging $440 an ounce for its most expensive strain. Montana offers the best bargain, charging on average $261 an ounce.

• A New Jersey patient getting started in the program can spend $700 for an ID card and an ounce of marijuana, compared with $300 in Colorado, $510 in Washington, D.C., $531 in Arizona, and $460 in Michigan.

The Star-Ledger used state and dispensary websites, patient interviews, and medical marijuana industry and other published reports to compile the information on Arizona, California, Colorado, Maine, Michigan, Montana, New Mexico, New Jersey, Rhode Island, Vermont, Washington and Washington, D.C.

"It’s a rich man’s game," said Jay Lassiter of Cherry Hill, a registered patient and marijuana activist who said he spent nearly $1,000 on doctor visits, state registry fees and the drug "before I took my first puff."

The review found some states provide discounts for the poor, veterans and elderly. In New Jersey, the registration card fee is sliced from $200 to $20 for people on permanent disability, food stamps and Medicaid. About half of the 1,000 registered patients paid the discounted price, state Health Department spokeswoman Donna Leusner said.

'TANTAMOUNT TO FRAUD'

Paul Cavise, 63, a father of three from Atlantic Highlands who suffers from a nerve disorder, said he hasn’t been able to buy medical marijuana and won’t use the black market. He wants the Health Department to return his $200 for the "worthless" registration card he bought last year. "This is tantamount to fraud," he said.

Leusner said patients still waiting to buy pot — and that would be nearly all of them, as Greenleaf has served 127 people out of 1,000 — will get a prorated discount when they renew their cards in two years.

Experts say New Jersey is having the same growing pains encountered around the nation because medical marijuana dispensaries are regulated more, have higher costs and a tougher time getting banks to back them than other nonprofits.

But they stress New Jersey’s program is even more expensive because the law signed by former Gov. Jon Corzine and regulations set by Gov. Chris Christie make it difficult and costly to open and maintain a dispensary.

"No matter what state you are in you can have a difficult time," said Betty Aldworth, deputy director for the National Cannabis Industry Association in Colorado. "New Jersey has the added challenge and difficulty that licensing has been terribly slow and the program is the most restrictive in the country for patients and business operators."

NONPROFIT DISPENSARIES

The law’s requirement that dispensaries operate as nonprofits is the "biggest impediment to the program," said Bill Thomas, president and chief executive for Compassionate Care Foundation of Egg Harbor Township, which hopes to open in the fall.

"To make safe products for patients takes extraordinary amounts of financing," Thomas said. "Meanwhile, the Corzine law … requires us to follow all of the not-for-profit rules with none of the benefits."

He said although charities avoid paying income tax, "We are at the other extreme. We have to pay 35 percent tax on gross income and donations."

Because they are producing what the federal government still considers an illegal substance, Thomas said he cannot get a federally backed bank loan. Enticing investors has been a tough sell. "They have to go through months of casino executive-level investigations that cost thousands of dollars to complete," he said.

Months before Compassionate Care’s anticipated September opening, the nonprofit’s board had to borrow $1.45 million for rent, construction, supplies, security, administrative costs and other expenses. To make the business work, patients will have to absorb the costs, Thomas said.

"I am not arguing for me making more money, I am just a salaried employee, but this forces people to go to the drug dealer on the corner who isn’t paying these taxes," he said.

Health Commissioner Mary O’Dowd said she knows dispensary operators have struggled "to appropriately organize as nonprofits. We have worked with the Attorney General’s Office to provide them guidance."

O’Dowd said another problem dispensary operators have had "seems to be the expectations of the return on the investment. The issue is not about getting a return but what is an appropriate return for a nonprofit."

The founders of Greenleaf in Montclair, which announced in June that it would temporarily close to build up more marijuana supply, stressed in a spring interview that they weren’t seeking to make big money. "The expenses are still being paid by the board members," said co-founder Julio Valentin Jr. "We are not in this to profit from our patients."

Medical marijuana patients are also required to get a doctor’s recommendation to get into the program, adding to their cost. Thus far, only 235 of New Jersey’s 38,300 registered doctors are on the state’s medicinal marijuana program’s physician registry, Leusner said.

The law requires a "bona fide physician-patient relationship," which means either a doctor who has been treating a patient for at least a year has seen the patient at least four times, or has conducted "a comprehensive medical history and physical examination" that shows how the patient responded to "conventional medical therapies."

Patients and advocates say many doctors demand four appointments. The state doesn’t track the cost of doctor visits. A half-dozen patients told The Star-Ledger they paid $50 to $300. Meghan Wilson of Scotch Plains, who is waging a public fight to obtain medical marijuana for her 2-year-old daughter with a severe form of epilepsy, said one doctor quoted her a $1,000 fee. Wilson said she mailed a check, but it was returned because the doctor did not want to take on a pediatric case.

Larry Downs, executive director of the Medical Society of New Jersey, said four doctor visits "doesn’t sound like a long time to establish a relationship, especially with a new patient."

"They need to work through the prognosis," he said. "I can see it taking a few visits to weed out the drug-seekers."

Downs said many doctors remain skeptical about the medicinal power of pot, citing a lack of research.

Anthony Anzalone, a physician from Rutherford, is not one of the naysayers. A gynecologist before the program started, he has referred about 100 patients, and is exploring research opportunities. His website address is drmarijuananj.com.

"Many people come in, they don’t have two nickels to rub together. I have a low price ($100 a visit), so I am not going to get rich on it," Anzalone said. "If I have a patient in a wheelchair, I won’t bring that patient in three times."

Anzalone said he is surprised the stigma of marijuana remains so strong, saying he believes cannabis is a compelling alternative to prescription drugs that carry many serious side effects.

Off of opiates

"I have had other physicians call me and ask, ‘Are you selling marijuana?’ If I can get people away from opiates, I feel I am doing my job. … If I can get somebody back to work, that’s a million dollars — to make a person a productive human being again."

The benefit of providing relief to the sickest patients who haven’t responded to conventional medicine is one selling point when the public and lawmakers are asked to support medical marijuana.

The other is money. Industry analysts said, thanks largely to California and Colorado, medical marijuana is a $1.7 billion industry.

New Jersey is not likely to share in this bounty. Unlike Colorado and California — constantly criticized by Christie for making it too easy to buy pot — the law limits the number of dispensaries in New Jersey to six, unless the health commissioner recommends more.

Thomas, of Compassionate Care, said the state doesn’t need to become like California or Colorado to bring down costs. He suggests regulating medical marijuana dispensaries "like insurance companies." He said that would free them from the tough restrictions on nonprofits while still allowing the state to set prices and limit profits.

"The reality is that a for-profit company would have lower prices for patients," Thomas said.

IT ADDS UP

For patients, New Jersey's medical marijuana program is among the most expensive in the nation in all categories. Here's a look at how it compares to other states:



State State SalesTax Registration fee * Average retail price per ounce

New Jersey 7% $200 for two years $500

Arizona 6.60% $150 annual $381

California 7.5% plus city tax varies by county $347

Colorado 2.9% plus city tax $35 annual $265

Maine 5% no fee $400

Michigan no tax $100 annual $360

Montana no tax $75 annual $261

New Mexico 5.10% $30 annual $356

Rhode Island 7% plus 4% surcharge $100 annual not available

Vermont no tax $50 annual no retail sites open yet

Washington 6.50% no fee $290

Washington D.C. 6% $100 annual $410





* Reduced price for low income residents: New Jersey, $20; Arizona, $75; California, 50 percent discount; Colorado, no fee; Michigan, $25; New Mexico, $15; Rhode Island, $25; Washington D.C., $25.



Sources: state and dispensary websites, published reports on the medical marijuana industry, weedmaps.com and interviews with patients .



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