By Shereef Elnahal

During my medical training in Baltimore, I met a 55-year-old florist whom I will always remember. We were treating her for a recurrence of throat cancer. The first time around, her treatment was so painful that she was placed on two types of opioids at the same time: a fentanyl patch and oxycodone pills. Her pain became intolerable, and she had to be hospitalized five times. Each time, she received another type of intravenous opioid therapy. By the time she completed her first round of chemotherapy and radiation, she was on the verge of addiction, soliciting pills from various doctors or buying and exchanging with friends. She did not know where else to turn.



After her cancer returned, a friend gave her a sample of marijuana. It was only after she tried it that her doctors were finally able to wean her off opioids. Unfortunately, she had to buy the marijuana on the black market to get a pain treatment that worked. Maryland did not have a medical marijuana program at the time.



We are doing things differently in New Jersey. We are expanding access to medical marijuana so those with legitimate medical needs are served with compassion. More than 11,600 new patients have registered since the beginning of the Murphy administration, putting us on track to double the number of patients since last year. The state Health Department is also revamping its regulations to make the program more accessible and responsive to patients' needs. These changes include reducing the registration fee by half for most individuals and by 90 percent for veterans and seniors, adding key conditions such as chronic pain and removing bureaucratic impediments to physicians' ability to recommend medicinal marijuana.



But while the Murphy administration has made strides in expanding access, we are only just beginning to meet the needs of thousands of potential patients. We must take additional steps, and I am asking for help from my fellow physicians, dispensaries and our colleagues in the Legislature.



I am asking my fellow physicians to enroll in the program and consider medical marijuana as another effective, therapeutic tool for many of their patients. In lectures that I have delivered to medical schools and teaching hospitals across the state, I have reviewed the evidence behind the therapy. Research has demonstrated the efficacy of marijuana in treating chronic pain, epilepsy, Crohn's disease and more. Better research is needed, and the administration is advocating for descheduling the drug at the federal level to obtain necessary funding.



But considering that medical marijuana's side effects are minimal compared with other prescription drugs, the benefit of recommending it often outweighs the risk. To date, no one has died from marijuana overdose or withdrawal. The same cannot be said of opioids. As they would with any other therapy, physicians should assess the risk/benefit for appropriate patients and avoid billing patients separately for "medical marijuana visits."



I am asking more dispensaries to enter into the market. Last week, we announced the first requests for applications for up to six alternative treatment centers -- two each in the north, central and southern regions of the state -- that combine cultivation, manufacturing and dispensing in one business. We must immediately start the process to open new alternative treatment centers to meet growing demand. Later this year, we anticipate other rounds of applications for businesses specializing in cultivation, manufacturing or dispensing distinctly.





Finally, I am asking the Legislature to pass a bill that allows edible forms of medical marijuana to be accessible for all patients; lifts the limit of 2 ounces per month; reduces doctor's visits for patients; removes the limit for patients receiving end-of-life care; and provides workplace protections. Current proposals have many of these elements, which is very encouraging.



For Jake Honig, a 7-year-old Howell resident who died after battling a rare form of cancer, medical marijuana proved to be the only therapy that worked during his final days. His other half-dozen medications -- to address nausea, vomiting, pain, agitation and insomnia -- caused serious side effects. In short, it was medical marijuana that allowed Jake to enjoy his last moments with his family.



For patients like Jake and tens of thousands of others in our state who would benefit, we need to work together to cross the finish line.

Shereef Elnahal, M.D., is New Jersey's state health commissioner.

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