SYRACUSE, N.Y. - Brian Wieder, an AIDS patient, was stunned when he discovered medical marijuana would cost him about $400 a month in cash.

Wieder, 65, moved to Syracuse in 2014 from California with his husband, Javier. In California, Wieder was enrolled in the state's medical marijuana program and used to spend about $75 a month.

He recently purchased medical marijuana from two new dispensaries in the Syracuse area. Now he wonders if he will be able to afford to continue using it.

"People will freak out when they go to the dispensary," Wieder said. "They will have to bring hundreds of dollars with them."

Cash only at medical marijuana dispensaries

Medical marijuana is not covered by health insurance because it's not approved by the U.S. Food and Drug Administration and is still classified as an illegal drug by the federal government.

Dispensaries, which accept cash only, negotiate prices with the state.



Wieder was diagnosed with AIDS in 2004. Before he got sick, he operated his own health care recruiting company which recruited doctors and nurses in China, Thailand and South America. Prior to that he worked as director of human resources at St. Luke's Hospital in San Francisco and for Sheraton International in Hong Kong.

One of the complications he developed is a form of neuropathy that causes severe shooting pain in his feet, legs and other parts of the body. He also suffers from nausea, dizziness, has trouble walking and is legally blind. He's on 19 prescription drugs, including morphine.

Pain feels like two buzz saws

"The pain is like two buzz saws giving off flaming sparks all through my legs, feet, groin, back and my throat," Wieder said.

Wieder said when he uses medical marijuana "I'm in a better place and I don't dwell as much on the pain."

New York launched its new, highly-restrictive medical marijuana program in January. Under state law, dispensaries cannot sell marijuana that can be smoked. They must provide the drug in oils and liquids that can be swallowed or vaporized, and in capsules. Only doctors who have taken a course and are registered with the state can prescribe it.

Dr. Elizabeth Asiago-Reddy

Wieder registered with the state's medical marijuana program and got his prescription from Dr. Elizabeth Asiago-Reddy, medical director of Upstate Medical University's Designated AIDS Center, which cares for about 1,200 patients with AIDs and HIV. Asiago-Reddy has prescribed medical marijuana to about 10 patients so far.

Many AIDS/HIV patients smoke pot

Many AIDS/HIV patients already smoke marijuana because they feel other medical options are not effective, she said. Some who have enrolled in the medical marijuana program find the legal version too expensive. "That's unfortunate because these are people who prefer not to do things that are illegal," Asiago-Reddy said.

Wieder said he bought a medical marijuana vape pen from Etain, a dispensary at 2140 Erie Boulevard East in Syracuse, for $211. A vape pen, similar to an e-cigarette, vaporizes concentrated marijuana oil so the user can inhale the vapors. Wieder said he bought vape pens for $70 in California.

A vape pen lasts Wieder seven to nine days. He said he would need at least two of them to last a month. He also purchased a small bottle of tincture, a liquid marijuana extract placed under the tongue with a dropper, from PharmaCann, another dispensary in Liverpool, for $40.

Medical marijuana prices lower in California

Wieder said he used to buy smokable medical marijuana in California that was more effective than vape pens or oils. He said he paid $75 in California for an eighth of an ounce that would last a month.

Etain spokesman Steve Stallmar said it's unfair to compare medical marijuana prices here with costs in California.

"Our medical marijuana program has much stricter regulations, with significantly higher quality extraction methods," he said.

Prices are lower in California because the market is saturated and there's more competition, he said. New York's program, by comparison, is just getting off the ground. "We anticipate costs for the medicine to decrease as more patients sign up," he said.

Across the state 471 doctors, less than 1 percent of the state's licensed active physicians, have registered so far to prescribe medical marijuana.

Asiago-Reddy is the only one at Upstate's AIDS center.

Difficult drug for docs to prescribe



Many patients mistakenly think they can get medical marijuana because HIV or AIDS is one of 10 chronic conditions eligible for the drug, she said. What they don't realize is patients also must have one or more of these complications: wasting syndrome, severe or chronic pain, severe nausea, seizures, or severe or persistent muscle spasms.

The other conditions eligible for medical marijuana include amyotrophic lateral sclerosis, Parkinson's disease, multiple sclerosis, spinal cord injury with spasticity, epilepsy, inflammatory bowel disease, neuropathy and Huntington's disease.

It is difficult to prescribe the drug and determine the correct dose because there is little research on medical marijuana available to prescribers, Asiago-Reddy said.

She starts patients out on a very low dose and gradually increases it. She would like to see more standardized protocols for evaluating patients for medical marijuana and prescribing it.

"We all need to ask ourselves as a country and a medical system, 'Can we formalize the process for evaluating herbal medications?'" Asiago-Reddy said. "Right now as providers we're all stabbing in the dark for medications that may or may not be very effective for certain conditions."

Wieder wants to see medical marijuana prices come down.

"All of a sudden there is something that will make your quality of life better, but you can't really touch it," he said.

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