Prescriptions for N.J. marijuana hard to get

Many of the doctors who recently registered with New Jersey's medical marijuana program are not accepting new patients, while some are charging nearly $500 in cash for visits before they will recommend the drug.

That may explain why only 130 patients have signed up so far for the state's new program, say members of the Coalition for Medical Marijuana-New Jersey, a patient advocacy group that has been pushing for the alternative pain relief for more than five years. In Arizona, more than 700 patients applied to use marijuana when that state's program opened last year.

"I wondered what it would be like for a hospice patient to try to navigate the program and to find a doctor," said Vanessa Waltz, a coalition board member who telephoned all 148 doctors listed on the state Department of Health's website last month when the patient registry was launched.

Since then, the number has grown to 160 doctors - out of nearly 36,000 licensed physicians in the state.

The program is not yet operational as no marijuana dispensary has received final approvals to sell to patients. A dispensary in Montclair, Essex County, is expecting to open this month.

Waltz, a breast cancer survivor who made the calls as a patient advocate, said that a lot of her voice mails were not returned and that she encountered a few rude receptionists who told her not to call again because their doctors were not in the program despite what the registry said.

She said she also spoke with several polite office staffers who told her they had been swamped with calls and had to withdraw from the program.

"It was very frustrating," said Waltz, who compiled a "white paper" with her findings. Of the 148 listed, more than 50 doctors across the state would have turned her away, while only 46 were willing to sign people up. The rest could not be reached.

An informal survey conducted by The Inquirer netted similar results. Of about 20 registered doctors in South Jersey, only three were readily available to give patients an appointment: Mark Angelo in Voorhees, Marshall Lauer in Collingswood, and Julius Mingroni in Blackwood.

Three physicians who practice in Williamstown, Gloucester County, were registered with New Jersey and with www.marijuanadoctors.com, a national organization of doctors who recommend the drug. They did not return calls, but their website said they will accept $150 in cash only for each of two to three required visits before they decide whether a patient is qualified to receive marijuana.

Another New Jersey doctor on that website charged $300 for the initial visit.

The state also has a fee: $200 for a marijuana ID.

In New Jersey, considered one of the strictest of the 18 states that allow medical marijuana, only patients who suffer from cancer, multiple sclerosis, Crohn's disease, or a few other conditions and diseases can get a doctor's recommendation to obtain the drug from a dispensary.

Assemblyman Reed Gusciora (D., Mercer), a cosponsor of the medical marijuana bill, which was signed into law in January 2010, said he obtained a copy of Waltz's report and has an appointment to meet with the Health Department commissioner later this week to discuss it.

"I am concerned," Gusciora said. "The department should be encouraging doctors" to sign up, and "I'm hearing anecdotally that patients are having a hard time finding a doctor."

The Department of Health should offer "a little more guidance," Gusciora said, since there also seems to be confusion among doctors as to how many visits are required to establish "a bona fide relationship" with a patient before they can recommend marijuana.

Some doctors have told patients they must have a minimum of four visits. Health Department spokeswoman Dawn Thomas said four visits was one option, but a doctor also has the discretion to decide when to make the recommendation after "conducting a comprehensive medical history and physical examination" and reviewing a "patient's reaction and response to conventional medical therapies."

Ken Wolski, who heads the Coalition for Medical Marijuana, said the lack of available doctors and the ambiguity in the regulations "may have a chilling effect on the program." Registered doctors shouldn't have to "jump through these hoops" in figuring out how to comply with the rules, he said, and the state should stop ignoring the needs of severely ill people to get treatment without delay.

Wolski also questioned why the doctors wouldn't accept health insurance for the visits.

Benjamin Chu, a psychiatrist in Elizabeth, Union County, said that he had gotten "almost 100 calls" and that he wanted to begin accepting patients but that the state had failed to "train us and provide us with information and education. They gave us nothing at all."

But Angelo, a pain management doctor who practices in the cancer palliative care program at Cooper University Hospital in Camden, has had a different experience.

In the last six months, Angelo said, he has received several newsletters and e-mails from the Health Department about the program. Officials "even called my office to find out if I had any questions," he said.

When the program was launched last month, he said, he was "getting inundated with a lot of calls, some appropriate, some inappropriate." Out of the roughly 100 calls he received, he said, he agreed to see about 24 new patients who he believes are qualified to receive marijuana.

Under the stringent guidelines, he said, he feels "comfortable that patients won't abuse it or divert the medication elsewhere."

The Health Department has set up a customer service number - 609-292-0424 - to answer the questions of physicians, patients, and the public. Thomas also said the department has reached out to the New Jersey Medical Society, the Drug Policy Alliance, and the Board of Medical Examiners to get the word out about the program.