When it was signed by Gov. Andrew Cuomo in July 2014, New York’s Compassionate Care Act became one of the most restrictive medical marijuana laws in the country. Regulations proposed in December and expected to be final by this spring appear to limit patient access even further. The rules are puzzling, with no apparent medical rationale or regulatory goal, except possibly to disguise a continuing policy of prohibition.
The law permits specially certified physicians to recommend the use of marijuana to patients suffering from one of only 10 designated conditions: cancer, HIV/AIDS, ALS, Parkinson’s disease, multiple sclerosis, spinal cord damage causing spasticity, epilepsy, inflammatory bowel disease, neuropathies or Huntington’s disease. It allows no more than 20 dispensaries statewide, to be operated by no more than five organizations. It also bans smoking marijuana. Patient cards will have to be reissued every year. The law, itself, will sunset after seven years unless reenacted by the legislature.
The draft regulations impose still further limits:
- Nurse practitioners will not be able to recommend marijuana, which may limit access in rural areas of the state and in care facilities, like hospices.
- Sales will be limited to five varieties (which may not have fanciful street names—forget Hindu Kush).
- Pricing will be at the sole discretion of the state’s health commissioner.
- Other than patients and caregivers, no one will be allowed into a dispensary without the written consent of the Health Department and an employee escort at all times.
- Delivery of medication, an important issue in a very large state with only 20 dispensary locations, will similarly require written approval from the Health Department, and
- Patients may not drink or eat on the premises of a dispensary, unless necessary for medical reasons.
The law and regulations put enormous power in the hands of one individual, New York’s Health Commissioner, Dr. Howard A. Zucker. Depending on his decision about pricing, a very limited number of licenses will either be worth a fortune (with 20 million state residents, that is a million potential patients per dispensary), or nearly nothing.
It is not immediately clear how any of these restrictions benefits patients. It is harder to imagine that they will do anything to shut down the black market. If anything, they seem like a continuation of New York’s draconian drug war policies that date back to the infamous Rockefeller laws.
Those laws, enacted in the early 1970s created mandatory minimum sentences of 15 years to life for possession of four ounces of narcotics—about the same as a sentence for second-degree murder. Vigorous enforcement caused the percentage of drug offenders in New York’s prison population to surge by 24 percent from 1973 to 1994, mostly a result of convictions for nonviolent, low-level drug possession and drug sales.
The laws, including the minimum sentencing guidelines, have now been amended, but they seem to have left their mark on the psychology of lawmakers. New York’s Compassionate Care Act and the proposed regulations seem to be directed at shutting down the legal marijuana industry, rather than supporting the legitimate needs of marijuana patients.