Advocates seeking more dispensaries

ALBANY, N.Y. _ As New York prepares to expand its medical marijuana program to include people who are prescribed opioids, advocates are urging the state to simultaneously increase the number of dispensing sites.

The expansion is a big deal to patient advocates, who have criticized the state's program as one of the most restrictive in the nation. While state Health Commissioner Howard Zucker said Monday he is unsure how many more individuals would be made eligible for the program as a result of the change, it is sure to be many, as prescription opioids like hydrocodone, oxycodone and morphine remain the most common treatment for pain in America.

"This means anyone who is taking prescription opioids can now use medical marijuana under our program, and our goal is for them to eventually get to a point where they can hopefully come off the opioids altogether," he said.

As the nation reckons with an opioid epidemic, caused early on by a glut of prescription painkillers and fueled in recent years by a surge in illicit heroin and fentanyl use, medical marijuana has emerged as a safe and effective alternative for patients who legitimately need relief for their pain. Not only is marijuana less addictive than opioids, but no one has ever died from an overdose.

A growing body of research suggests it can even cut down on opioid use and opioid-related overdose deaths. States with medical cannabis programs have been found to have lower rates of opioid overdose deaths, in some cases by as much as 25 percent, Zucker said. Other studies have found that states with medical marijuana laws have noted a 5.88 percent lower rate of opioid prescribing.

But if New York really wants to combat its opioid epidemic by increasing medical marijuana use, advocates say, it needs to start adding more medical marijuana dispensaries.

"Expanding the program to serve opioid users is an amazing thing, and it's going to save lives," said Fred Polsinelli, founder and CEO of Polsinelli Public Affairs, which represents several clients in the medical cannabis industry. "The problem is, it doesn't mean much because New York has practically no dispensaries. It has none in Brooklyn, none in Staten Island. When patients have to drive an hour away to get this medicine and pass 30 CVS's along the way _ that's a problem."

There are currently 21 sites statewide where medical marijuana patients can pick up their medicine, including five in the Capital Region. Together they serve nearly 60,000 patients.

More sites are expected to open soon. Last summer, the state Health Department increased the number of medical marijuana companies that are allowed to operate in New York from five to 10. Since each company is allowed to open one grow facility and four dispensaries, a maximum of 40 dispensaries are allowed under state law.

A bill currently making its way through the state Senate would double the number of dispensaries each medical marijuana company is allowed to operate, bringing the total number of dispensaries statewide to 80.

Advocates say that's not nearly enough. Polsinelli uses Florida, which has a comparable population to New York and allows for up to 425 medical marijuana dispensaries, as an example.

"It's just not enough, especially when you compare them to the number of opioid dispensaries statewide, which is pretty much all of your CVS's and Rite Aids," he said.

Three of the 10 companies operating in New York currently offer home delivery _ a way of easing access to patients who may not have transportation or who live far from the nearest dispensary.

Vireo Health of New York, which operates a grow facility in Fulton County and has a dispensary in Albany, offers virtual consultations with its pharmacists as well as free home delivery for those patients who can't make it out to a dispensary.

"Many of our patients have to travel hours to make it to our Binghamton dispensary, but it's hard to put a dispensary in a rural location. It just doesn't always make business sense," said Dr. Stephen Dahmer, chief medical officer at Vireo. "So that's where offering home delivery might make a big difference."

Another way to ease the travel burden, Dahmer said, would be to increase the amount of medical marijuana a patient is allowed to take home on each visit. Patients are currently limited to a 30-day supply under state law.

"We feel strongly about anything that's going to improve accessibility to this medicine for our patients," he said.

The biggest hurdle to overcome, of course, is outside the state's control. Because marijuana remains illegal under federal law, insurance companies typically won't cover its use as medicine _ meaning it's out of reach for anyone who can't afford to pay for it out of pocket.

"We think the evidence supports medical cannabis over opioids when it comes to treating pain," Dahmer said. "So the fact that it costs just $6 after insurance for a bottle of opioids we feel is an unfair advantage."

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