Where does this Medical Marijuana journey start?
Besides the high cost of both the Medical Marijuana in New Jersey and having access to the “process” of being able to obtain Medical Marijuana in New Jersey, and none of it eligible for coverage by healthcare insurance, another big problem I’ve encountered thus far is knowing who to see to start the approximate one (1) month to six (6) week process of obtaining Medical Marijuana. For example, last week I met a fellow New Jersey Crohn’s Disease patient on social media after I posted I was in the process of switching to Medical Marijuana for treatment of my Severe Crohn’s Disease. This person responded with a comment something to the effect of: “Well, I would love to try Medicinal Marijuana for my Crohn’s Disease, especially since so many people I meet with Crohn’s can’t say enough good things about it, but my gastroenterologist does not recommend it.”
My first thought was how cruel and inhumane his gastroenterologist was treating him but I wasn’t sure how that conversation exactly took place. Did he ask the gastroenterologist for a Medical Marijuana “prescription” and the doctor rejected the concept of using Medical Marijuana for Crohn’s Disease or did the gastroenterologist simply state the fact that he doesn’t “recommend,” or is not permitted to “prescribe,” Medical Marijuana? In either case, the doctor seems like an arrogant know-it-all who clearly doesn’t care what his patients have to say because he should have told this Crohn’s Disease patient: “I don’t recommend the use of Medical Marijuana for the treatment of Crohn’s Disease but many patients are trying it and if you want to try it you must go through a certain process pursuant to the 2010 Medical Marijuana law passed in New Jersey. My assistant can get you the information and I only ask that you keep me in the loop so that when I treat you going forward I will know you are trying Medical Marijuana.”
This gastroenterologist-reliant Crohn’s Disease patient had to rely upon the SHEER LUCK of running into me on social media in order to take advantage of the Medical Marijuana law which was passed in New Jersey in 2010. That SHOULD NEVER HAPPEN IN ANY STATE and Crohn’s Disease patients in New Jersey should be more in tune with their rights and options regarding their treatments. At a certain point in time, I was just as guilty of being uneducated about my rights as this Crohn’s Disease patient. It is my serendipitous interaction with this New Jersey Crohn’s Disease patent which provided the impetus for this Blog Post. If New Jersey and its gastroenterologists are not going to publicize this Medical Marijuana law in which CROHN’S DISEASE PATIENTS ARE SPECIFICALLY MENTIONED, then I will promote it and I hope other Inflammatory Bowel Disease (“IBD”) patients will follow my lead. More specifically, New Jersey Crohn’s Disease or IBD patients seeking to try Medical Marijuana should contact Dr. Anthony Anzalone at 1-855-768-3621. His current main office is located at 331 Newman Springs Road, Red Bank, New Jersey 07701. His office is located in Building ONE (1) on the 4th Floor in Suite 143. He also has offices located in East Rutherford, NJ and in East Brunswick, NJ. His website is located at: http://njgreenmd.com .
In New Jersey, IBD & Crohn’s Disease are Medical Marijuana-worthy
I’m also writing this contemporaneous series of Blog Posts as I go through the various steps to obtain Medical Marijuana in the State of New Jersey for treatment of my Severe Crohn’s Disease. I mention my ailment specifically because the 2010 law which made Medical Marijuana legal in New Jersey cites, as qualified people, only those with the following debilitating medical conditions:
- Amyotrophic lateral sclerosis (“ALS”)
- Cancer (chronic pain and nausea related thereto)
- Multiple sclerosis (”MS”)
- Terminal cancer
- HIV/AIDS (chronic pain and nausea related thereto)
- Muscular dystrophy
- Seizure and/or Spasticity disorders
- Inflammatory bowel disease, including Crohn’s Disease (“IBD”)
- Terminal illness, if the physician has determined a prognosis of less than 12 months of life.
Seeing Crohn’s Disease specifically mentioned in such a short list alongside of ALS, a disease I consider to be one the most devastating known to the universe, is disconcerting because I’ve never viewed my Crohn’s Disease that way since being diagnosed with Crohn’s in 1984 at the age of 21 despite almost thirty (30) surgeries, gastrointestinal and beyond, and two-hundred+ (200+) hospitalizations. I guess it’s an eye-opener for me impacting me in the same shocking manner as reading aloud a list of all my surgeries after they are chronologically-listed on a notepad in preparation for a surgical consultation. But people with incredibly challenging diseases never see themselves as “sick,” for if they did, depression or a “woe is me” attitude would set in and such emotional sentiments are counterproductive to moving forward, as we all must do in life. However, ever since Crohn’s Disease disabled me in 2010, I’ve dedicated much of my healthy time to raising global awareness of Crohn’s Disease and its potential pervasive, devastating, financial, social, professional and painful effects. But it’s been difficult to convince ordinary people that IBD, and Crohn’s Disease specifically, is much more than a “bathroom disease.” Some get it, most don’t and even seasoned IBD patients have trouble spelling “Crohn’s” correctly. People tell me I look very healthy and I’m sure others who don’t know me cringe when they see me exit my motor vehicle in a prime handicapped parking spot even after spotting the official, government-issued handicapped parking placard hanging from the rear view mirror. But now Crohn’s Disease is specifically listed as Medical Marijuana-worthy in most, if not all, of the twenty-four (24) States (including the District of Columbia) which currently have legalized Medical Marijuana alongside of just a few other diseases which I think it’s fair to say most people would categorize as horrific. In a strange way, this finally represents an accurate mainstream awareness of Crohn’s Disease which I never thought was possible.
While I wish there was an easy way to explain Crohn’s Disease to these understandably skeptical people, it is an “invisible illness” from their vantage point, and besides, they’d never believe my story were I afforded the time to explain it. Nevertheless, I understand their simultaneous contempt toward me and their respect for the handicapped but it’s quite sobering to read about Crohn’s Disease in a governmental official listing of the very few approved serious diseases (such as ALS) for which Medical Marijuana is permitted as an alternative treatment in New Jersey. For Crohn’s Disease, Medical Marijuana is authorized to conceivably combat the often excruciating pain and/or unimpeded systemic inflammation. To that end, maybe now people will better understand the potentially systemic, pervasive and lifestyle-threatening effects of Crohn’s Disease? Unfortunately, for at least the time being, not a chance because New Jersey’s Medical Marijuana law is perhaps the most restrictive law of its kind within the medically permissible 24 states (including the District of Colombia). New Jersey’s law is also not promoted very well as an alternative to the very patients it was signed into law to help. There also doesn’t seem to be any support for the patients who choose to take advantage of the relatively new law nor is there support for the compassionate or profit-driven medical professionals who seek to help these patients comply with the law. The result is stigmatized patients referred to as “druggies” or “drug-seekers” and medical professionals denigrated as neighborhood “pot dealers” whom are often kicked out of their professional office spaces on little or no notice once their landlords discover their role in the facilitation of a law enforced by New Jersey’s Department of Health.
For many years I relied on the most professional of Pain Management Doctors and managed my obstructional Crohn’s Disease and chronic pain with carefully monitored narcotic pain medications. But I never liked being so beholden to these drugs nor to insurance companies deciding for themselves the appropriateness of the amount of drugs prescribed by my Board Certified and Crohn’s Disease experienced Pain Management Doctor given my multitude of painful problems especially considering that these insurance company doctors never examined me or even contacted me to ask me how much pain I was in and/or whether or not the pain medications were helping me. Then most recently I began to see a pattern of politicians looking to change the laws regarding prescription painkillers due to the tragic apparent epidemic of overdoses of these drugs. I certainly support efforts to eradicate such a tragic problem but it always seems to me like many of these politicians have their own selfish unrelated agendas similar to those of sketchy public figures who “take advantage” of a tragic school shooting to bring attention to themselves by recommending harsh gun laws as a response, all the while knowing such laws will never be passed by Congress.
Obviously, there are some incredibly-dedicated civic-minded people who become politicians to make a difference in these types of areas and I commend them for making such a sacrifice and I have the utmost respect for them. But I disdain politicians proposing to “strengthen” narcotic prescribing laws without giving any thought to the millions of people battling chronic pain who rely upon these drugs and the responsible Pain Management Physicians who prescribe them. It’s as if they are discriminating against patients battling potentially horrific diseases like ALS, Multiple Sclerosis, Crohn’s Disease, Ulcerative Colitis or those fighting chronic pain. These laws seem to get more and more “anti-narcotic” rather than “anti-drug-abuse” or “anti-drug-misuse” such that even the most conservative of these laws is predicated on “throwing out the baby with the bathwater.” People like me are the “baby” in this metaphor, and there are patients MUCH WORSE OFF THAN ME, don’t we matter? Why don’t these politicians mention us when they seek to combat this tragic epidemic of overdose or misuse of these prescription painkillers? How come we are never consulted or even asked our opinions regarding these issues? Do ALL or ANY of these politicians understand the severity of pain involved with an intestinal obstruction, a fairly frequent occurrence in an aggressive case of Crohn’s Disease like mine? What about waking up in so much pain because of Rheumatoid Arthritis that someone has to come to help you get out of bed so you can start your day to contribute to society and/or a prescription narcotic is needed to take the edge off the pain so you can simply go about your daily personal hygiene routine?
A major factor in considering alternatives to pain relieving narcotics is my vulnerability to some schmuck politician who could ruin my quality of life by passing some ridiculously restrictive law pertaining to prescription painkillers. That’s when I started learning about New Jersey’s Medical Marijuana Law. Also, for a few years I’ve been contacted by THOUSANDS of Crohn’s Disease patients each telling me how Medical Marijuana substantially enhanced their quality of life. These were not “Extras” from the 1982 classic movie, “Fast Times at Ridgemont High;” they were respected professionals with families raising children. They too had grown frustrated by all the unreasonable rules and regulations imposed upon their use of narcotic pain medications. They sought something better which actually helped treat their disease in addition to their pain. They were each searching for something which gave them more control over their lives to the extent they had any left after Crohn’s Disease had ravaged the quality of their lives, put strains on their marriages, compromised their prolific careers and left them feeling controlled by their disease instead of the other way around. Then they came upon Medical Marijuana, after internet and Crohn’s Disease social media group searches for something better, kept yielding the same answer.
Who to Call in New Jersey for Medical Marijuana?
I read the New Jersey Medical Marijuana statute and by virtue of having Crohn’s Disease I clearly qualified. But over the years each time I contemplated switching Pain Management Doctors to a more convenient one in New Jersey, I’d seen a few Pain Management Doctors in New Jersey and I knew they hadn’t yet been recommending Medical Marijuana so I turned to Google. The name “Dr. Anthony Anzalone” kept popping up. He offered consultations during which he would “recommend” Medical Marijuana, if it was appropriate in his opinion after closely reviewing my medical records and discussing with me the severity and progression of my Crohn’s Disease. There were a few other doctors who did the “recommending” [a magic word in the statute] so I jotted down 2 phone numbers and began calling. The phone lines at BOTH were busy for HOURS. I finally got through to Dr. Anzalone’s office and a kind woman asked me a few questions and made an appointment for me to see Dr. Anzalone the following Tuesday, April 19, 2016, at their Iselin, New Jersey office. After we set up the appointment she passed me to a “Patent/Counselor” so he could tell me what to bring and what to expect. He too suffered from Crohn’s Disease and he raved about how Medical Marijuana had changed his quality of life.
He told me to bring my New Jersey Driver’s License, a current (i.e., within 60 days) utility bill in my name and a written diagnosis of Crohn’s Disease (if that, in fact, was my diagnosis) from a credible New Jersey doctor, i.e., either a NJ gastroenterologist or a NJ Pain Management Doctor. We briefly discussed my expectations and he shared with me what his were when he first started. He explained the different active ingredients of Medical Marijuana, that is, the anti-inflammatory component (i.e., “Cannabinoids” or “CBD”) and the pain relief ingredient (i.e., “Tetrahydrocannabinol” or “THC”) and how using one could enhance the effectiveness of the other. I hung up the phone feeling confident I had called the right doctor.
I specially mentioned the town where Dr. Anzalone’s office WAS because when I got there on the day of the appointment and went up to his office, I was told by a very nice lady that he no longer had an office there. But something about the way in which she addressed me made me feel like she thought I was a “drug-seeker.” It reminded me that I had Googled Dr. Anzalone a few weeks prior and noticed that a few of his landlords (as he had offices at several locations) had unexpectedly evicted him despite him and his staff never dispensing Marijuana. As I walked back to my car I honestly couldn’t tell whether I was angrier at not being called and notified of the office change or that some holier-than-thou landlord in Iselin or Woodbridge, New Jersey (the address was 33 Wood Avenue South, Iselin, NJ but I believe the town was technically Woodbridge) had suddenly evicted a doctor who truly was making a difference in so many people’s lives. So I called the only number I had for Dr. Anzalone and I left a terse message about not being notified but I also admitted I suspected what had probably happened so unexpectedly and it made me so angry that patients like me and doctors like Dr. Anzalone were being stigmatized like this. The very kind Office Manager called me back within 2 minutes and asked me how far away I was from a town close by because the doctor could see me there. I thanked her and headed there.
The In-Person Appointment w/ Dr. Anthony Anzalone
This was not like a typical doctor appointment because much of it involved EDUCATION, which, when you really think about it, should be included when you go to see ANY DOCTOR. While it wasn’t necessary to do so, I prepared a 4-page Chronological Summary Listing of my almost thirty (30) surgeries. On that same document I also listed my major sources of pain and how severe the pain becomes and what typically triggers the pain, if I knew, and when it typically occurred, again, if I knew. This may sound strange amidst my explanation of unpredictable Crohn’s Disease pain but when the weather abruptly changes or the seasons change and the temperature becomes abruptly colder or warmer, that’s when I typically have my worst Crohn’s Disease flare-ups and that’s when I am prone to Sacroiliitis, etc. I know this because I could see the pattern when I look at all my surgeries or recall any of my two-hundred+ (200+) hospital stays. I also included a detailed list of all the medications I take.
The more Dr. Anzalone spoke about the benefits of Medical Marijuana for Crohn’s Disease the more he appeared to be a passionately-driven auto-didactic expert and I was impressed. I’ve been privileged in my life to meet a few pioneers in healthcare and Dr. Anzalone seemed to fit within that description. Then he explained what happened at the Iselin, NJ office and the attorney in me was fascinated by the legal problems this man was going to have to navigate in order to help so many people. I wanted to help him. I still do but I’m disabled and can’t practice law until I can reasonably rely upon my health. He mentioned his staff was unable to get in touch with me prior to my appointment because they were helping him deal with a staggering amount of local and national media requests and also they didn’t know where to send me if they were able to even get in touch with me. Here is an article written about the eviction experience in a local New Jersey newspaper/website. I was thoroughly impressed by his logic and directness and I appreciated his personalized explanation about the Iselin oversight. He did not at all seem like an attention-seeking doctor nor did he seem like a man using the notoriety of “recommending” Medical Marijuana in New Jersey to suit his own agenda, whatever it may be.
He explained the two (2) different helpful components of Medical Marijuana, that is, the anti-inflammatory “Cannabinoids” or “CBD” and the pain relieving “Tetrahydrocannabinol” or “THC.” Dr. Anzalone explained how the THC could be used initially for pain relief but that when used with the Cannabinoids it could actually increase their anti-inflammatory effect which in the long run would cut down on the amount of THC Medical Marijuana I’d have to use in order to obtain reasonable pain relief. This is important because the Cannabinoids do not create a euphoric feeling and they can be used every day as a genuine therapeutic substance to help with inflammation. The man is a peripatetic true believer who does whatever he can to communicate his healthy message. But he is not alone in this Medical Marijuana crusade and I believe there are actual medical studies in Israel which confirm all that I’ve been told thus far. I suspect there will be many other studies conducted all over the world so that Medical Marijuana no longer requires crusaders like Dr. Anzalone and it can be embraced and utilized by the mainstream.
Dr. Anzalone then studied the documents I had prepared and suggested a combination protocol for me but he deferred to an actual Crohn’s Disease Patient/Medical Marijuana Counselor to counsel me on the specific protocol for my disease and on everything I needed to know about Medical Marijuana in New Jersey. This Crohn’s Disease Patient/Medical Marijuana Counselor was extremely knowledgeable about the New Jersey law and he detailed how taking Medical Marijuana had helped him with his battle against Crohn’s Disease and it had also so significantly increased his quality of life. He also accurately explained the UNFORGETTABLE description of an intestinal obstruction so I knew he was a kindred spirit. He went through the technicalities with me including how they would aggregate all my information and email it to the NJ Department of Health, Medical Marijuana Project. He went over the timing I should expect for my participation in the program to commence.
How long does it take to get the New Jersey Medical Marijuana Card?
More specifically, I would receive an email from the Medical Marijuana Project at the New Jersey Department of Health in approximately 10-15 BUSINESS DAYS indicating I’ve been approved for a Medical Marijuana Card which apparently costs $200.00 and I would be prompted by the email on how to pay it. I glanced at the website and saw there could be discounts for patients like me receiving Social Security Disability so I will inquire at the appropriate time. After they receive my payment, the Medical Marijuana Card will be mailed to me (Dr. Anzalone’s staff had taken my picture after confirming my identity via my Driver’s License and my NJ residency via my Verizon Wireless recent bill) so I should receive it after another 5-10 days. Essentially the wait after this appointment for the Medical Marijuana Card, and thus the ability to purchase Medical Marijuana in New Jersey, is approximately one (1) month to six (6) weeks. There is also a requirement that I receive counseling at least 4 times prior to my initial use of Medical Marijuana and based upon our intensive phone and in-person discussions thus far, it appears I have satisfied that aspect of the law. That said, I’m sure I will be in contact with this Patient Counselor once I receive my Card from the State so that I know exactly what to purchase.
The financial cost of participating in the New Jersey Medicinal Marijuana Program
The initial $200.00 Medical Marijuana registration is good for 2 years but I must see or consult with the doctor again at some point so he can evaluate my needs going forward after 30, 60 and 90 days. But I am not sure how Dr. Anzalone and his staff handles that “visit.” The Initial In-Person Consultation/Appointment with Dr. Anzalone costs $350.00 and that seemed to be the standard initial fee. Health Insurance does not cover ANY OF THESE COSTS RELATED TO MEDICAL MARIJUANA. (Note for comparison purposes: New York’s Medical Marijuana Program charges a one-time fee of $50. At New Jersey’s five (5) operating dispensaries, the medicinal-quality Medical Marijuana costs about $500 an ounce, which is twice the street value. Patients in New Jersey are allowed to buy only 2 ounces per month.)
The Five (5) New Jersey Medical Marijuana Dispensaries
The Patient/Counselor and I then discussed which of the five (5) “dispensaries” (known as “Alternative Treatment Centers” or ATCs in the “New Jersey Compassionate Use Medical Marijuana Act”) would be best for me. I presently live in West Orange, New Jersey so I thought the dispensary closest to my residence would be best but he suggested a different one above all the others even though I lived fairly close to one of the other dispensaries. He recommended that particular dispensary because he felt the people running it were very knowledgeable and their prices were fair. Then he started recommending different combinations of product and that’s when I started to fog out as it was too much information to process. I think he understood and I will most assuredly contact him before I go to make my first purchase.
Smoking the Pot, No Edibles in New Jersey & Paperwork Assistance
I had several questions which the Counselor answered thoroughly and the Office Manager was kind enough to chime in with her experiences when they were instructive regarding my questions. I was concerned about having to smoke the Medical Marijuana due to my lung problems and this fleshed out a major inadequacy with the New Jersey Medical Marijuana law in that they do not offer ANY “Edibles” or Medical Marijuana which can be digested. It seems they offer, at a very steep price, the kitchen tools to bake Medical Marijuana brownies (and I may have to do this) but they do not offer Brownies as a product, like they do, for example, in New York. In any event, the 2-member office staff could not have been more helpful and they each made me feel comfortable as I began my journey into the world of Medical Marijuana. It is also important to note that the Patient Counselor and the Office Manager organized all of my information during our Consultation and then they electronically packaged it properly and emailed it to the appropriate New Jersey governmental office. It is my understanding this does not happen at all other New Jersey Medical Marijuana-recommending doctor offices. Therefore, when you make an appointment, you would be best served by asking if they submit all of the required paperwork to the government in New Jersey or if some of that is your responsibility.
Limitations of the New Jersey Medical Marijuana Law
By quick comparison, the New York Medical Marijuana law limits the monthly amount to what the doctor believes is a 30-day supply and therefore does not list a specific amount. This makes sense given that “Pain” is subjective and its severity differs from person to person, even for the same malady. The New Jersey law limits the monthly amount to two (2) ounces as if everybody responds to pain in the same manner and thus requires the same exact amount of pain medication. As someone who’s switched from narcotics, this seemingly limited amount of monthly Medical Marijuana could force me to supplement the pain relief from the Medical Marijuana with some narcotics from my Pain Management Doctor. I simply have no idea at the moment; I’m just pointing out a potential problem with the law especially if part of its intent was to help patients in pain reduce their intake of the more highly addictive narcotic painkillers once they’ve switched to Medical Marijuana.
Again, by way of example, here’s a list of the different Medical Marijuana “Edibles” being legally sold around the United States. The benefit to Edibles can be significant in terms of the medicinal effects lasting longer and possibly even being more potent. It is also a more preferable form to consume Medical Marijuana for people with lung problems or for folks who wish to be more discrete in how they consume Medical Marijuana. Here is a summary of these benefits along with the packaging concerns regarding Edibles possibly attracting the attention of children or other individuals for whom the drug is NOT intended. Lack of access to the Medical Marijuana in edible form is also of particular concern for lung-cancer patients and children, for whom smoking dried medicinal Cannabis is problematic. Moreover, experienced Medical Marijuana users prefer the edible form of Cannabis because it eliminates extraneous plant material and contains only the essential medicinal cannabinoids. Apparently, an owner of one of the New Jersey’s five (5) Medical Marijuana dispensaries says making edibles available is the “number one” change the State should make to the program.
New Jersey may have the MOST RESTRICTIVE Medical Marijuana law in the United States. From a limit of only two (2) ounces per month, no “Edible” product, only five (5) dispensaries, an almost thirty (30) to forty-five (45) day “Waiting Period” to get a New Jersey Medical Marijuana Card (which seems more suitable to the purchase of a handgun than to the purchase of a fairly benign natural drug which has been proven to help MANY PEOPLE SUFFERING WITH A VARIETY OF PAINFUL SYMPTOMS) and an extremely HIGH COST of product and HIGH COST OF MAINTAINING ACCESS to the Medical Marijuana process, it’s almost as if patients are being penalized or paying a tax simply because they want to try Medical Marijuana to get off of much more addictive narcotics to treat chronic pain or, for example, an Inflammatory Bowel Disease like Crohn’s Disease. Accordingly, the New Jersey Medical Marijuana law needs major revamping in order to meet the true medicinal needs (and financial capabilities) of the patients it purports to support. The doctors brave enough to want to help these patients are being evicted from high-end doctor office buildings on no notice simply because of their involvement with Medical Marijuana and they don’t EVER dispense product. These medical professionals need to be better supported for this Medical Marijuana law to effectuate its excellent intentions.
This is a fascinating issue about which I expect to see much debate in the very near future which hopefully triggers some changes to the existing New Jersey Compassionate Use Medical Marijuana Act.