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New York's medical marijuana program grows, tackles new problems


As New York’s medical marijuana program continues to expand, the program faces new challenges and more work to be done, especially with recreational legalization on the horizon, according to our next guest on "Take Care."

Brett Dahlberg reports for WXXI news in Rochester and has been covering the state’s medical marijuana program and its effects on Rochester and surrounding areas for several years. He said he has seen significant growth in the state’s program since its start.

One of the biggest changes is in the list of conditions that qualify a person for medical marijuana, recently including chronic pain as a way to enable people to treat themselves for long-lasting pain that does not involve opioids. This is indicative of the state’s efforts to conquer a serious crisis, Dahlberg said.

“It’s part of a recognition that opioids are tremendously addictive and that there’s been a growing problem in this state with people starting on prescription opioids, ending up addicted and then having some bigger problems as a result,” Dahlberg said.

A common argument in support of this practice is that marijuana poses far fewer health problems than opioids, including having little chance of its users becoming addicted. Dahlberg said marijuana also has nowhere near the same withdrawal effects of opioids, which makes it easier to quit if it does become a problem.

"There’s no other substance that is both regulated medically and also available recreationally."

Chronic pain and additional qualifying conditions means more people qualify and are using medical marijuana under the program, which Dahlberg said has called for changes in how the program is run. In its beginning, there was some difficulty on all sides. It was hard for doctors to get certified to prescribe marijuana, for dispensaries to get set up and for patients to use the program.

Now, telemedicine has come onto the scene, and it is generally easier for people to qualify for a medical marijuana prescription. The success of the program, however, is harder to measure, Dahlberg said. There is not a lot of research into humans as to whether medical marijuana is successful on a broad, peer-reviewed level for alleviating the symptoms that the state wants people to use it for.

“We have a small but growing amount of scientific literature, but we still don’t have a robust body of medical knowledge on whether this stuff works on people or, potentially, whether these are some really powerful placebo effects,” Dahlberg said.

The program continues to face challenges, Dahlberg said, including a large gap in the access people have to the program in urban areas compared to rural areas. There is a limit on the number of dispensaries allowed in the state, which means the dispensaries that do exist are located in urban areas with greater access to more customers.

“If you live in a more rural area, you either have to pay a lot more to get your medical marijuana products delivered or you have to get yourself some somehow,” Dahlberg said.

Urban and rural areas have the same medical concerns but less access to services, Dahlberg said. So, even though a list of providers is always available online, getting to those providers and taking advantage of their services is harder depending on where a person lives.

People in rural areas looking to use medical marijuana face long distances between practitioners. Getting their prescription delivered increases the price, and driving almost two hours to the site costs time. In addition, though there are doctors willing to drive to meet with patients, that costs the doctors time and money for which they are often not reimbursed, Dahlberg said.

Dahlberg said physicians and medical professionals are also concerned about new challenges the program could face when and if recreational marijuana is legalized in the state.

He said there are contraindications, factors that provide a reason to withhold a medical treatment on account of possible harm to the patient, for medical marijuana, including cardiovascular and psychological conditions. However, the state does not have a good way to prevent those people access to recreational marijuana the same way it currently does for medical marijuana.

“There is concern among some of the medical professionals that we’ve talked to locally that people who should not be using marijuana because of some existing medical condition are going to have access to recreational marijuana if the state legalizes recreational use,” Dahlberg said.

This can lead to multiple health problems, which Dahlberg said states like Colorado have already seen. In Colorado, after recreational use was legalized, research showed a significant jump in the number of emergency department visits that included a marijuana code. Dahlberg said this shows that there is still more research needed to fully understand marijuana and its effects on the human body.

“Marijuana is a huge cocktail of different chemical compounds, and some of those we’ve got some idea of, when extracted, what sort of effects they’re likely to have, but … we don’t know all of the interactions,” Dahlberg said.

Though medical professionals are concerned, Dahlberg said it is tempered under an understanding that marijuana does not have the same sort of potential for harm as other synthetic drugs, including fewer addictive qualities and side effects. But marijuana remains a unique case, he said.

“Recreational use … does pose a potential threat to people’s health just because, as far as we can tell, there’s no other substance that is both regulated medically and also available recreationally,” Dahlberg said.