Nearly three years after the New Hampshire legislature legalized medical marijuana, terminally ill cancer patient Linda Horan was able to take her first legal puff to ease her pain. But not in New Hampshire.
Horan successfully sued the state for the right to use her therapeutic cannabis card to travel to neighboring Maine and buy different strains of marijuana buds, tincture and edibles at a Portland dispensary to help stimulate her appetite and relieve pain.
Others followed her. After Horan won her lawsuit in late 2015, the New Hampshire Attorney General’s Office told the state’s Department of Health and Human Services it needed to start issuing cards to qualifying patients, even though the in-state dispensaries would not open until months later.
Horan died in February in her Alstead home.
After her death, four alternative treatment centers opened their doors this spring and summer, providing a legal option for patients looking to get off strong opioids. New Hampshire moved slowly on the issue of medical marijuana; it was the last state in New England to implement its program.
State officials and alternative treatment center heads have spoken highly of their new working relationship, but the program has seen some bumps along the way.
In September, state officials said they were dealing with a backlog of therapeutic cannabis cards, with some patients waiting 40 days or more for their application to be approved. That’s twice as long as the waiting period mandated by law.
Department of Health and Human Services officials said a lack of dedicated staff was contributing to the problem. In late September, state officials estimated they were getting about 20 applications per day, a drop from 35 applications per day at the busiest time.
“With the additional resources, I think by early October we’ll eliminate the backlog and it will be easier to stay caught up,” John Martin, chief of the DHHS Bureau of Licensing and Certification, said at the time.
A lingering problem with the program is the refusal of some doctors to certify their patients who have a condition that qualifies them for medical marijuana. Doctors don’t technically prescribe the drug to patients, but with little research on its health effects, medical experts in New Hampshire said some providers are hesitant to sign off.
For doctors accustomed to prescribing medications with exact dosages for their patients, the idea of therapeutic cannabis dispensaries can be a new frontier.
After certifying a patient has a qualifying condition, doctors are essentially putting patients in charge of their own treatment under the guidance of alternative treatment center staff.
Dispensaries offer a wide array of cannabis strains and consistencies for a range of different medical conditions.
“You’re not going to have any way of knowing that before they go and pick it out,” said Dr. Stuart Glassman physiatrist and the New Hampshire Medical Society physician representative to the state’s Therapeutic Cannabis Advisory Council, in a January interview.
Another contributing factor is the fact that many New Hampshire doctors have little formal training on therapeutic cannabis.
“You have to make sure you know all the issues for a patient you might certify,” Glassman added. “We want to help our patients but not do any harm.”
In addition to the barriers some patients face accessing therapeutic cannabis, the nation’s veterans face even higher hurdles.
With marijuana still illegal at the federal level, veterans who receive medical care at the VA also must jump through extra hoops to use therapeutic cannabis, needing to see other providers who can certify their conditions.
New Hampshire patients who qualify for therapeutic cannabis must be certified by a physician they’ve seen for at least three months, meaning veterans need to pay out of pocket to get certified.
Veterans using marijuana cannot be denied VA services after a policy directive was passed in 2011. Before then, vets who were caught using marijuana risked being kicked out of the program.
Marijuana Policy Project New Hampshire Director Matt Simon said he’s been contacted by several veterans who say that getting an outside doctor is “not worth the bother, not worth the expense.”
“I think most veterans go to the VA and that’s their primary source of health care,” he said.
(Ella Nilsen can be reached at 369-3322, enilsen@cmonitor.com or on Twitter @ella_nilsen.)