N.J. panel wants expanded medical marijuana, but which governor will decide?

The list of ailments that qualify a patient to use marijuana in New Jersey doesn't cover all the people it could help, says a panel of doctors and health professionals that studied the issue for 19 months.

Migraines, Tourette's, and anxiety and chronic pain stemming from various maladies should be added to the current list of 13 ailments, according to the New Jersey Medicinal Marijuana Review Panel. The panel voted, 5-1, late last month to make this recommendation to the health commissioner, after listening to hours of emotional testimony at hearings, examining petitions from 68 patients, and analyzing the research and statements from doctors who reported their patients had success using medical marijuana.

"The recommendation is based only on available scientific evidence, not opinion," said Alex Bekker, an anesthesiologist who chaired the panel.  "We had lots of deliberation, lots of discussion, and it was revealing and interesting."

The new ailments could bring an estimated 200,000 new patients into a program that now has 14,600 participants, according to medical marijuana advocates who lobbied for an expanded list.

Medical marijuana was legalized in New Jersey nearly eight years ago. Pennsylvania expects to implement a similar program next year.

Among the 13 ailments that appear on New Jersey's list are cancer, when conventional treatments fail or cause side effects and chronic pain; Crohn's disease; multiple sclerosis; epilepsy; and glaucoma.  The majority of those who use medical marijuana in the state are diagnosed with intractable skeletal muscular spasticity.

The decision on whether to expand the list rests with Health Commissioner Cathleen Bennett, and she's leaving her post Thursday.

Bennett, a Haddonfield resident who was appointed by Gov. Christie, will become president and CEO of the New Jersey Hospital Association.

She has declined requests for an interview.

A spokesperson for the Health Department said the commissioner would have 180 days to act on the panel's recommendation.

It's up to Christie to appoint the next commissioner, or an acting commissioner, and that person might only serve a couple of months since Christie's two-year term expires in January.

"It's unclear, even to the Health Department, whether it will be the current or future commissioner who will decide," Bekker, the head of the department of anesthesiology at Rutgers New Jersey Medical School in Newark, said in a recent interview.

The governor's spokesperson did not respond to a request for comment.

Christie has said that he opposes expanding the list, and his administration delayed creating the review panel for five years.

In May, the health panel took an initial vote, and said it would approve the use of medical marijuana to combat chronic pain or anxiety stemming from nearly 40 conditions or ailments that were noted in the petitions it received. Those conditions include autism, Alzheimer's, opiate use disorder, arthritis, back and neck pain, lupus, and fibromyalgia.

Marijuana is "not a treatment for disease, but for the manifestation of a disease," Bekker said last week.

In a July 2017 letter to Bennett that outlined the panel's recommendations, Bekker also said that "there is strong scientific basis to consider cannabinoids (chemical compounds in marijuana) as a therapeutic intervention for patients requiring high doses of opioids. This would have the secondary impact of helping to curb the opioid epidemic. … Patients with chronic pain who were treated with cannabis were more likely to experience a significant reduction in their pain symptoms."

Some say the question of expanding the medical marijuana list could be moot if Democrat Phil Murphy, a candidate for governor, is elected.  He has said he would legalize marijuana for recreational use and polls show he is ahead of  his opponent, Republican Lt. Gov. Kim Guadagno, who has said she would support decriminalization.

Her husband, retired Appellate Division Judge Michael Guadagno, last month wrote a legal opinion while on recall to the bench ordering the state to consider lowering the classification of marijuana, which currently is Schedule I, deemed among the most dangerous drugs in the state.

But medical marijuana advocates and some lawmakers say full legalization would not replace the medical marijuana program.  In other states where marijuana is legal, medical marijuana patients either pay a lower tax rate or are not taxed at all.