Last week, the two local medical marijuana dispensaries announced they would open their doors on Thursday. On the fated day, however, some 18 months after Governor Andrew Cuomo signed the program into law, no drug was dispensed and neither dispensary was open. At the Bloomfield site in Williamsville, protesters rallied outside the facility, holding pictures of the office interior still under renovation. At the PharmaCann site in north Amherst, a general manager announced they were still waiting on the state’s Department of Health to give its manufactured product the final go-ahead.
But the lack of the drug didn’t stop some advocates from visiting both sites and expressing their optimism for the program. One of those on hand at the PharmaCann site was Dr. Laszlo Mechtler, medical director at the Dent Neurologic Institute, one of the largest neurology practices in the US.
Mechtler shared with us that he came to the site—after seeing five brain cancer patients that morning—to support the state’s nascent program and to join the mother of one of the institute’s epilepsy patients, Lisa Valle, in talking with the media.
Of the 10 diagnoses that the state has initially approved for its medical cannabis program, seven of them—and sometimes eight—are neurological disorders. Staff from the Dent Institute told us that the they are already fielding 100 phone calls a day on medical marijuana.
Is there any frustration that medical marijuana is not available today? Were you expecting it to be available today?
I’m not frustrated, I’m happy! Because most of our individuals are not having acute symptoms over the last two weeks. These are chronic patients. They have been suffering for a long time. So yeah, I wish it was a year and a half ago, but I’m happy that today is today. There will be growing pains, like any other business. This is a very complex issue. Today, there’ll be some drug in this pharmacy. It’ll be one drug. Not enough. We need at least five or six. But in the following weeks, it’s going to develop. Right now, I don’t know if any patient could walk in and get a prescription because they don’t know who the certified physicians are.
Do you know any patients who have received their cards yet?
No. I’m one of the first certified physicians in New York State.
When did you do that?
I did that a week ago. I have eight other colleagues, partners of mine, who are certified. So we have eight at the Dent Institute.
How did that process work for you?
I took the four-and-a-half hour course, sent in some documentation on who I am. I got it back within a few hours. And I have a certificate that I printed out that says I passed the examination, and then New York State certified me. It’s just a question of who is going to do it. Not every physician will do it; the minority will.
Do you think it behooves neurologists to really look into this and get certified for their patients?
I can’t speak for the other neurologists, but for neurologists that sees a lot of ALS, sees a lot of MS, sees a lot of Parkinson’s, sees a lot of brain cancer—at the end of the day, I don’t think they have a choice. Unless they say, “Well, the Dent’s doing it, we’ll refer these patients to the Dent.” The one thing I would tell you is that not every patient with MS or Parkinson’s will need medical marijuana. There’s a percentage that don’t and a percentage that will, and the physician will make that decision in discussion with the patient.
There’s still a lot of issues going on with medical liability, with licenses and the fear of federal involvement. But I firmly believe that if a physician acts in a compassionate way and doesn’t make a business out of this, then the physicians have every right to prescribe medications to relieve the suffering of their patients. After doing this 25 years, it does get tiring to see people suffer and you can’t cure. Would an individual in practice for two years do this? I don’t know. I don’t think so.
Do you look at medical cannabis as something to add to your toolbox?
Two things: I want to relieve suffering for my patients and improve their quality of life. That’s the basis for the Hippocratic oath. Number two: Step in and do the research. Let’s take a disease and use our institute as the largest and say we want to look at this drug at this dosage. And put it out there so other doctors are more comfortable. The reason doctors are not comfortable is there’s not enough science. And the science we have is being criticized because it’s in small groups and lot of it is retrospective science, and it’s being somewhat tainted by involvement of the pharmaceutical companies. They don’t want medical marijuana out there.
Because they don’t make it?
It’s not a drug, it’s an herb. It’s herbal research, yeah? The next year is going to be very interesting.
Even though other states have been doing this for years, there’s not enough research?
You can’t because it’s a Schedule I drug. Schedule I drugs, enacted by Nixon in 1970, says that this has no medical use and that it’s addictive and dangerous. Both of which are untrue about marijuana. So there’s no federal funding. A physician at the VA can’t even prescribe it.
We’re all putting our DEA and medical licenses at risk. In fairness, I think physicians that are professional will not be harassed if done properly. There’s legal drugs like opiates. Physicians are scared. They don’t want to give narcotics. Take a federally legal drug and know the fear that physicians have, where every month someone in the Buffalo News is being taken away. I’m not saying it’s right or wrong but that the fear is there. Now take something that is federally illegal, most doctors will say, “I don’t need that.”
Has the Dent Institute itself made a policy statement on this or have they left it up to the individual physicians?
I was very proud of my partners because I sent an email out yesterday asking who was registered, because I wasn’t sure. This was not discussed on an individual basis.
So there were no meetings about this?
Oh, there will be one tomorrow. [He laughs.] Immediately eight said, “I’m registered,” and two said, “I will be registered,” so we’ll have 10. And the reason they’ll register is because they’re epilepsy specialists, they’re MS specialists, they’re ALS specialists, [they’re] brain cancer and pain specialists.
Everyone does it because of compassion for their patients. There’s no other reason. This takes money away from us. More logistics: Seven pages have to be filled out on each patient to get them certified. Who’s going to do that? I found out that in New York City, doctors are asking $200 just to certify somebody.
Seems like an ethical question there.
It’s an ethical question, but doctors can’t lose money on it. We can, because we’re an institute. We don’t have to make money, we have to show the compassion and leadership. We do well because we’re large. If I was in solo practice, I would be nuts to do it.
DENT NEUROLOGIC INSTITUTE
3980 Sheridan Drive, Suite 300
Amherst, NY 14226
Phone: (716) 250-2000