Marijuana coming out of a dispensary container. Medical marijuana use is legal in New York State in cases where patients have debilitating or life-threatening conditions whose symptoms could potentially be alleviated with the drug. STATESMAN FILE

This year, New York Gov. Andrew Cuomo started directing efforts to legalize recreational marijuana use in the state. This expansion from current state laws around medical marijuana has been justified with projections that new taxes could generation around $300 million in revenue, which could be used for things like public works projects, opiate addiction treatment and substance-use prevention education programs.

The push toward legalizing marijuana illustrates society’s growing acceptance of the drug. But most debates over legalizing cannabis miss a crucial point. While the debate over recreational marijuana use persists, getting medical marijuana to patients who need it is still often difficult.

Medical marijuana use is legal in New York State in cases where patients have debilitating or life-threatening conditions whose symptoms could potentially be alleviated with the drug.  But there are still too many hurdles for sick patients to overcome before they get access.

First, a qualified physician has to diagnose them with one of the requisite conditions, such as cancer, HIV, Parkinson’s disease or ALS. But many doctors are still reluctant to recommend medical marijuana due to the legal risk of recommending a drug that is still outlawed at a federal level. It is not a prescription drug, so it can only be recommended.

Fortunately, 2015 Senate Bill S2405 opened the door for online companies like NuggMD to offer physician services over the internet and allow for patients to apply for a medical marijuana card online.

The cost of getting the physician online certification ($149) and medical marijuana ($50) card, however, is still a hurdle for many prospective users.

While advancements in technology help to reduce the barriers to access, few patients are aware of these services, especially the elderly, who may not be technologically proficient. Most medical marijuana users in New York are between 50 and 70 years old, and technological issues, as well as questions over the program’s legitimacy, harm patient trust in online services.

Once a patient receives their medical marijuana card, there is still the cost of obtaining the marijuana. Medical marijuana can cost upwards of $100 a month depending on the type and quality of the product. Insurance plans do not cover medical marijuana, despite the fact that for many patients, it can be a safer alternative to prescription drugs with significant side effects and withdrawal symptoms.   

There is also a shortage of dispensaries that can offer medical marijuana, which could further stalwart severely sick potential users who have a hard time travelling significant distances.

The challenge is compounded by the fact that when it comes to payment, once again federal laws are working against the patient. Dispensaries usually cannot take credit or debit cards because the banks are federally insured. This is a cash-only transaction.

Kudos to New York State for getting the ball rolling by making medical marijuana legal and establishing a process to obtain it through dispensaries. But accessibility is still being stymied at the federal level, where marijuana is still recognized as a controlled substance with heavy criminal penalties, where doctors cannot prescribe it under federal law and where distributors are unable to obtain basic business bank accounts that would allow them to conduct business.   

Because of these hurdles, we are asking sick, elderly, immobile and often terminally ill patients to go through a series of complicated processes just to get the chance to relieve their pain. Until there is change at the federal level, access may continue to be limited for those who need it most.