N.J. Admin. Code § 13:35-7A.5

Current through Register Vol. 56, No. 21, November 4, 2024

Section 13:35-7A.5 - Written instruction requirements; reassessment; records

(a) A physician may provide written instructions for the medical use of marijuana for a qualified patient registered with the Department of Health and Senior Services, provided the requirements in this section are satisfied. If authorized by the Department of Health and Senior Services, the physician may provide the written instruction by electronic or other means directly to an alternative treatment center on behalf of a registered qualifying patient.

(b) The physician's written instructions shall include the following information:

1. Physician name, address and telephone number;

2. Physician license number and CDS registration number;

3. Patient name, address, telephone number, date of birth and registry identification number;

4. If applicable, caregiver name, address, telephone number, date of birth and registry identification number;

5. Name of the permitted alternative treatment center;

6. Quantity of marijuana to be dispensed; and

7. Any other information required by the Department of Health and Senior Services by rule.

(c) A physician authorizing the medical use of marijuana shall review, at a minimum of every three months, the course of treatment for the patient's debilitating medical condition, and the patient's progress toward treatment objectives as a result of the use of medical marijuana, including whether the patient is achieving the therapeutic results intended, has developed significant untoward side effects, or is experiencing any physical or psychological problems associated with marijuana use. If the physician determines that the patient is achieving treatment objectives, and is not experiencing untoward side effects or physical or psychological problems associated with marijuana use, the physician may continue the patient's treatment with medical marijuana without alteration.

(d) If treatment objectives for the patient's debilitating medical condition are not being met as a result of the use of medical marijuana, or the patient is experiencing untoward side effects or physical or psychological problems associated with marijuana use, the physician shall:

1. Modify the dosage of medical marijuana or mode of delivery authorized, provided the authorized amount does not exceed two ounces in a 30-day period consistent with (g) below, undertake a trial of other drugs or treatment modalities, or discontinue the use of medical marijuana; and

2. Consider referring the patient for independent evaluation or treatment in order to achieve treatment objectives.

(e) The physician shall remain alert to the possibility that marijuana may be misused or diverted. A physician issuing written instructions for a patient with a history of substance abuse shall exercise extra care by way of monitoring, documentation and possible consultation with addiction medicine specialists, and should consider the use of an agreement between the physician and the patient concerning the medical use of marijuana and consequences for misuse.

(f) The physician shall keep accurate and complete records that include:

1. The medical history and physical examination of the patient;

2. The diagnosis of the debilitating medical condition, including the patient's symptoms and their severity and the patient's reaction and response to conventional medical therapies, which qualify the patient for the medical use of marijuana;

3. Other evaluations and consultations;

4. Treatment plan objectives;

5. Evidence of informed consent. In obtaining informed consent, the physician shall advise the patient about the lack of scientific consensus for the medical use of marijuana, its sedative properties and the risks for addiction;

6. Treatments and other drugs prescribed or provided;

7. Any agreements with the patient; and

8. Periodic reviews conducted.

(g) A physician shall not issue written instructions authorizing a patient to receive more than two ounces of marijuana in a 30-day period.

(h) A physician may issue multiple written instructions at one time authorizing the patient to receive a total of up to a 90-day supply of marijuana, provided that the following conditions are met:

1. Each separate set of instructions is issued for the treatment of the patient's documented debilitating medical condition;

2. Each separate set of instructions indicates the earliest date on which the alternative treatment center may dispense the marijuana, except for the first dispensation if it is to be filled immediately; and

3. The physician has determined that providing the patient with multiple instructions in this manner does not create an undue risk of diversion or abuse.

(i) The physician shall keep a copy of the patient's, or if applicable, the caregiver's registry identification card, in the patient's medical record.

(j) If the physician determines that the patient's underlying debilitating medical condition no longer exists or that the patient's continued use of marijuana is no longer appropriate, the physician shall notify the Department of Health and Senior Services of his or her findings.

N.J. Admin. Code § 13:35-7A.5