Only six months after a grand opening, southern New Jersey's sole medical marijuana dispensary is struggling to survive.
This spring, Compassionate Care Foundation was planning to triple its production, using a $357,000 loan from the state Economic Development Authority. Simultaneously, the dispensary was preparing to convert cannabis leaves into liquid medicine, transdermal lotions, and lozenges, according to Bill Thomas, the nonprofit's CEO.
About 100 pounds of the leaves sit in brown grocery bags at the dispensary, waiting to be sent to a manufacturing plant in Pennsauken to be turned into the new products.
But where are the patients?
Located just outside Atlantic City, the dispensary has but 600, who currently can get only marijuana buds. The number is far short of what he needs to pay bills and support an expansion, Thomas told The Philadelphia Inquirer.
For now, the $357,000 project to expand growing space is on hold.
When the nonprofit applied for one of six dispensary licenses offered three years ago by the state Department of Health, Compassionate Care projected it would have 5,000 patients upon opening and 10,000 in its second year. "Our cultivation facility has the capability of servicing up to 20,000 patients at two ounces per month," its bid said.
But so far, only 2,200 patients statewide have registered to buy cannabis.
Many patients complain that the application and doctor approval process takes three months, on average, and is too cumbersome for the program to succeed, Thomas said.
Patients also report they spend about $1,000 on doctor visits and registration "before they even get in the door" of the dispensary, he said.
Because of marijuana's uncertain status - it is still illegal under federal law - insurance does not cover the visits.
Nor does it cover the cost of the drug, about $400 an ounce.
"If the regulations don't change, there's no reason for us to stay open," Thomas said. "Woodbridge can handle it all," referring to the Garden State Dispensary in Middlesex County. It has about 1,300 patients and the ability to serve 25,000, according to Michael Weisser, its CEO.
A third dispensary, in North Jersey, has about 300 patients. Three other dispensaries with preliminary approvals have not opened.
Thomas said shutting down is not a serious option — yet. The regulations are due to be modified, and that could open the door to thousands more patients, he said.
At the top of the list would be a change allowing the dispensaries to deliver marijuana to hospice facilities, nursing homes, and hospitals, Thomas and Weisser both said.
Weisser, spokesman for the six dispensaries' Alternative Treatment Center Association, presented the proposal to the Health Department last week.
"It makes sense. Obviously a person in hospice can't get out of bed and fill out a form, and the same goes for a patient in a hospital undergoing chemotherapy," Weisser said. He said vans with guards could be used to make the deliveries.
"These people are not getting the medicine now," Thomas said, blaming the lengthy registration and doctor approval process. He also said that a patient who qualifies for hospice should simultaneously qualify for marijuana, since terminal illness is one of a dozen medical conditions the state deems eligible for the drug.
Donna Leusner, a Health Department spokesperson, said deliveries are currently prohibited. When asked if the proposal was something the department would consider, she said in an e-mail: "Everything is always being reviewed."
Kevin Roberts, a spokesman for Gov. Christie, also would not comment specifically on the proposal but said in an e-mail: "The governor has signaled his willingness to make changes to the program if there is a demonstrable need."
Another issue, Thomas said, is that only about 200 doctors have registered for the program. He said the Health Department could help by not requiring the registered doctors to appear on a published list, which some consider a stigma.
"We believe there are over 1,000 doctors who would sign up if was not for this. . . . We could probably help 10 times more patients if it were not for this one issue," he said.
Thomas is moving ahead with plans to manufacture other cannabis products at a plant in Pennsauken that is pending state approval. The dispensary now sells only buds and must discard the leaves, which could be used for the new products.
Starting next month, he hopes to begin producing lozenges that would be dissolved under the tongue and then absorbed directly into the bloodstream. The plant also would produce liquid cannabis for children, similar to an acetaminophen syrup, and cannabis lotions that would be applied to the skin, he said.
Compassionate Care plans to lease a machine that uses a "supercritical carbon dioxide extraction process" similar to that used to make freeze-dried coffee, vanilla extract, and rose oil, Thomas said. The new products are expected to be sold at his dispensary by Sept. 1, he said.
Similar products, as well as candies and brownies, are marketed in Colorado, which legalized the drug for recreational use in January after having a medical marijuana program.
Weisser said that his Garden State Dispensary presented a plan to the Health Department last week to produce lozenges, a topical lotion, skin patches, and capsules at its facility.
At a dispensary he runs in Colorado, he said, more than 150 edibles are sold. In New Jersey, he said he is only proposing one, a capsule. He does not have approval to begin manufacturing.
Until last year, New Jersey's medical marijuana law excluded edibles. After being confronted by parents with severely sick children who cannot smoke, Gov. Christie signed an amendment to allow this type of cannabis to be offered. But he called the change a "slippery slope" and restricted it to children.
Both Thomas and Weisser said that they also would like the Health Department to revisit this issue because many sick adults cannot smoke cannabis and would benefit from edibles.
"The reason we only have 2,000 patients is because of difficulties with the law," Thomas said. "I'm looking forward to the state opening up the regulations."