MSSNY eNews – Thoughts on New Marijuana Regs?

Thomas J. Madejski, MD MSSNY President

Thomas J. Madejski, MD
MSSNY President

August 3, 2018
Volume 20  Number 28


Dear Colleagues:

MSSNYPAC Sarasota Race Track

Day at the Races. Dr. Myrna Sanchez; Dr. Bill Latreille; Dr. John Kennedy; Barbara Ellman; Mrs. Pinto and Dr. Greg Pinto; and MSSNYPAC Chair Dr. Joe Sellers

Our best laid plans don’t always work out as intended. We had a splendid time at Saratoga Springs Race Track Saturday afternoon at MSSNYPAC’s Day at the Races.  We had physician members from all over New York State join us for an afternoon of camaraderie and widely variable statistical analysis.  We picked a couple of winners, but the house won in the end.  We hope to create similar events throughout the State for the enjoyment of our members, and to enhance MSSNYPAC funds.

My travels were not all fun and games.

I have heard from many MSSNY members about the emergency regulations on the use of marijuana for both pain and for opioid use disorder. As a result of these comments, I—along with other MSSNY representatives—met this week with NYS Department of Health officials to discuss these regulations and to gather additional information before submitting MSSNY’s comments on these regulations.

We met with Sally Dreslin, RN, deputy executive director of the New York State Department of Health (DOH); Richard Zahnleuter, Esq., DOH Counsel; Erin Hammond, DOH’s Office of Governmental Affairs; Josh Vinciguerra, Esq., director DOH’s Bureau of Narcotic Enforcement and Nicole K. Quackenbush, Pharm.D, Director, NYS DOH’s Medical Marijuana Program. MSSNY representatives included myself, Dr. Frank Dowling, MSSNY secretary and a member of the American Medical Association’s Task Force on Opioids; Dr. Jeffrey Selzer, Medical Director for the Committee on Physicians’ Health; Phil Schuh, C.P.A , M.S., MSSNY Executive Vice President; and Pat Clancy, MSSNY’s Sr. Vice President for Public Health and Education/Managing Director.

The topics we discussed included the use of marijuana for the purposes of “acute” pain and as an alternative for the treatment of opioid use disorder. Physicians can now certify a patient to use marijuana for both these conditions under the emergency regulations. However, in order to be eligible for a physician to certify them for marijuana, a patient must be in an OASAS approved program.. We discussed both the process for the regulations and the anecdotal evidence and expert opinion that the department used to make its decision to expand the use of marijuana for the treatment of these conditions.

The intent of the DOH’s regulations are laudable: to provide alternatives for treatment that may have less risk for patients with acute pain, and additional treatment options for opioid use disorder. Dr. Selzer, Dr. Dowling, and I expressed concern about the evidence base for expansion of the approved indications. The Health Department participants acknowledged that there are not well controlled long term studies available regarding the use of marijuana for the new indications, but felt that the expansion of treatment options as an alternative to opioids for pain and medication-assisted treatment for opioid use disorder outweighed the risks.  MSSNY expressed concern that with little long term data on efficacy and side effects, patients may be exposed to significant adverse reactions that could divert them from more effective treatments.

I am particularly concerned that promotion of marijuana use for opioid use disorder may worsen psychiatric co-morbidities, and give a false impression to patients that it is as effective as established effective treatments such as methadone and buprenorphine, particularly in the prevention of fatal opioid overdose.

DOH indicated that it is collecting data on medical marijuana usage, but is not involved in studies of efficacy of marijuana for the existing approved conditions at this time.  I will ask our Legislative Committee to consider— as part of our agenda—a request for the State to provide funding for research on the efficacy and long term effects of our experiment with marijuana.

My personal assessment of the available data and anecdotal experience is that marijuana is helpful in a small number of patients and a small number of conditions. One of the good parts of New York’s experiment is development of definable products that can be studied.  The expansion of opioid use two decades ago began with anecdotal experience and expert opinion that turned out to be incorrect, and subsequently promoted by industry to create the societal problem we are dealing with today.

History repeats itself, but sometimes in cunning disguise—so that we never detect the resemblance until the damage is done.

Primum non nocere! 

Please send your thoughts to

Thomas J. Madejski, MD 
MSSNY President


Share Your Thoughts on New Marijuana Regulations
MSSNY will be formally submitting comments on these regulations in the near future and will involve its Addiction and Psychiatric Medicine Committee in the drafting of the comments.  Please share your thoughts and comments with us at

DOH Adds Pain and Opioid Use Disorder as Conditions for Marijuana Use
The New York State Department of Health (DOH) has added pain and opioid use disorder as conditions that marijuana could be used under the New York State marijuana program.  Under regulations released earlier this month, a physician, nurse practitioner and/or a physician assistant can now certify patients for these conditions. However, a patient who suffers from opioid use disorder must be in an OASAS program in order to qualify for use of marijuana.  A copy of the emergency regulations can be found here.

Additionally, the DOH released its interagency report on recreational marijuana in New York State.   The report, entitled, “Assessment of the Potential Impact of Regulated Marijuana in New York State,” concludes that the “positive effects of a regulated marijuana market in NYS outweigh the potential negative impacts. Areas that may be a cause for concern can be mitigated with regulation and proper use of public education that is tailored to address key populations. Incorporating proper metrics and indicators will ensure rigorous and ongoing evaluation.” The report was issued by the DOH under the direction of Governor Andrew Cuomo, who directed NYS agencies to evaluate the health, public safety and economic impact of legalizing marijuana. The report, to MSSNY knowledge, did not involve any outside medical groups or organizations in making this assessment. A copy of the report can be found here.

Join MSSNY’s Member Perks Program and Enjoy $4,500 in Savings!
MSSNY is pleased to announce our newest member benefit!  Our new Abenity App provides members with exclusive perks and over $4,500 in savings on everything from restaurants, City Pass, AMC movie tickets, theme parks, hotels, car rentals, mortgage savings, auto care and much more!

Popular Features Include:

  • Nearby Offers: Use our show and save mobile coupons to quickly access savings on the go.
  • eTickets On Demand: Save up to 40% with no hidden fees.
  • Showtimes: Find movies, watch trailers, and save up to 40% at a theater near you.
  • Monthly Giveaways: Win cash, movie tickets, electronics and more with our monthly contests.

And, with over 302,000 available discounts across 10,000 cities in the United States and Canada, you’ll never be far from savings!

And, with over 302,000 available discounts across 10,000 cities in the United States and Canada, you’ll never be far from savings!


Click on the following link: and then create a unique username and password.

ZocDoc Update
We posted a note in our last newsletter regarding Zocdoc’s plans to change their pricing model.  MSSNY, together with its General Counsel, Garfunkel Wild, P.C., has been engaged in discussions with Zocdoc to better understand and analyze the planned changes and engage in what we anticipate will be productive conversations on behalf of our members.

To enable physicians to provide feedback and to enable Zocdoc and MSSNY time to work collaboratively together in advance of any changes, Zocdoc will not be moving forward with changes to its pricing model in October. Zocdoc has indicated that they are committed to taking the time necessary to better understand the feedback that we have received from members.  We will provide updates as these discussions continue.

Summer is a Great Time to Catch Up on CME
MSSNY now has more than 30 modules on our CME website (note: new users to the site will need to create an account).  You can earn free CME credits on emergency preparedness topics that range from Anthrax to Zika Virus.  We also have modules on Veterans Matters as well as diabetes prevention and concussion in pediatric and adult patients—including a CME accredited podcast on the same topic.

MSSNY also has more than ten informative podcasts that you can listen to here. There are multiple brief podcasts on immunizations and MSSNY’s Physician’s Emergency Preparedness Toolkit.  Each podcast offers insights from medical experts. 

New York’s Single-Payer Bill Would Require 156% Increase in Tax Revenue
Crain’s New York Business (8/1, LaMantia) reports on the New York Health Act, a proposal that would create a statewide single-payer health plan in New York, that has passed the Assembly in each of the past four years, but “it hasn’t advanced in the Republican-controlled Senate.” Research from the Rand Corp. and the New York State Health Foundation into the legislation found that in order “to finance the program, the state would need to raise an extra $139 billion in taxes, a 156% increase compared with the $89 billion expected in 2022.” The study considered a new tax structure which would increase taxes on the wealthy.

Does Your Practice Use Social Media? Learn about Risks and Inappropriate Use
The use of social media by medical practices allows them to better market their services and share important medical information with current and prospective patients. However, there are a number of concerns associated with the use of social media, including advertising risks, breaches of patient confidentiality and inappropriate use. Join the Medical Society of Queens, in collaboration with MLMIC, for a one-hour presentation entitled Social Media in Healthcare. The presentation by William Hassett, Esq., will review the unique benefits and appropriate use of social media in a practice and will address the associated liability issues and offer strategies to minimize the risks.
: Wednesday, August 15, 2018, 8:30-9:30 am
Where: Medical Society of the County of Queens, 112-25 Queens Blvd, 4th Fl, Suite 1, Forest Hills 11375. Click here for more information.

Nominations Open for 2017 Albion O. Bernstein, MD, Award
The Medical Society of the State of New York is accepting nominations for the 2017 Albion O. Bernstein, MD Award.  This prestigious award is given to: “…the physician, surgeon or scientist who shall have made the most widely beneficial discovery or developed the most useful method in medicine, surgery or in the prevention of disease in the twelve months prior to December, 2017.”

This award was endowed by the late Morris J. Bernstein in memory of his son, a physician who died in an accident while answering a hospital call in November, 1940.

The $2,000 award will be presented to the recipient during a MSSNY Council Meeting.  Nominations must be submitted on an official application form and must include the nominator’s narrative description of the significance of the candidate’s achievements as well as the candidate’s curriculum vitae, including a list of publications or other contributions.

To request an application, please contact: Committee on Continuing Medical Education, Miriam Hardin, PhD, Manager, Continuing Medical Education, Medical Society of the State of New York, 99 Washington Avenue, Suite 408, Albany, NY 12210 or call 518-465-8085 or email


Garfunkel Wild ASC Symposium on Nov 2; MSSNY Members Receive $65 Discount
November 2, 2018 is Garfunkel Wild’s 5th Annual NY Metro ASC Symposium at the Marriott Marquis (Manhattan). Please find the agenda for the day and additional information by clicking here:

MSSNY members will be entitled to a $65 discount. 



Upper East Side Plastic Surgery Office Available for Rent Part Time
Located in posh Carriage House off Park Avenue with fully certified operative suite (AAAASF). OR can be rented separately.  OR Packages available for multiple case use. Please contact 212-628-7600between 11am and 6pm for further information.

Orthopedist to Rent Space
Sports Medicine Multidisciplinary Practice. MIDTOWN MANHATTAN. Exclusive Referrals Available
Turn key operation with full services. Unique opportunity with little to no risk.
Excellent for satellite or primary office. Flexible options available.
Inquire with

Are You Trying to Lease Your Medical Office or Sell Your Medical Practice? Trying to Sell New or Used Medical Equipment?
Clineeds, the new online platform designed for medical providers. With Clineeds you can lease your medical officeshared your office spacebuy and sell used medical equipment, or post healthcare job opportunities. LISTING IS FREE! Why wait? Click here to sign-up:


Chief of Medical Services
MINIMUM QUALIFICATIONS: Possession of a license and current registration to practice medicine in New York State, plus six years of experience in the practice of medicine, two years of which must be in an administrative or supervisory capacity. Appointee must be eligible for and maintain eligibility for full and unconditional participation in Medicaid and Medicare programs. Appropriate certification by an American Medical Specialty Board and one year of post certification experience in that specialty can be substituted for four years of general experience.
PREFERRED QUALIFICATIONS: Board certification in Geriatric Medicine and/or Certification as a Medical Director (AMDA), and experience in a long-term care facility.
RESPONSIBILITIES: Serve as Medical Director of a 242-bed skilled nursing facility for veterans and their dependents. Provide medical leadership and oversight ensuring the delivery of quality health care services while also ensuring compliance with clinical, statutory and regulatory standards.Send resume to:  NYS Veterans Home, Attn: Human Resources, 4207 State Highway 220, Oxford, NY 13830

The New York State Veterans Home at Oxford is a 242-bed skilled nursing facility operated by the NYS Department of Health located in Chenango County. It is an Affirmative Action/Equal Opportunity Employer.