EGG HARBOR TOWNSHIP, N.J. - Before buying cannabis at South Jersey's only medical-marijuana dispensary, patients must circle one of six animated faces that stare out from a clipboard.
The row of smiling, wincing, frowning, and sobbing cartoon faces is being used to rank the degree of pain that patients experience due to cancer, multiple sclerosis, epilepsy, and several other conditions the state deems treatable by cannabis.
When the patients return to the Compassionate Care Foundation dispensary in Egg Harbor Township for a refill, they again are handed the Wong-Baker FACES Pain Rating Scale so that the effect of the marijuana can be assessed.
The results so far are "absolutely dramatic," said Suzanne Miller, a researcher with a Ph.D. who sits on the dispensary's board of trustees. Miller is also a professor and the director of behavioral medicine at Fox Chase Cancer Center/Temple Health in Philadelphia. About 80 percent of the 145 CCF patients who completed the rankings at least twice over the last two months have charted significant improvement, she said.
Still being collected and analyzed, the data show that on average, most patients are reporting their pain levels decreased by 30 to 50 percent, Miller said. "You usually see smaller results, about 10 percent, or 20 percent," she said.
An author of four books and a contributor to more than 100 academic articles, Miller will be the lead researcher on a report she plans to submit to medical journals for publication possibly this fall. The dispensary has 600 registered patients and expects to have more data by that time.
On a gloomy, wet morning last week, several patients walked into the dispensary to purchase cannabis, which is packaged in plastic bottles and sold at $428 an ounce. Two patients who agreed to be interviewed afterward said the marijuana they bought had changed their lives. Three other patients who were reached by phone said it markedly eased their pain.
"I was addicted to Vicodin," said Gary Carnevale Sr., a multiple sclerosis patient from Bayville, Ocean County, shortly after he picked up an ounce of "Red Cherry Berry" marijuana from an employee behind a glass window at the dispensary. Carnevale, 57, a former licensed practical nurse, said increasing amounts of prescribed Vicodin, OxyContin, Percocet, and other narcotics did not relieve the throbbing pain shooting up his back and legs, and he then had to be hospitalized for two weeks early last year.
Carnevale was among the first patients to come to CCF, which opened six months ago inside a cavernous warehouse just outside Atlantic City. Marijuana plants are also grown at that location under special purple, red, blue, and yellow lights.
"I took three or four hits. I laid in bed, and I could not believe the pain slipping away," Carnevale said, recalling the first day he smoked it using a vaporizer. "My pain was like ten. . . . But when I smoke marijuana, I swear it's zero," he said. While he previously spent most of his days in bed, he said he now is able to function and even took a recent vacation with his family, including his two grandchildren.
Jacqueline Angotti, a nurse-practitioner from Robbinsville, began sobbing when asked the effect the marijuana had on her 9-year-old son, Miles, who had suffered multiple, daily seizures since he was 2. "He's been seizure-free; he's had none for the past 31 days and has had no side effects," she said. "And he's better cognitively."
In the past, Miles was forced to wear a mask to protect his face and teeth from frequent falls caused by the violent seizures, she said. And, for the same reason, he had to eat meals from a tray while sitting on the floor. Angotti turned the marijuana buds into a tincture, which she gives to Miles in tiny doses three times a day, and he no longer needs his mask, she said. "He eats dinner at the table now," she added.
Bill Thomas, the dispensary CEO, said the frequent hugs that grateful patients bestow on staff and the tears he has witnessed in the waiting room convince him of marijuana's medical worth. "To us, this is medicine. To everyone else, it's something else. It's pot. . . . But this is not Colorado," he said. His staff wear white medical jackets, and only patients who have a doctor's approval may buy the drug.
Those afflicted with seizures, multiple sclerosis, Crohn's disease, irritable bowel syndrome, and glaucoma are reporting the greatest benefit, Thomas said. One patient who had Crohn's disease experienced a "total reversal" and was able to return to work, he said.
Because there is a dearth of scientific studies, anecdotal evidence is practically the only proof available at this time, Thomas said. Marijuana's status as a federally prohibited Schedule I drug, ranking it more dangerous than opium, has blocked studies on its medicinal value, he said.
Though the federal government still considers marijuana illegal, the Obama administration recently announced it will not enforce the ban in states that have legalized it for medical and for recreational use except in egregious trafficking cases and when it is being marketed to minors.
New Jersey is one of 22 states that have legalized medical marijuana, and many others are weighing it. Its strictly regulated program calls for doctors to write "recommendations" - not prescriptions - authorizing patients to obtain cannabis. But they are not required to provide dosing information, leaving patients to use marijuana on a trial-and-error basis.
Thomas said he looks forward to having an analysis of the patient surveys completed and having a more detailed questionnaire for patients developed so that CCF can determine what doses and strains are most helpful for its patients. "This is the drug that needs to be studied," he said.
One in five patients initially told staff that they did not get relief by taking the cannabis they had purchased, Thomas said. But when the strain and dose were modified, he said, half of those patients reported their pain had lessened. Marijuana contains 60 chemicals, he said, and the various strains have different ratios of the ingredients. CCF currently sells six strains and is planning an expansion next month.
Back in the dispensary waiting room, a 60-year-old Brigantine woman who suffers from multiple sclerosis was busy gathering up her one-quarter ounce of marijuana and her umbrella as she prepared to head home. "I had pain every day in my feet and occasionally in my face," she said, declining to be named. "It's debilitating, and when it's in my face it's like lightning."
After baking marijuana brownies with the cannabis, she said, her pain improved 80 percent. "It's a valid medicine," she said. "And it is time it's seen that way."