Before her doctor recommended daily doses of medical marijuana, Krista Robbins frequently blacked out. Later, she would awaken with multiple self-inflicted cuts on her body. One was so bad that it required 80 stitches.
Robbins, who suffers from post-traumatic stress disorder, says her doctors put her on "more drugs than would kill the average person," including 1,400 miligrams of Seroquel, a powerful antipsychotic.
"Keeping my symptoms at bay made me a zombie on pharmaceuticals," the Farmington resident tells SFR.
It also made her unable to raise her five children. Robbins says her once-medicated existence has blocked out her memory of her oldest child's first year.
In April, her doctor recommended medical marijuana, which Robbins credits with saving her life. With her anxiety now in check, Robbins says she can be a mother again—but she worries that renewing her license, the latest wrinkle in a program plagued with growing pains, will be a frustrating obstacle.
"As somebody with an anxiety disorder, that's the last thing I need," Robbins says.
Robbins' switch from conventional medicine to medical marijuana has, at least in New Mexico, become increasingly unremarkable. The New Mexico Medical Cannabis Program has expanded significantly just in the past year, adding 2,100 patients so far in 2011.
The New Mexico Department of Health, which runs the program, has also begun hiring additional personnel just to keep pace.
At an Oct. 15 meeting, the DOH announced it would add five temporary positions to the program's three current employees. DOH Secretary Catherine Torres says the new positions will soon become permanent.
The new hires are charged not only with addressing the program's growth, but also with serving its approximately 5,500 patients, many of whom are due for license renewals.
New Mexico's program is uniquely state-run: The DOH is responsible for licensing patients and producers and for enforcing strict state regulations.
State law requires the DOH to renew patient licenses within 30 days, but some at the meeting said they've been waiting much longer. Richard Rubin, a physician's assistant at Zia Health and Wellness in Albuquerque, says he's heard the delay can be as long as three months.
"It's been a joke," Melissa Milam, the Cannabis Program's former coordinator, tells SFR. "The program isn't functioning well."
Milam says she's heard of DOH staff hanging up on patients who need renewals—a new iteration of the program's chronic customer-service problems. Earlier this year, producers often lacked adequate supplies to meet patient needs [Indicators, July 20: "Green Light"].
Torres attributes the backlog to a lack of staff and incomplete paperwork from patients.
"People do not realize that in [September 2008] we only had 183 patients," she tells SFR. "There's a lot more patients now, all due for renewal."
At the meeting, MCP Harm Reduction Manager Dominick Zurlo told attendees the new hires are addressing the lag in license renewals. They're also helping speed the approval of new patients: In October, 372 new patients enrolled in the program, compared with 135 in September and 89 in August.
Zurlo also said he hopes a newly imposed annual fee on the program's 25 licensed producers will cover the added personnel costs.
Beginning next month, producers must pay $20,000 if they've been operating for more than a year or $10,000 if they've been around for less than a year. But how far that money will go remains uncertain.
"People think all that money is going to help the program," Larry Love, host of Medical Marijuana Radio, tells SFR. "This money is going into the state's general fund. Who knows when it will go to the Department of Health."
Unless specified by law, all state fees imposed by departments automatically go to the general fund, preventing one department from receiving a disproportionate revenue increase. The DOH plans to ask the Legislature to, in January's session, mark the fees specifically for the Medical Cannabis Program.
Even if the Legislature approves such a measure, Love anticipates it could still take months for the DOH to see the funding.
In other states, crackdowns by federal government authorities have further complicated the administration of medical cannabis programs.
On Oct. 7, federal prosecutors mailed letters to dispensary owners in California, threatening intervention for selling marijuana, a Schedule 1 controlled substance. Across the country, banks have started closing accounts with medical marijuana dispensaries to avoid being targeted in federal investigations.
Albuquerque lawyer Patricia Monaghan says she's heard banks have pulled accounts from a few local producers, though she wouldn't name them out of confidentiality concerns.
Charlie Kokesh, who's been trying unsuccessfully to start his own producing operation, says producer GrassRoots Rx recently had to transition to a cash-only basis after its bank accounts were closed.
GrassRoots declined to comment.
But Monaghan says she's hopeful the feds won't intervene in New Mexico anytime soon.
"Because it's so tightly regulated and controlled, the feds like it," Monaghan tells SFR. "I think the DOH has done a great job trying to help sick patients."
At the same time, crackdowns in other states are hard to ignore. Robbins says she and other patients are worried about federal action. She's also planning to file for her license renewal months ahead of its April expiration date. She fears having to go back on heavy medication again, but says she won't revert to the street if her license renewal is delayed. "I'm a mother of five. I don't mess in illegal things," she says.