Medical marijuana: Nearly 2,000 MMJ patient recommendations nixed over quiet rule change

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Over the past week or so, medical marijuana patients across the state have learned that doctor recommendations for the card allowing them to use MMJ have been rejected. Why? A new health department policy that slid into place almost unnoticed -- one that's likely to disenfranchise and anger nearly 2,000 patients, as well as infuriating impacted doctors and clinics.

Why? A change in definition for doctors approved to write medical marijuana recommendations that the Colorado Department of Public Health and Environment began enforcing late last month. Department spokesman Mark Salley confirms that eighteen doctors specializing in MMJ are now forbidden to recommend cannabis. But instead of informing the affected physicians, the department has been telling patients who received the recommendations, some of which date back to the early months of 2010. They've then been filling in the doctors, often in extremely heated ways.

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Dr. Ned Calonge.
Some background: Amendment 20, the 2000 measure that legalized medical marijuana in Colorado, defines a physician allowed to recommend medical marijuana as "a doctor of medicine who maintains, in good standing, a license to practice medicine issued by the state of Colorado." But in recent years, Ned Calonge, Colorado's chief medical officer until earlier this month, has been concerned about doctors who specialize in writing MMJ recommendations without engaging in followup care with patients.

In a 2009 Westword interview, Calonge decried such doctors, saying, "You might walk in to a dispensary, and they give you a pre-completed form. You check off chronic pain. They might do a blood-pressure check, and then a physician looks at you, asks you a couple of questions, signs your form and your application is complete. And that's not appropriate medical care. That's substandard." He added that recommendations from just fifteen doctors statewide led to 73 percent of the state's almost 16,000 MMJ licenses at that writing.

State Senator Chris Romer believed many of these patients didn't really need medical marijuana -- and he set out to tighten restrictions on doctors specializing in MMJ as a result. That's why Senate Bill 109, which he sponsored, defines a doctor in good standing like so:

THE PHYSICIAN HOLDS A DOCTOR OF MEDICINE OR DOCTOR OF OSTEOPATHIC MEDICINE DEGREE FROM AN ACCREDITED MEDICAL SCHOOL; THE PHYSICIAN HOLDS A VALID, UNRESTRICTED LICENSE TO PRACTICE MEDICINE IN COLORADO; AND THE PHYSICIAN HAS A VALID AND UNRESTRICTED UNITED STATES DEPARTMENT OF JUSTICE FEDERAL DRUG ENFORCEMENT ADMINISTRATION CONTROLLED SUBSTANCES REGISTRATION.

The key word in the passage above is "unrestricted." Some doctors' licenses are tagged with conditions or stipulations often related to a specific area of practice. And it so happens that many of the most prolific recommenders of medical marijuana have such restrictions. Until Colorado Governor Bill Ritter signed SB 109 in June, these doctors could recommend medical marijuana -- and for months afterward, they continued to do so. Little did most of them know that recommendations written afterward, and even ones written in the months before the measure became law, would be rejected.

Dr. Janet Dean, an OB/GYN based in Denver, found this out the hard way.

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