Medical marijuana: 2,000 patient aps to be nixed under health board MMJ doc compromise

medical marijuana doctor holding bottle with green cross cropped.JPG
Update: Last November, we reported that nearly 2,000 medical marijuana patient recommendations had been rejected over a change in the definition of doctors okayed for this task. After an uproar, around 1,300 were temporarily reinstated pending formal action by the state board of health. That action came yesterday, with as many as 2,000 aps to be nixed as a result.

This situation was set in motion by Senate Bill 109, a measure sponsored by Chris Romer, now a Denver mayoral candidate, that was intended to clarify the relationship between doctors and medical marijuana patients. Here's a key passage from the legislation:

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 term "unrestricted license" is important. Some doctors have either conditions or restrictions placed on their licenses that disallow them from providing certain types of care, often due to rulings by the Colorado Medical Board. A frequently cited example is a surgeon who's been told he can no longer perform surgery because he suffers from arthritis. However, these caveats frequently have nothing to do with medical marijuana.

chris romer photo 1.jpg
Chris Romer.
Many of the most prolific MMJ doctors had restrictions or conditions on their licenses -- and because Amendment 20, which legalized medical marijuana in Colorado, required only that a physician be classified as being "in good standing," they had no reason to believe their recommendations were invalid. But even before the passage of SB 109, the Colorado Department of Public Health and Environment set aside applications recommended by doctors with conditions or restrictions on their license -- and afterward, the agency sent letters informing impacted patients that their aps had been rejected owing to the new language.

Around 1,300 patients recommended by physicians with conditional licenses were subsequently told their applications would be set aside until formal rules were adopted. Around 500 whose recommendations had come from doctors with restricted licenses remained out of luck.

Cut to yesterday, when the Board of Health formally established that physicians with conditions or restrictions on their licenses cannot write medical marijuana recommendations -- without going through an appeals process, that is. According to CDPHE spokesman Mark Salley, the board created a mechanism by which "a physician can go to the medical board and seek a confidential agreement that would allow them to authorize medical marijuana" -- a provision in a bill presently moving through the legislature this session.

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What's this mean for patients whose applications had been temporarily approved -- 2,000 of them, says Salley, updating the 1,300 figure from late last year? He reveals that the effectiveness date of the new rule is April 30. As a result, patients "will be notified of a denial because the recommending physician had a condition or restriction -- and at that point, a couple of things might happen. The physician might go out and attempt to receive one of those confidential agreements with the medical board that would allow them to go ahead and authorize, or the patient might have to seek a different physician and submit a new application."

The latter prospect seems more likely, especially since it's uncertain how long the confidential-agreement process might take -- or whether it could be completed prior to April 30.

Other rules approved by the board include the requirement that MMJ recommenders actually examine the patient in question. "You can't have any kind of Skype long-distance exam," Salley confirms. Moreover, such doctors must make themselves available for future appointments.

An Associated Press article about yesterday's moves suggests that thousands of patients are in "limbo" due to the ruling, but Salley doesn't think that's quite right.

"I don't know that I'd describe it as limbo," he says. "The thousands of individuals whose applications were submitted by physicians with restrictions or conditions had been deemed approved until the state took action. And now that the rule has been approved by the board, the department will take action to notify those individuals that their application came from a physician with a restricted or conditioned license, and therefore would be refused." In that sense, then, "the air is beginning to clear on what their status is based on the rule-making yesterday."

Page down to read the revised regulations, as well as a previous minority report from board of health members who objected to the blanket rejection of conditional or restricted recommenders prior to the establishment of the confidential-agreement provision.

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Generic Viagra
Generic Viagra

Excellent article. You have made your point and there is notmuch to argue about. It is like the following universal truth that you can notargue with: No truth is universal, everything has its exception. Thanks for theinfo.

Christian Conser Vative
Christian Conser Vative

Jesus said to do unto others as we would have them to do unto us. None of us would want our child thrown in jail with the sexual predators for using a little marijuana. None of us would want to see our parent's home confiscated and sold by the police for growing a couple of marijuana plants to ease the aches and pains of growing older. It's time to stop putting our own families in jail. It's time to let ordinary Americans grow a little marijuana in their own back yards, and it's nice to see our culture coming to terms with this in a more wholesome fashion. This will go a long way toward putting the criminal drug gangs out of business for good!

Letyourvoicebeheard
Letyourvoicebeheard

Genesis 1:11 Then God said, "Let the land produce vegetation: seed-bearing plants and trees on the land that bear fruit with seed in it, according to their various kinds." And it was so.1:12 The land produced vegetation: plants bearing seed according to their kinds and trees bearing fruit with seed in it according to their kinds. And God saw that it was good.

Genesis 1:29 Then God said, "I give you every seed-bearing plant on the face of the whole earth and every tree that has fruit with seed in it. They will be yours for food.

There you have it folks.... God says, on the FIRST page of the Bible, THREE times, that mj (seed bearing plant) is good, and there to be used.

Just sayin'....

Michael Roberts
Michael Roberts

Interesting post, Letyourvoicebeheard. We're going to make it an upcoming Comment of the Day. Congrats.

Chuck Sheen
Chuck Sheen

Same for opium! And co-fucking-caine!

WINNING!

solar_satellite
solar_satellite

We should end the prohibition of all drugs as a matter of principle and to improve public health. I agree that quoting Genesis is (mostly) ineffective rhetoric, even with those who delude themselves that it is divine writ.

MOMPdotORG
MOMPdotORG

Exactly how is cannabis legally included in Schedule I, with drugs that have no accepted medical use in the United States?

In 2003, U.S. Patent No. 6,630,507 entitled "Cannabinoids as antioxidants and neuroprotectants" was assigned to the Department of Health and Human Services. Since DHHS applied for the patent in 1999 citing dozens of references*, over 6 million citizens have been arrested on the demonstrably false claim that cannabis has no medical use.

In the abstract of that federal document, one finds:

". . . cannabinoids useful in the treatment and prophylaxis of wide variety of oxidation associated diseases, such as ischemic, age-related, inflammatory and autoimmune diseases. The cannabinoids are found to have particular application as neuroprotectants, for example in limiting neurological damage following ischemic insults, such as stroke and trauma, or in the treatment of neurodegenerative diseases, such as Alzheimer's disease, Parkinson's disease and HIV dementia. "

* see: http://tinyurl.com/classaction...

offscreen
offscreen

The minority report is right on the money. The Colorado Medical Board has repeatedly testified there is no definition of "in good standing" in statute, rule, regulation, or policy. The CMB used the categorizations of "restricted" and "conditioned" interchangeably. Whether a doctor's license is restricted or conditioned is arbitrary, often depending on the quality of his/lawyer. The CMB has avoided this issue for years, and needs to get its own act together to provide clarity. The fact that the arbitrary CMB is coordinating with the biased CDPHE on the medical marijuana issue only compounds the problem.

Michael Roberts
Michael Roberts

Defining these terms is indeed confusing, offscreen. Thanks for the post.

solar_satellite
solar_satellite

There is some confusion about the Colorado Medical Board (undoubtedly emerging from the Solons and half-assed lawyers manning the Legislature) -- C.R.S. refer both to the "Colorado Medical Board" and to "the board of medical examiners", which are apparently identical. The use of capitals in the former would certainly suggest that it was the proper formal designation (and that "C.M.B." is the correct abbreviation to use), but DORA refers to the "Colorado Board of Medical Examiners", and "BME" appears to be the preferred abbreviation.

offscreen
offscreen

The Board of Medical Examiners name has been changed to the Colorado Medical Board. That's all.

solar_satellite
solar_satellite

So we were (again) misinformed -- a so-called "compromise" has been reached which invalidates thousands of physicians' recommendations even though their licenses are in good standing. The Board of Health failed to uphold physicians' constitutional prerogative to recommend cannabis in order to pander to the CDPHE's implacable determination to slow, thwart, and eschew its responsibility for medical cannabis. The CDPHE's utter failure should give any Coloradan concerned for the public health pause -- if it brings one tenth of the incompetence, duplicity, and bad faith it has demonstrated with respect to medical cannabis to other medical issues, our public health establishment is in serious trouble. What is the Department doing to research cannabis' ability to cure (not just palliate) cancers? Absolutely nothing. Most of Colorado's doctors apparently lack even a modicum of scientific curiosity or integrity, and content themselves with sneering at the public's (correct) determination that cannabis is medicine. The Colorado Department of Health and Environment should be reconstituted from the ground up.

More Regulations Please
More Regulations Please

Chris Romer is trying to ride SB109 into the mayor's office. Time for Chris to get his head out of his ass and respect the views of the residents of Colorado. His grandstanding on this issue should eliminate any serious consideration as mayor. There are many better options.

Amendment 20 only requires a doctors recommendation, not a red card. Go ahead and eliminate these doctors. CO patients will stop getting cards, stop visiting dispensaries and grow their own.

Who loses? The state of CO loses taxes and CDPHE fees. Who win? Patients.

Perfect.

solar_satellite
solar_satellite

What you wrote sounds crazy, but it's true -- in a city in which the electorate has voted four (4) times to liberalize cannabis laws (by a plurality of 57% in 2007), Romer hopes to profit from last year's debacle over medical cannabis in the General Assembly and his support for unconstitutional laws which multiplied regulations, created a new police force (the Medical Marijuana Enforcement Division), and provided for the hiring of 110 new full-time employees at the Department of Revenue. Romer is counting on a non-existent backlash against medical cannabis (he and the General Assembly may be about the only people in Denver stupid enough to buy into the Post's campaign of yellow journalism against cannabis), but he is also counting on retrograde voters. We can elect the only unequivocally pro-cannabis rights candidate in the race (Doug Linkhart) just by educating the 57% of voters who passed Municipal Ordinance 38-176 less than four years ago and turning them out to vote. There is one genuinely progressive candidate in the race -- Doug Linkhart. What are we going to do to elect him?

Boulder Med Cannabis
Boulder Med Cannabis

true. the red card is voluntary. one dr's rec is good for life. you won't be able to shop at MMCs, but there is plenty of 'other' cannabis available due to the big black market created by the 70/30 rule.

Herbert
Herbert

So if you grow your own, have a chronic mmj approved medical condition, and have a doctor's recommendation 1+ year old you're legal and have no reason to register? Is there any benefits to registering? I know the reasons not to register but can you still get arrested and prosecuted for growing and using medical marijuana without a current doctor recommendation or license? Annual doctor visits and registering with the state for a chronic medical condition with no cure is time consuming and costly but if the alternative is risk prosecution then that is not something I want to fear, even if I am entitled to an affirmative defense.

solar_satellite
solar_satellite

Do read Article XVIII, Section 14 -- it's seven pages long. The Constitution states that it is "an exception from the state's criminal laws for any patient or primary care-giver in lawful possession of a registry identification card to engage or assist in the medical use of marijuana", but merely offers an affirmative defense to patients who have just a recommendation. Patients should not be charged if police have evidence before them that a patient was engaged in the medical use of cannabis, but the official card may well deter officers who would otherwise ignore a doctor's written recommendation or other evidence of appropriate medical use.

Jesus "Herbert" Christ
Jesus "Herbert" Christ

Is this fact? "one dr's rec is good for life" ? Can you or someone quote laws to back this up? I know the registry (red card) is voluntary but I thought annual dr rec was required...and I think I remember reading something in 1284 that says a patients waves affirmative defense if they are not registered with the cdphe..... Anyone with legal knowledge of the situation care to clarify?

Jesus
Jesus

There was no reply button under your comment Robert but my post and questions are above. Many thanks to anyone with advice on the situation. The laws are confusing to the average patient.

solar_satellite
solar_satellite

The legal authority for the use of cannabis derives not from any statute of the General Assembly, but from Article XVIII, Section 14 of Colorado's Constitution. The relevant section (Article XVIII, Section 14 (2) (a) (II)) provides that patients and primary caregivers have established an affirmative defense to charges of violating our fascist laws against cannabis if "the patient was advised by his or her physician, in the context of a bona fide physician-patient relationship, that the patient might benefit from the medical use of marijuana in connection with a debilitating medical condition". HB10-1284 did not (and could not) do away with this fundamental, constitutional protection granted to patients and caregivers by the People of Colorado.

Michael P.
Michael P.

Dispensaries (not MMCs) and Patient Collectives are still valid methods of obtaining cannabis medicine under the constitution. And unlike MMCs, they have constitutional protection. MMCs are getting ready to hand all their patient info. over to the Department of Revenue MMED cops anyway. Is it time to Boycott the Registry?

Guest
Guest

Romers douchbaggery once again fucks the MMJ community. God forbid this guy win as mayor in Denver, prepare for a dispensary licensing fee of $800,000,000,000.

Letyourvoicebeheard
Letyourvoicebeheard

Don't want Romer to be Mayor? Volunteer for a candidate that supports MMJ. This means Linkhart, or possibly Meija.

Linkhart was recently one of only 3 candidates in the nation that the TeaPot Party endorsed.

Meija, I think says he supports mmj. I think.

solar_satellite
solar_satellite

I met with Mejia's campaign manager months ago to discuss a wide range of issues including Denver's failure to abide by the lowest law enforcement priority ordinance regarding possession of cannabis -- she was new to the City and not up to speed on most issues. We agreed to talk again when she was better informed (and Mejia had taken a position on Municipal Ordinance 38-176) -- I have given up waiting. Denver wants its police department to stop ignoring our own law, and James Mejia is afraid to grasp the nettle. Doug Linkhart has the knowledge and the political fortitude to champion the People over a corrupt establishment. Linkhart for Mayor!!!

Letyourvoicebeheard
Letyourvoicebeheard

Well I guess the candidate to help is definitely Linkhart then. Their campaign HQ's phone number is 303-295-5003

Seize this opportunity - and help make a difference. Volunteer today!

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