CO Doctors Differ Widely on Medical Marijuana Views

Doctors differ widely on views about medical marijuana

By Mike McPhee
The Denver Post
Posted: 11/01/2009 01:00:00 AM MST
Updated: 11/01/2009 01:06:49 AM MST

An average of 400 requests for medical marijuana cards flow into the
state health department for review daily, but the real gatekeepers in
the rush to buy pot legally are the physicians and osteopathic doctors
who sign the patients' applications.

A doctor's signature validates that the applicant suffers from one of
eight medical conditions specified in state law that cause great pain or
discomfort that may be eased by consuming pot, and the signature gives
the patient legal access.

Some doctors interpret the law with great precision, making referrals
for patients only with whom they have relationships.

Others, worried that being linked to medical marijuana might interfere
with their licenses to prescribe other controlled substances, refuse to
refer patients at all.

But a handful of physicians have set up clinics, such as The Hemp and
Cannabis Foundation and CannaMed, for the sole purpose of reviewing
medical records and signing applications, charging as much as $200 for
the service.

Founded in Oregon, THCF employs 10 staff doctors who operate marijuana
referral clinics in California, Michigan, New Mexico, Montana, Oregon,
Hawaii, Nevada and Washington. In Colorado, THCF runs clinics in Denver,
Glenwood Springs and Durango.

At THCF in Denver, Dr. Eric Eisenbud signs an average of 100
applications each week, THCF regional manager Scott Carr said.

The state health department does not track how many applications are
signed by individual doctors, but Carr says Eisenbud may be the most
prolific referring physician in Colorado.

"We're responsible for 5,000 applications, if not more, since we moved
here in June 2006," Carr said. "This state is very vague about it. The
law was written for primary doctors to sign up their full-time patients.
But most doctors have very little to do with it."

That a few doctors are responsible for large numbers of pot referrals is
not surprising, given the relative newness of its legal use, said Wanda
James, a Democratic political operative and restaurant owner who is
attempting to open a medical marijuana dispensary.

"What you're seeing is a handful of doctors who are not afraid of being
part of the beginning of this industry," James said. "There are lots of
doctors, because of ignorance of the law, who are nervous about writing
referrals, especially if they have a good practice."

Doctors are investigated only if someone files a complaint against them,
so signing medical-marijuana registry applications opens physicians to
no more scrutiny than any other part of their practices, said Susan
Miller, a health care section director who oversees the state Board of
Medical Examiners.

Still, some doctors aren't taking any chances.

Pain-management specialist Dr. Jeffrey Kesten said that a partner in his
Aurora practice will sign registry applications, but he prefers not to
because he is worries about potential repercussions.

"I need to feel I can feed the kids at home," he said.

Medical marijuana was legalized in 2000 in Colorado, for the treatment
of pain and discomfort related to cancer, glaucoma, HIV or AIDS,
wasting-away disorder, severe pain, severe nausea, seizures and
persistent muscle spasms.

On July 31, the last time the state health department released
statistics, there were 11,094 people on the medical-marijuana registry.
Since then, doctor-approved applications have flowed in at a rate of
about 400 per day, spokesman Mark Salley said.

That boom "reflects the fact that it's very helpful," said Cherry Creek
North psychiatrist Dr. David Muller, 74. He now devotes about half his
practice to pot referrals.

"If a person meets the criteria and doesn't like to use prescription
drugs, I'll sign his form," Muller said. "But I won't sign applications
if they don't have one of the eight conditions. I won't sign if someone
is suffering from anxiety or from insomnia, which marijuana is supposed
to be very good for — it's not one of the eight conditions. And I
won't sign for someone who's bipolar."

Some doctors appear to approach the review process much more casually.

Paul Hutchinson, 61, of Golden, a retired Denver Post reporter, said he
recently drove to the CannaMed offices on Leetsdale Drive, "just out of
curiosity."

He had no medical records with him and had never met the doctor on site.
He spoke with the doctor "maybe three to five minutes," paid a $55 fee
and received the doctor's signature on his application for medical
marijuana.

"What convinced him was when I lifted up my shirt and showed him my
scars from open-heart surgery," Hutchinson said.

CannaMed, which specializes in pot referrals and has clinics in Boulder,
Colorado Springs, Denver, Durango, Fort Collins, Grand Junction and
Pueblo, refused an interview request.

Muller said he understands the anxiety surrounding the sudden
proliferation of medical marijuana dispensaries, which are unregulated,
but sees hypocrisy in the fact he is allowed to prescribe Marinol, an
FDA-approved drug containing a synthetic version of a key marijuana
ingredient, for his patients — with or without a medical-marijuana
card.

"I can write you a prescription right now," he said. "You could walk
over to King Soopers and fill it."

Mike McPhee: 303-954-1409 or mmcphee@denverpost. com

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