Pubdate: Sat, 09 Nov 2013
Source: Arizona Republic (Phoenix, AZ)
Copyright: 2013 The Arizona Republic
Author: Yvonne Wingett Sanchez


Arizona health officials want to collect more-nuanced information 
about medical-marijuana users who claim they suffer from "chronic 
pain" when seeking pot recommendations as part of an effort to find 
physicians improperly recommending pot to their patients.

Patients seeking permission to use medical marijuana cited chronic 
pain as a debilitating condition about 26,500 times from July 2012 
through June 2013, representing 73 percent of Arizonans who qualified 
to use the drug.

Will Humble, director of the state Department of Health Services, 
said he wants to more quickly root out physicians who are improperly 
recommending medical marijuana, and continue intensive training for 
doctors who recommend pot in high volumes.

A new report by the health department analyzed the second year of the 
state's medical marijuana program and found that a small number of 
physicians write a big share of the pot recommendations

Just several hundred physicians appear to specialize in the 
recommendation of medicinal cannabis, according to the report, which 
was released Friday. It said 472 physicians certified 36,346 patients 
from July 2012 through June 2013.

The report found that 99 naturopathic physicians, who combine 
traditional medicine and natural medical approaches in treating 
patients, certified 27,275 patients. Seventy-five percent of patient 
certifications were issued by naturopaths, and just 21 naturopaths 
were responsible for about 72 percent of certifications by such 
medical professionals.

Medical doctors certified 6,434 patients while osteopaths certified 
2,587 patients and three homeopathic physicians certified 50 patients.

Humble said he was troubled that so few physicians were writing so 
many marijuana recommendations.

Arizona's medical-marijuana program, narrowly approved by voters in 
2010, allows people with certain debilitating medical conditions to 
use marijuana. They must obtain a recommendation from a physician and 
register with the state, which issues identification cards to 
qualified patients and caregivers.

Humble reiterated that the numbers raise concerns that patients are 
seeking recommendations from what he has called "certification mills" 
instead of primary-care doctors who are generally more well-versed 
about individual patients' medical histories.

"It's a problem that all the states (that allow medical-marijuana 
use) face: Just a handful of physicians write the certifications," 
Humble said. "We've got to start doing a better job to broaden the 
base - and I don't mean writing more certifications - but ... have 
them be written closer to the patients medical home."

Humble said that over the past year, he has lectured at a 
naturopathic college to help physicians better understand the 
regulatory process.

Regarding a different issue, state health officials could change the 
way they interpret rules regarding the distance patients must live 
from medical-marijuana dispensaries in order to grow their own pot.

Over time, the vast majority of patients who live within 25 miles of 
dispensaries have lost permission to legally cultivate pot as 
dispensaries have opened statewide. The Arizona Department of Health 
Services, which oversees the program, issues cards that allow 
patients to use medical marijuana, grow it or both. Those cards must 
be renewed each year, and those who live within 25 miles of an 
operating dispensary cannot, in most cases, be allowed to grow the plant.

But how the distance is calculated, whether it's "as the crow flies" 
or "as the car drives," is a key point of controversy. State health 
officials interpret the rule as the area within a 25-mile radius of a 

Many patients and advocates, however, say the rule should be 
interpreted as driving distance - actual mileage measured on an 
odometer driving from one location to another. They argue that the 
state's interpretation unfairly covers too much ground and bans too 
many people from growing in their homes.
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MAP posted-by: Jay Bergstrom