DENVER (AP) - A dozen physicians have issued half of the medical marijuana recommendations in Colorado, one sign that the state is not providing enough oversight so only qualified individuals get referrals to use the drug, according to an audit released Monday.
The report released to lawmakers found that 12 physicians were responsible for 50 percent of the current 108,000 medical marijuana "red cards" as of March.
Some doctors have also recommended what appear to be higher-than-reasonable amounts of the drug, auditors said, noting that one patient received a recommendation for 501 plants and another got a referral for 75 ounces of marijuana.
The vast majority of red-card holders, 94 percent, got referrals after complaining of "severe pain," according to the audit. One percent of patients got a referral because they had AIDS or HIV, 3 percent were cancer patients, and 1 percent had glaucoma, according to the audit.
Auditors said that the Department of Public Health and Environment, which oversees the medical marijuana registry, has not referred physicians to the Colorado Medical Board for investigation since January 2011. Auditors recommended that the department increase its oversight by revising its physician certification form so that doctors explain why they're making a recommendation and attest that they don't have ties to any medical marijuana business.
Auditors accused the health department of "weak controls" over the doctors recommending pot. The result, they said, is a broad perception that medical marijuana cards go to people who aren't sick.
"These weak controls also undermine the legitimacy of marijuana as a medical treatment by fostering the impression that physician recommendations for marijuana are not held, or should not be held, to the same rigorous standards as a typical prescription for medicine," auditors wrote.
Department officials agreed to strengthen oversight of recommending physicians. The department also agreed to work with the state medical board to identify risk factors that signal potentially inappropriate doctor referrals - another audit recommendation.
Pot is now legal for everyone over 21 in Colorado, but the state still maintains a medical-marijuana registry. Auditors said that because of the age restriction for recreational use of the drugs, the medical marijuana registry will continue to be needed.
However, auditors asked whether the state's current system of having marijuana patients designate a single dispensary as their medical pot provider should be changed now that pot is legal without a doctor's recommendation.
"A new approach may be warranted for ensuring that marijuana providers are not producing more marijuana than is needed by patients with legitimate medical needs," auditors wrote. "The requirement for patients to affiliate with dispensaries may no longer make sense with the legalization of recreational marijuana."
The audit also faulted the health department for slow processing of red cards, taking longer than the required 35-day window a third of the time.
Finally, auditors faulted the health department for charging patients more than needed to run the program. The health department's cash fund ended the 2012 fiscal year with a $12 million surplus, money that came from individuals paying $35 annual fees. The cash fund isn't intended to be a money-maker for the health department, just to cover the costs of running the marijuana program.
Medical marijuana has been a booming industry in the last four years in Colorado. In 2009, there were about 6,000 medical marijuana patients. The 108,000 patients now is a 1,700 percent increase, the audit said.
The health department oversees the patient registry but not the production and sale of medical pot. That is done by the Department of Revenue, which was subject of blistering criticism in March.
That audit accused the Revenue Department of overspending on things like cars and office furniture and then running out of money to enforce its rules on marijuana production.
- By Ivan Moreno, AP Writer
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