Final Rules on Medical Pot Too Tough on Patients, One Doctor Says; Other Pot Advocates Satisfied With Rules
The final rules for medical marijuana are too tough on patients and may encourage a lawsuit, says one Valley doctor.
Edgard Suter, an East Valley nuclear medicine physician who has been an outspoken advocate for medical marijuana, decried an addition to the draft rules that requires doctors to state the underlying condition causing "chronic or severe pain." He already was unhappy that state officials plan to monitor the recommendations that physicians make and turn in prolific recommendation writers to medical boards for possible discipline.
Suter's one of the few critics of the final set of rules, published on the state Department of Health Services' website on Monday. Other pot advocates seem satisfied with the state's rule-making job.
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Andrew Myers, formerly of the Arizona Medical Marijuana Policy Project, which put Prop 203 on the ballot, told the Prescott Daily Courier, "Overall, I think it's a good package... Patients are treated very fairly."
Tom Salow, the DHS' rule-making lawyer, tells New Times today that he didn't expect to please everybody, but he thinks "the department did a great job. A lot of states are looking at this. I believe we set a new standard."
Only a few minor corrections will need to be made before the rules are filed with the Secretary of State's office on April 14, he says.
The requirement to list the underlying medical condition makes sense, says Steve Schafer of the Arizona Medical Marijuana Certification Centers. His businesses' three locations have been contacted by thousands of people in recent months, many of whom obtained preliminary approval by doctors for a marijuana recommendation.
In other states with medical marijuana programs, "chronic and severe pain" is the most commonly cited ailment by patients. It'll probably be the same story in Arizona, but Schafer says his company will need to see "good documentation" for the pain claims. Some would-be patients already have been rejected, he notes.
Complaints like "my tailbone hurts because I slipped and fell on my skateboard" won't cut it, he says. The pain has be to "severe, and it's gotta be over a period of time." The centers' doctors prefer to see MRIs or x-rays to help document the problem, he says.
One area for potential improvement in the system is the application process, Schafer says. While computer users will be able to submit applications and payments electronically, he estimates that 20 percent of the patients seen by the certification centers don't own a home computer.
Suter, though, he says he's concerned that the state's vocal anti-pot stance has been reflected too well in the rules.
The state plans on examining the recommendations made by doctors, looking for an excessive amount (no hard numbers have been established) or a lack of proper documentation. Will Humble, DHS director, believes that if registration cards are issued to thousands of people in their 20s or 30s who don't have documentable maladies, that'll be evidence that the system is getting abused.
To Suter, that means Humble and the state are trying to play doctor. Only the physician should determine if the person might be helped by weed, and full documentation of "chronic and severe pain" might not always be possible. For instance, if a doctor has written that a patient has "moderate" back pain in his or her notes, that doesn't mean the patient doesn't have "severe" pain, he insists. It could simply be that the doctor underestimated the patient's pain.
The doc says he and the director got into a heated dispute recently.
"Humble was yelling at me, purple-faced, saying 'You better have those records!'" Suter says.
Honestly, it's hard to imagine the bespectacled bureaucrat yelling at anyone. But it sounds like Suter's planning on writing a cargo-ship-load of recommendations and that he doesn't want anyone to second-guess him.
Any doctor the DHS refers to the state medical board -- which he says is among the toughest in the country -- is going to have a rough time of it, Suter says.
"You get a letter from the board, it's going to cost you money," he says.
He has a point, but it's too early to tell what the DHS or medical board will do. We think it's likely that the DHS will only go after the low-hanging fruit: It'll refer to medical boards the physicians who are writing hundreds of recommendations to people with no documented history of qualifying problems.
In other pot news, we peeked at the marijuana-related proposed laws wending their way through the Arizona Legislature and found that two are still headed for passage.
One is the bill we call the "Patient Discrimination Act," because it gives so much power to employers. The other is a bill that would require information about patients' medical marijuana approval status to be included in the state's prescription drug monitoring program.
Bills that appear dead include proposals to tax marijuana that's sold at dispensaries, make possession of marijuana a civil offense for everyone, and limit the amount of tax that could be imposed on medical pot.
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