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Montana aims to curb mass medical pot screenings

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Montana aims to curb mass medical pot screenings

Associated Press Writer

HELENA, Mont. (AP) -- The number of registered medical marijuana users in Montana has boomed from 800 to 12,000 in just two years, partly through mass patient screenings and the use of out-of-state doctors. Now the state medical board wants to curb those practices, saying not enough care is taken to properly diagnose patients.

A Montana Board of Medical Examiners review suggests people are being added to the state's medical marijuana registry who do not suffer from the chronic and debilitating conditions that are required for certification, Dr. Dean Center, a Bozeman physician and board member, told state lawmakers Tuesday.

"As everyone knows, the number of people being certified has just exploded," Center said. "The entrepreneurial spirit has taken hold."

Under scrutiny are clinics hosted by medical marijuana advocates that travel across the state with doctors who spend just a few minutes screening hundreds of potential patients. Then there are out-of-state physicians involved in medical marijuana screenings, sometimes using teleconferences or videoconferences to diagnose patients as having a qualifying condition.

The advocacy group Montana Caregivers Network hosted a round of clinics earlier this year and is gearing up for an 11-city tour of its "Cannabis Conventions" next month. The group's website also advertises "TeleClinic Statewide Daily Appointments" that says: "Visit the Doctor from anywhere! Got a computer? You can visit the doctor, online, and get your green card. Doctors are available all day long, every day!"

The medical board is preparing a position statement on adequate evaluation and monitoring of patients with chronic and debilitating illnesses. The statement that "will likely affect the process of mass screenings and may preclude remote electronic method of evaluation without some sort of modification or adjustment," Center said.

Center also said complaints against physicians who sign medical marijuana recommendations will be treated the same as those against doctors prescribing other forms of care, even though the language used in the medical marijuana law is different. Doctors "evaluate and certify" medical marijuana patients instead of the normal "diagnosing and prescribing."

He did not detail the changes the statement would make, nor did he say when they would become effective. Calls to the medical examiners board were not returned on Tuesday.

The number of medical marijuana patients in Montana began rising exponentially after the Obama administration changed federal policy last year to say it will not seek to arrest users and suppliers as long as they conform to state law.

At the end of March, there were 12,081 medical marijuana patients registered in the Montana, with more than 4,800 new patients added since the beginning of the year, according to the state Department of Public Health and Human Services.

There are also about 2,800 registered caregivers who provide marijuana to registered patients, according to the health department.

Jason Christ, the head of the Montana Caregivers Network, said it is the medical board's right to decide what constitutes a bona fide relationship between a doctor and a patient if it decides a change is needed in the screening process.

But it's hard to find doctors in Montana, especially for poor workers without access to heath care, Christ said.

"For a doctor to spend an hour for each patient, it would be prohibitive," he said.

Christ estimated the caregivers network has seen 15,000 potential patients in its nine-month existence and has kept records of each doctor visit.

Source: http://hosted.ap.org/dynamic/storie...TOL-?SITE=MTBOZ&SECTION=HOME&TEMPLATE=DEFAULT
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Medical marijuana law flawed, all sides agree

From police to physicians to patients, a legislative panel Tuesday got an earful on the problems — or possible fixes — that face the state’s medical-marijuana scene, which has seen an explosion in the number of users.

Law-enforcement, school and city officials said the huge growth in patients certified to use medical marijuana in Montana has exposed them to numerous legal dilemmas as they try to balance the state law allowing its use with anti-drug laws and efforts.

For example, Lewis and Clark County prosecutor Mike Menahan of Helena said most of the felony drug offenders on probation or parole in his county have medical-marijuana cards, essentially allowing them to use drugs in violation of the terms of their release.

“I see that as a terrible problem and a huge loophole in the law,” said Menahan, who is also a state legislator.

Even some of the strongest supporters of Montana’s medical-marijuana law said Tuesday it needs some changes to protect against its abuse.

Yet supporters also told the Children, Families, Health and Human Services Interim Committee that people with a legitimate medical need for marijuana need to be able to obtain the drug without fear of being arrested or harassed by law enforcement.

“This law is about compassion, liberty, health and patients’ rights,” said Tom Daubert, director of Patients and Families United, a group representing medical-marijuana users. “I think it’s very important that we make it work.”

Montana voters enacted the state’s medical-marijuana law in 2004 by passing Initiative 148, with 62 percent in favor.

It allows people with a “debilitating medical condition,” as certified by a physician, to obtain a state registry card allowing them to possess up to 1 ounce of marijuana for medical use. Patients with a card can designate a “caregiver” who can legally supply marijuana to one or more patients.

Since June 2009, the number of registered patients in Montana has jumped from nearly 3,000 to more than 12,000. Businesses growing and supplying medical marijuana have sprung up around the state, and some have organized traveling “clinics” at which people can line up to see physicians to become certified as patients.

Rep. Diane Sands, D-Missoula, who chairs the interim committee, said Tuesday it wants to hear all sides of the issue so it can “bring some order to the chaos at the moment” and recommend proposed changes to be forwarded to the 2011 Legislature.

Marijuana growers and their representatives testified that the law does create ambiguities on what’s legal and what’s not. But they said medical marijuana has become a legitimate industry in the state, with “secondary service providers,” like chemists, bakers and couriers, and that most of those involved are trying to follow the law.

“Take the time to come and look,” said Rick Rosio of Montana Pain Management in Missoula. “Our doors are open to you. Our growing operations are open to you.”

Daubert, however, said voters who passed I-148 didn’t think they were voting for “open smoking or public use of cannabis,” traveling clinics or large growing operations in residential neighborhoods.

Sen. Jim Shockley, R-Victor, asked whether supporters would object to registering marijuana-growing sites with the state, listing the patients served by caregivers, requiring records of all marijuana transactions or a list of physicians certifying patients.

Jim Gingery, executive director of the Montana Medical Growers Association, indicated that most of those changes might be acceptable, as long as the privacy of patients is preserved.

Powell County Attorney Lewis Smith suggested that the program be regulated by the Department of Labor and Industry, by a professional board appointed by the governor, so it could react more quickly to problems rather than waiting for the Legislature to address things every two years.

Much of Tuesday’s testimony focused on how the law can create conflicts with other laws or policies, such as those forbidding drug use at schools.

Aaron Bouschor, an attorney with the Montana School Boards Association, said questions are being raised about whether students who have a medical-marijuana card can participate in extracurricular activities, which forbid drug use by participants, or whether they can use medical-marijuana products during the school day.

“We are still in the Wild West, figuring out just what the scope is with medical marijuana,” he said.

And some came to testify that the law needs to be tightened to prevent its abuse by people who clearly don’t need marijuana for medical purposes and who are abusing an illegal drug.

Kay Parmiter of Missoula noted that many recently certified patients are people between the age of 21 and 30, and she doubts they have legitimate “debilitating conditions” that need medical marijuana. She said her 22-year-old son is a “marijuana addict” who obtained a card so he can legally obtain the drug.

“Close the loopholes for our youth,” she said. “Stop people from profiting from our youth.”

Source: Medical marijuana law flawed, all sides agree
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