Doctors' Legal Risks With Medical Marijuana

Mark Crane


June 04, 2015

In This Article

How to Recommend Medical Marijuana Legally

Each state has its own system and requirements.

In Rhode Island, for example, the patient must have a "qualifying disease" and a "debilitating medical condition." That's similar to how most other states operate. Those diseases and conditions can include cancer, glaucoma, HIV-positive status, AIDS, and hepatitis C, or the treatment of these conditions. "A chronic or debilitating disease or medical condition produces one or more of the following: cachexia or wasting syndrome; severe, debilitating, chronic pain; severe nausea; seizures, including but not limited to, those characteristic of epilepsy; or severe and persistent muscle spasms, including but not limited to, those characteristic of multiple sclerosis or Crohn's disease; or agitation of Alzheimer's Disease," according to thestatute.

"It's a three-step process," said Steven R. DeToy, director of government and public affairs for the Rhode Island Medical Society. "The patient must have a qualifying disease. There must be a legitimate doctor/patient relationship, although nurse practitioners and physician assistants can also be involved. And there must be a serious informed consent discussion with the patient about the pros and cons of marijuana use. The patient must take the certification to register with the state and then go to a highly regulated and licensed dispensary."

The written certification can be made "only in the course of a bona fide practitioner-patient relationship after...a full assessment of the qualifying patient's medical history. The written certification states that in the doctor's professional opinion, the potential benefits of medical marijuana would likely outweigh the health risks for a patient."

In Arizona, the doctor must perform a physical exam, review a year's worth of medical records, talk about the risks and benefits of the drug, and review a state database that tracks prescription-drug use.

California's law is looser than in other states and allows recommendations for a "serious medical condition" that includes "any chronic or persistent medical symptom that substantially limits a person from conducting 1 or more major life activities." That's led to law enforcement groups urging the legislature to tighten the law.

"Enforcement is spotty at best because criteria for recommending medical marijuana are so loosey-goosey," said Keith Humphreys. "In California, virtually anyone can qualify for medical marijuana."


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