HELENA – Montana’s medical board wants to curb the practice of mass screenings and remote doctor teleconferences to certify new medical marijuana patients in a state where the number of registered users has boomed from 800 to 12,000 in about two years.
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.
Speculation that the state’s medical marijuana law is being abused and that there are too many patients registered is a myopic view, Christ told lawmakers. The number of registered medical marijuana patients is about 1.2 percent of the population, which he said is far less than the number of chronic pain sufferers.
“At the heart, you can tell that medical cannabis is a populist movement,” Christ said. “This is the story of Montanans shedding off the economic tyranny of our current health care system, adopting instead a self-sustaining viable alternative to a 4,000 percent markup to often toxic pharmaceuticals.”
The rush of patients and caregivers has exposed gray areas in state law that were not anticipated. For example, authorities have no idea how much marijuana is being grown in or shipped to the state, and they don’t know most of the locations of the caregivers.
“I couldn’t even hazard a guess, there’s too many variables there. I have no idea,” said Mark Long, chief of the Montana Narcotics Investigation Bureau, when pressed by lawmakers on the amount of marijuana in the state.
Ambiguity in the law makes it difficult for authorities to inspect caregivers’ operations for compliance and to know whether it’s worth the resources to arrest or prosecute users and growers, officials said.
Users don’t have to carry their registration card with them. Plus, if an unregistered person gets arrested but they can prove they would qualify for a card, they can use that as a defense against prosecution.
Long, Center, Christ and others testified before an interim committee that aims to identify areas to shore up the state law when the Legislature meets next year. Several ideas are being floated — though no concrete fixes have been proposed — including having the state grow or sell the patients’ marijuana.
“It would give us control over the use of the drug, over growing the crop, and (after) the testimony over how much that stuff is worth, hey, we could be rolling in dough,” said state Sen. Jim Shockley, a Republican from Victor.
Christ has suggestions of his own for lawmakers: Increase the allowable amount of marijuana from 1 ounce to 2 ounces, add a minimum for edible marijuana products, such as brownies, and expand the type of qualified illnesses to include post-traumatic stress disorder, depression and anxiety.
Tom Daubert, one of the leaders of the campaign to allow medical marijuana in Montana, said voters who approved the initiative in 2004 are now seeing consequences they never intended. He is the head of a medical marijuana advocacy group called Patients and Families United, but he says more oversight and regulation are needed.
Montanans “did not vote for mass traveling clinics held in hotels or warehouses,” Daubert said. “Montanans, I don’t think, I’m convinced, did not vote for patients to receive recommendations from doctors who aren’t even meeting with them at the time, without the benefit of either medical records or a thorough physical exam and diagnosis.”
Related: Council Votes to Prohibit Medical Marijuana Businesses in Kalispell