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Medical Crackdown in Colorado

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Medical Crackdown in Colorado3

Starting November 17, Colorado will implement new rules for issuing medical cannabis cards.

A memo from the Colorado Medical Board dated on September 22 lists the new regulations. For starters, medical consults must be conducted in person; telehealth consults are prohibited. Before signing off on a medical card recommendation, physicians must review a patient’s medical records and medical history. In the past, doctors could assign recommendations without reviewing medical records, although reviews were advised by state regulators.

As part of a risk assessment, physicians will consider any drug interactions between cannabis and the patient’s ongoing pharmaceutical regimen. The patient’s past history of drug abuse, history of mental or physical abuse, and history of mental illnesses must be factored into the risk assessment. Physicians are encouraged to coordinate with the patient’s other healthcare providers in order to minimize adverse reactions or misuse of medical cannabis.

There is also an additional assessment for pain, which is the most prevalent qualifying condition according to the state’s medical registry. To date, over 90 percent of the state’s medical card holders are approved for severe pain. The pain assessment must document the severity of the patient’s pain, its patterns of behavior, and how the condition impedes the patient’s ability to function.

Doctors may also order imaging studies or laboratory tests as a prerequisite for a proper diagnosis. Doctors can even request urine tests to check if patients are complying with the physician’s recommendations. For women, pregnancy tests may be administered to ensure there is no risk to the fetus.

After the initial assessments, lab tests and diagnosis, doctors are required to educate the patient on the risks related to cannabis consumption–up to and including death. Patients will be informed of their recommended dosages, methods of consumption, as well as review any alternatives to cannabis therapies that could treat their conditions.

Finally, all patients must be available for follow-ups with their physician in order to monitor their progress with medical cannabis treatments.

The new rules were drafted after the passage of SB-15-014, which addressed the state’s potential loss of tax revenue from medical cannabis sales. Recreational sales are taxed on a tiered system totaling 25 percent. Medical dispensary sales are taxed at 10 percent, and transactions between patients and caregivers are taxed at 2.9 percent.

SB-15-014 was sponsored by Sen. Irene Aguilar, a practicing physician and Democrat from Denver. Aguilar pushed the bill due to her concerns that some patients were claiming pain as their qualifying condition but did not require cannabis out of medical necessity. According to the bill’s language, SB-15-014 was designed to limit medical cannabis only to patients with “debilitating conditions.” The bill also sought to prevent the state from being “deprived of valuable tax revenue” by transferring patients with non-debilitating pain to the recreational market.

Unlike recreational grows, home grows aren’t tracked under a seed-to-sale system. SB-15-014 restricts caregivers to five assigned patients, and they’re capped at a 90-plant maximum. As of last year, 4,600 out of the state’s 116,000 registered patients assigned their plant counts to caregivers.

However, doctors still have the final word on a patient’s plant counts. The new regulations comply with Amendment 20, the medical cannabis bill approved by Colorado voters in 2000. Doctors may increase a patient’s plant counts from the standard six plants to any number deemed appropriate by the consulting physician, so long as the physician can provide a rationale for the increase.

 

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