The Denver post reports on a judge temporarily blocking the suspension of four doctors allegedly over-recommending a high plant count to medical marijuana patients.
The doctors – Maiocco, Dunlop, Parr and Stone were suspended by the Medical Board. They have allegedly written recommendations allowing more than 1 500 medical marijuana patients to grow or possess 75 or more cannabis plants. The standard plant count per medical marijuana patient is six. Doctors may recommend more at their discretion, should they find it medically necessary.
How can cannabis doctors in the US determine how many plants one patient needs?
It seems like yet another controversial issue has hit the medicinal cannabis stage. To determine the amount of plants a patient needs is no easy task.
For instance William Courtney, a Mendicino County-based physician and leading proponent for ingesting raw cannabis is convinced eating, or juicing and then drinking, raw cannabis leaf and buds, is the a way to go. He is all for it because of the mega-dose therapeutic impact without psychoactive effect. The green leaves of the plant contain tetrahydrocannabinol (THC) in its acid form, THCA, which is not psychoactive.
“The main psychoactive compound in dried, aged cannabis is delta-9 THC, which is absent in the raw, fresh leaf. In general, patients do not experience a ‘high’ from consuming the raw product” he explains.
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Juicing requires a lot of plant material
He recommends using up to 25 large fan leaves per day in juice, salsa, pesto, salad, etc. to his patients. He also recommends one bud a day for general health maintenance. If patients are suffering serious conditions it could go up to several buds per day
A patient on the raw juice regime sent 30 large leaves for analysis to a lab in Los Angeles. The leaves were found to contain a combined 11.5 milligrams of cannabinoids acids. To reach a target of 600 mgs of cannabinoids a day, one would have to ingest 1 500 leaves or a significant amount of buds a day, by this measure.
From this it is clear that one patient may need more than six plants to successfully treat their condition. All plants should also not be planted at the same time to ensure a sustainable supply.
These four doctors were the first in the state to be punished for allegedly over-recommending a high plant count to medical marijuana patients.
The doctors were prohibited from making any recommendations until their disciplinary cases were resolved.
Dr. Robert Maiocco, one of the four suspended doctors, said after the hearing that the judge’s decision was fair.
The Colorado Medical Board who is determined to crack down on doctors signing off large plant counts sees the ruling of Judge Ross Buchanan as a setback.
The doctors argued that state health officials selected an arbitrary number of plants per patient, which brought about the initial scrutiny, and didn’t inform doctors about it. It is an unwritten law. An attorney for the Medical Board, Russell Klein, defended the approach by saying the board had the authority to determine whether actions of physicians met a standard of care.
Judge Buchanan was not swayed.
“If they’re the first physicians to be affected by the rule,” he asked, “and they literally find out the morning they’re told to stop practicing, that isn’t fair, is it?”
This could be the first round of a long fight as the doctors have the right to request a hearing before the Medical Board and then take the matter to the administrative courts system of the state. Or, they could proceed with their lawsuit against the Medical Board in Denver District Court, in the hopes of winning a permanent injunction against the suspensions.
These doctors also see non-medical marijuana patients who they said were harmed by them being suspended. Dr. Maiocco decided not to write any medical marijuana recommendations as he feels his name has been harmed and he is very disappointed in the Medical Board.
To conclude, it is clear there is no real guideline to doctors recommending medical marijuana to patients on how many plants should be allowed. The storm has not nearly subsided, and there is still a lack of clarity around all the legal issues cannabis doctors in the US face. Until such time as the regulations are clear, the answer might lie in the use of CBD oil, a legal and uncomplicated solution to many of the controversial issues around medicinal marijuana.