The state's top health official wants an investigation of eight Arizona doctors who together have written nearly half the nearly 10,000 recommendations for medical marijuana since the program started.
Will Humble said the voter-approved law making medical marijuana legal denies him the legal authority to discipline or even question the doctors. But the state health director said that does not preclude him from turning their names over to the regulatory boards that do have that power.
At this point, he said, it is up to those boards to decide whether the doctors have violated professional standards.
Humble also is legally precluded from making the names public. And officials at both the Arizona Medical Board, which regulates medical doctors, and the Naturopathic Board of Medical Examiners who oversees that specialty said investigations are confidential unless and until there is action against a practitioner.
He was able to say, though, that while some are from the Phoenix area, at least one practices in Tucson.
In an interview with Capitol Media Services, Humble said his staff extracted the names of any doctor who had written at least 200 recommendations in the 100 days since the law took effect.
"I'm not saying that just because you wrote 1,200 certifications in the last 100 days that you weren't doing your job,'' he said.
But what Humble found among that list were eight doctors who were not complying with the requirement of the regulations that they check a statewide database of people who already have prescriptions for controlled substances. That database is designed to help doctors determine if patients are "shopping around'' for drugs.
In fact, Humble said, three of the doctors did not even have a sign-on to access the database.
The other five were registered to use the site but Humble said they rarely, if ever, checked in.
"But in all cases, they attested that they had,'' Humble said.
Humble said he fears that is just an indication of how little attention these eight doctors are paying to their patients.
He pointed out that doctors also are required to attest on the recommendation that they have looked at 12 months' worth of medical records for the patient and that they have talked to the patient about alternative treatments and strategies.
"If you haven't done one thing, what else haven't you done?'' he said.
Humble said while he can't demand doctors produce those records, the regulatory boards can.
Humble said of the eight, five are naturopaths and three are medical doctors. And one of those doctors alone had more than 1,300 recommendations in just 100 days.
He said his decision to seek investigations of the eight doctors is not over some hyper-technical requirement.
"It's about patient safety and making sure that physicians are focusing on the best interests of their patients and not just revenue coming into their clinic,'' he said.
Humble also said he wants to be sure that what the state has is a true medical marijuana program and not simply a thinly disguised method of getting the drug into the hands of "recreational'' users.
"If we were to look the other way ... we really do head down that recreational road because there's no accountability or oversight,'' he said.
The doctors are the focus because, under the voter-approved law, they are the gateway to what Humble called "those little green cards'' which show someone is a state-approved marijuana user.
Only individuals with a state-issued ID card are permitted to obtain up to 2 1/2 ounces of marijuana every two weeks. But to get that card, a patient first needs a doctor to formally recommend, on a form approved by the health department, that the patient needs that particular drug.
The law lists the kinds of medical conditions that would qualify a doctor to recommend marijuana. These range from cancer and Crohn's disease to any condition that causes "severe and chronic pain.''
More than 80 percent of the recommendations fall in that last category, though that figure includes applications with multiple conditions.
But the law gave Humble broad authority to enact rules governing the process. And he came up with the regulations about reviewing medical records, discussing alternatives and checking the controlled substances database.
Joe Yuhas, spokesman for the Arizona Medical Marijuana Association which crafted the law, said the organization has "no problem with the rules and regulations being enforced.'' He said Humble is correct to act if he believes some doctors are acting improperly.
What the association does object to, Yuhas said, are the rules being enforced selectively.
He pointed out that the law required Humble to enact regulations to set up about 125 state-regulated dispensaries where medical marijuana card holders could legally obtain the drug. But Humble, acting on orders from Gov. Jan Brewer, has refused to accept applications.
Brewer and Attorney General Tom Horne said they fear state health officials, in processing the applications, could run afoul of federal laws which make it a crime not only to possess and sell the drug but also to facilitate anyone getting it. Brewer said no applications will be accepted until a federal court rules on a lawsuit they filed seeking clarification of whether the state law provides any sort of shield from prosecution under federal laws.
As far as the doctors go, it could be months before either board acts.
Lisa Wynn, executive director of the Arizona Medical Board, said her members need to review the allegations and decide what course to follow.
She said it could be a relatively simple inquiry if the board decides to look only at the question of false certifications on checking the controlled substances database. But Wynn said the board might have to retain an outside expert in the relatively new field of medical marijuana if the board decides to review the records of doctors to see see if they followed proper medical protocols before recommending the drug.
wdgnas posted at 6:07 am on Sat, Aug 20, 2011.
are doctors that prescribe oxycontin being treated the same way?
PeacefulCat posted at 8:43 am on Sat, Aug 20, 2011.
wdgnas Exactly they are not-we we would not have so many pill mills!! On top of the AZ Health department being accused of pushing pharmaceuticals.
What is this their third try at trying to circumvent the law....afraid they will have to function without the the drug was money???
Do they not have better things to do with their time and money? Look at where we stand at nationally on health, education, etc.
AZIraqVeteran posted at 10:51 pm on Sat, Aug 20, 2011.
To the 2 above posters @wdnas and @PeacefulCat : Do you have first hand knowledge of a person getting an OxyContin prescription who doesn't need it. If so why haven't you reported the physician to the AZ Board of Medical Examiners? No? Hearsay you say. Could it be the heavily regulated Schedule of narcotics requiring doctors to use special triplicate pads to write the prescriptions for Schedule II and III narcotics. These pads are submitted to the DEA by the doctors. Hmm.... OxyContin just gets your tongues wagging. Morphine, Fentynl, Hydrocodone, Vicodin, Duiladid, hydromorphone, Methadone, are just the same and for some reason it is all about OxyContin.
I pray that you are left in extreme chronic pain from a horrible tragic injury and the only treatment that is effective is OxyContin and the doctors you get are so scared to write a prescription to relive your pain so you can suffer like so many hundreds of thousands suffer in the USA because so many doctors are being terrorized by the DEA because of idiots like you two. I can only hope as a Veteran from OIF who suffered a through an IED attack of his HMMWV resulting in a broken back and crushed ankle and hope that a-holes like you lose your fight to terrorize Veterans who can not get proper treatment because of your ignorance. Enjoy Freedom? Thank a Vet
wdgnas posted at 6:15 am on Sun, Aug 21, 2011.
aziraqvet: first and foremost, thank you for your service. i know plenty of people that doctor shop for prescription drugs. they somehow think they are above the law. that the law should pertain to others, not them. by the way, using oxycontin as an example, got your attention. i have no intention of terrorizing veterans or anyone that needs medication. i am only asking if those doctors that prescribe the drugs you named are treated the same way. you believe they are. i do not. given they choice of all the drugs you name or marijuana, i would choose marijuana any day of the week. and to quote slabside: it is the law. get used to it.
PeacefulCat posted at 5:04 pm on Sun, Aug 21, 2011.
AZiraqveteren..check your stats about prescription drugs before attacking someone's position on what drug there would prefer to you. Many doctors in our area have been turned in.they have to have another physician with them when seeing other patients due to the amount of complaints. complaining is like asking the fox into the hen house.
May you find a way to rid yourself of your pain; which has nothing to do with us nor your problem getting drugs. May your hate and vicious be eased as well. I hope you get what you need to help you. I wish you no ill will; just some pain relief and some education.