DENVER - Just 12 doctors account for more than half the 108,000 patients on Colorado's medical marijuana registry, a state audit revealed Monday.
One doctor had more than 8,400 patients on the registry, according to the report from the Office of the State Auditor. A typical family doctor has 2,300 patients, according to a study in the Journal of General Internal Medicine and cited in the audit.
The audit pointed to continuing weaknesses in the way Colorado regulates medical marijuana, which exploded in popularity in 2009.
"The system relies on doctors making only appropriate recommendations," said Nina Frant, a state auditor who presented the report Monday.
Colorado voters legalized marijuana for medical purposes in 2000. In order to use medical marijuana legally, Colorado residents need to get a "red card" from the Department of Public Health and Environment. They need a doctor's recommendation to get on the red card registry.
The heavy presence of patients from a dozen doctors on the registry suggests what medical marijuana critics have always said - many "patients" and cooperative doctors use the law as legal cover for recreational use of marijuana.
As of January, 59 percent of red-card holders reported "severe pain" - the most general disorder allowed by law - as their only qualifying malady for getting on the registry. Three percent of patients on the registry had cancer, 2 percent suffered seizures, and 1 percent each reported having glaucoma or HIV/AIDS.
Patients are supposed to be limited to two ounces of medical marijuana or six plants they can grow at home. But the audit found in some cases, doctors recommend much higher levels. One doctor recommended 501 plants for a single patient, and another recommended 75 ounces of marijuana.
Concerns about marijuana doctors aren't new. In 2011, the health department started investigations of five doctors who wrote a disproportionate share of red card recommendations. One doctor's license was suspended, another agreed to stop writing medical marijuana recommendations, and the other three are still practicing, the audit said.
The audit also found a host of other problems with the way the Department of Public Health and Environment manages the medical marijuana registry.
Although the names on the registry are supposed to be secret, auditors found seven times when Department of Revenue employees used the database in an investigation of marijuana dispensaries.
Also, the health department has piled up a $12 million surplus in the account that pays for the registry, which is funded by fees on red card holders. The fee originally was set at $110, but it was cut to $90 in 2007 and $35 last year. Even if the fee were abolished, the department would have enough money to run the registry for four years, auditors said.
"We've simply been overwhelmed by the registry and its growth," said Karin McGowan, interim executive director of the health department. "We need to address it, and we need to go to the Board of Health."
However, the Board of Health, which makes the rules on medical marijuana, does not want to make joining the registry free, out of fears that it could lead to even more abuse of the system, McGowan said.
Ordinarily, the Legislative Audit Committee hears critical audits of state agencies and proposes law changes to fix the problems. But, as Sen. Lucia Guzman, D-Denver, pointed out, Colorado voters legalized recreational marijuana last November, so medical marijuana might plummet in popularity before the Legislature can act.
"Someday, all of this might not be necessary," Guzman said.
This was the second part of an audit of Colorado's medical marijuana system. The first part, earlier this spring, found that the Department of Revenue had badly fumbled its enforcement of retail dispensaries. It ran out of money to closely track marijuana inventories, and it had to lay off the majority of its employees when license fees did not roll in as anticipated.
