03/18/2010 05:12 am ET Updated May 25, 2011

The Legislature Should Implement Amendment 20, Not Create a New Industry

It's hard to believe but less than a year ago, Denver was not home to its own "Little Amsterdam" on South Broadway, and Coloradans were not faced with dispensaries within a stone's throw of the schools their children attend. And yet today Colorado is facing a ballooning "medical" marijuana industry with more 300 marijuana dispensaries in Denver alone and nearly 30,000 patients statewide. Even relatively small towns like Windsor and Aspen have multiple dispensaries.

The situation Colorado is facing -- and lawmakers will grapple with this month -- is clearly out of sync with 2000's Amendment 20, which legalized marijuana for medicinal purposes only.

The world envisioned by Amendment 20's proponents and the reality of medical marijuana facing cities, towns and counties across Colorado could not be further apart. During the 2000 election cycle, Amendment 20's supporters wheeled out the sickest of Coloradans for whom medical marijuana might have some palliative effects. However, with increasingly younger and fitter Coloradans being certified as medical marijuana "patients" at a pace of 600 per day and dispensaries popping up at break-neck speed, the contrast is stark.

The model Colorado's law enforcement community believes the General Assembly should adopt is one focused on patients and caregivers, akin to the system Colorado had until 10 months ago. At that time, Colorado's medical marijuana registry included only 1,600 patients who generally fit the mold Amendment 20's supporters advertised in 2000. Less than a year ago, 55 percent of patients had a designated caregiver. And the vast majority of caregivers had no more than three patients each. The focus, then, was on a bona fide patient-caregiver relationship, with caregivers providing more than just marijuana.

However, in the wake of the Colorado Board of Health declining to adopt a five-patient-per-caregiver cap and the Obama Justice Department announcing it would not prosecute those using or distributing medical marijuana, the focus of Amendment 20's advocates shifted to profit.

The law enforcement community's proposed legislation has four crucial components:

- Capping the number of patients per caregiver. The Colorado Court of Appeals made it clear in an October decision that caregivers must do more than merely provide marijuana to patients. Instituting a five-patient cap per caregiver would place the focus on patient care over profit.

- Ensuring that doctors have a bona fide relationship with their patients. Countless members of the media, from Denver to Grand Junction, have conducted undercover operations to see if they could obtain a medical marijuana card with evidence of minor maladies, such as an earache, or even no problems at all. We have yet to hear a report of anyone attempting to secure a medical marijuana certification and being turned down. Everyone who has seen a dispensary-provided doctor, paid a fee and professed an imagined illness has received a card. Clearly something is wrong.

- Making sure that doctors certifying patients are in good standing. Three quarters of the Colorado's 30,000 patients were certified by 15 doctors. And 50 percent of the state's marijuana patients were certified by five doctors. A significant number of these doctors have disciplinary restrictions on their licenses and could not prescribe other medications. If a doctor cannot prescribe other treatments or practice medicine, why should they be allowed to certify Coloradans for medical marijuana?

- Taking profit out of the equation. Can you imagine any other drug or treatment where a doctor is directly incentivized to prescribe a specific treatment method? The public would be outraged if a drug company were effectively paying a doctor in cash to prescribe their product. That is exactly what is happening today with medical marijuana. Doctors are being paid hundreds of dollars for each patient they refer, creating a clear incentive to create marijuana consumers where an unbiased doctor would not.

If anyone can obtain a medical marijuana certification in exchange for cash with no questions asked and caregivers are not required to provide any substantive medical care beyond merely selling marijuana, Colorado has de facto legalization. Nothing could be further from the intent and plain language of Amendment 20.

Amendment 20 was not about legalization. In fact, faced with a statewide legalization proposal, the voters rejected 2006's Amendment 44 by a 59-41 margin. If marijuana proponents want full legalization or de facto legalization through a dispensary model, they should go back to the voters again.

In the meantime, I would encourage our lawmakers to fix the broken system and work with the law enforcement community to place the priority on patients over profits.

John Suthers is Colorado's 37th attorney general.