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It's not cancer or Alzheimer's or glaucoma that had droves of Michiganders going to doctors over the past two years to get certified to use medical marijuana.

 

The vast majority of about 64,000 people authorized to use marijuana as medicine have unspecified ailments that cause severe and chronic pain, muscle spasms and nausea, state data obtained by the Free Press show.

 

And just 55 doctors certified about 45,000 patients -- 71% of all the authorized medical pot users.

 

In all, 2,197 doctors wrote at least one certification for a patient asking for marijuana approval.

 

The Michigan Department of Community Health data, obtained by the Free Press, is the first peek at what has happened under the state's new medical marijuana law.

 

The top nonspecific ailments cited by medical marijuana patients were severe and chronic pain, muscle spasms and nausea.

 

Of specific diseases, cancer was the most cited. It was given as a reason for certification by 1,407 patients (2.2%).

 

The numbers come from a broader report the department compiled on the medical marijuana law that is expected to be released within days.

Opponents: Pot law being exploited

 

Advocates and opponents of medical marijuana had very different views of the first snapshot showing how patients and doctors are responding to Michigan's 2-year-old law permitting pot's use as a painkiller.

 

Attorney General Bill Schuette, who led the opposition to the voter-passed ballot proposal in 2008, said: "This is just what we predicted. It is totally out of control."

 

He responded when a reporter informed him that most certifications under the law were for chronic pain, not specific illnesses and that 55 doctors were writing most of the prescriptions in Michigan.

 

"We were told (medical marijuana) was designed to treat a very narrow set of ... chronic and severe illnesses," Schuette said, "and what's going on is that this poorly drafted law is being exploited by those who want to legalize marijuana or make money ... or by unscrupulous doctors."

 

Karen O'Keefe of the Washington, D.C.-based Marijuana Policy Project, which helped draft the legislation that was overwhelmingly approved by voters, strongly disagreed.

 

Chronic and severe pain is a serious medical condition, one that results in millions of Americans seeking medical treatment and receiving prescription painkillers, O'Keefe said.

 

"It is absolutely unfair to suggest that severe pain is not a serious condition," she said.

 

O'Keefe said the campaign for Proposal 1 in 2008 also was transparent about the range of conditions, both specific and general, that could justify medical marijuana use.

 

"We never said it was just cancer," she said.

 

Rob Mullen, a Farmington Hills attorney involved in multiple medical marijuana-related prosecutions, said he is convinced there are a lot of recreational pot smokers who have obtained Michigan medical marijuana certificates, and there are certainly physicians who see a huge volume of medical marijuana patients.

 

But that doesn't necessarily signify abuse of the law, Mullen said. Some doctors are turning to marijuana as a relatively less risky treatment for patients who might otherwise become addicted to or overdose on prescription painkillers, he said.

 

Mullen said he is concerned the interests of legitimate medical marijuana patients are in danger of being obscured or overwhelmed by the confusion and conflict created by overly zealous law enforcement authorities on one side, and the pro-legalization and commercial factions on the other.

 

Kelly Niebel, spokeswoman for the Michigan Department of Community Health, declined to comment on what, if any, conclusions the department has drawn from the data. In fact, the MDCH will no longer be the regulatory agency after this weekend, Niebel said.

 

Under a reorganization ordered by Gov. Rick Snyder, processing of medical marijuana certification will move to the Department of Licensing and Regulatory Affairs.

 

"They are aware there are some outstanding issues, and they will be looking into them," Niebel said. "We're all committed to administering the law within the scope that was intended by those who voted for it."

 

Russ Westbury, a partner in the Ann Arbor Medical Clinic, which deals exclusively in marijuana referrals, said he wasn't surprised that some doctors specialize in medical marijuana referrals.

 

"Some have made it their primary focus," Westbury said. "The doctors that we have, they believe in it" as a less-addictive alternative to pain relief than some prescription medicines.

 

He said he uses marijuana for back pain and he's not unusual -- something the state data confirms.

 

"Of course, chronic pain is the most frequent, because there are so many people affected by that," he said.

 

He estimates he spends about $25 a month for marijuana, and uses it mostly at night when he's trying to get to sleep. He has known others who consume hundreds of dollars of pot weekly.

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In the year and a half that has passed since I stopped doing straight internal medicine and began to concentrate on certifications, I would agree that most are for chronic pain. Considering 'traditional' medicine treats these patients with highly addictive medications that have serious side effects, such as oxycontin and vicodin, it is my experience and belief that MMJ is far more effective and safer alternative. I've found that most chronic pain patients that choose to use MMJ have a more realistic expectation of what the medication can do for them. Unlike chronic narcotic patients, folks that go for MMJ tend to realize the goal is being functional, not numb or 'pain free'. Overall, I feel that MMJ is a very good alternative for them and I am happy to be one of the 55 docs that write the majority of certs in this state.

 

On that latter point- compared to general internal medicine or family practice, what percentage of doctors are endocrinologists or 'pediatric cardiologists'? Is the fact that there are 55 doctors that seem to have made this the main focus of their practice somehow an indication that were are greedy docs exploiting the law? I think not. I think that given the fact that many physicians are either unfamiliar with the rules, or due to their employment or hospital status are forbidden to write certs, I think it is totally expected that the majority of certs would be written by a group of doctors that have expertise and comfort doing so.

 

Of course there are abuses, just as there are abuses with narcotics, because there will always be those people that insist on trying to get 12 items through the express check out at the grocery store. There are those that sell medications they get by manipulation. We are pretty good at sniffing them out and not writing for them, but some will get through. There are some docs that don't follow the rules in the quest for money. There are similar problems in practices that have a high volume of narcotics, and in some cases the doctors are the same.

 

So how do we use this information? We police ourselves. We ask for certifications for appropriate medical conditions, not as an excuse to 'get legal' when it comes to illegal recreational drug abuse. We demand our certifications be done based on records, that they stand up in court, and that our doctors do the right thing and follow not only the law, but every court ruling that puts patients at risk if we cut corners. We build our numbers until there are 500,000 certs out there and we have a card holder on every jury. And above all we police ourselves.

 

In April I issued a call to action. I asked every Michigan card holder to find 10 qualified, record based patients that needed and wanted MMJ for their conditions and get them in front of a certification physician. That is the quickest way to get to 500,000 card holders. I am going to ask an additional thing of you. Police the certification clinics to make sure they are doing the right thing. Are they violating your privacy by sending bright green cards to you that identify you to the public as a MMJ patient? Spread the word and file criminal and civil charges against them to shut them down. Are you filling out a presigned certification, with no doctor visit? Turn them in and spread the word to your friends not to attend those clinics. Is there something fishy about the cattle call hotel clinic- listen to your inner voice and walk out. If it is not like any other doctor appointment you have been to in your life, if you don't feel you had a few min with a doctor that was interested in you more than just getting your money and getting you out the door, leave. Granted you may have been to 'regular doctors' that treated you that way, but since we are under the microscope, we have to be 'better' than them.

 

300 Spartans stood their ground against a million man Persian army at Thermopylae and saved civilization as we know it. I am proud to be one of the 55 standing our ground in Michigan and easing the suffering of those in need.

 

Dr. Bob

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Nice read!

 

25 a month,,,I wish! I dont pay that now,,but before getting a compassionate c.g, I was paying 400 a month for 2 zips of top shelf,,for over 2 yrs,,,thank god I got rid of that expense!

 

Chronic pain is a very real issue, and a very big problem for opoid addiction,,I know im one of the people that was hooked on opoids for over 12 yrs! I only use mm for my pain now,,,,and when I dont have any,,,im in pain,,,but not buckled over on the floor in a fetal possision swetting and throwing up! I only need to get a hold of a friend with weed!

 

a friend with weed is a friend indeed!

 

Peace

FTW

Jim

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GIVE SCHEUTTE THE BOOTY! - SIGN THE RECALL PETITIONS WHEN THEY ARE STARTED

 

 

AG Schuette you are a worthless, unfeeling, incompetent human being! How dare you minimize the suffering agony that severe chronic pain (neuropathy) causes, people have committed suicide from the pain.

 

Yesterday a report released showed that the U.S.takes 80% of the narcotic pain pills prescribed world wide and vicodin is the most prescribed narcotic. And who prescribes the most? Primary care Drs, dentists, and internists.

 

Several states including MICHIGAN MR.ATTORNEY GENERAL are dealing with rampant abuse of narcotic pain pills and deaths from over doses but you sir, you take the easy road and go after sick people.

 

Michigan an industrial manufacturing state and this azz hole is surprised people have chronic pain what a dick.

 

You and our other lazy employees in Lansing are the ones responsible for each and every fraudulent card out there for not shutting down the card mills and veiled threats to arrest and or suspend the licenses of established MI Drs about signing certifications that led to the card mills.

 

Do not try and blame your incompetency on the sick! Although I'm sure that's what you've done your entire life is blame other people for your short comings.

 

Get your medical license and then start treating WORKING PEOPLE and tell me that chronic pain isn't an issue.

 

Tell the carpenter with bad knees and hips he's a liar, or the roofer, or the assembly line worker that their pain isn't real.

 

Thousands die each year from narcotic pain pills schuette why aren't you as focused on stopping that as you are on arresting and jailing the sick who use a medication that HAS NEVER KILLED ANY ONE....EVER!!

 

 

There is nothing more frightening than ignorance in action.

- Goethe

 

Ed

 

http://abcnews.go.com/Health/PainManagement/white-house-targets-painkiller-abuse/story?id=13411505&page=3

 

"Prescription painkiller abuse now matches abuse of illegal drugs, and deaths from the prescription drugs exceeds overdose deaths from cocaine and heroin combined."

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In the year and a half that has passed since I stopped doing straight internal medicine and began to concentrate on certifications, I would agree that most are for chronic pain. Considering 'traditional' medicine treats these patients with highly addictive medications that have serious side effects, such as oxycontin and vicodin, it is my experience and belief that MMJ is far more effective and safer alternative. I've found that most chronic pain patients that choose to use MMJ have a more realistic expectation of what the medication can do for them. Unlike chronic narcotic patients, folks that go for MMJ tend to realize the goal is being functional, not numb or 'pain free'. Overall, I feel that MMJ is a very good alternative for them and I am happy to be one of the 55 docs that write the majority of certs in this state.

 

On that latter point- compared to general internal medicine or family practice, what percentage of doctors are endocrinologists or 'pediatric cardiologists'? Is the fact that there are 55 doctors that seem to have made this the main focus of their practice somehow an indication that were are greedy docs exploiting the law? I think not. I think that given the fact that many physicians are either unfamiliar with the rules, or due to their employment or hospital status are forbidden to write certs, I think it is totally expected that the majority of certs would be written by a group of doctors that have expertise and comfort doing so.

 

Of course there are abuses, just as there are abuses with narcotics, because there will always be those people that insist on trying to get 12 items through the express check out at the grocery store. There are those that sell medications they get by manipulation. We are pretty good at sniffing them out and not writing for them, but some will get through. There are some docs that don't follow the rules in the quest for money. There are similar problems in practices that have a high volume of narcotics, and in some cases the doctors are the same.

 

So how do we use this information? We police ourselves. We ask for certifications for appropriate medical conditions, not as an excuse to 'get legal' when it comes to illegal recreational drug abuse. We demand our certifications be done based on records, that they stand up in court, and that our doctors do the right thing and follow not only the law, but every court ruling that puts patients at risk if we cut corners. We build our numbers until there are 500,000 certs out there and we have a card holder on every jury. And above all we police ourselves.

 

In April I issued a call to action. I asked every Michigan card holder to find 10 qualified, record based patients that needed and wanted MMJ for their conditions and get them in front of a certification physician. That is the quickest way to get to 500,000 card holders. I am going to ask an additional thing of you. Police the certification clinics to make sure they are doing the right thing. Are they violating your privacy by sending bright green cards to you that identify you to the public as a MMJ patient? Spread the word and file criminal and civil charges against them to shut them down. Are you filling out a presigned certification, with no doctor visit? Turn them in and spread the word to your friends not to attend those clinics. Is there something fishy about the cattle call hotel clinic- listen to your inner voice and walk out. If it is not like any other doctor appointment you have been to in your life, if you don't feel you had a few min with a doctor that was interested in you more than just getting your money and getting you out the door, leave. Granted you may have been to 'regular doctors' that treated you that way, but since we are under the microscope, we have to be 'better' than them.

300 Spartans stood their ground against a million man Persian army at Thermopylae and saved civilization as we know it. I am proud to be one of the 55 standing our ground in Michigan and easing the suffering of those in need.

 

Dr. Bob

 

 

I respect you and your work! what is the difference between getting 500k card holders to cert dr.'s and dr. mills? I mean I know the difference but how are 55 dr's gonna handle that many pt's and how is the state gonna handle getting that many cards out,,,,be nice to see a card holder on every jury, that is for sure!

 

You are going to be one busy dr getting that many people certed! I can hurry up and go to get my m.a,,so i can be your nurse, lol well northern gal already has me in a dress! may as well make it a nurses dress! what ever it takes to get as many people we can to legaly be a card holder!

 

Peace Doc! Keep up the awsome Job!

FTW

Jim

 

Edit= doc my better half got a cert from a clinic in a hotel lobby,,,the dr. there actualy asked me what condition he should write down for condition,,,we had records, none of them were read! Im not even sure if the dr was a dr. (tounge twister) my lady does qualify and now i have her seeing my dr. on a reg basis, which will be needed for renewelll, Un less of course we come see you,,,and im sure you will find mine and her records in order, I did not make her appt for her she did it,,,but im sure glad I was there with her to see how they operate! it realy is a joke and like cattle lining up for slaughter,,,everyone with 200 bucks walked out of there smiling! im thinking a few are not smiling now! What you think?

Edited by phaquetoo
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Little fun with math....

 

55 physicians were responsible for 45,000 certs over 2 years. That is about 400 working days to certify about 820 patients each, about 2 per day. The remaining 2142 physicians that wrote 'at least one' certification averaged 8 certifications total in those same 400 working days, about 1 every other month. Is the first really an outrage, and is the second really appropriate? How many scripts for narcotics did those physicians in the latter group write in the same time frame?

 

Looking at a general internal medicine practice with about 20 patients per day, at least 5 or 6 will be treated for hypertension and a similar number will have their diabetes addressed (combine both and get about 11). So compared to the 820 patients that receive a certification from one of the '55', had I remained in Internal Medicine I would have treated 4,400 diabetics or hypertensive patients. Does that mean I am abusing the system when it comes to Glucophage or Lisinopril? How many echocardiograms did a cardiologist perform in the same period of time?

 

Let's say I do 10 certifications per day. Remember as an internist 20 a day plus a couple in the hospital was a typical work day. Let's say I take vacation or get sick once in awhile- I work 300 days out of the 400 work days in the last couple of years. That means that I would personally be responsible for 3000 certifications- about 6% of certs written by the 55. Does that indicate I am gaming the system? Is it an outrageous number? I think not.

 

We had a saying in Alaska when it came to the weather- weather reports are tea leaves with numbers, just look out the window and if the sky isn't blue, don't fly. If a certain disease has a frequency of 1 in 10,000 people, we can mine the data and perhaps find that almost 1.1 out of 10,000 left handed people have the disease compared to 0.9 out of 10,000 right handed people have it. The numbers really don't mean anything, but I can see folks writing about the '20% increase in risk' for those that are left handed. Yes there is a difference, but in real numbers and real situations, the difference is meaningless.

 

Dr. Bob

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I respect you and your work! what is the difference between getting 500k card holders to cert dr.'s and dr. mills? I mean I know the difference but how are 55 dr's gonna handle that many pt's and how is the state gonna handle getting that many cards out,,,,be nice to see a card holder on every jury, that is for sure!

 

You are going to be one busy dr getting that many people certed! I can hurry up and go to get my m.a,,so i can be your nurse, lol well northern gal already has me in a dress! may as well make it a nurses dress! what ever it takes to get as many people we can to legaly be a card holder!

 

Peace Doc! Keep up the awsome Job!

FTW

Jim

 

Edit= doc my better half got a cert from a clinic in a hotel lobby,,,the dr. there actualy asked me what condition he should write down for condition,,,we had records, none of them were read! Im not even sure if the dr was a dr. (tounge twister) my lady does qualify and now i have her seeing my dr. on a reg basis, which will be needed for renewelll, Un less of course we come see you,,,and im sure you will find mine and her records in order, I did not make her appt for her she did it,,,but im sure glad I was there with her to see how they operate! it realy is a joke and like cattle lining up for slaughter,,,everyone with 200 bucks walked out of there smiling! im thinking a few are not smiling now! What you think?

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I know the group, and their day is coming soon. They represent what is bad about certifications and are the ones that give Uncle Bill his ammo. No I don't believe you saw a doc. Did you actually see him sign the cert? Or was it a pre-signed cert and you filled in the conditions or told him what to fill in. Were you told to wait three days before sending it in so the 'doc' had a chance to review it?

 

Come on, you and everyone else in here know better. Just getting your ticket punched isn't worth it when it comes to destroying the system with fraud and CRIMINAL activity like practicing medicine without a license as this group does.

 

There are other docs that occasionally see folks in hotel rooms, me, Crocker, Kenewell, THCF, that do things right, use records and stand behind our patients with clean records, DEA licenses, documentation and a history of following the rules. We have regular offices as well, just like any other doc. Furthermore, I took care of folks in tents when I was in the Army- it is not WHERE you do it, it is HOW you do it. There are enough of us doing it right that there is no reason to go to a mill that cuts corners, has different prices for record vs non-record based certs, or hands out pre-signed certs in exchange for your cash.

 

Dr. Bob

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Thank you Dr. Bob and Dr. Dave, you are true proffesionals and devouted to the cause of real medicine.....Helping hurting and sick people!!! I hear horror stories all the time from my neighbor who is a trauma nurse of the things that prescription drugs and alcohol do to people, yet he tells me he hardly ever sees anyone in the ER room because of MJ. The facts are out there in ER rooms, DR offices, morgues, etc.....alcohol and prescription drugs are killers!!! You cannot hide from the facts Mr. Schuette, but you fail to give us all the facts, shame on you Mr AG you are failing to hold your oath of office and the people in this state see it every single day!!!

Dr. Bob I commend you and Dr. Dave for being the pioneers in this new/old field of medicine, you truely are caring and compassionate DR's because you listen and understand your patient's needs and that alot of us don't want to use these's killer drugs!!! I know both of you go out of your way to help more than just your patients, you are helping all patients with your dedication to MMJ and helping to opening peoples eyes to it's great uses. I was certified by Dr Dave in his office and I can truely say Dr Dave and his staff are true proffesionals, I felt like I was in any other Dr's office and thats the way it should be. I hope both Dr Bob and Dr Dave can find the time to attend the rally next month in Lansing because you both truely deserve recognition and I will be there to lead everyone in one hell of an applause for you both!!!!

 

D

 

I know the group, and their day is coming soon. They represent what is bad about certifications and are the ones that give Uncle Bill his ammo. No I don't believe you saw a doc. Did you actually see him sign the cert? Or was it a pre-signed cert and you filled in the conditions or told him what to fill in. Were you told to wait three days before sending it in so the 'doc' had a chance to review it?

 

Come on, you and everyone else in here know better. Just getting your ticket punched isn't worth it when it comes to destroying the system with fraud and CRIMINAL activity like practicing medicine without a license as this group does.

 

There are other docs that occasionally see folks in hotel rooms, me, Crocker, Kenewell, THCF, that do things right, use records and stand behind our patients with clean records, DEA licenses, documentation and a history of following the rules. We have regular offices as well, just like any other doc. Furthermore, I took care of folks in tents when I was in the Army- it is not WHERE you do it, it is HOW you do it. There are enough of us doing it right that there is no reason to go to a mill that cuts corners, has different prices for record vs non-record based certs, or hands out pre-signed certs in exchange for your cash.

 

Dr. Bob

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Thank you Dr. Bob and Dr. Dave, you are true proffesionals and devouted to the cause of real medicine.....Helping hurting and sick people!!! I hear horror stories all the time from my neighbor who is a trauma nurse of the things that prescription drugs and alcohol do to people, yet he tells me he hardly ever sees anyone in the ER room because of MJ. The facts are out there in ER rooms, DR offices, morgues, etc.....alcohol and prescription drugs are killers!!! You cannot hide from the facts Mr. Schuette, but you fail to give us all the facts, shame on you Mr AG you are failing to hold your oath of office and the people in this state see it every single day!!!

Dr. Bob I commend you and Dr. Dave for being the pioneers in this new/old field of medicine, you truely are caring and compassionate DR's because you listen and understand your patient's needs and that alot of us don't want to use these's killer drugs!!! I know both of you go out of your way to help more than just your patients, you are helping all patients with your dedication to MMJ and helping to opening peoples eyes to it's great uses. I was certified by Dr Dave in his office and I can truely say Dr Dave and his staff are true proffesionals, I felt like I was in any other Dr's office and thats the way it should be. I hope both Dr Bob and Dr Dave can find the time to attend the rally next month in Lansing because you both truely deserve recognition and I will be there to lead everyone in one hell of an applause for you both!!!!

 

D

 

I'll be there, hopefully Dr. Dave will as well. He is a better speaker and I am not ashamed to say I learned much from him when we worked together in Kalamazoo.

 

Dr. Bob

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Isn't this the same info Eric paid for and requested that supposedly did not exist?

 

 

 

The Michigan Department of Community Health data, obtained by the Free Press, is the first peek at what has happened under the state's new medical marijuana law.

 

The top nonspecific ailments cited by medical marijuana patients were severe and chronic pain, muscle spasms and nausea.

 

Of specific diseases, cancer was the most cited. It was given as a reason for certification by 1,407 patients (2.2%).

 

The numbers come from a broader report the department compiled on the medical marijuana law that is expected to be released within days.

Opponents: Pot law being exploited

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It's not cancer or Alzheimer's or glaucoma that had droves of Michiganders going to doctors over the past two years to get certified to use medical marijuana.

 

The vast majority of about 64,000 people authorized to use marijuana as medicine have unspecified ailments that cause severe and chronic pain, muscle spasms and nausea, state data obtained by the Free Press show.

 

And just 55 doctors certified about 45,000 patients -- 71% of all the authorized medical pot users.

 

In all, 2,197 doctors wrote at least one certification for a patient asking for marijuana approval.

 

The Michigan Department of Community Health data, obtained by the Free Press, is the first peek at what has happened under the state's new medical marijuana law.

 

The top nonspecific ailments cited by medical marijuana patients were severe and chronic pain, muscle spasms and nausea.

 

Of specific diseases, cancer was the most cited. It was given as a reason for certification by 1,407 patients (2.2%).

 

The numbers come from a broader report the department compiled on the medical marijuana law that is expected to be released within days.

Opponents: Pot law being exploited

 

Advocates and opponents of medical marijuana had very different views of the first snapshot showing how patients and doctors are responding to Michigan's 2-year-old law permitting pot's use as a painkiller.

 

Attorney General Bill Schuette, who led the opposition to the voter-passed ballot proposal in 2008, said: "This is just what we predicted. It is totally out of control."

 

He responded when a reporter informed him that most certifications under the law were for chronic pain, not specific illnesses and that 55 doctors were writing most of the prescriptions in Michigan.

 

"We were told (medical marijuana) was designed to treat a very narrow set of ... chronic and severe illnesses," Schuette said, "and what's going on is that this poorly drafted law is being exploited by those who want to legalize marijuana or make money ... or by unscrupulous doctors."

 

Karen O'Keefe of the Washington, D.C.-based Marijuana Policy Project, which helped draft the legislation that was overwhelmingly approved by voters, strongly disagreed.

 

Chronic and severe pain is a serious medical condition, one that results in millions of Americans seeking medical treatment and receiving prescription painkillers, O'Keefe said.

 

"It is absolutely unfair to suggest that severe pain is not a serious condition," she said.

 

O'Keefe said the campaign for Proposal 1 in 2008 also was transparent about the range of conditions, both specific and general, that could justify medical marijuana use.

 

"We never said it was just cancer," she said.

 

Rob Mullen, a Farmington Hills attorney involved in multiple medical marijuana-related prosecutions, said he is convinced there are a lot of recreational pot smokers who have obtained Michigan medical marijuana certificates, and there are certainly physicians who see a huge volume of medical marijuana patients.

 

But that doesn't necessarily signify abuse of the law, Mullen said. Some doctors are turning to marijuana as a relatively less risky treatment for patients who might otherwise become addicted to or overdose on prescription painkillers, he said.

 

Mullen said he is concerned the interests of legitimate medical marijuana patients are in danger of being obscured or overwhelmed by the confusion and conflict created by overly zealous law enforcement authorities on one side, and the pro-legalization and commercial factions on the other.

 

Kelly Niebel, spokeswoman for the Michigan Department of Community Health, declined to comment on what, if any, conclusions the department has drawn from the data. In fact, the MDCH will no longer be the regulatory agency after this weekend, Niebel said.

 

Under a reorganization ordered by Gov. Rick Snyder, processing of medical marijuana certification will move to the Department of Licensing and Regulatory Affairs.

 

"They are aware there are some outstanding issues, and they will be looking into them," Niebel said. "We're all committed to administering the law within the scope that was intended by those who voted for it."

 

Russ Westbury, a partner in the Ann Arbor Medical Clinic, which deals exclusively in marijuana referrals, said he wasn't surprised that some doctors specialize in medical marijuana referrals.

 

"Some have made it their primary focus," Westbury said. "The doctors that we have, they believe in it" as a less-addictive alternative to pain relief than some prescription medicines.

 

He said he uses marijuana for back pain and he's not unusual -- something the state data confirms.

 

"Of course, chronic pain is the most frequent, because there are so many people affected by that," he said.

 

He estimates he spends about $25 a month for marijuana, and uses it mostly at night when he's trying to get to sleep. He has known others who consume hundreds of dollars of pot weekly.

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It's not cancer or Alzheimer's or glaucoma that had droves of Michiganders going to doctors over the past two years to get certified to use medical marijuana.

 

The vast majority of about 64,000 people authorized to use marijuana as medicine have unspecified ailments that cause severe and chronic pain, muscle spasms and nausea, state data obtained by the Free Press show.

 

And just 55 doctors certified about 45,000 patients -- 71% of all the authorized medical pot users.

 

In all, 2,197 doctors wrote at least one certification for a patient asking for marijuana approval.

 

The Michigan Department of Community Health data, obtained by the Free Press, is the first peek at what has happened under the state's new medical marijuana law.

 

The top nonspecific ailments cited by medical marijuana patients were severe and chronic pain, muscle spasms and nausea.

 

Of specific diseases, cancer was the most cited. It was given as a reason for certification by 1,407 patients (2.2%).

 

The numbers come from a broader report the department compiled on the medical marijuana law that is expected to be released within days.

Opponents: Pot law being exploited

 

Advocates and opponents of medical marijuana had very different views of the first snapshot showing how patients and doctors are responding to Michigan's 2-year-old law permitting pot's use as a painkiller.

 

Attorney General Bill Schuette, who led the opposition to the voter-passed ballot proposal in 2008, said: "This is just what we predicted. It is totally out of control."

 

He responded when a reporter informed him that most certifications under the law were for chronic pain, not specific illnesses and that 55 doctors were writing most of the prescriptions in Michigan.

 

"We were told (medical marijuana) was designed to treat a very narrow set of ... chronic and severe illnesses," Schuette said, "and what's going on is that this poorly drafted law is being exploited by those who want to legalize marijuana or make money ... or by unscrupulous doctors."

 

Karen O'Keefe of the Washington, D.C.-based Marijuana Policy Project, which helped draft the legislation that was overwhelmingly approved by voters, strongly disagreed.

 

Chronic and severe pain is a serious medical condition, one that results in millions of Americans seeking medical treatment and receiving prescription painkillers, O'Keefe said.

 

"It is absolutely unfair to suggest that severe pain is not a serious condition," she said.

 

O'Keefe said the campaign for Proposal 1 in 2008 also was transparent about the range of conditions, both specific and general, that could justify medical marijuana use.

 

"We never said it was just cancer," she said.

 

Rob Mullen, a Farmington Hills attorney involved in multiple medical marijuana-related prosecutions, said he is convinced there are a lot of recreational pot smokers who have obtained Michigan medical marijuana certificates, and there are certainly physicians who see a huge volume of medical marijuana patients.

 

But that doesn't necessarily signify abuse of the law, Mullen said. Some doctors are turning to marijuana as a relatively less risky treatment for patients who might otherwise become addicted to or overdose on prescription painkillers, he said.

 

Mullen said he is concerned the interests of legitimate medical marijuana patients are in danger of being obscured or overwhelmed by the confusion and conflict created by overly zealous law enforcement authorities on one side, and the pro-legalization and commercial factions on the other.

 

Kelly Niebel, spokeswoman for the Michigan Department of Community Health, declined to comment on what, if any, conclusions the department has drawn from the data. In fact, the MDCH will no longer be the regulatory agency after this weekend, Niebel said.

 

Under a reorganization ordered by Gov. Rick Snyder, processing of medical marijuana certification will move to the Department of Licensing and Regulatory Affairs.

 

"They are aware there are some outstanding issues, and they will be looking into them," Niebel said. "We're all committed to administering the law within the scope that was intended by those who voted for it."

 

Russ Westbury, a partner in the Ann Arbor Medical Clinic, which deals exclusively in marijuana referrals, said he wasn't surprised that some doctors specialize in medical marijuana referrals.

 

"Some have made it their primary focus," Westbury said. "The doctors that we have, they believe in it" as a less-addictive alternative to pain relief than some prescription medicines.

 

He said he uses marijuana for back pain and he's not unusual -- something the state data confirms.

 

"Of course, chronic pain is the most frequent, because there are so many people affected by that," he said.

 

He estimates he spends about $25 a month for marijuana, and uses it mostly at night when he's trying to get to sleep. He has known others who consume hundreds of dollars of pot weekly.

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I guess it's OK that lives are being ruined by narcotics if the big pharmaceutical companies are making money.

 

Narcotics account for nearly one quarter of all workers' compensation prescription drug costs

 

 

 

Narcotics, a persistent component of workers' compensation claims, account for nearly one quarter of all workers' compensation prescription drug costs in America, according to a study released in December by the National Council on Compensation Insurance. Few members of the medical community would object to the use of narcotics to treat severe, chronic, cancer-related pain.

 

However, the medical community seems divided over the suitability of narcotics to treat other forms of pain, such as those resulting from the majority of workers compensation injuries.

 

So-called "Schedule II" opioid drugs, such as oxycodone, hydrocodone, fentanyl and morphine, are being prescribed mostly for back injuries in workers' comp claims. The number of such prescriptions in the first year after an accident is on the rise and payments for such drugs increase the longer a claim continues, states the NCCI research brief. The report reviewed a sample of claims for services provided from 1996 to 2007, the latest data available.

 

Among adverse events associated with opioid pain relievers are depression of the respiratory system, central nervous system depression, addiction and death. Such problems often are associated with improper dosing, abuse and addiction, said the report, quoting statements by the U.S. Food and Drug Administration.

 

Narcotics have accounted for about 25% of all workers' comp prescription costs since 1999. More than 44% of dollars paid and 32% of prescriptions written for narcotics are for claims involving back injuries.

 

A closer look at the 2007 service year showed that oxycodone, marketed under the brand name OxyContin, represented the largest share of narcotics costs, at 37.4%. That was followed by hydrocodone at 23% and fentanyl, which includes one of the most expensive drugs — Duragesic, a narcotic pain patch, at 11.8%.

 

Based on the active ingredients, drugs with hydrocodone represented 57.6% of the narcotics prescribed in 2007, oxycodone accounted for 21.3%, propoxyphene was at 8.6%, morphine at 3.3% and codeine at 3.1% of the total.

 

And high-cost prescriptions — those costing more than $75 per prescription — account for 9% of narcotic prescriptions in the first year of a worker injury, but steadily increase to 45% of all narcotic prescriptions in the 12th year for long-term claims.

Regional differences appear in the data, with California, Texas, Louisiana and Alabama among the mostly coastal states that had higher average workers' comp narcotics costs per medical claim, defined as $30 or more per claim. Midwestern states, including Michigan, Illinois and Kansas experienced lower costs that averaged $15 or less per claim.

 

 

Key Findings of the report include:

 

* Narcotics account for nearly one quarter of all workers compensation Rx costs

* The narcotics share of drug costs increases as claims age

* Narcotics costs per claim vary by state with apparent regional differences

* Narcotics are used mostly for back injuries in workers compensation

* Narcotics use early in the life of claims is increasing

* Narcotics use can persist for many years

* Heavy narcotics use for workers compensation injuries is related to substance-abuse treatments

 

 

 

To review the full NCCI report, Narcotics In Workers' Compensation, visit the NCCI webpage at: http://www.ncci.com/. (https://www.ncci.com/documents/Narcotics_in_WC_1209.pdf)

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Guest finallyfree09

dr bob... are there any records out there that would indicate how many people are being prescribed pills for chronic pain? I'd be willing to bet that the number would be a lot more shocking than the ones released by mdch.

 

i think its time for full disclosure. i think its time to know exactly how many people are prescribed narcotics every day. the govt seems to think its their business to tell the citizenry how many "evil potheads" are out there. how many "pillheads" are out there? (no offence anyone, if you needem you needem). makes me wonder if there would be as big of an outcry about those numbers

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dr bob... are there any records out there that would indicate how many people are being prescribed pills for chronic pain? I'd be willing to bet that the number would be a lot more shocking than the ones released by mdch.

 

i think its time for full disclosure. i think its time to know exactly how many people are prescribed narcotics every day. the govt seems to think its their business to tell the citizenry how many "evil potheads" are out there. how many "pillheads" are out there? (no offence anyone, if you needem you needem). makes me wonder if there would be as big of an outcry about those numbers

 

potential free press response, what do you think?

 

Well yesterday I put out some math about certifications for MMJ. The '55' average TWO certs a day and the 'Normal' docs gave one every two months (a little less, once every 50 days). Let's take a 'chronic pain doctor'. Figure 20 patients a day for 20 days (the number of working days in a month). That is 400 patients seen per month. If each one had a qid (that means 4x a day for you DEA agents out there) prescription for vicodin, it would represent 400 x 120 doses of vicodin per month or 48,000 'doses' per month. Multiply that by 24 months in 2 years and you have 1,152,000 'doses' of pain meds over that time frame. It also represents some 9600 patient encounters, a far cry from the 820 the '55' saw for certifications on average in the same period of time. Even if only half these doses were given, say bid (again twice a day, just trying to help you with the funny letters) of a long acting agent like oxycontin, we are talking over 1/2 million doses. The numbers are just staggering. But in reality, they are not that out of line.

 

According to one of the many articles I read yesterday, it is estimated that about 1 in 5 patients that go to general primary care (and get MMJ certs) present with a complaint of chronic pain. Assuming the same level of pain control stated above, 4 doses per day (some are on more) it would be reasonable to say that the average MD/DO writes over 100,000 doses of narcotic pain medications per year, actually a little closer to 10,000 a month.

 

So when you get down to it, giving a total number of doses of pain meds given makes headlines, but doesn't really tell you that much. Dr. Buck wrote 1.5 million doses of pain meds, claimed to be in a pain practice, and apparently was rather busy, so really the totals aren't that far off. The true charge was based on judgement in giving those pain meds. So the '55' wrote 71% of the 64,000 certs out there. Though 45,000 certs in 2 years may 'seem' like a lot, the math works out to 2 per day. I've already shown that every average primary care doc that sees 20 patients per day, 1/5 or 4 patients will be chronic pain patients. If even 1/2 of those were given a cert for MMJ, every primary care doc in the state would be one of the '55'. Where is the leap of faith that shows writing an average of 2 certs a day demonstrates a 'lack of judgement'.

 

Let's take it one step further. http://www.mhc.org/file_archive/PhysicianProfileFINAL09_2.pdf shows there are about 30,000 active, practicing physicians in Michigan. There were 1 in 15 (about 2000) of those doctors that wrote even ONE certification in the last 2 years (apparently 28,000 didn't write a single cert). Why is this?

 

1. Some doctors are federal (VA, IHS, Tribal) and cannot write certs

2. Some doctors work for clinics, hospitals and healthcare systems that do not allow their docs to write certs

3. Some doctors don't understand the rules, don't feel comfortable writing certs or simply don't want to be involved.

 

Ok, how many docs fall into the above 3 categories? 1/2 of the total, 2/3 of the total? Even if fully 75% are not 'capable' of participating in the certification system for whatever reason, that leaves at least 7,500 doctors to write certs. Yet only 2000 did, even if only once. Those 2000 doctors were responsible for writing certs for the 28,000 that would not. Of those 2000 only 55 handled 71% of those certs, averaging 2 per day. Bad judgement and bad doctors? Or good doctors providing a service that their colleagues would not or didn't feel they had the expertise to do? The same analogy can be used elsewhere. Do you realize that a small group of nephrologists (kidney specialists) in this state are responsible for managing over 95% of the patients on dialysis? My God lets reform the rules of kidney failure and investigate these miscreants and 'unscrupulous' doctors. Clearly the hemodialysis system in Michigan is 'out of control'. Where is the AG when we need him?

 

IF you took the 64,000 certs to date, divided it by the 2200 doctors that wrote them, you come up with 30 certs per doctor over 2 years. With 30,000 active doctors in this state, that means that 900,000 certs would have been written if all doctors participated by writing 2 per month. If only 1/2 participated, we would have the 450,000 statistically Michigan should have, or at least 250,000 with a renewal for each. We have a long way to go, I am proud to be one of the '55' and encourage my colleagues to educate themselves, listen to their patients and make it a point to write one well qualified cert a month. Sure there are bad certification doctors out there running no record clinics. But if 'regular doctors' would pull even a part of their share, they wouldn't be able to stay in practice, they would not have a market.

 

Dr. Bob

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is anyone, other than me concerned that MDCH is no longer the regulatory agency for mmj and the dept. of licensing and regulatory affairs will be. how will this impact HIPA?

 

No your not alone, i also have concerns about it.. There is something a foot. They are hiding what there ultimate objective is. Like we don't know what it is, but they are trying to sneak it past us. ????

We must find out what it will cause as ramifications.

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OPEN SEASON ON ALL MMM Patients/C.G's that will be their agenda-it will happen over years, but- they still might get most of us-hey why not make MMM Patients wear a ankle bracelet tracking device so they always know where we are/were and with whom

 

OR BETTER YET WE ALL HAVE TO SEW A GREEN STAR ON ALL PIECES OF CLOTHING-wait they(NAZIS) did that to the jewish folks pre world war two............................................just thinking out loud

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OPEN SEASON ON ALL MMM Patients/C.G's that will be their agenda-it will happen over years, but- they still might get most of us-hey why not make MMM Patients wear a ankle bracelet tracking device so they always know where we are/were and with whom

 

OR BETTER YET WE ALL HAVE TO SEW A GREEN STAR ON ALL PIECES OF CLOTHING-wait they(NAZIS) did that to the jewish folks pre world war two............................................just thinking out loud

 

Ankle bracelet? Just carry an iPhone

 

Ok guys, we have had our whine party and gone through the conspiracy theory, look at the response I am going to send into the Free Press. Does it read well, is understandable, and meet their attack in a way we want to present ourselves? I could use some suggestions. Granted their position is absurd, we need to show we are better spoken, better researched and go for the 'hearts and minds' of the undecided who may be walking away from the front pages with a bad view of us.

 

The key here is that 30 years ago the wild eyed hippies in the back of the room full of 'normal' folks were the MMJ people. Now WE are the normal folks and the anti's are the 'weirdos' in the back of the room. I like it that way.

 

Dr. Bob

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Guest finallyfree09

potential free press response, what do you think?

 

Well yesterday I put out some math about certifications for MMJ. The '55' average TWO certs a day and the 'Normal' docs gave one every two months (a little less, once every 50 days). Let's take a 'chronic pain doctor'. Figure 20 patients a day for 20 days (the number of working days in a month). That is 400 patients seen per month. If each one had a qid (that means 4x a day for you DEA agents out there) prescription for vicodin, it would represent 400 x 120 doses of vicodin per month or 48,000 'doses' per month. Multiply that by 24 months in 2 years and you have 1,152,000 'doses' of pain meds over that time frame. It also represents some 9600 patient encounters, a far cry from the 820 the '55' saw for certifications on average in the same period of time. Even if only half these doses were given, say bid (again twice a day, just trying to help you with the funny letters) of a long acting agent like oxycontin, we are talking over 1/2 million doses. The numbers are just staggering. But in reality, they are not that out of line.

 

According to one of the many articles I read yesterday, it is estimated that about 1 in 5 patients that go to general primary care (and get MMJ certs) present with a complaint of chronic pain. Assuming the same level of pain control stated above, 4 doses per day (some are on more) it would be reasonable to say that the average MD/DO writes over 100,000 doses of narcotic pain medications per year, actually a little closer to 10,000 a month.

 

So when you get down to it, giving a total number of doses of pain meds given makes headlines, but doesn't really tell you that much. Dr. Buck wrote 1.5 million doses of pain meds, claimed to be in a pain practice, and apparently was rather busy, so really the totals aren't that far off. The true charge was based on judgement in giving those pain meds. So the '55' wrote 71% of the 64,000 certs out there. Though 45,000 certs in 2 years may 'seem' like a lot, the math works out to 2 per day. I've already shown that every average primary care doc that sees 20 patients per day, 1/5 or 4 patients will be chronic pain patients. If even 1/2 of those were given a cert for MMJ, every primary care doc in the state would be one of the '55'. Where is the leap of faith that shows writing an average of 2 certs a day demonstrates a 'lack of judgement'.

 

Let's take it one step further. http://www.mhc.org/file_archive/PhysicianProfileFINAL09_2.pdf shows there are about 30,000 active, practicing physicians in Michigan. There were 1 in 15 (about 2000) of those doctors that wrote even ONE certification in the last 2 years (apparently 28,000 didn't write a single cert). Why is this?

 

1. Some doctors are federal (VA, IHS, Tribal) and cannot write certs

2. Some doctors work for clinics, hospitals and healthcare systems that do not allow their docs to write certs

3. Some doctors don't understand the rules, don't feel comfortable writing certs or simply don't want to be involved.

 

Ok, how many docs fall into the above 3 categories? 1/2 of the total, 2/3 of the total? Even if fully 75% are not 'capable' of participating in the certification system for whatever reason, that leaves at least 7,500 doctors to write certs. Yet only 2000 did, even if only once. Those 2000 doctors were responsible for writing certs for the 28,000 that would not. Of those 2000 only 55 handled 71% of those certs, averaging 2 per day. Bad judgement and bad doctors? Or good doctors providing a service that their colleagues would not or didn't feel they had the expertise to do? The same analogy can be used elsewhere. Do you realize that a small group of nephrologists (kidney specialists) in this state are responsible for managing over 95% of the patients on dialysis? My God lets reform the rules of kidney failure and investigate these miscreants and 'unscrupulous' doctors. Clearly the hemodialysis system in Michigan is 'out of control'. Where is the AG when we need him?

 

IF you took the 64,000 certs to date, divided it by the 2200 doctors that wrote them, you come up with 30 certs per doctor over 2 years. With 30,000 active doctors in this state, that means that 900,000 certs would have been written if all doctors participated by writing 2 per month. If only 1/2 participated, we would have the 450,000 statistically Michigan should have, or at least 250,000 with a renewal for each. We have a long way to go, I am proud to be one of the '55' and encourage my colleagues to educate themselves, listen to their patients and make it a point to write one well qualified cert a month. Sure there are bad certification doctors out there running no record clinics. But if 'regular doctors' would pull even a part of their share, they wouldn't be able to stay in practice, they would not have a market.

 

Dr. Bob

wow! thanks for the response. i do believe that this is an EXCELLENT response to any media group. the points you make in this post are points that should be brought out (when i say brought out i mean shouted from the top of the capitol building in lansing) and thrown in the face of the opposition on every occasion that presents itself. it would be great to see this point brought up directly to mr schuette actually.

 

great post!

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