A dozen doctors have issued 50 percent of the referrals for medical marijuana in Colorado, with one physician alone recommending pot for almost 8,500 patients - indications that inadequate oversight has hindered the state from investigating and preventing fraudulent pot prescriptions, according to a critical audit released Monday.
"We found evidence suggesting some doctors are making inappropriate recommendations or have ties to medical marijuana facilities," Nina Frant, with the state auditor's office, told the Legislative Audit Committee.
In order to receive a medical marijuana "red card," patients need a recommendation from a licensed doctor and approval of an application by the Department of Public Health and Environment.
The number of people with such cards has grown 1,700 percent in four years: In March 2009 there were 6,000 patients with valid red cards; by March 2013 there were 108,000.
With a red card, a patient may grow up to six marijuana plants and possesses up to 2 ounces of marijuana product. Some doctors have requested exceptions for patients to possess far more than the legal limit. In one case, Frant said, a doctor recommended 501 plants for a single patient and another received a referral for 75 ounces of pot.
Sen. Lucia Guzman, D-Denver, asked if suspected abuses of the medical marijuana system might be moot given that voters have since legalized the recreational use of marijuana without a red card.
But Frant emphasized there is still significant incentive for people to abuse the medical marijuana system even though the drug is available recreationally.
For one, recreational pot is only available to people age 21 and older, while those 18 and older are able to get red cards for use of medical marijuana.
In addition, medical marijuana will be taxed at a much lower rate if voters in November approve an additional sales and excise tax on recreational pot. A red card application costs $35.
The red card 'low profile'
Finally, a statement from the federal government in 2009 indicated that federal law enforcement would not use its resources to prosecute medical marijuana users.
Frant said the "Ogden Statement" may give some users a sense of security with a red card that they wouldn't have as a recreational user.
The audit recommended that the health department make a number of changes to prevent abuse of the medical marijuana system.
One recommendation includes more actively investigating and passing along suspect doctors to the Colorado Medical Board for investigation and possible disciplinary action.
The Medical Board can revoke a doctor's license or prevent him or her from working with marijuana patients if abuses are found.
Frant said the last time the health department sent a physician to the board for investigation was 2011.
Karin McGowan, interim director of the Colorado Department of Public Health and Environment, said the agency tries its best to enforce the laws while also respecting patient and doctor confidentiality.
"Sometimes it feels like we're between the dog and the fire hydrant on this issue," McGowan said.
She said the department is normally responsible for regulating facilities and processes, not people and behaviors.
This isn't the first time an audit has criticized the medical marijuana system in Colorado.
In March, the state auditor's office released a scathing report on how the Department of Revenue has regulated the businesses or dispensaries licensed to distribute medical marijuana.
In an update Monday, the department reported to the audit committee how it has responded to concerns about the licensing and regulation of businesses.
Contact Megan Schrader