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Colorado bill would allow doctors to recommend medical marijuana instead of prescription painkillers

Colorado Senate Bill 19-013 is aimed at allowing doctors to recommend medical marijuana instead of painkillers in an effort to curb opioid addiction.

DENVER — Gov. Jared Polis (D-Colorado) is reviewing a Senate bill focused on fighting the opioid epidemic that would allow doctors to recommend medical marijuana in many of the same situations where they could prescribe opioids.

Sponsors of Senate Bill 19-013 said this option could help doctors avoid prescribing addictive painkillers for things like chronic pain, but members of the medical community are worried there’s not enough research about the effects of cannabis and that the bill’s language is too broad.

Rep. Edie Hooton (D-Boulder) is a sponsor of the bill, and said it is not a mandate, but rather an option for doctors to consider – especially when it comes to making recommendations for children.

“This is going to be a pretty big deal for acute pain for athletes,” Hooton said, “and also for kids who have surgeries.”

In order for children to currently be recommended medical marijuana, they need two physicians to sign off. Should SB 19-013 pass, it would also ask for a review of diagnosing records from the primary care physician. Hooten said this goes beyond what’s required in the constitution.

Kids would not be able to smoke marijuana, but could use a nasal spray or extract.

Jared Penman, who owns RiNo Supply Company – a medical marijuana dispensary – has been diagnosed with osteochondritis dissecans of the talus, tibia and fibula stage four. It's a condition that causes extreme pain. 

“The inside of your bones basically fall out into your joints,” Penman said, “and the only thing doctors had to give me was opioids.”

Penman said his doctors kept increasing his dosage to keep up with his pain levels and it took him some time to realize his dependency, since he was following his doctor’s orders.

“I feel like medical marijuana basically saved me,” he said.

Penman got a medical marijuana card, made a commitment to stop using the pills, and said marijuana helped with his withdrawals and pain management. Penman said he hasn’t touched an opioid in seven years.

He applauds the bill, saying supporting it is a no-brainer.

Dr. Stephanie Stewart, an addiction medicine fellow, also applauds the efforts, saying the intentions were good, but has a lot of concerns.

“It conflates the opioid epidemic and marijuana,” Stewart said.

She’s worried people already addicted might be steered toward marijuana for their pain instead of medication assisted treatment, which many doctors turn to treat opioid addiction.

Dr. Rob Valuck, also an addiction expert, said this bill feels like it’s following a similar pattern as what happened with opioids, since it’s an option that’s being put out to the community that’s familiar -- but not well-researched

Valuck said there isn’t enough research into the link between medical marijuana and pain control, even though chronic pain is a medical condition that can qualify a patient to get a medical marijuana card. He said the same goes for how medical marijuana affects withdrawal symptoms.

Hootan said she stands by her assertion that medical marijuana is a safer option, pointing out it’s been legal in Colorado since 2000.

“This bill is not about people with addiction issues,” she said. “It adds acute pain as a condition that would qualify for medical marijuana.”

“If it doesn’t have anything to do with addiction,” Stewart countered, “I wouldn’t have included opioid in the title of the bill.”

As for tax revenue, medical marijuana is taxed at 2.9% while recreational is taxed at 15%. A fiscal review of the bill said it may not have a major impact on tax revenue, but Hooton said it could. On the other hand, she said it would be a cheaper option for families if they and their doctors choose this is the right decision for them.

The governor has until June 3 to decide if he’ll sign the bill.

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