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Colorado voters passed a ballot initiative on November 7, 2000, to remove state-level criminal penalties for medical marijuana use, possession, and cultivation. On June 1, 2001, less than three weeks after the U.S. Supreme Courts negative ruling on medical marijuana distribution in U.S. v. Oakland Cannabis Buyers' Cooperative, the Colorado Department of Public Health and Environment (CDPHE) implemented the Medical Marijuana Registry program and began issuing identification cards to patients and caregivers who qualify for legal protection under state law.

After scrutiny from Gov. Bill Owens (R) and then-Attorney General Ken Salazar (D) — both of whom oppose medical marijuana — no reason could be found to scrap the Medical Marijuana Registry program. Following exhaustive research and vigorous debate by attorneys in their offices, Owens and Salazar jointly said that "the Supreme Courts holding in the Oakland case was deliberately narrow enough to permit Colorado's medical registry to go forward."1

Colorado's program received a boost in legitimacy when, in July 2001, Kaiser Permanente gave its Colorado doctors permission to recommend medical marijuana.2 Kaiser, one of the nations largest health maintenance organizations, has over 400,000 patients in Colorado.

Since the programs inception, there have been only two widely publicized cases of patients encountering trouble with police.

James Scruggs, a Crohn's disease patient from Cherry Creek, was accused of growing 22 marijuana plants, which police said were more than what one person would need for his or her own medical purposes.3 While the law restricts patients to growing six plants, three of which may be mature, it permits patients to argue at trial that quantities in excess of that amount are medically necessary. Although Mr. Scruggs' case was dismissed due to insufficient evidence, it indicates that law enforcement may pursue patients who exceed the numerical limit of six plants.

In a second case, the home of Don Nord — a 58-year-old state-registered medical marijuana patient — was raided by a local-federal drug task force, which seized his marijuana and charged him with marijuana possession and possession of drug paraphernalia. Routt County Judge James Garrecht

1 "Owens' and Salazar's joint statement on medical marijuana," Denver Rocky Mountain News, May 31, 2001.

2 "Kaiser to allow medical marijuana," Daily Times-Call, July 7, 2001.

3 "Defendant cites medical pot law," Denver Post, Dec. 12, 2001, and "Medical marijuana case takes interesting twist," Denver Rocky F-4 Mountain News, May 15, 2002.

dismissed the charges against Mr. Nord and ordered the federal authorities to return the marijuana that rightfully belonged to him.

The DEA returned his growing equipment but refused to return the marijuana. Judge Garrecht ordered the officials who participated in the raid of Mr. Nord's home to be held in contempt of court. Garrecht planned a "show cause" hearing, where the officers would have had to explain to the judge why they should not have been held in contempt of court.

The U.S. Attorney's office had the case transferred to federal court, where U.S. District Judge Walker Miller heard arguments in 2004. In July 2005, Miller dismissed the contempt citation, concluding that the agents were protected by federal immunity and were therefore not required to return the marijuana that they confiscated from Nord. Nord has not been prosecuted on federal charges.

Patients have expressed two main complaints regarding the state's law. First, some patients find the annual $110 registration fee to be a financial burden. The fee was lowered from $140 on June 1, 2004, but some patients say they still cannot afford to register. Second, patients complain that no authorized distribution system exists; many would prefer not to grow their own marijuana or obtain it on the illegal market.

For those who can grow their own medical marijuana, however, the program is working well. Although the program has 35 days to approve or reject applications, the average turnaround time is two to three days. The program is staffed by one full-time employee and receives an average of fifteen new applications per week.

Severe pain is the ailment most commonly reported by registered patients (77%), followed by muscle spasms (39%), severe nausea (20%), cachexia (6%), seizures (6%), cancer (5%), glaucoma (3%), and symptoms related to HIV/AIDS (2%). (The total adds up to more than 100%, since some patients report using medical marijuana for more than one debilitating medical condition.) CDPHE accepts and reviews petitions to add conditions to the current list of debilitating medical conditions and symptoms. Three petitions have been received since the program began: one for Parkinson's disease, one for bipolar disorder, and one for asthma. All three petitions were denied, "due to lack of scientific evidence that treatment with marijuana might have a beneficial effect."

About half (53%) of registered patients have designated primary caregivers. On June 14, 2004, CDPHE stopped issuing cards to caregivers, after determining that the law does not allow for caregiver identification cards. Caregivers are still legally protected, however, provided they are designated by registered patients. The average patient age is 46, with a range of 18 to 77. No minors have been registered. Seventy-five percent of the state's counties have at least one registered patient. Sixty-three percent of patients come from rural areas, while 37% come from the Denver and Boulder areas. El Paso County has the most registered patients (13%).

Almost 300 physicians have submitted supporting documentation for patients, giving Colorado one of the highest physician-to-patient ratios among the states with medical marijuana registry programs. This high rate of physician participation may stem directly from information they receive from the program. Debra Tuenge, the program's administrator, tells physicians who are concerned about liability that Drug Enforcement Administration officials have informally told her that doctors are not breaking federal law by signing the program's registration forms.

Information and application forms for the Colorado registry program can be obtained from the CDPHE Web site at www.cdphe.state.co.us/hs/medicalmarijuana/marijuanafactsheet.asp.

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