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Recommending Cannabis in Arizona
A medical professional recommending medical cannabis must be a licensed physician (MD or DO) or a licensed Naturopathic or Homeopathic physician. The law and rules specify requirements for issuing written certifications for patients with a debilitating medical condition (“qualifying patients”) for the medical use of marijuana. The written certification must be made on the form provided by the Arizona Department of Health Services (“ADHS”). A physician is required to:
- Make or confirm a diagnosis of a debilitating medical condition (as defined below) for the qualifying patient;
- Establish a medical record for the qualifying patient and maintain the qualifying patient's medical record;
- Conduct an in-person physical examination of the qualifying patient within the last 90 calendar days appropriate to the qualifying patient’s presenting symptoms and the debilitating medical condition the physician diagnosed or confirmed;
- Review the qualifying patient’s medical records, including medical records from other treating physicians from the previous 12 months, the qualifying patient’s responses to conventional medications and medical therapies, and the qualifying patient’s profile on the Arizona Board of Pharmacy Controlled Substances Prescription Monitoring Program database;
- Explain the potential risks and benefits of the medical use of marijuana to the qualifying patient, or if applicable, the qualifying patient’s custodial parent or legal guardian;
- If the physician has referred the qualifying patient to a dispensary, disclose to the qualifying patient, or if applicable, the qualifying patient’s custodial parent or legal guardian, any personal or professional relationship the physician has with the dispensary;
- If the written certification is being made for Post-Traumatic Stress Disorder, that the physician has reviewed evidence documenting that the patient is currently undergoing conventional treatment for PTSD; and
- Attest that, in the physician’s professional opinion, the qualifying patient is likely to receive therapeutic or palliative benefit from the qualifying patient’s medical use of marijuana to treat or alleviate the qualifying patient’s debilitating medical condition.
The law requires that qualifying patients under 18 obtain an additional certification from a reviewing physician. The DHS form of this certification requires that the reviewing physician:
- Conduct a comprehensive review of the qualifying patient’s medical records from other physicians treating the qualifying patient;
- If the physician has referred the qualifying patient to a dispensary, disclose to the qualifying patient, or if applicable, the qualifying patient’s custodial parent or legal guardian, any personal or professional relationship the physician has with the dispensary; and
- Attest that, in the physician’s professional opinion, the qualifying patient is likely to receive therapeutic or palliative benefit from the qualifying patient’s medical use of marijuana to treat or alleviate the qualifying patient's debilitating medical condition.
The law applies to the following “debilitating medical conditions”:
- Human Immunodeficiency Virus (HIV)
- Acquired Immune Deficiency Syndrome (AIDS)
- Hepatitis C
- Amyotrophic Lateral Sclerosis (ALS),
- Crohn’s disease
- Agitation of Alzheimer's disease
- A chronic or debilitating disease or medical condition or the treatment for a chronic or debilitating disease or medical condition that causes:
- Cachexia or wasting syndrome
- Severe and chronic pain
- Severe nausea
- Seizures, including those characteristic of epilepsy
- Severe or persistent muscle spasms, including those characteristic of multiple sclerosis.
- Post-Traumatic Stress Disorder (PTSD) (note: patient must also be undergoing conventional treatment for PTSD)
In addition, the law provides a mechanism for adding other debilitating medical conditions to the above list through a petition and review process administered by the ADHS.
Any physician acting as a medical director for a dispensary is not permitted to provide written certifications.
More information on the physician’s role in Arizona’s medical marijuana program is available on the DHS website.