CONTACT Mile High Macaroons: marijuana medicalization in Colorado - Dr. Christian Thurstone

This article was originally published in The Journal of Global Drug Policy and Practice in 2011.

Authors: Abraham M. Nussbaum, MD, MTS, Christian Thurstone, MD


Since the passage of Amendment 20 in November 2000, over two percent of Colorado’s population has registered with the state to possess and use marijuana for medical purposes. Entry to the registry requires the recommendation of a physician for any of eight conditions, but 94 percent of users are registered for severe pain. The average age of registrants is 40 years old, and 69 percent of registrants are male. The registry requires the recommendation of a physician, and while more than 1,200 of the state’s physicians have signed a medical marijuana registry form, 49 percent of all users were registered by one of just fifteen physicians. To service this demand, Colorado is now home to more than a third of America’s marijuana dispensaries. Colorado’s embrace of medical marijuana is due to high preexisting use of marijuana, minimal barriers to amending the state’s constitution, difficulties regulating the medical marijuana industry, and entrepreneurial physicians. The social effects of the medicalization of marijuana remain impressionistic, but preliminary data are concerning.

The city of Denver, Colorado’s capitol and largest city, has more marijuana dispensaries than public schools, liquor stores, or even Starbucks coffee shops, an oft-cited statistic that suggests the extent of the state’s medical marijuana industry (1). The city’s many dispensaries advertise on street corners and in local newspapers, offering discounts and free samples of marijuana strains with evocative monikers (“Bruce Banner,” “Dirt Weed,” “White Widow,” and “Stevie Wonder”) along with sodas, ice creams, pizzas, and baked goods like “Mile High Macaroons,” all prepared with marijuana.
The Mile High City is home to the nation’s fastest-growing medical marijuana industry and capitol of the state with the largest per capita use of medical marijuana in the country. In this article, we review the use of marijuana by Coloradoans before medicalization, the development of the medical marijuana registry, attempts to regulate medical marijuana, the demographics of its use, the medical marijuana industry, the relationships between physicians and patients, the available mental health and substance abuse services, and the still-developing effects of medical marijuana on the state’s communities.

You can download the full paper here.

About Chris Thurstone

Dr. Christian Thurstone is one of only a few dozen physicians in the United States who are board-certified in general, child and adolescent and addictions psychiatry. He is Director of Behavioral Health Services at Denver Health and a professor of psychiatry at the University of Colorado, where he conducts research on youth substance use and addiction and serves as director of medical training for the university’s addiction psychiatry fellowship program. You can read more about him here.

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