The medical marijuana proposition received just enough voter approval to pass in November.

Now doctors must wade through murky waters surrounding the measure to make decisions about what patients are qualified to use the drug, and whether they will prescribe it.

Proposition 203 states that patients may qualify for medical marijuana if they have “a chronic or debilitating disease or medical condition or its treatment that produces ... severe and chronic pain.”

However, other states, including Colorado and California, have discovered a large number of medical marijuana users in those states are young males using the drug to treat pain that may or may not be from a chronic illness.

Arizona will be the 15th state to legalize medical marijuana. The Arizona Department of Health Services is expected to begin reviewing dispensary and patient applications by April 2011.

Tiffany Jenkins, the public relations manager for Cancer Treatment Centers of America in Goodyear, said the new law will require the facility to amend its policies and procedures.

“There are a lot of little things that have to be factored in,” Jenkins said.

Licensed physicians could recommend medical marijuana to patients with debilitating medical conditions, including cancer, glaucoma, HIV/AIDS, hepatitis C and Alzheimer’s disease. Patients would register for identification cards with the state health department. They could also receive up to 2½ ounces of marijuana every two weeks from dispensaries or cultivate up to 12 plants if they live 25 miles or more from a dispensary.

Doctors must certify in writing the patient’s debilitating medical condition after assessing the patient’s medical history in “the course of a physician-patient relationship,” the meaning of which is still to be determined by the Arizona Department of Health Services.

Dr. Daniel Nixon, an oncologist at the Cancer Treatment Centers of America, said it will be interesting to see what happens with the new law.

Nixon was a chairman on the board regulating the use of medical marijuana in Georgia in 1980, when that state first legalized the drug. The demand dropped dramatically after medical marijuana became accessible, and Nixon said they shut it down after just a few years.

When the Arizona law came up, Nixon said he was neutral about it after his experience in Georgia.

“I will say that it’s useful to have it available,” Nixon said.

Nixon said he has already received questions from patients about the drug. The biggest thing he has to explain is marijuana is not a cancer treatment, but it can help with the symptoms, especially loss of appetite and nausea associated with chemotherapy.

The latest anti-nausea medicines work well enough, however, that Nixon said there might not be a need for medical marijuana.

“If newer medicines don’t work, I expect that medical marijuana would be the next step,” Nixon said. He would prescribe the drug to his patients “as long as it’s legal and all the Arizona laws are complied with.”

Jenkins said Cancer Treatment Centers of America does carry and use FDA-approved medications in pill form derived from the same compound found in marijuana. The medication is called Marinol or dronabinol, which is used to treat both chemotherapy-induced nausea and stimulate appetite.

Other doctors and physicians contacted by the Daily News-Sun were reluctant to talk about their plans for prescribing medical marijuana because the law is still new and untested.

Dan Kingston, founder of the website, said there are about a dozen doctors in the West Valley registered on the site, which offers patients a forum to ask questions or discuss the new law, and to look up doctors in their area.

The site is a marketing tool for the doctors, Kingston said, but they go through a large background check before being entered into the directory.

Kingston said 100 doctors have registered on the site since it became active in November.

“It’s not about people that are getting high, it’s about people that have been in pain,” Kingston said. “There are a lot of people that really truly need this medication.”

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