MEDICAL MARIJUANA BRINGS NEW MEANING TO 'ROCKY MOUNTAIN HIGH'

The ski communities of Summit County, San Miguel County and Pitkin
County are some of the youngest, fittest and healthiest counties in
Colorado.

So it would stand to reason that those counties would have the lowest
rates of registered medical marijuana users. After all, use of medical
marijuana, approved by voters in 2000, is limited to patients with
debilitating medical conditions, including cancer, HIV and glaucoma.

And yet medical marijuana use in these mountain communities is twice
the state average, as measured by per capita number of medical
marijuana cardholders in each county.

When it comes to medical marijuana in Colorado, topography has more
influence than health.

People seeking medical marijuana have to get a referral from a doctor
and register with the Colorado Department of Public Health and
Environment to legally use the drug.

An analysis of the state's registry shows the highest rates of
registered medical marijuana users lie in a swath of high country
dominated by ski resorts like Aspen (Pitkin County), Breckenridge
(Summit County) and Telluride (San Miguel County.) Those counties,
meanwhile, have some of the state's lowest rates of cancer and HIV.

Call it the green belt.

In contrast, flat, rural communities of the eastern plains and San
Luis Valley barely touch the stuff. Some counties on the plains have
no patients registered to use medical marijuana at all.

The urban counties of the Front Range fall in between, ranked roughly
in order of wealth: Boulder, Denver, Colorado Springs, Pueblo.

Marijuana is not only pervasive in ski towns, it's flaunted and even
vaunted. Aspen held a two-day festival this spring to crown the best
cannabis in the state. Breckenridge residents voted three to one in
2009 to legalize possession of small amounts of marijuana, and the
town now boasts a club where members can toke up, whether they are
registered patients or not.

"It seems to be a function of lifestyle," said John Harner, a
geography professor at the University of Colorado at Colorado Springs,
when he saw the numbers. "The mountains are dominated by a
recreational culture. They are there to have a good time. And perhaps
that includes recreational use of medical marijuana. If that is true,
it confirms suspicions that people are gaming the system."

The health department's registry seems to back up this hunch. Though
many backers of medical marijuana focused on how it would help cancer
and AIDS patients, only 3 percent of people on the registry have
either, while 92 percent cited "severe pain" - a condition as hard to
prove as it is to disprove, but which also is allowed.

As much as they encourage it, cultural values also can discourage use
of medical marijuana.

In the windswept prairie of Kiowa County, snug against the Kansas
border, where the economy is dominated by wheat farming and cattle
ranching, dispensaries were outlawed before one even arrived.

As of the beginning of 2010, the most recent data available from the
state, the county had no registered medical marijuana users.

"People around here are not much for modernization. A dispensary would
be a big change, and folks here are not that into change," said Jan
Richards, economic development coordinator for Kiowa County's largest
town, Eads (pop. 747).

It's not that patients couldn't get marijuana if they wanted it, said
Dr. Jeffery Waggoner, one of the few physicians in the county. Some
doctors are willing to refer patients, he said, but, "Kiowa is
terribly conservative, and marijuana is not the drug of choice,
medically or otherwise. Booze is widespread, and causes a lot of
damage, but when it comes to marijuana, there is a tremendous stigma
attached. I think some people would be afraid to try it."

Tradition has the same power in counties where rates of medical
marijuana use are high.

Gilpin County, wedged in the mountains between I-70 and Boulder, has
the highest rate of marijuana cardholders in the state. In this former
mining community now dominated by the gambling towns of Central City
and Black Hawk, 32 of every 1,000 people are registered.

Residents say it has less to do with health than with the region's
long tradition of growing weed.

For decades, the secluded hills stretching from Rollinsville in Gilpin
County north to Ward in Boulder County acted as the Humboldt County of
Colorado, where growers secretly tended crops of top-shelf bud to sell
on the Front Range. Nederland, in the center of the region, is so
tolerant of pot that people often call it Nedsterdam - a play on the
Dutch city of Amsterdam, where pot is legal.

"People here have been growing for a long time and they are very good
at it. It's just part of the culture. I'd say five of my customers
today are known to be in the business," said a clerk who answered the
phone at the Rollinsville Country Store, but declined to give his name
because he felt uncomfortable talking about something that is widely
known but rarely said.

David Forsyth, director of the Gilpin Historical Society, said the
pattern might be explained by the fact that mountain communities have
always been more tolerant of vice.

"It's a very old attitude," he said. "A lot of people moved up to get
away from society, get away from rules of the big city. For
generations, gambling, prostitution, and bootlegging were quietly
accepted, as long as you kept your place and did not make it too
obvious. I don't see marijuana being any different."

Gilpin does have the highest rate of cancer in the state, according to
the The National Cancer Institute, but looking at all 64 Colorado
counties, factors besides disease rate seem to have more influence on
who registers to use pot and who doesn't.

Where median income is highest, so is medical marijuana use. Same with
college degrees. Same with voting for Barack Obama.

One of the few areas where there does not seem to be a correlation
with is health.

"I would be wary to say it is totally people scamming the system,"
said Harner, looking over the map. "Perhaps because these communities
where we see high numbers are more liberal and progressive, they are
more open to new, alternative medicines. But I'm not sure that could
account for all of it."