COLORADO DOCTOR DEFENDS RECOMMENDING MARIJUANA TO A PREGNANT PATIENT

A Colorado doctor under fire for recommending marijuana to a pregnant
woman says he provided the patient with appropriate care and disputes
that pregnancy and medical marijuana don't mix.

Dr. Manuel Aquino, who could lose his medical license over the
recommendation in January, also says the woman's behavior was
"intentional, reckless or grossly negligent" in not telling him
during the exam that she was pregnant. He also accuses the Colorado
Medical Board of taking too long to bring a case against him and says
newlaws requiring a fuller relationship between doctors recommending
marijuana and patients seeking it were not in place when he made the
recommendation.

"The charges herein do not allege conduct below the standard of
care," Aquino states in his defense.

Aquino's response comes in a document filed late Wednesday in the
administrative case against him. In that case, the Colorado Medical
Board is seeking to strip his license, which would make him the first
doctor punished for substandard care in making a marijuana recommendation.

The medical board accuses Aquino of writing the recommendation for
the woman, who was six months pregnant, after a 3-minute visit in
which he didn't perform a physical exam, didn't review her medical
history and didn't ask whether she was pregnant.

Aquino, though, says new regulations requiring him to have a
"bona-fide" relationship with marijuana-seeking patients weren't in
place in January. He also denied a statement contained in the medical
board's complaint that "pregnancy is a contraindication for the use
of medical marijuana."

Aquino's attorney, Sheila Meer, has declined to comment. The case is
scheduled for a hearing in March.

News of Aquino's prosecution has spurred comments on online cannabis
message boards debating whether marijuana use during pregnancy is
harmful. Medical research hasn't been unanimously conclusive on the
subject, though several studies suggest prenatal marijuana exposure
can have negative consequences for children.

A 2009 article in the European Archives of Psychiatry and Clinical
Neuroscience noted that numerous studies have shown marijuana use
during pregnancy can result in low birth weight and children with
hyperactivity, and short-term memory and impulse-control problems.

"Recent evidence suggests that perinatal (marijuana) exposure alters
fundamental developmental processes," the study's authors wrote.

Other studies, such as a 1983 report in the American Journal of
Public Health, conclude that differences between children of
marijuana users and non-marijuana users aren't statistically
significant. Nearly every study says the question needs further research.

Alan Shackelford, a Denver nutritional and behavioral medicine doctor
who is also a medical-marijuana specialist, said it is important for
doctors to do thorough exams on patients seeking cannabis. He said
his exams last up to an hour and include detailed discussions about a
patient's conditions and prior treatment.

When making a decision, Shackelford said, doctors must weigh the
benefits of marijuana versus the risks and err on the side of caution.

"It's not different if someone is being evaluated for cannabis," said
Shackelford, who serves on a state medical-marijuana advisory board.
"The person is being evaluated for their medical condition."