Recommendation

A recommendation (also "certification") is the written statement by a state-authorized healthcare practitioner attesting that a patient has a qualifying condition for which medical cannabis may provide therapeutic benefit. Because cannabis is a Schedule I controlled substance under federal law, DEA registrants cannot lawfully prescribe it; instead, states have adopted the "recommendation" model, under which the practitioner's statement is a state-law prerequisite to patient registration without purporting to constitute a federal prescription. The constitutional protection for physician recommendations was established in Conant v. Walters, 309 F.3d 629 (9th Cir. 2002), which held that the First Amendment protects physicians' ability to recommend cannabis in the context of bona fide medical practice, and that the federal government cannot revoke DEA registrations in retaliation. Certifying practitioners are typically MDs or DOs, with NPs, PAs, pharmacists, and (in some states) dentists and podiatrists authorized in particular programs. Recommendations are typically valid for one to two years and must be documented in the patient's medical record. *→ See also: Prescription, Medical card, Qualifying condition, Patient registry