A Golden Diagnosis Turns to Rust


There’s a phrase I’ve heard in the drug using community, “Golden Diagnosis.” It means a medical diagnosis that allows legal access to narcotics or other drugs that can be abused. It’s golden because the patient can exaggerate symptoms to get more of their preferred drug – either for sale or to take themselves.

An example might be a back injury and repair that shows up nicely on an X-ray. The actual condition might be very painful or it might not. In most cases, a doctor will have to rely on the patient’s word. As far as the law is concerned however, this is a legitimate reason to have narcotics prescribed.

Let’s be clear here. There are conditions which cause severe and chronic pain. But that’s what makes a golden diagnosis so handy. You cannot tell without testing (which isn’t done) whether someone is having a sickle cell attack, or a gout attack, or any of a number of conditions that might need strong narcotics. Very few patients take advantage of their conditions to work the system. But some do.

A new list of golden comes to Michigan

When the legislation to legalize marijuana in Michigan was passed, there was a specific set of diagnoses attached. Some were more general, but the law was written with the idea that only those patients who needed marijuana would be able to use it legally. Of course, this meant a new round of golden diagnoses, only now the object was to get weed with a special card.

And so it went for a year or so. The market grew and the patient numbers increased and the clinics popped up. Until last week, all was well. August 27th, the Detroit News reported a crackdown in Oakland County with 15 arrests. Among them were people holding the ‘legal weed’ card.

In what is seen as partially a political move, the local sheriff (who had run for governor as a strong law and order candidate) made arrests at two locations, a dispensary for marijuana and a private club held after hours at “Everybody’s Café.” A quote from the Sherriff, Michael Bouchard, says a great deal, “This is Michigan, not some Cheech and Chong movie."

The bottom line is that thinking you have a golden diagnosis and actually having one might depend at least partly on who is enforcing the law. A doctor’s prescription and a card are fine if you have a legitimate need, but crossing the line can be foolish – especially when the local law has political points to score.


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