The Colorado Department of Public Health and Environment's recent rejection of nearly 2,000 medical marijuana patient licenses over a quiet rule change caused such an uproar that the department promised to temporarily reinstate licenses for around 1,300 MMJ users -- among them Larry Shurtleff, who suffers from stage 4 cancer. But he remains confused and anxious over the state jerking him back and forth.

"This has been just about unbearable on me," says Shurtleff, 53. "One day, I think everything's going good, and then I get shot back down again. I really don't know what's going on."

Some background: Amendment 20, the 2000 measure that legalized medical marijuana in Colorado, describes a physician allowed to recommend MMJ as "a doctor of medicine who maintains, in good standing, a license to practice medicine issued by the state of Colorado." But Senate Bill 109, a piece of legislation intended to clarify the relationship between doctors and medical marijuana patients, which became law in June, tweaked this definition, stating that a doctor in good standing must hold "a valid, unrestricted license to practice medicine in Colorado."

Beginning late last month, the health department began enforcing its understanding of the SB 109 standard. Since February or so, personnel had set aside recommendations written by doctors with either restrictions or conditions on their license, even though there's no specific mention of conditional licensees in the law. (Restrictions and conditions aren't synonymous.) Then, beginning late last month, they mailed letters to patients, informing them that their applications had been rejected because their doctors -- eighteen physicians were impacted statewide -- had been retroactively deemed unqualified to write recommendations.

This information threw Shurtleff, a hospice resident, into a panic, due in large part to the fact that medical marijuana has provided him with some of the only real relief he's experienced over the past five years or so.

Back in 2004 or 2005, Shurtleff says, a pea-sized tumor developed inside his left cheek. As it grew, he went to a hospital, where he was diagnosed with a sinus infection and prescribed antibiotics. But the tumor continued to increase in size -- so he saw another doctor, and after a battery of tests, he was determined to have stage 4 cancer.

Having lost a fiancee to breast cancer, Shurtleff was reluctant to submit to chemotherapy and radiation, but he decided to go forward with this treatment regimen anyhow. During the process, he lost all of his teeth and one eye, and he was in nearly constant, agonizing pain. When narcotic medication failed to give him comfort, his doctor suggested that he try marijuana. He initially resisted, but he eventually chose to give it a try following conversations with his sister, an MMJ patient herself, as well as a fellow patient at a nursing facility in Wheat Ridge.

For Shurtleff, the results of sample treatment were immediate and positive. "It helped out tremendously," he enthuses. "It helped with the pain, with the nausea, with my appetite. It helped everything."

With that in mind, Shurtleff connected with Dr. Mary Daehn, a Boulder physician in good standing, albeit one with a condition on her license. She wrote him a recommendation earlier this year, and although he hadn't received his license -- because, he assumed, of the enormous delays that have stricken the program -- he's been able to legally obtain MMJ using his paperwork.

These forms came in handy around May of this year, when a policeman stopped and cited him while he was walking for having a small amount of marijuana on his person. "I explained to him that I was licensed, but he wasn't hearing any of it," Shurtleff says. "So he took the medicinal marijuana from me and gave me a ticket, and I had to go to court. I brought all my papers with me, and they ended up throwing out the case, because I was legal."

Given this experience, Shurtleff was frightened and upset when he received the health department letter informing him that his license had been rejected. A week or two later, his caregiver informed him that the health department had backed down regarding patients whose recommendation had been written by a physician with a conditional license (but not a restricted one). The caregiver added that he would receive another letter informing him that he can continue to legally obtain MMJ until the department makes a final determination about the matter, probably in March -- although additional delays are possible. However, he's still concerned.

"I'm a worrywart," he admits. "I just won't believe it until the paperwork is actually in my hands."

In the meantime, Shurtleff faces more serious medical issues related to his tumor, which has decreased in size but hasn't gone away. He recently underwent another surgical procedure, and since then, he's been unable to fit his prosthetic eye into the socket -- plus, he's experienced a sharp pain that even medical marijuana hasn't been able to eliminate entirely. He's got a doctor's appointment later this week to determine the next course of action -- and the last thing he needs is to have more problems related to MMJ.

"I"ve been through this three or four times now," he says. "And each time, it hasn't been anything on our part. It's just been a real pain."

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