Good for state Sen. Josh Green for insisting on long-overdue accountability for medical marijuana before the Legislature plants the seeds of a dispensary system that could lead to a California-like situation where pot fliers are handed out at malls.

A bill for a single, state-licensed pilot marijuana dispensary died in conference committee last week after lawmakers couldn’t agree on its location and Green, a Kona emergency physician and chairman of the Senate Health Committee, pushed for a tighter rein on the medical conditions for which pot could be prescribed.

At this point the 11-year-old law that allows patients to obtain marijuana prescriptions and grow their own plants in limited numbers is managed in far too loosey-goosey a manner.

Putting the state in the pot distribution business without addressing the concern would be less about medicine and compassion than filling state tax coffers and opening a back door to legalizing pakalolo for recreational use.

The numbers raise troubling suspicions that only a small percentage of medical marijuana in Hawaii is going to patients with the serious conditions that pot is reputed to relieve.

Of the more than 8,000 marijuana permits now in circulation, 57.8 percent are on the Big Island, which has become pakalolo central with 13.6 percent of the state’s population.

Many of the prescriptions, which must be renewed annually, are written by a relatively small group of doctors, some of whom charge up to $300. One Big Island physician had authorized nearly 3,000 marijuana certificates as of last June, according to the state. It’s lucrative enough that doctors are flying in from the West Coast to get in on the action.

There’s little control over what constitutes an illness that benefits from pot, and the Department of Public Safety says most prescriptions are being written for patients in their 20s and 30s, who are demographically the least likely to have the major medical conditions associated with marijuana relief.

Most of these prescriptions are for pain and nausea from common injuries, Green says, citing potential abuses in which more than 500 people under age 21 on the Big Island have been prescribed marijuana.

Green would eliminate general prescriptions for pain and nausea and limit marijuana cards to patients diagnosed with major diseases such as cancer, HIV, AIDS, multiple sclerosis and glaucoma.

This might be too rigid, but he’s on the right track that we need to bring tighter control to medical marijuana lest we end up allowing virtually any recreational user to get a prescription and obtain pot from a state-sponsored dispensary.

If their aim is truly medical compassion and not a back door to legalized recreational pot, promoters of medical marijuana should have no problem with the same accountability placed on any other pharmaceutical product.