BY DR. MICHELLE WEINER & DAGOBERTO J. MORALES, B.S.

On January 3, 2017, Amendment 2, also known as the Florida Medical Marijuana Legalization Initiative became effective, allowing the use of medicinal marijuana for people with at least of the of following ten diagnoses: Cancer, Glaucoma, Epilepsy, HIV/AIDS, PTSD, Parkinson’s disease, Crohn’s disease, ALS, and Multiple Sclerosis or a terminal illness deemed by two Physicians. A patient may have chronic non-malignant pain related to one of the ten diagnoses however this is not a standalone qualifier despite the substantial evidence in the literature that exists about cannabis’ effects on pain. If a patient is under 18 years of age, two Physicians are required for the certification process.

The first step to getting a medicinal cannabis card is to have a physical exam and be evaluated by a certified medical marijuana doctor, who will determine if medical cannabis is an appropriate treatment for your condition(s). Physicians should be requesting medical records to confirm the diagnosis. As stated in the Florida Department of Health’s guidelines, only certified marijuana doctors can recommend the use of medical marijuana for patients who reside in Florida, have a valid Florida ID or driver’s license, and meet at least one of the qualifying medical conditions. There is no reciprocity from other states. If a doctor determines that a patient qualifies due to a debilitating medical condition of the same kind or class as or comparable to those ten, then they are required to MAIL additional documentation to the Board of Medicine justifying why the condition is in the same kind or class   and that clinical, medical, or scientific data justifies the use of medicinal cannabis for their patient’s condition within fourteen days after issuing the certification. Penalties will be enforced for Physicians who do not abide by these rules.

Once the doctor certifies a medical marijuana patient, basic identifying information is entered into the state of Florida Department of Medical Marijuana Use Registry, and a patient number is issued. The patient’s medical history or diagnosis information is not shared with the registry. After the doctor sees the patient and has entered the patient into the registry, the patient is ready to submit the Department of Health application form. The Florida Department of Health issues the medical marijuana card directly to the patient. The ONLY valid medical marijuana card in Florida is issued by the Department of Health. The patient must fill out the application along with a $75 check or money order and passport photo. The process of obtaining card after application is sent has been taking up to six weeks.

Licensed marijuana growers, Medical Marijuana Treatment Centers (MMTCs), and law enforcement use the registry and state-issued medicinal cannabis card to verify valid patients. In the event that a patient is stopped by law enforcement while carrying marijuana in Florida all they need to do is provide the officer their registry number to avoid any legal repercussions.

Depending on the doctor’s recommendations, patient’s can purchase a full 70-day order at once or break up it up into smaller orders. The Physician is allowed to give the patient refills lasting up until 210 days and must see the patient again within 30 weeks. There are various routes of administration available for the consumption of cannabis such as inhalation, oral tinctures and syringes, concentrates, topical creams, and oral capsules. Physicians will decide if Low THC (CBD), or Medical Cannabis (THC) (different “strains” including Sativa, Indica, and Hybrid) or a combination of both best meets the patient’s medical needs and which TWO routes are most appropriate. Many patients use more than one route of administration and have different doses of medication as well as ratios of CBD: THC recommended for different times of the day or if they have an exacerbation of their condition. MMTCs (dispensaries) are being opened statewide, maximum of 25 stores per one MMTC, and for convenience purpose, dispensaries deliver statewide directly to the patient’s home for an additional fee. For those patients with economic constraints, it is important to note that private insurances, Medicare, and Medicaid do not cover medical marijuana evaluations or medical marijuana. Many MMTCs are giving discounts for certain populations such as Veterans or Pediatrics.

Currently there are 45,000 qualified patients in the Office of Medical Marijuana Use Registry with roughly 1000 Physicians who have taken the two-hour course to become certified. My medical opinion based on my clinical experience and review of the literature is that more diagnoses should be added to our list so Physicians should do their due diligence in justifying the same kind or class conditions so the Board of Medicine and Department of Health can review our information and include additional diagnoses for the future. This process will continue to evolve and we need to embrace it together.

Spine and Wellness Centers of America