6 minute read
Florida’s Weed Woes
State of Confusion
by Allison Gorman
If Floridians are confused about how medical marijuana works in their state, it’s no wonder. After all, the legalization of this natural drug has been a two steps forward, one step back process.
First, medical marijuana was made legal in Florida for a relatively small subset of severe chronic health conditions, such as HIV/AIDS and cancer. Then last year, Florida voters okayed its use for a broader range of “like” conditions—that is, the sort of physical and emotional symptoms, such as chronic pain and anxiety, that often accompany those severe health conditions.
Now, under the new law, medically qualified patients can get a referral that enables them to purchase medical marijuana products at a state-approved dispensary.
And there are so many products! You can ingest them, vape them, rub them on your skin, smoke them … oh, sorry, you can’t smoke them. First you could, but now you can’t; Florida’s legislature wrote that restriction into the new law. But Gov. Ron DeSantis just announced that if the restriction isn’t lifted by March, he’ll drop the appeal preventing that from happening.
So the state law is still being hashed out, and meanwhile Floridians who are interested in trying medical marijuana—a potentially life-changing treatment—are asking lots of questions.
Like, is it really OK to use medical marijuana if federal law still prohibits it? What happens if I test positive for it at work? Can I use it and not get high? What’s the difference between medical marijuana and CBD? And why do I have to go to a dispensary for some CBD products, when I just saw a bunch of them at the gas station down the street?
Then there are the logistical questions, about time, cost and process. And, of course, there’s the most important question of all: Can medical marijuana help me?
With input from three local providers who offer medical marijuana referrals, we found some answers.
Who can use medical marijuana?
To get a medical marijuana card, you must be diagnosed with a qualifying medical condition by an M.D. who’s approved to
make medical marijuana referrals. Qualifying conditions include cancer, epilepsy, glaucoma, HIV/AIDS, post-traumatic stress disorder (PTSD), amyotrophic lateral sclerosis (ALS), Crohn’s disease, Parkinson’s disease, multiple sclerosis (MS); medical conditions similar or comparable to any of those conditions; chronic pain related to one of those conditions; or a terminal condition diagnosed by a physician other than the one making the medical marijuana referral.
What’s the process?
“If you try to figure it out on your own, it can seem complicated, but any doctor’s office that does these things can make it pretty simple,” says Kevin Hogan, D.C., owner of East Hill Medical Group.
Some practices, like East Hill, request that patients wanting a medical marijuana referral bring in medical records showing that they’ve been treated for a qualifying condition. Other practices will diagnose first-time patients before making a referral.
While the time spent on consultation and follow-up varies from one practice to another, the referring doctor generally talks with the patient about the various types of products and intake options (edible, topical, etc.), as well as the dispensary process, before uploading the referral—indicating dosage amount and often intake type—to the Florida Health Department Office of Medical Marijuana Use (OMMU).
Within minutes, the patient will receive an email from the state with instructions to submit a passport photo and $75. About 10 days later, the patient will receive email notification that he or she is registered in the state system and can purchase medical marijuana from a dispensary. An official medical marijuana card will be issued within a few weeks.
The card must be renewed via medical referral every seven months. During that time, the referring physician can issue certifications for three 70-day supplies of product.
How much does it cost?
There’s the cost of the doctor’s visit, the cost of the medical marijuana card and then the cost of the products themselves. Kim Hawkes, senior manager of government
and public relations at Surterra Wellness, a dispensary based in Tallahassee, says products cost between $25 and $150 each, depending on the delivery device.
Currently insurance doesn’t cover the office visit unless the referring physician is also the patient’s primary care doctor for the qualifying condition, and it’s a regular visit. Patients should check with the referring physician about this.
Felipe Muñoz, mindfulness and meditation coach for Empathic Practice, a Pensacola clinic that offers medical marijuana referrals, says the issue of insurance has been confusing for patients. He often has to explain that insurance doesn’t cover medical marijuana products because they’re still federally illegal.
Then again, many prescription medications are pricey even with insurance. If medical marijuana is a good or better substitute, with fewer side effects, it could be well worth the out-of-pocket expense.
Kent Beams, M.D., owner of Releaf Medical Marijuana Clinics, says that medical marijuana “is so often effective with pain management that many of our patients have decreased or completely stopped all of their prescription medications.”
What are the different types of marijuana products?
First of all, there are the various strains of marijuana, which are categorized into three main types that produce different effects. Indica strains, which help with pain and insomnia, promote deep relaxation. Sativa strains, which help with depression, anxiety, pain and low energy associated with ALS, tend to improve mood. The hybrid strains combine qualities of both.
Then there are the various delivery systems. The one Americans are most familiar with—smoking—is self-explanatory but currently illegal in Florida. The closest legal equivalent is vaping, where the marijuana is heated (but not ignited) to release the active ingredients, which are inhaled as vapor.
There are edibles, whose appearance is strictly regulated so children won’t be attracted to them (no cute shapes); capsules, for folks who like their drugs in pill form; and tinctures—basically concentrated drops you put under your tongue. And then there are topicals—marijuana-infused creams and lotions absorbed by the skin.
William Haas, M.D., owner and medical director of Empathic Practice, notes that different people respond to marijuana in different ways, depending on their physiology, so consultation and follow-up with the referring doctor is key to ensuring that the patient achieves the best results possible.
“Each person is unique, and their response to any product needs to be carefully observed and customized,” Haas says. “What works for your friend may be wrong for you.”
Will medical marijuana make me useless, dangerous, or illegal at work?
That’s a complicated question.
First, it’s important to note that medical marijuana is designed and intended to be used like a pharmaceutical drug—that is, responsibly and precisely, for a specific condition.
Second, different strains of marijuana have different effects on different people (see above). Some strains might make you sleepy, while others might actually serve as pick-me-ups. The best doctors will help you figure out what strain works best with your physiology and lifestyle. a technique called microdosing. Muñoz explains in our sidebar, below.
Fifth, as Hogan points out, some employers, especially those with ties to the federal government, might not consider medical marijuana a legal drug—card or no card. He advises concerned patients to check with their HR department.
Speaking of illegal, how does that work?
Florida and federal law contradict each other and it’s a weird dynamic, for sure. The OMMU’s website states it pretty clearly (if not grammatically correctly): “Medical marijuana is available in Florida, however, remains illegal under federal law.”
The fact is, since last fall’s election, 30 states and Washington, D.C., have legalized medical marijuana to some extent, and the federal government has shown little appetite for fighting what appears to be a losing battle in the court of public opinion.
At the state level, especially in Florida, the general attitude seems to be “Proceed with caution.” That is, develop strict protocols and regulate heavily.
There are bugs to be worked out in Florida, but so far, so good.
How does CBD fit into the picture?
This has been a little confusing, because there are two types of CBD. The kind you saw at the gas station down the street (and lots of other places) is legal everywhere in the country. It’s derived from hemp, so it contains only trace amounts of THC (the compound in marijuana responsible for its psychotropic effects). It won’t make you high.
Hemp-derived CBD has been marketed as something of a miracle drug, and while some people have reported that they’ve experienced the sort of health benefits medical marijuana provides, there’s no record of evidence that it is a reliably effective medical treatment. It’s also important to note that hemp-derived CBD products aren’t regulated by the U.S. Food and Drug Administration.
“These products suffer the same problems as any other herbal medication,” Muñoz says. “You’re buying something that might be mislabeled, that’s not strictly regulated … we just advise a lot of care where you purchase your product, whatever that is, and be cautious with the research behind it.”
CBD products sold through dispensaries, on the other hand, are FDA regulated. They are derived from marijuana, so they contain higher levels of THC, but they still won’t make you high.
“I recommend CBD products that are derived from marijuana only,” Beams says. “This is the most reliable source of CBD that is a good alternative to prescription and over-the-counter anti-inflammatory medications. The conditions for which patients seek medical marijuana often involve chronic conditions that are significantly helped with CBD.”
Wait, you didn’t answer my question!
We tried to hit the high spots—see what we did there?—but this is a complex topic. The OMMU has an exhaustive Q&A on its webpage (under FloridaHealth.gov). There’s more great info at EmpoweringWellness.org, from the nonprofit that’s helped steer the national debate on the issue by advocating for smart medical marijuana policies.
