The passage of Amendment 2 by an overwhelming margin in November changed Florida’s constitution to allow more people to use higher-strength medical marijuana as of Tuesday. But don’t expect to be able to ask your doctor for a weed prescription this week — or even this month.
The Florida Legislature and Department of Health still have to work out rules and regulations that will govern the state’s nascent medical marijuana industry.
Yet already, about 200 doctors in Florida are qualified to prescribe marijuana, and their patients — eager for a new antidote to their pains, nausea and other ailments — are asking questions.
“There are many patients with cancer, neurological disorders or serious digestive problems that are waiting with hope of using a natural product,” said Silvia Bentancor, an internist who has a private, cannabis-based practice at CBD Clinic in Southwest Miami-Dade.
Under a 2014 law that legalized a limited form of medical marijuana, patient don’t have access to medical marijuana until they’ve been seeing their doctor for at least three months. Bentancor, who is among those 200 doctors, said she’s already starting to see new patients who want to establish a relationship now.
Marijuana growers and dispensaries, like South Florida’s Modern Health Concepts, have also heard from a growing number of patients newly covered under the amendment.
“We get dozens of inquiries on a daily basis,” said CEO Richard Young.
He said his company is poised to meet demand, but without guidance from the Legislature, it’s unclear if doctors can begin prescribing marijuana to newly covered patients before all the rules are worked out.
“The notion that medical marijuana [amendment] becomes effective is a little anticlimactic,” said Ben Pollara, executive chairman of advocacy group Florida for Care. “It’s effective as a point of law. But before anybody can see access to medical marijuana under this new law, there needs to be rulemaking and regulations passed by the Legislature.”
That industry is already operating under law passed in 2014 that permitted the growth and use of low-strength cannabis for people with a very limited number of specific conditions — including cancer or a physical medical condition that causes chronic spasms and seizures.
Medical cannabis products, which have a larger dose of tetrahydrocannabinol (THC), the chemical that gives a user a “high,” are currently available only to patients who have been certified terminally ill by two doctors.
Now that Amendment 2 is in effect, the list of approved conditions for medical marijuana has expanded to:
▪ Post-traumatic stress disorder (PTSD)
▪ Amyotrophic lateral sclerosis (ALS or Lou Gehrig’s disease)
▪ Crohn’s disease
▪ Parkinson’s disease
▪ Multiple sclerosis
But as the law stands, the expanded group of patients have access to the same format of medicine as before — oils, tinctures and capsules. No existing Florida law allows smokeable marijuana for patients; Amendment 2 doesn’t specifically address smokeable marijuana, so it’s unclear if it will be allowed.
Bentancor and the other doctors who have undergone a $1,000 eight-hour training program with the Department of Health — a new annual requirement under Amendment 2 — will have to submit each qualifying patient’s treatment plan to the University of Florida for research purposes.
The rest of the regulations that will put the amendment into practice have yet to be written, but the Legislature and the Department of Health have hard deadlines for writing them.
The legislature must figure out how to issue and renew medical marijuana cards, the “adequate” amount of marijuana to prescribe and all the fine print on how treatment centers can and should operate — all before June. Then they have three months to start issuing licenses and ID cards. If not, the amendment gives citizens the right to sue.
A new wrinkle the legislature will have to work out is the qualifications and standards for caregivers, people over 21 years old who will dispense medical marijuana to qualified patients.
Apart from the regulatory issues, the Legislature and local governments will have to grapple with zoning issues surrounding the expected increase in dispensaries opening. Some cities, like Hialeah and Miami Beach, have temporarily banned the opening of dispensaries while they develop their own zoning rules for where dispensaries can operate.
Wherever it’s available, medical marijuana is projected to be big business in Florida. A recent study by marijuana industry analysts pegged the 2020 medical marijuana market at $1 billion. And with big banks leery of regulations on accepting money from drugs deemed illegal by the federal government, much of that business is done in cash.
Medical insurance companies do not cover medical marijuana, nor does Amendment 2 require them to. Patients, like those at Modern Health Concepts, pay out-of-pocket in cash for their marijuana.
Modern Health Concepts, through Costa Nursery Farms, is one of the state’s seven designated growers for medical marijuana.
Most of the company’s product is delivered to homes across South Florida, although a few patients visit the dispensary at its headquarters in Redland.
Inside the Modern Health Concepts lab, the flower of the marijuana plant is dried and tested for contaminants like mold and bacteria, as well as potency, before it’s turned into oil.
The oil product is tested again, mixed with coconut or safflower oil and packaged into capsules or bottled in liquid form. An independent lab located onsite tests the product again before it’s ready for market.
“We have to make sure bottle No. 1 is the same as bottle number 1,000,” said Young, the company’s CEO. “It’s a medicine. It has to be consistent.”
With growing patient interest and businesses ready to roll, state lawmakers and health officials will in the coming months need to hash out the details of how to make Amendment 2 a reality.
“We’re in this, like funky gray period right now where you’ve got medical marijuana in the state constitution but with no regulation,” said Pollara of Florida for Care.