The cannabis boom is under way in Florida, and government is struggling to keep up.
Thousands of new patients have sought access to medical marijuana this summer following the passage of a new law expanding the list of maladies that qualify for treatment. Since June 7, the number of patients certified over the entire first three years of Florida’s fledgling cannabis program has nearly doubled from 16,760 to more than 31,000.
But patients are finding it’s one thing to receive a doctor’s certification, and another to receive the state-issued identification card needed to legally place an order. Doctors seeking state-required training through a new course that has yet to be offered are equally frustrated, leading to a growing feeling that the Florida Office of Medical Marijuana Use and its 12 employees — nine of whom are part-time — are simply overwhelmed.
“I’m not sure the state was prepared,” said Pete Sessa, chief operating officer of the advocacy-minded Florida Cannabis Coalition.
Right now, the average patient — who might suffer from cancer, HIV, Parkinson’s or other serious illnesses — waits 30 days after applying to receive a medical marijuana card. And that’s if everything goes according to plan.
Patients on Facebook message groups and frustrated doctors tell stories about unexplained delays, applications rejected on technicalities related to photos, and paperwork lost in the mail. Cory Young, a cancer survivor and former paramedic from the Florida Keys who suffers from neuropathy and post-traumatic stress disorder, said he waited on hold for hours over five frustrating weeks trying to find out what happened to his application and $75 money order.
At one point, he was told his application was incomplete because his physician began the process online and Young finished it by sending documents and payment in the mail. Last week, though, Young said he learned from an email that his card was being printed.
“Their system is absolutely broken,” he said.
The pace may be frustrating, but patients are slowly receiving their cards. As of Aug. 6, the state had awarded 12,226, according to a spokeswoman. And, even if patients have to wait a month, that’s still an improvement on the 90-day waiting period for new patients required by law as recently as June.
Still, physicians and patients say it’s unnecessary.
“I think it’s crazy that patients still are waiting four weeks to get their card. That’s ridiculous. And most of the time, they’re getting their card [applications] returned,” said Michelle Weiner, a South Florida Interventional Pain Management Physician qualified to issue marijuana recommendations. “I have cancer patients who are still suffering.”
by David Smiley
Florida cities and counties are in a dilemma about pot.
State lawmakers approved regulations in June that left city and county officials with a Hobson's choice about the sale of medical marijuana in their communities.
Local governments can either impose outright bans on medical-marijuana dispensaries or allow unlimited numbers of marijuana retail outlets, under an “all or nothing” approach approved during a special legislative session.
Dozens of cities have approved or are considering temporary moratoriums on medical- marijuana dispensaries, but it's unknown exactly how many local governments have acted on the issue, because nobody —- including state health officials —- is officially keeping track.
Marijuana operators' search for retail space has bloomed after voters overwhelmingly approved a constitutional amendment in November that legalized marijuana for a broad swath of patients with debilitating medical conditions.
The scramble for retail outlets is expected to intensify as the number of marijuana operators continues to increase, and as local governments seek ways to restrain the sales of cannabis in their communities, at least for now.
As another result of the legislation approved during the June special session, state health officials recently authorized five new medical marijuana operations, on top of the seven businesses already active in the state. Five more are supposed to come online in October.
Nearly 72 percent of voters approved the constitutional amendment last fall, making it difficult for local officials to close the door completely on the sale of medical cannabis.
But while saying they respect the will of voters, many local officials also want the power to regulate the number of dispensaries, and where the businesses can be sited, something that's essentially off the table in the new state law, which requires local governments to treat medical marijuana distribution centers in the same way pharmacies are handled.
Most cities and counties don't have special regulations regarding pharmacies, but instead treat them like other retail, or “light commercial,” businesses.
While some communities contemplate new zoning rules for pharmacies, a move that also could curb the development of marijuana dispensaries, others are focused on the cannabis retail outlets.
For example, St. Augustine Beach commissioners last week approved a moratorium barring medical-marijuana dispensaries from opening in the waterfront community.
“I think the main reason was just wanting to see how the situation is going to shake out and what sort of problems might occur with the sales of this stuff. There was no particular anxiety over it, but I think it's a fear of the unknown,” said Jim Wilson, a lawyer who represents the city. “We're a small community, and we'd rather see how this works elsewhere before we connect into it. It may work out fine later on.”
But Sen. Rob Bradley, who has been a key player in the creation and passage of the state's medical-marijuana laws the past three years, said the new regulations were meant to encourage competition in the state's burgeoning marijuana industry.
“I would encourage our local partners to see the bigger picture here. We are bringing online several new licenses over the next year-and-a-half. It's important for the long-term future of the medical marijuana industry that we have real competition among not only the incumbents but the new license holders,” Bradley, a Fleming Island Republican and former prosecutor, said in a recent interview. “If local governments were allowed at this point in time to restrict in their communities the number of dispensaries to only one or two or three, that would provide an unacceptable advantage to the incumbents.”
Regarding local officials' fears about what are disparagingly known as “pot shops,” Bradley said he thinks they may be uninformed.
“When I see some of the comments from local officials, I'm not sure that they've read the details of the law. We have strict limitations on advertising and signage, and all of these dispensaries are required to have a doctor's office feel,” he said.
The new restrictions imposed by the Legislature, paired with a push by marijuana operators to open retail facilities, create “an awkward situation for a lot of cities,” said John Wayne Smith, a lobbyist who represents numerous cities and counties as well as the Florida League of Cities and the Florida Association of Counties.
While local governments are largely focused on budget issues during the summer, they may turn their attention to medical marijuana later in the year, Smith predicted.
Others may wait for the Legislature to revamp the state law.
“I would say that it's probably half-baked and this is probably an issue that is going to evolve and get tweaked over the next five to 10 years,” Smith said.
But the passage of the state-imposed prohibition on local governments' ability to limit the number of retail outlets poses a problem for cities like Lake Worth, which authorized two medical marijuana dispensaries before approving a moratorium aimed at preventing others from opening.
It's unclear, however, whether the new state law will require the city to open its doors to more dispensaries, an issue on which municipal lawyers are divided.
By doing a nothing or all, and because we already have two, this is what you've done to my city. Everyone around me has a moratorium, but you've now told my city it's a free-for-all,” Lake Worth City Commissioner Andy Amoroso told The News Service of Florida.
Amoroso stressed that he supports legalization of recreational marijuana and endorses the use of medical marijuana for sick patients. But he also emphasized that the state law “jeopardizes what our cities look like.”
Lake Worth is surrounded by other communities that have banned the sales of medical marijuana, meaning that retailers will likely target his city, Amoroso maintained.
Lake Worth officials need “to be able to control” what their 7-square-mile city “looks like,” Amoroso said.
“If I have medical marijuana on every corner, I can't do that,” he said.
But Orlando city attorney Kyle Shephard said he believes a moratorium recently passed by his commission will allow the city to stop any more medical-marijuana retail shops from opening.
“Every city attorney may answer this differently, depending on their own local situation,” Shepard told the News Service.
Orlando adopted its ordinance allowing up to seven medical marijuana dispensaries before the state law (SB 8-A) was passed, Shepard said. The city believes that means its ordinance won't be affected by the new law.
“If you didn't get your rules on the books before SB 8 went into effect at the end of June, then you are sort of hamstrung,” Shepard said.
Orange Park council members recently advanced an ordinance that would prohibit pharmacies from opening in “light” commercial areas —- something that wouldn't affect any of the drug stores currently in operation, according to Mayor Scott Land.
The town council approved the new regulation in response to the state law, which the mayor called “an all or nothing, almost.”
“So instead of doing the all, a lot of people are going to probably choose the nothing,” he said. “I think it's going to make it difficult for the dispensaries.”
by Dara Kam
Hundreds of doctors in Florida are now certified to recommend medical marijuana for patients, and one of the biggest concentrations is in South Florida.
Palm Beach County ranks sixth of Florida’s 67 counties for the number of qualified doctors per resident. Miami-Dade County is ninth and Broward 15th.
More than 100 doctors signed on in the three weeks between June 16, and Aug. 4, according to the Florida Department of Health.
The increase comes as the state moves forward to implement a constitutional amendment approved by voters that allows marijuana use for certain ailments.
Still, patients in some parts of the state have no access and insurance doesn’t cover marijuana, so poorer patients could be priced out of the market.
Among recent changes:
- State lawmakers eliminated the 90-waiting period to get medical marijuana.
- There are now 957 doctors in Florida qualified to recommend medical marijuana, with 357 of them in South Florida.
- On a per capita basis, Monroe County has the most doctors who can recommend medical marijuana, with one for every 8,208 residents in the county, state numbers show. Miami-Dade, Broward and Palm Beach counties all finish in the top 15 counties.
- Of Florida’s 30 largest cities, Boca Raton has the state’s highest per capita number of doctors credentialed to make the recommendations: one for every 4,005 residents.
- Most counties in the Panhandle have no doctors who have taken and passed the required $500, two-hour medical marijuana course. A four-county area in south central Florida — including Hardee, De Soto, Glades and Hendry counties — is in the same situation.
Doctors “recommend” marijuana rather than “prescribe” it, because it is a controlled substance. For that reason, many doctors have not signed up for fear of losing their federal licenses. And since pharmacies can’t carry it, there are dispensaries to distribute it.
How to get medical marijuana
Patients must have a qualifying ailment to receive marijuana. Those include cancer, epilepsy, glaucoma, HIV/AIDS, PTSD, ALS, Crohn's disease, Parkinson's disease, multiple sclerosis, or “other debilitating medical conditions of the same kind or class,” per the amendment’s language.
To find a local doctor, check this list. You can also go to Floridahealth.gov or call the Florida Department of Health’s Office of Medical Marijuana Use at 850-245-4657.
Once approved, the patient is entered into the state’s medical marijuana registry and then must apply for a medical marijuana card. According to Florida Department of Health spokesperson Mara Gambineri, that can take a month.
Patients can receive a 70-day supply at a time. After that, they must get a new recommendation, which can be phoned in. After 30 weeks, patients must once again see their doctor in person.
Insurance cannot cover any part of the process.
A typical in-person visit costs about $250. Patients also pay a $75 fee for their medical marijuana card. And then there’s the cost of buying the marijuana, which ranges from about $100 to $200 for a 70-day supply.
“It’s pricey for the patients,” said Dr. Bruce Stratt, who treats about 50 medical marijuana patients at his Boca Raton clinic. “And the people I’m seeing are sick people. They need their medicine.”
He has used the law’s “other debilitating medical conditions” provision to prescribe marijuana for auto-immune diseases similar to Crohn’s, severe arthritis and chronic pain from nervous system damage.
After an initial consultation, Stratt places a patient on the state’s medical marijuana registry and walks the patient through the application to get a medical marijuana card. His office manager even takes their photo, as the Department of Health has photo requirements similar to those of a passport.
Patients face a wait period of about 30 days as their application is processed.
“We have seen a significant and steady increase in the volume of card applications since Amendment 2 went into effect,” said Gambineri, the Health Department spokesperson.
The number of licensed growers has increased from seven under an old, less-expansive medical marijuana law passed in 2014 to 12 in August, with five more to be added in October.
Those in-state growers will have to supply all of the medical marijuana for Florida’s patients — it would violate federal law to transport the product across state lines.
But the growers agree they have enough capacity to supply patients.
Top 15 counties for medical marijuana doctors
- Monroe: one per 8,208 residents
- Martin: one per 8,676 residents
- Indian River: one per 10,684 residents
- Pinellas: one per 10,921 residents
- Hernando: one per 12,364 residents
- Palm Beach: one per 14,055 residents
- Sarasota: one per 14,165 residents
- Jefferson: one per 14,658 residents
- Miami-Dade: one per 16,237 residents
- Hillsborough: one per 16,254 residents
- St. Lucie: one per 16,493 residents
- Citrus: one per 17,504 residents
- Okaloosa: one per 18,348 residents
- St. Johns: one per 19,582 residents
- Broward: one per 20,002 residents
By Daniel Sweeney
TALLAHASSEE — Orlando attorney John Morgan sued the state Thursday, saying a new law that bans smoking medical marijuana violates the constitutional amendment that he fought to get approved.
“Today is a day that should not have been necessary, other than the Florida Legislature decided not to do their job,” Morgan said.
A law signed by Gov. Rick Scott that took effect Saturday sets up rules surrounding the medical marijuana industry, which was legalized through a constitutional amendment that Morgan helped put on the ballot and was approved by voters last November.
Morgan contends that because the ballot amendment says that smoking medical marijuana in public could be banned, it should be assumed that smoking it in private would be legal.
“It doesn’t take a genius to figure out that if smoking is not allowed in public, it must certainly be allowed in private,” Morgan said. “That’s the intent. That’s what we said before we started.”
A spokeswoman for the Florida Department of Health, the state agency overseeing the new rules, said they have not received the lawsuit yet but will review it.
The lawsuit, filed in Leon Circuit Court, seeks a declaration from the court that smoking medical marijuana is legal.
House Majority Leader Ray Rodrigues, an Estero Republican who sponsored the legislation and insisted on the smoking ban, defended lawmakers’ actions, saying he was certain courts would uphold the law.
Rodrigues said other states that permit smoking of medical marijuana made it clear in the proposals that went before their voters.
“If you look at those other states, their constitutional amendments declared that it could be smoked and that it could be self-grown. If that’s what John Morgan wanted for Florida, he should have declared it in the amendment,” Rodrigues said.
Morgan, though, said he believes lawmakers trying to clamp down against the will of the voters will instead spark a move toward fully legalized recreational use of marijuana, and he’s ready to lead the charge.
“If they [expletive] me off too much, I’ll address the smoking issue by having a constitutional amendment legalizing marijuana,” he said. “If I lose in court, I’ll go through all the marijuana people I know — it won’t take a lot of money — and we will move to legalize the recreational use of marijuana. Then they’ll really be sorry they pushed me.”
The medical marijuana amendment passed with 71 percent of the vote last November. It legalizes medical marijuana for patients with cancer, epilepsy, glaucoma, HIV, AIDS, post-traumatic stress disorder, amyotrophic lateral sclerosis, Crohn’s disease, Parkinson's disease, multiple sclerosis or other debilitating medical conditions.
Morgan tried and failed to pass a medical marijuana ballot measure in 2014. In total, Morgan raised $14.3 million, including $6.8 million of his own money, to advocate for the amendment over the past four years.
The law passed by the Legislature has disappointed supporters of the amendment, who say it puts too many regulations on the new industry. The law limits the number of licenses to grow marijuana to 17, with each license holder allowed a maximum of 25 dispensaries.
Meanwhile, some local governments, including Winter Park and Maitland, have threatened to block dispensaries from setting up shop in their cities. Orlando may cap its dispensaries at two.
But it is the smoking ban that spurred Morgan to file suit. The law only allows for cannabis products to be vaped, sold as oils and as edibles.
In his suit, Morgan cites a 2012 study published in the Journal of the American Medical Association that shows “marijuana smoking was shown to not impair lung function, based on the doses inhaled by the majority of users, as compared to non-smokers and tobacco smokers. In fact, marijuana smoking was shown to increase lung capacity.”
In any case, people with life-threatening diseases aren’t worried about the potential negative effects of smoking in the future, Morgan said.
“Do we give a rat’s ass if a person died from ALS smokes instead of vapes? I don’t,” Morgan said.
Smart Approaches to Marijuana, a Washington, D.C., group that advocates for decreased use of marijuana, disputes this and pointed to statements from the American Medical Association, the American Cancer Society and other health groups expressing skepticism about the effectiveness of medical marijuana.
“Patients suffering from debilitating chronic illness deserve access to the very best modern medicine has to offer to alleviate their pain — not spurious solutions offered by modern day snake oil salesmen,” said Dr. Kevin Sabet, president of SAM.
by Gray Rohrer
TALLAHASSEE - Gov. Rick Scott on Friday signed into law a broader medical marijuana system for the state, following through on a promise he made earlier this month.
Lawmakers passed the measure (SB 8A) in a special session after failing in their regular session that ended in May to implement a constitutional amendment legalizing the drug, which was supported by 71 percent of voters last year.
Under the constitutional amendment, patients with a host of conditions can buy and use medical marijuana. Among the conditions that qualify for the drug: cancer, HIV/AIDS, glaucoma and epilepsy.
The new law also sets in motion a plan to license 10 new companies as growers by October, bringing the statewide total to 17.
It allows patients to use cannabis pills, oils, edibles and “vape” pens with a doctor’s approval, but bans smoking.
Lawsuits are likely to follow. John Morgan, the Orlando trial lawyer who bankrolled the constitutional amendment’s campaign, has promised to sue over the smoking ban, and Tampa strip club magnate Joe Redner said he will file a suit because people cannot grow their own plants.
“Great Scott,” Morgan said Friday after hearing that Scott signed the bill. “It’s a no-brainer. Gov. Scott wants to run for U.S. Senate. If he didn’t sign this bill, he couldn’t run for dog catcher.
“It’s not perfect. I’m going to sue for the smoking but I know there are sick people who will see relief starting in July.’’
The marijuana law was among 38 bills Scott signed Friday afternoon.
He also approved a measure (HB 441) that will give court clerks added protection in public record cases.
Current law does not specify whether clerks can be sued for handing out information that is supposed to be protected from public disclosure if the lawyers who filed documents with that information did not mark it as confidential. Now, they will have that protection.
And a bill (HB 689) to let anyone with a beer and wine license sell sake beginning July 1 was signed into law as well.
by Michael Auslen
For a moment on Friday, as Florida leaders announced plans for this week's special legislative session, it was believed medical marijuana would be added to the list of contentious issues on tap for resolution.
After all, if cooler heads could compromise on the year's biggest fight — money for economic development under Enterprise Florida — surely they could agree on the rules that will guide the growth of Florida's budding medical marijuana industry.
Unfortunately, it didn't happen.
Rather, the Florida House and Senate remain deadlocked over how to regulate what's expected to become the nation's largest medical marijuana marketplace.
It shouldn't be so difficult to implement the will of 71 percent of Florida voters, who last November approved a state constitutional amendment that legalizes the use of medical marijuana by people with debilitating conditions. The amendment says the implementing rules must be written by July 3. If lawmakers fail to do their job, the state Department of Health will take over. And history says we don't want that.
To be clear, medical marijuana needs government regulation, despite the bad name given government regulations. This is a medicine, after all. It is either ingested or inhaled. It affects behavior and body chemistry. It is more like alcohol and tobacco than retail consumer goods, and should be regulated as such. On this, everyone agrees.
But as always, the devil is in the details.
Here's our take on the differences, and how to bridge the divide:
Caps on dispensaries: Seven companies currently hold licenses to cultivate, distribute and dispense medical marijuana in Florida. They were chosen a couple years back after lawmakers legalized a non-euphoric strain of marijuana, called Charlotte's Web.
The state health department wrote the implementing rules and gave the licenses to five nurseries — one in each of five regions of Florida. To be considered, a nursery had to have been in business for 30 years and have an inventory of 400,000 plants. Later, two other licenses were awarded to companies that successfully challenged the process. A recent court ruling might mean two more companies get licensed, too.
Incredibly, these licenses aren't limited to cultivating marijuana, a new product for growers who previously specialized in trees, shrubs and house plants. Rather, they give these nurseries exclusive control of the supply chain — from "seed to store" — no matter their lack of experience in manufacturing, prescribing or dispensing drugs.
The winning nurseries quickly teamed up with companies that filled in the gaps. Still, the health department's monopolistic rules created the foundation for today's standoff.
When the legislative session ended on May 8, the House — under Speaker Richard Corcoran — wanted to award another 10 licenses by next July and cap at 100 the number of dispensaries a company could open around the state.
The Senate — under President Joe Negron — also wanted another 10 licenses awarded, but by October, reducing the head-start of the first seven companies, which are busy scooping up investors and securing prime storefront locations. More importantly, the Senate wanted to cap at 15 the number of dispensaries each company could own.
"The House version, with the caps and the timing of new licenses, would give a gigantic advantage to the existing license-holders," says Ben Pollara, who along with Orlando trial attorney John Morgan, led the constitutional amendment drive. By capping a company's retail outlets and giving more companies access to the marketplace, he believes the Senate took the more free-market approach, a value trumpeted by the Republicans who control Tallahassee.
Morgan holds the opposite view. "To me, Negron is the problem. He's the most un-free-market Republican I have ever met. … It's like telling Walgreens you can have five stores in Florida. There's how many counties in Florida? 67?"
Morgan agrees the House proposal "would keep monopolies. It would. But do we care about that? There would be 17 to begin with and other licenses would come with demand. Isn't 17 better than seven?"
Negotiations fell apart on the session's last day after the Senate proposed capping dispensaries at 15, up from 10, but far beyond its starting point of three, then five. The House countered with 50, down from 100. When the counteroffer was quickly rejected, the House amended its bill back to 100. And that was that.
Absent the legalization of recreational marijuana, no one expects today's patient pool — estimated at about 500,000 — will support 17 license-holders with 100 stores. And in the 27 states that have legalized medical or recreational marijuana, no company has more than 25 outlets.
But money-wise, the cap means a great deal to the value of these nursery conglomerates. The Miami Herald recently discovered one company's pitch to investors. It said it expects to gross $138 million in sales by 2021— based on the premise of opening 55 retail outlets. The brochure also said Florida's medical marijuana marketplace is forecast to generate $2 billion a year.
We don't know where the cap should be set, though somewhere around 25 sounds like middle ground — not a free market, but not a closed monopoly, either.
We also agree that 17 is better than seven, and awarding these licenses sooner than later would better allow more companies to compete on product, price and service, which best serves patients.
A few other issues:
Franchises: Both chambers would preserve the "vertical integration" that gives nursery conglomerates control of the supply chain from seed to store. However, the Senate would let these companies subcontract or franchise opportunities. The House would ban subcontracting for any part of the business that touches marijuana, leaving only things like janitorial, security and professional services.
Morgan suggests franchises are the future and companies will make their real money by selling product to them. At issue is who would approve potential franchisees — the company or the state? This doesn't seem an insurmountable obstacle. If franchises help mom-and-pops open businesses and grow jobs, unshackle the chains.
No Smoking: Both the House and Senate would ban people from smoking medical marijuana, a position sure to draw a lawsuit from Morgan. Given that the constitutional amendment says smoking medical marijuana in public places doesn't have to be accommodated, voters clearly anticipated that patients would be able to smoke medical marijuana. Plus, cancer patients have reported greater relief from smoking marijuana than the pill derivative. Lawmakers should avoid committing taxpayers to a lawsuit they're sure to lose. Kill the "no smoking" provision. Let doctors decide the best administration method.
90-day rule: The House proposed making patients wait 90 days before they could get treatment. It's an arbitrary timeframe with no business in law. Again, let doctors decide how best to treat their patients.
Debilitating conditions, including pain: The amendment says doctors may prescribe medical marijuana for patients with debilitating conditions, including cancer, epilepsy, glaucoma, HIV, AIDS, post-traumatic stress disorder, amyotrophic lateral sclerosis, Crohn's disease, Parkinson's disease, multiple sclerosis and "other debilitating medical conditions of the same kind or class."
That last clause is the door-opener. The House proposed that to treat any patient with an unlisted condition, doctors must submit a great deal of justification to the Florida Board of Medicine, a step too far.
However, the House would allow doctors to prescribe medical marijuana for chronic pain. The Senate would not. Rather, the upper chamber said pain must be tied to one of the listed conditions.
Experience elsewhere suggests medical marijuana could help curb the opioid epidemic, which is largely fueled by people taking prescription or illicit drugs for chronic pain. More research is clearly needed. Again, in the interim, lawmakers should trust doctors to do what's best.
Will some doctors violate standards and will some patients misrepresent their conditions? Yes, they will. But by allowing doctors to prescribe medical marijuana for chronic pain, researchers will get a better handle on whether it works. And if it doesn't, changes can be made.
Research: Both chambers want Florida to be a leader in data, analysis and research on medical marijuana. As in other states, patient names will be entered into a registry accessible only to doctors, dispensaries and law enforcement. The research that comes from this registry should help policymakers better understand the landscape and whether changes are needed.
In the final analysis, the two chambers aren't light years apart.
Rather than let bureaucrats write more flawed rules, legislative leaders should commit this week to passing a law that provides proper direction to Florida's new medical marijuana industry.
Award the 10 new licenses this fall. Meet in the lower middle on dispensary caps, maybe 25. And implement the will of the people, who seem to have gotten lost in the debate.
Editorials are the opinion of the Sun Sentinel Editorial Board and written by one of its members or a designee. The Editorial Board consists of Editorial Page Editor Rosemary O’Hara, Andrew Abramson, Elana Simms, Gary Stein and Editor-in-Chief Howard Saltz.
Medical marijuana implementing legislation died on Friday in Tallahassee. The House and Senate couldn't come to a reasonable negotiation on the last day of session. As a result, implementation will have to operate under rules soon to be finalized by the Department of Health—at least until lawsuits are filed and the courts rule on behalf of patients.
When we wrote Amendment 2, we were all very aware that the legislature—which deliberately ignored the needs of patients year after year—would not immediately do an about face and live up to the access now codified in the constitution. We knew that this was likely to go to court at some point. It felt like a given.
However, when we won with 71% of the vote, I think there was great (and perhaps naive) optimism that they would see the light, and make some kind of good faith effort to comply with the overwhelmingly strong wishes of the electorate. There were a number of legislators that did just that and pushed very hard on patients' behalf.
The initial bill out of the House was horrendous. Partially drafted by Mel Sembler and Drug Free America, it was severely restrictive and not only banned smokable, edible, and vapable forms of marijuana, but it also added onerous restrictions on patients, such as a 90-day waiting period and recertification period. It limited treatment to the very specific, enumerated diseases in the constitution, and required insanely detailed justifications from doctors to issue certifications for non-enumerated conditions. It also reinforced the cartel system of marijuana businesses, giving a few big corporate special interests control of the entire market. I believe strongly that this cartel system will ultimately harm patient access through high prices, a lack of diverse products, and no true competition.
The Florida House took a position that maintained and strengthened the cartel-system by allowing them to open unlimited store fronts around the state. The Senate took a position to restrict the number retail facilities a single MMTC (Medical Marijuana Treatment Center) could operate, so that a more diverse, freer market could emerge to serve patients. I advocated strongly for the Senate position, believing—as I still do—that it would result in better access for patients.
Naturally, the cartels didn’t like that and this one industry-oriented detail set off a very intense lobbying battle on both sides.
My mission was to push for—and pass—the best bill we could get. We were one of a number of players engaged on implementation, and unfortunately, this push for greater competition became an intractable sticking point between the House and the Senate, wrapped up in the in-fighting that occurred between the chambers all session.
Our mission—to pass a bill that would guarantee at least some kind of reasonable patient access—failed. For that I am truly sorry to all of you.
John Morgan is livid over this and blames me entirely for the failure to pass legislation this session. I accept that I deserve some of that blame.
However, the choices we faced were "bad", "worse" and "the worst” (which is what happened).
Both bills banned smoking marijuana. Both placed onerous restrictions on the doctor-patient relationship. Both contained numerous new criminal penalties for patients and caregivers. Both would have resulted in litigation.
For nearly five years, I have been an advocate for patient access in Florida. I believed that these details would ultimately matter to patients, and that I was representing their interests.
Those interests tended to align with businesses that wanted entry into the Florida market, and were kept from doing so by an incredibly flawed and politically influenced licensee bidding process three years ago; a process that resulted from the legislature passing a low-THC medical marijuana law in 2014, at least in part in an attempt to thwart the campaign to pass Amendment 2 that year. It is no secret that individuals and businesses in the marijuana industry contributed to both United for Care and Florida for Care.
Florida for Care always advocated for a free market that allowed businesses to grow, because that means better patient access. Period.
I am deeply saddened, not just by the failure in Tallahassee, but about how John views what happened and why.
I love and respect John, without whom we would have never passed Amendment 2. We’ve had very heated arguments in private over policy and strategy in the past, but in the end we recovered and kept our eyes on the goal.
Here’s the thing: Though I’m devastated by his anger, I understand it. He’s a passionate guy, and if he wasn’t, we wouldn’t be this far. If our relationship never heals, it will not erase the many years of fighting together on an incredibly important cause. I have a deep respect and affection for John Morgan and I wish him well. Whether he believes it or not, our interests are largely still the same.
In the meantime, we now have a new mission.
This isn't over.
DOH has implementing authority and Florida for Care will continue to push for the two principles which we advocated for throughout the legislative session:
1. Respect for the doctor-patient relationship as written in the Florida Constitution.
2. An expanded, free market for medical marijuana in Florida, that provides affordable, diverse, patient access through competition.
I will continue to fight for those principles until the will of 71% of Floridians is finally realized in this state.
Florida for Care will continue to fight.
We will be sending more updates soon as to where we go next, but I promise you we aren't going away.
We can’t go away. We have to follow this through.
Once again, I'm sorry to all those who I let down. And I want to—from the bottom of my heart, and on behalf of everyone at Florida for Care—thank you for everything you've done and continue to do to advance this cause.
With love and sorrow,
Florida for Care
Saint Peters Blog: New wrinkles in Florida’s medical marijuana implementation raise doubts, concerns
I’ve not been shy about expressing my concerns about the implementation of Amendment 2, many of which stem from the fact that I’m the father of a young daughter. From that perspective, it’s imperative to me that Florida exercises necessary prudence and caution while putting in place the mandate from voters on medical marijuana.
I’m not ashamed to say: “Surely, not in my backyard!”
Call me NIMBY. Call me old fashioned. Just don’t call me Shirley.
The existing seven licenses to grow marijuana in Florida have, for the most part, taken a similar stance as I have on a responsible roll out of the new law. They have good reason to do so: a cautious, slowly phased-in, expansion of medical marijuana in Florida is good for their bottom lines.
That may seem greedy or cynical to some, but I don’t think it is. The intersection of philosophy and self-interest tends to be a strong impetus for the creation of public policy, and that’s a good thing.
But self-interest being self-interest you also can’t expect that intersection to remain static on a big piece of public policy, with big dollars at stake, like medical marijuana.
Certain recent events have given me a reason to take a step back on some of these issues and evaluate the philosophical honesty of the approach of Florida’s current Dispensing Organizations, soon to be reregistered as MMTCs under Amendment 2.
Let me start by saying that I accept the basic premise put forward by these DO’s and legislators that they’ve built businesses by a foregone conclusion that our nascent medical marijuana system would expand dramatically – either under Amendment 2’s passage or legislative action. And they have done so at significant expense, without much in the way of return, thus far.
Now, that investment alone doesn’t necessarily justify a policy of abject protectionism in implementing the constitution, but again, as it intersects with the notion of caution and public safety, the case gets stronger to do so.
Except for some new wrinkles.
This week, Canadian mega-marijuana corporation, Aphria Inc., announced a deal to essentially buy CHT Medical outright, one of the seven licensed DOs. They’re doing so with $25 million cash, while launching a $35 million raise, valuing the company at $177 million (!!!). CHT only began selling low-THC marijuana to patients in January, mind you.
As I outlined in my last piece on this subject, there was an intense and rigorous application process to select those current license holders. Particularly in the case of CHT’s apparent wholesale unloading of their license to Aphria, would essentially circumvent that entire vetting process. These investors could be great news for Florida, we just don’t know, since they didn’t go through the process like everyone else.
Second, it strikes me as a tad intellectually inconsistent to argue for sympathy over their investment in the Florida market in one breath, while raising big foreign investment dollars in the next. (And CHT isn’t alone in its fundraising, just the most public. As the Miami Herald has reported, almost all of the licensees are currently raising capital from investors.)
Finally, let’s think about the pitch these companies naturally would have to make to secure these sorts of massive capital infusions. Legal marijuana is big business, to be sure, but it’s also an industry in its infancy that is handcuffed in many ways by the glaring conflicts between state laws and federal law, where marijuana remains a DEA Schedule 1 substance. That’s why you still don’t see traditional money players like Goldman and Citi and their ilk playing in this space.
So why the big investments and insane valuations? The answer lies more in the licenses granted by Florida, and less in the P&Ls of the companies in question.
Under current law, after having gone through the rigorous application process, posting a $5 million bond, building growing, processing and retail facilities, and receiving DOH approvals to cultivate and then distribute medical marijuana, licensees can pretty much do whatever they want.
Most states with some form of legal marijuana require separate applications and licenses for each individual business operation. A grow has its own license, retail dispensaries are individually licensed, etc. Other states with vertical integration, like Florida, allow multiple operations under a single license. In those states, the maximum number of retail facilities that can be operated under a license is limited to 3 or less (except for New York, which allows 4).
In Florida? There is no limit.
That’s right, folks.
What the press corps and I have likewise been derelict in reporting on, is that our present cohort of marijuana growers in Florida can open unlimited retail facilities – “pot shops” in the parlance of this issue – across the state. And that’s precisely what they are planning to do with all of this new capital they are raising by the truckload.
A pot shop on every corner? Without action to fix this glaring loophole (heh), that’s where we’re headed.
Not in my backyard.
By Peter Schorsch
After voters overwhelmingly approved expanding medical marijuana in Florida, lawmakers should be smoothing the way for a statewide market to get established. Instead, proposed legislation would strangle growth and access by inserting bureaucrats into medical decisions, hindering competition in the industry and needlessly monitoring doctors and patients. It's a stubborn and suspicious approach that insults the will of voters, and it should be scrapped in favor of legislation that makes medical cannabis a truly accessible option.
The bill, HB 1397, by House Majority Leader Ray Rodrigues, R-Fort Myers, outlines rules for implementing Amendment 2, which expands the limited medical uses of pot allowed in Florida. But instead of letting doctors determine when patients are candidates for medical marijuana, the bill defines a limited number of qualifying conditions, including cancer or multiple sclerosis. And it does not make eligible patients suffering from chronic pain — such as from a car accident, surgery or condition like arthritis. Instead of letting doctors alone make treatment and dosage decisions, the bill puts a 90-day limit on the supply a patient can obtain and prohibits numerous forms of cannabis, including vaporizers and smokable and edible products except for terminally ill patients. It also forces patients to wait three months after registering with the state before they can obtain marijuana, a cruel and unnecessary restriction.
The House bill lays bare how disconnected legislators are from the 71 percent of voters who approved the amendment in November. It keeps in place the monopoly on suppliers and authorizes more only when the patient registry reaches 150,000. It preserves an existing requirement that suppliers be equipped to service the entire supply chain from seed to sale, which stymies competition and growth. A bill moving through the Senate, SB 406 sponsored by Sen. Rob Bradley, R-Fleming Island, allows more new licenses to be granted faster but also keeps vertical integration in place. The free-market enthusiasts in Tallahassee seem to have abandoned that ideal when it comes to an industry they aren't keen to see grow.
The legislation contains numerous other barriers and oversight provisions, suggesting that legislators are more worried about recreational users getting their hands on marijuana than ensuring that suffering patients have reasonable access. But the Department of Health is not a law enforcement agency, and implementing Amendment 2 should not be an exercise in how little the law can allow. Doctors and patients should not be subject to nanny state-style rules that don't apply in other medical decisions.
Florida should not turn into California when it comes to the availability of marijuana. But voters delivered a mandate that they want reasonable access to this long-stigmatized drug for limited medical purposes. Legislation implementing Amendment 2 should allow chronic pain sufferers to use the drug, leave treatment decisions to doctors, abandon unnecessary oversight and get out of the way of a competitive, thriving market.
The devastation of the opiate epidemic cannot be understated, nor can the urgency of doing something — anything — to alleviate its effects.
Gov. Scott and Attorney General Pam Bondi understand the gravity of this crisis, working with law enforcement, the Legislature and other stakeholders to attack the insidious threat to public health and safety from multiple fronts.
Freshman Rep. Nick Duran gets it as well, filing a bill to modernize our prescription drug monitoring program to stave off abuses. Duran’s comprehension of this issue is sadly borne from the tragic death of his brother-in-law, David.
David was a friend of mine, too. He ran the statewide grassroots campaign for the 2014 medical marijuana initiative, and managed efforts to collect thousands of petitions to put medical marijuana back on the ballot in 2016. He had been clean and sober for years when he relapsed last year. Fentanyl took his life.
Opiate overdose deaths rose by 72.2 percent from 2014 to 2015, the most recent two years for which data is available. There is no one who believes that 2016 — the year David died — will be any improvement.
Addiction is a disease, like cancer, or AIDS, or influenza. It cannot be eliminated wholesale, but we can and must take steps to obviate its human impacts.
This sorrowful state of affairs begs the question of why the Legislature — and Gov. Scott — are not acting more swiftly and forcefully to implement the medical marijuana law that 71 percent of Floridians approved last fall?
Researchers at the Johns Hopkins Center for Mental Health and Addiction Policy Research found that in states that had enacted medical marijuana laws from 1999-2010, opiate overdose deaths fell by an average of 25 percent vs. states where medical marijuana remained illegal. On that basis, more than 800 lives could have been spared in 2015.
Authors of the Johns Hopkins study point out they haven’t established a direct link between medical marijuana laws and the decrease in deaths. But the correlation is too strong to ignore. It also tracks with anecdotal reports.
I’ve been a medical marijuana advocate for more than four years. Throughout that time, I’ve spoken with innumerable people throughout Florida who give medical marijuana the primary credit for saving their lives: People who clawed their way back from an addiction to prescription painkillers by using marijuana. Others who must still take narcotics to manage their suffering, but who take far less as a result of having access to marijuana. Still others who chose to never swallow that first OxyContin or Percocet, relying on marijuana at the outset, fearing even a flirtation with opiate dependence.
During last year’s campaign for medical marijuana, which I managed, we ran a television ad featuring Miami Beach physician Dr. Jeffrey Kamlet. A specialist in pain management and addiction medicine, and twice past president of the Florida Society of Addiction Medicine, Kamlet pleaded with viewers to approve Amendment 2 so that he could have the option of recommending marijuana, instead of narcotics with addictive and lethal potentials, to his patients.
It is such an established cliché that the Chinese word for “crisis” is the same as the word for “opportunity.” With medical marijuana, though, the opportunity isn’t being presented as a result of the opiate crisis, but because of the popular will of 71 percent of Florida voters.
Legislators should seize it nonetheless.
Here is what we know: Opiate overdoses claimed 3,228 lives in Florida in 2015; marijuana has never taken a life by overdose, in thousands of years of human use; data suggests — but does not prove a direct link — that medical marijuana might save countless lives from opiate overdose.
Acting swiftly to implement medical marijuana doesn’t even necessitate political courage — it’s mandated by the state Constitution. All state lawmakers have to do to save lives is to do their jobs.
By Ben Pollara