Almost six years after Florida voters approved a constitutional amendment legalizing medical marijuana, health officials are imposing new restrictions. The new rules set THC dosage amounts and supply limits. The Health Department imposed the restrictions under “emergency rule“ powers given by the Legislature, reports The News Service of Florida.
The changes come more than three years after lawmakers authorized smokable marijuana for patients in the Sunshine State.
The emergency rules set a 70-day total supply limit of 24,500 mg of THC for nonsmokable marijuana. They also establish dosage caps for different routes of administration such as edibles, inhalation and tinctures.
Override Available, But No Appeal Process On Requests
The changes — sent to patients and doctors on Friday — went into effect Monday. Florida law also imposes a 2.5-ounce limit on smokable marijuana purchases by patients over a 35-day period.
The restrictions lay out limits for THC in nonsmokable products. But the limit for whole flower and other smokable products are based on weight. They are not based on levels of THC, the main psychoactive component in marijuana.
The emergency rules create a process for doctors to seek an override for patients they believe need more. The rules provide no way for patients or doctors to appeal if their requests are denied.
It’s An ”Emergency,” Don’t You Know…
In setting up the framework for the medical marijuana program, lawmakers gave the Department of Health the power to use special ”emergency” to impose restrictions. The state can impose ”emergency” rules, you see, without taking public input. Florida law requires that input for non-emergency regulations.
The use of that emergency rule is “kind of the burr in my bonnet” about dosage and supply caps, Pensacola physician Michelle Beasley told The News Service of Florida on Monday.
“Regardless of the numbers, what harm has there been, what is the rationalization that they need to use emergency rule power and exclude the comments of all the physicians and all the patients in the state to do this?” Said Beasley, who works for MMTC of Florida.
70-Day Supply Restrictions
The rule sets 70-day supply restrictions for different routes of administration and calculates the equivalent daily dose for those limits. The rule restricts patients’ daily THC doses to an absurdly low 60 mg for edibles. The new restrictions set daily limits of 350 mg for vaporization, and 200 mg for capsules and tinctures. Other new daily limits include 190 mg for sublingual tinctures; 190 mg for suppositories; and 150 mg for topicals.
Industry insiders predict the dosage limits and supply restrictions will make marijuana products more expensive for patients. Medical Cannabis patients frequently seek out sales when making their medicine purchases.
Because marijuana remains illegal under federal law, patients have to pay all costs for doctor visits and supplies.
“Making People Shop At Publix When They Could Go To Sam’s Club”
“It’s basically making people shop at Publix when they could go to Sam’s Club and get the bulk discount,” Dr Beasley said. She noted many medical marijuana patients in Florida are retired or on fixed incomes. “If they had done the normal rule process, where they had public comment from patients, from doctors, they would have had that (information).”
The dosage restrictions also could stop patients who buy products ineffective for them from being able replace those for 70 days.
Many authorizing physicians blasted the new restrictions and the complete lack of doctor and patient input.
“I think what this demonstrates is just the utter disregard that the DOH has for not only the doctors who actively participate in the program with honor and integrity and diligence, trying to follow the rules of a very difficult process to navigate already, much less the patients who are disrespected,” said Dr. Barry Gordon, with Compassionate Cannabis Clinic in Venice. “But to send this out on a Friday afternoon with no discussion, with no workshops, with nothing, is just an unbelievable malfeasance. … Who does that?”
The state instructs patients to use guides and calculators provided by the Office of Medical Marijuana Use. Patients can thus supposedly determine how much they have purchased, how much they can buy and when their orders can be renewed.
Beasley called the process “unnecessarily burdensome” for patients, especially for older patients who may be experiencing cognitive declines. ”I do this full time and I have a medical doctorate and it’s taxing for my brain,” she said.
Will Patients Adjust?
However, John Lockwood, an attorney representing several hugely profitable medical-marijuana corporations, predicted patients will adjust to the restrictions.
“I’m hopeful the patients will be able to quickly acclimate to the changes, given that the industry was not afforded the benefit of a public workshop prior to the rule adoption,” he said Monday.
Patients face the new limits shortly after the launch of a ballot initiative to legalize adult use of marijuana for Floridians 21 and older. Trulieve, the state’s largest medical-marijuana company, coughed up $5 million in seed money to get the initiative on the 2024 ballot.
Restrictions Could Increase Support For Adult-Use Legalization
Beasley indicated state policymakers’ regulatory approach to cannabis could drum up support for the legalization effort.
“It just seems like there is this disconnect where some of the politicians — not all — feel as if building a good medical program leads to legalization faster,” Beasley said. “In my opinion, it’s the opposite.
“If you make the medical patients mad and limit their access to their medicine and make it expensive and harder to get, then they’re just going to say, ‘Screw this. I’m just going to sign the legalization petition so I don’t have to deal with jumping through these hoops.’”