Medical Cannabis In Florida: A Battle Well Waged

Congratulations Florida!  We are the first state in the south to have a legitimate medical cannabis program.

Please note the above usage of the proper scientific term cannabis rather than the racially charged, prohibitionist derived marijuana.

The legislation that Governor Rick Scott signed into law last Friday has officially renamed the Office of Compassionate Use and the Compassionate Use Registry to the Office of Medical Marijuana Use and the Medical Marijuana Use Registry, respectively.

Small, seemingly inconsequential changes in verbiage clearly demonstrate that, while we should celebrate the passage of the bill expanding the legal medical cannabis program, we advocates still have much work to do.

I was always taught and continue to believe that after a hard fight, you accept the results and work together for the common good. In this spirit, I’d like to reach out to the advocates, other physicians, and each elected official and bureaucrat from the state of Florida. Let us beat our swords into plowshares and work together to continue to make this the best medical cannabis program in the world! We now have this continued window of opportunity to modify what we have into the model for all.

On behalf of my many patients, I would like to offer thanks to many for their hard work and rational voices in the Florida House and Senate. I want to salute the political leadership, including Leader Ray Rodriquez and Senator Rob Bradley, who marshaled their respective bills through the legislative process.

As repressive as the early versions of the Rodriquez bill were (no vaping or even edibles and an unreasonably burdensome and risky qualification process), the final version of the bill that is now law is one that can be interpreted and utilized by Physician Advocates to help a large pool of patients.

We can claim victory on maintaining the language of Amendment 2, which was of utmost  importance – keeping the ability to recommend medical cannabis for the enumerated conditions but also for similar and likewise conditions of the same kind or class, based upon the decision of the examining physician that the risk of cannabis is outweighed by the benefits of using it.

Still very troubling is the continued definition of “chronic non malignant pain”, and this needs further and more appropriate definition.

From Senator Bradley’s first presentation on the Senate floor in committee hearings, his definition of chronic nonmalignant pain never changed throughout the process and is maintained in SB8A, the final bill. In this view, the chronic pain one experiences must be directly caused by one of the enumerated conditions. This makes no sense in the practical qualification process for patients.

For example, back pain from failed back surgery, progressive spinal stenosis, or various other arthritic or disc related causes appear to be not allowable. Only that chronic non malignant pain caused by a cancerous tumor, multiple sclerosis, Parkinson’s or another of the 10 conditions appear to be eligible.

A severe debilitating neuropathy (like what may be caused from military service related Agent Orange exposure) does not appear to qualify a patient within the state’s system, nor that from diabetes, or any other non-enumerated causes.

I’d like to pose a serious question to the Legislators:

How would you feel looking into the eyes of a Veteran with chronic service-related neuropathy and tell him he doesn’t qualify for a chance to diminish his many narcotics and other manufactured pharmaceuticals?

One thing that needs to be understood is the simple fact that there exists a vast quantity of patients of all ages, but specifically in their 50’s, 60’s, 70’s, 80’s and 90’s who have never used cannabis prior – not even “recreationally”. Not all of these individuals fit in the easy boxes of qualification, but by definition they are not coming to me to “get high”, but to try to feel better and to obtain wellness in a more natural way.

Many if not most of these older, cannabis naive patients are very fearful the the feeling of “getting high” and the psychoactive effects of THC.  They have no desire to alter their mentation. These patients just want a chance to feel the best they can, and they deserve this chance.

A strong physician advocate can work with these types of patients to achieve their recommendation. However, in order for these patients to have better access to their medication, doctors need the support of the system and the freedom to serve the needs of the patients first and foremost to fulfill their Hippocratic oath to serve.

Oversight is both necessary and fair, however there is no need whatsoever to extend that regulation further than any other practice of medicine in the United States. The opiates that are killing patients, those modern manufactured products.

As I like to say, those that are happy with their traditional healthcare and the associated manufactured pharmaceuticals should continue with confidence in their treatment plans with their doctor. Conversely, those that are looking for a safe and possibly very effective treatment for their chronic conditions should be allowed to pursue medical cannabis.

I don’t believe that the Legislature ever truly separated their fears of recreational cannabis to allow for the appropriate scientific debate on medical cannabis. Believe me, this is a new, truly fascinating world of medical cannabis. It isn’t about a cloud of smoke over Woodstock, but an appropriate combination of both CBD and THC to obtain the desired effects.

I invite every interested lawmaker, bureaucrat, and physician to join me for a day in my office to observe what I do and speak with my patients. That experience alone will enlighten all to the process.

I hope to work with my Legislative friends as we go forward. I have been honored to meet with progressive Representatives Carlos Guillermo Smith and Amy Mercado, as well as initiating direct contact with Republican Representative Joe Gruters and Senator Jeff Brandes.

My goal is to develop a bipartisan coalition to work with physicians like myself to further the education of their fellow leaders. I invite the Physicians of the House – Dr’s Pigman, Gonzalez and Mazullo – specifically in the spirit of collegiality, to work together as Doctors. There is much to learn as we work together for the betterment of the constituents, our patients. I will be happy to lead a symposium for the leadership during the committee sessions later this fall, and will rearrange my schedule to travel to Tallahassee at no charge.

While there is much left to accomplish in the fight for patient access to medical cannabis, in reality it is a day of joy in Florida. When we opened the doors to our practice, we had no idea of what we were about to experience. Never in our wildest dreams could any of us have imagined the gratification of our new life’s mission. The program is up and running, we’ve got our rules and guidelines now set, but we already know that medical cannabis is helping our patients lead better lives. Everyday we’re told of vast reductions in manufactured pharmaceuticals and vast increases is betterment. It makes us glow inside to know that in patients are able to accomplish their goal of taking control of their health care.

Each and every advocate should be proud. We did it!

I will continue to do all that’s within my power to bring compassionate care to patients statewide.

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