My Patients Have A Right To Try Cannabis
When Patrick DeLuca and I conceptualized the idea of beginning a first-of-its-kind cannabis practice in Florida back in November 2016, we knew it wouldn’t be an easy task. The legal hoops we had to jump through our first few months were both maddeningly complex and ridiculously expensive. No matter how unnecessarily difficult our area of practice within the current statutory environment has become, our guiding principle of offering people with chronic illnesses a more natural option of treatment allows us the absolute knowledge that we are on the right side of medical history.
As our practice has evolved and our patient base has grown beyond any initial expectation (we’ve seen nearly 600 individuals), we’ve learned much that we didn’t know prior. We’ve found that our patients simply want to feel the best they can in a more natural way without manufactured substances, and they desire to do so legally.
Since the resounding passage of Amendment 2 on November 8, 2016, we’ve kept close tabs on the evolution of Florida’s medical cannabis program. Each legislative action, news story, and opinion piece has crossed my desk – thousands of pages of documents. Patrick and I even spent two days personally lobbying legislators in Tallahassee back in March, just as the Florida Senate and House of Representatives began crafting what would become the definitive law for physicians and patients alike.
Our mission has evolved from that of a simple medical practice to the stewards of a greater cause – the basic human right to try remedies and therapies to better the standard of living in people suffering from a variety of illnesses. We’ve always taken patient advocacy seriously and the urgency of our cause is of paramount importance at this moment.
As a physician, I am bound by Hippocratic Oath to provide the best level of care for my patients. Of many things, I am tasked to “…apply, for the benefit of the sick, all measures which are required, avoiding those twin traps of overtreatment and therapeutic nihilism”.
Furthermore, my bioethics training instructs me to follow the Latin phrase ‘primum non nocere’, plainly “do no harm” to my patients.
Anyone with a bit of education in cannabis can determine rather quickly that, regardless of its efficacy for various illnesses, the plant is essentially safe. With a limited and predictable side effect profile, no instances of fatality, very few drug-drug interactions, and thousands of years of documented use, the case for cannabis is an easy one for to make.
The majority of my patients are using legally prescribed pharmaceutical medications, which often include opiate derivatives, benzodiazepines, nerve blockers, SSRI’s, and more. Unlike cannabis, these substances often have horrific side effect profiles that can include organ failure and death.
It doesn’t take 4 years in medical school to plainly see the difference between cannabis and pharmaceuticals. Cannabis is the “do no harm” choice.
Medicine aside, the obstruction that has been created by our lawmakers keeps me up at night. Mel Sembler’s Drug Free America Foundation, the driving force against Amendment 2, has been given a seat at the table of legislation.
House Bill 1397, first introduced by Representative Ray Rodrigues (R-Estero), is the most detrimental piece of proposed legislation in regard to patients within the state of Florida. While the House Leader dropped the 90-day establishment requirement late yesterday, within the bill contains language that will destroy the program:
The department shall monitor physician registration in the medical marijuana use registry and the issuance of physician certifications for practices that could facilitate unlawful diversion or misuse of marijuana or a marijuana delivery device and shall take disciplinary action as appropriate.
Paragraph F further explains:
The Board of Medicine and the Board of Osteopathic Medicine shall jointly create a physician certification pattern review panel that shall review all physician certifications submitted to the medical marijuana use registry. The panel shall track and report the number of physician certifications and the qualifying medical conditions, dosage, supply amount, and form of marijuana certified.
This “pattern review panel” requirement would be unique to any practice of medicine that currently exists. In no other medical practice – general or specialized – exists an independent review body that could question a physician’s opinion regarding the care of patients for which he or she has personally examined.
Enforced under the threat of first degree misdemeanor penalties and possible license revocation for physicians, it’s doubtful that any doctor would partake in such a program that has been intentionally created to entrap medical practitioners.
More infuriating is that some legislators (such as representatives Ralph Massullo, Cary Pigman, and Julio Gonzalez) are also medical doctors. While they’d surely not like any of their diagnoses or treatment plans subject to third party oversight, they seem to find it acceptable to create such barriers to patient access with cannabis.
As the Florida House pontificates about free markets, the importance of the sacred doctor/patient relationship, and less government regulation of alcohol, they’ve crafted the false promise of “protecting” the citizenry from cannabis, a substance that will not harm them.
The 71.3 percent of Floridians who voted for Amendment 2 did not cast their votes to create an overly complicated system chock full of barriers to access. The electorate mandated an expansion of the state’s limited medical cannabis program to help more people in need.
We will continue to operate as we have, under the verbiage of Section 29 Title X of the Florida state constitution. We will continue to see patients with chronic and debilitating illnesses who are looking for another option in care. As Attorney Michael Minardi mentioned during a House subcommittee hearing a few weeks back, no jury will convict a patient in Florida for utilizing cannabis to treat their illness.
Should the state, whether by legislation or regulation, intentionally try to block access to patients whom I’ve examined and whom I’ve determined cannabis as a viable treatment, we will initiate legal action against the state of Florida. Additionally, we are building a coalition of physicians who would be willing to bring suit under equal circumstance, or perhaps in a class action manner.
Doctors should be allowed to be doctors. No state board or bureaucrat knows my patients. No oversight panel could possibly know what’s best for my patients without even examining them. No “pattern review panel” should be able to interfere with my 35 years of practical experience.
Such governmental overreach is not only offensive to doctors such as myself, it is inherently immoral and quite possibly illegal. Amendment 2’s passage mandated the state – via voter referendum – expand access to medicinal cannabis to patients with debilitating illnesses for which the physician believed the benefit outweighed the risk.
I sleep well at night knowing I am on the right side of care, and I will do anything within my power to advocate for every single patient within this state.
Florida, I’ll see you in court.
-Barry Gordon, M.D.