Patients in Florida’s Medical Cannabis Program Observe Flaws in System
Florida’s Legal Medical Cannabis Legalization Initiative, Amendment 2, achieved approval from general election voters on Tuesday, November 8th, 2016. Under Amendment 2, physicians believing that medical use of Cannabis would likely outweigh the potential health risks for a patient are permitted to recommend Medical Cannabis to that patient. Under a statute passed by the Florida State Legislature patients could not smoke the plant. However, Leon County Circuit Court Judge Karen Gievers struck down this ban on May 25, 2018.
So now that Medical Cannabis is a legal choice of medication for patients, hoards of Floridians are taking advantage of their newfound freedoms, right? Well not exactly. In fact, according to Florida’s Office of Medical Marijuana Use, just under a third of all patients to receive their Medical Cannabis Use Card have allowed this licensure to lapse. Of the original 389,120 patients, only 277,659 remain active patients in Florida’s Medical Cannabis Use Registry. Why are patients in Florida’s Medical Cannabis System allowing their Active status to expire?
There are Huge Flaws in Florida’s Medical System
High Fees for Florida’s Medical Cannabis Patients
According to the Center for Disease Control’s National Center on Birth Defects and Developmental Disabilities, 28.1% of Florida residents have some type of disability. This is higher than the national average of 25.6% of adults in the U.S. with some type of disability. Unfortunately, individuals living with disabilities also suffer economic struggles at a higher rate than those without. A 2015 Disability Status Report carried out by Yang-Tan Institute on Employment and Disability at Cornell University showed startling correlations. The employment rate of working-age people with disabilities in Florida was 31.0 percent. Whereas, by stark contrast, the employment rate of working-age people without disabilities in Florida was 76.4 percent.
High fees associated with Florida’s Medical Cannabis System pose a serious disadvantage to individuals living on disability income, fixed incomes, Social Security or even minimum wage.
All individuals applying for a Medical Cannabis Use ID must submit a $75.00 Processing Fee to the Florida Department of Health once each year. This is mandatory for each individual and the state provides no resources or exceptions for individuals who can not afford this fee.
In order to receive approval in Florida’s Medical Cannabis program, individuals must first receive a doctor’s recommendation for Medical Cannabis. This is achieved through a scheduled appointment with a qualified physician. Physicians evaluate patient conditions to determine whether Medical Cannabis is an option for that individual. Physicians maintain the authority to charge whatever rate they feel is proportionate to the services they have provided. Unfortunately, this sometimes means that patients pay up to $300.00 or more on these singular appointments. Individuals must receive this recommendation once every 210 days. However, physicians also maintain the authority to require patients return for these recommendations in shorter intervals if the physician deems it necessary. Once again, they maintain the authority to charge any rate they feel is acceptable.
Medication costs are also a huge issue plaguing Florida’s Medical Cannabis System.
Compared to prices in other Western States like Colorado California and Oregon, Florida dispensaries are robbing their patients. The cost of one ounce of Medical Cannabis flower in Florida can range from $345 – $448, whereas prices in Colorado can range from $90 – $200 an ounce with varying quality. One dispensary in Colorado, Lightshade, boasts pre-packed ounces for $90 or mix and match ounces for $115! The reason for higher Cannabis rates in Florida lies in the structure of the Vertical Integration Market. This structure currently remains set in place for Florida’s Medical System.
Navigating a Vertical Integration Market
Florida’s Medical Cannabis System is structured as a Vertical Integration Market. What does this mean for patients? In order to understand that, we must first decipher what a Vertical Integration market is. Vertical integration is a common term in the Cannabis industry used to describe companies that facilitate multiple points in the supply chain, such as cultivation and retail, rather than operating one specific phase, such as cultivation or retail. Currently, Cannabis companies may only sell the products they make. Therefore, MedMen, for example, cannot sell Harvest products and vice versa.
Due to this structured market, there are few dispensaries in the state. Therefore, when one dispensary runs out of a patient’s preferred product, that patient must go to a local competitor who does not necessarily carry the same products. This market also caps licenses and allows a few select companies to have a monopoly on the Cannabis supply chain. This has been known to create friction in the industry. The New York Times comments “States should keep the production and retail sales of Cannabis separate to ensure that the industry does not evolve into a group of politically and financially powerful vertically integrated businesses.”
Additionally, by these regulations, a company must cultivate, process, package and sell Medical Cannabis all under one entity. This effectively eliminates the possibility for ancillary businesses to handle different aspects of the process. The number of available career positions in this industry remains tightly capped.
Florida’s Vertical Integration Market has allowed a few powerful companies to control the “Cannabis Wealth”, effectively controlling patients with incredibly high prices, a lack of variety, and poor industry standards.
Poor Oversight and Regulation of Medical Cannabis Treatment Centers
Patients are not only navigating high fees and a poorly structured market. These individuals are often forced to settle for inferior products due to poor product regulation by Florida’s Department of Agriculture and Florida’s Department of Health. In the current system, the FDA sets and uphold regulations. Whereas the Dept. of Health carries out oversight and handles complaints. Sounds totally logical, right? Given the overwhelming accounts of consumer dismay, this may not be the case.
Regulations for “Medical Marijuana Treatment Centers” include limits on quantities of locations for facilities, qualifications necessary to operate such facilities, requirements of product analysis, and much more. Unfortunately, many consumers maintain the opinion that these centers remain under-regulated and produce poor quality and even dangerous products. Groups of these patients converse on social media sites like “Facebook and Reddit”, exchanging horror stories of these subpar products. Some individuals even include pictures as “evidence”.
Consumers beg Legislature to enact more stringent requirements on Cannabis processing and manufacturing. This includes more in depth material analyses performed by third party laboratories. Many consumers feel that current Certificates of Analysis provided by MMTC’s not only lack information but also provide false information. Groups of these consumers have even paid for their own third party analysis through independent laboratories, claiming contrasting results.
No matter the case, the common consensus is that these MMTC’s could benefit from closer oversight.
*Consumer claims referenced in this paragraph do not represent the views of Healthy Hempies. These claims have not been evaluated or supported by any state departments.
Lack of Cannabis Education Among Physicians
Arguably the most dangerous issue regarding Florida’s Medical Cannabis Program is rooted in the lack of Cannabis education required by the physicians. By regulatory standards, physicians wishing to participate in this field are only required to have an active, unrestricted license. (Chapter 458, Florida Statutes or Chapter 459, Florida Statutes) Additionally, complete a 2-hour Continuing Medical Education course/exam provided by the Florida Medical Association/Florida Osteopathic Medical Association. They even self-register in the system, receiving no oversight.
Moreover, medical schools are not adequately preparing their graduates to recommend Medical Cannabis, according to the findings of a new study published in the online journal Drug and Alcohol Dependence. Researchers from Washington State University, led by Anastasia B. Evanoff, sent surveys to medical residents throughout the United States. They found that 9 out of every 10 physicians-in-training are unprepared to answer questions regarding medical Cannabis, and 85 percent haven’t received any education about medical Cannabis at all. This information bodes poorly for Florida patients, as eastern Cannabis markets are evolving at a much slower rate.
The researchers also sent surveys to medical school curriculum deans at 172 medical schools in North America. Of the 101 that replied, 66.7 percent reported that their graduates remain unprepared to prescribe Cannabis. Even more troubling, 25 percent of deans said their physicians-in-training remain under equipped to even answer questions regarding medical Cannabis.
Data from the Association of American Medical Colleges (AAMC) revealed that just 9 percent of medical schools reported teaching their students about medical Cannabis and its cannabinoids.
This information raises concerns with patients around the nation. If our bodies are equipped with an Endocannabinoid system, why aren’t physicians educated about it? These individuals maintain a responsibility to their patients, yet receive subpar training in one of the fastest growing medical fields.
Florida Legislature can do Better
Long story short, Florida’s medical program still has many kinks to work out. While there have been many great new advances to the system, many issues still remain. High fees associated with the products as well as the state and physicians back consumers into a financial corner. A Vertical Integration market threatens consumer supply and career opportunities. While physicians and medical professionals receive subpar education surrounding Cannabis use. Many other issues exist as well. Patients look to legislature to clean up Florida’s Medical Cannabis Program.