Panel eyes medical marijuana approvals by doctors
Two new studies have found a link between frequent cannabis use and increased risk of stroke, as well as a link between cannabis use disorder and increased risk of arrhythmia. (Courtesy of the American Heart Association)
TALLAHASSEE, Fla. - Florida medical board members --- confronted with a new state report that details how a relatively small number of doctors have approved patients to use medical marijuana --- are taking a pass on whether they need to act.
Instead, members of a joint panel of the Florida Board of Osteopathic Medicine and the Florida Board of Medicine say they want to better understand the information in a 384-page report that tracks the amount of medical marijuana ordered in the state.
“Before we come to any conclusions about providers and the amounts and any other details around why there are outliers, I think we first have to look at the data entry,” said Sandra Schwemmer, an emergency medical physician from Tavernier and chair of the joint panel.
The report shows that 1,487 physicians certified patients for using medical marijuana between Oct. 1, 2018, and Sept. 30. But the majority of certifications --- 61 percent --- were done by just 9 percent of the physicians. In all, 291,865 patients had certifications during the 12-month period.
The small number of physicians certifying patients has worried members of the panel who fear that medical marijuana could become the state’s next pill-mill crisis.
Before sounding the alarm, though, Schewemmer wants to ensure the information is accurate.
“It’s important to be able to make sure all the physicians are entering (the information) the same way, because some of these outliers may not be outliers,” Schwemmer said.
The report is compiled from data collected from the Medical Marijuana Use Registry maintained by the Florida Department of Health’s Office of Medical Marijuana Use and the state’s medical licensure database. At a meeting Thursday in Altamonte Springs, Schwemmer asked the Office of Medical Marijuana Use to meet with the physicians on the joint panel and explain how data is entered into the statewide registry.
The report also showed during a six-month period, between March and September, that more than 1.82 million ounces of smokable medical marijuana were ordered for 128,040 patients. That translates to 113,922 pounds, or 57 tons, of flower marijuana.
The maximum amount of smokable marijuana a physician can order for a patient is 2.5 ounces over a 210-day period. The report shows that the average amount of smokable marijuana ordered for patients during the six-month period was 2.46 ounces.
Florida voters in 2016 approved a constitutional amendment that broadly legalized medical marijuana in the state, but lawmakers initially banned smokable marijuana. That changed after Gov. Ron DeSantis took office in January and pushed lawmakers to eliminate the ban.
Florida patients can use medical marijuana to treat 10 specific conditions, such as cancer, HIV, AIDS and post-traumatic stress disorder. Additionally, patients who suffer from conditions that are the same kind as the 10 specific conditions, patients who have terminal illnesses and patients who suffer from chronic non-malignant pain can qualify.
Some patients have more than one qualifying condition, and patients can be certified for low-THC cannabis or types of marijuana that can make them feel high, or both.
The report shows that 34 percent of the patients who qualified for medical marijuana did so for the treatment of non-malignant pain, followed by the broader “same kind” category.
Steven Rosenberg, a dermatologist from West Palm Beach and member of the joint panel, wanted a better understanding of the physicians who were qualifying patients for treatment for post-traumatic stress disorder and whether the physicians were psychiatrists.
According to the report, 22.6 percent of the patients who were certified for medical marijuana suffer from post-traumatic stress disorder.
Rosenberg said there was really “no objective criteria” for a PTSD diagnosis and that “it’s really up to the physician.”
It wasn’t just the amounts of medical marijuana ordered that gave the board members concern. For instance, the report showed that 2,221 certifications were done by physicians who identified themselves as “not practicing.” Those certifications were for low-THC cannabis and medical marijuana by sublingual, suppository or topical routes.
Likewise, another 3,203 certifications were done by out-of-state physicians.
Staff members said physicians who live out of state but practice in Florida can certify marijuana for patients. Moreover, physicians who have taken proper educational courses and registered with the state can certify patients. But physicians can list “not practicing” in the state database even if they have an active unencumbered license.