FL: Duval County Physicians Struggle With Confusing Medical Marijuana Laws As Access

Katelyn Baker

Well-Known Member
Diana Cordero is one of the few doctors in Duval County who is qualified to prescribe medical marijuana to her patients. But barely one month after the drug was legalized for the treatment of various medical conditions, Cordero said she can't keep up with demand.

"We receive at least five calls per day from patients wanting to be in the program," Cordero said. "It's becoming more word of mouth because, sadly, the community has not been well educated. ... The state was not ready for it."

While voters overwhelmingly approved the Amendment 2 referendum in November legalizing medicinal marijuana, after the law went into effect Jan. 3 there have been increasing complaints about confusion, delays and potential changes to the regulations surrounding the law.

Just last week, a series of workshops conducted by the Florida Department of Health around the state, including one held in Jacksonville, drew sharp criticism from both patients and the medical industry that access to the drug remains remote, slow and inadequate.

Cordero said she has similar concerns because despite the increasing demand for medical cannabis, she still only has three patients that she has cleared to enter the state registry that authorizes access to the drug that's being grown in one of seven state-licensed cultivation centers.

The current regulations require a patient to be under observation from a qualified physician for three months to determine if they have a debilitating condition that qualifies for medicinal marijuana. Cordero said she's trying to expedite that regulation by including patients who have been under her care well before the new law went into effect last month.

"We have at least 10 patients, probably, who are waiting to get on the registry," Cordero said.

One measure she takes to get her patients on the registry quicker is to include months of observation she's had with many of her patients before the law went into effect. But even then, there are delays.

"Patients with cancer, they don't have time to wait," Cordero said.

Cordero's concerns are increasing among physicians across Florida. While there are only about 20 physicians in Duval County qualified to prescribe medical marijuana according to the DOH's list of physicians in the state cleared to prescribe it, many are holding off going through the qualification process because of mixed signals in the early going.

"There's definitely confusion," said Bryan Campbell, CEO of the Duval County Medical Society which represents about 1,900 physicians. "It's essentially entirely new territory. Clearly, it is something that is still not legal across the United States and there are still states that are bringing that into play.

"From a medical standpoint, physicians are trained to go with the medical evidence and use that as guidance to prescribe something. That data doesn't set exist for what is called medical marijuana," Campbell said.

In addition, the regulations for the physicians are in a state of flux. The length of time for required observation before prescribing medical marijuana may soon change. With that, Campbell said those potential changes have led many physicians to hold off going through the process of becoming qualified, which actually isn't that complicated.

"In order for a physician to even see the patient [being considered for medical marijuana], the physician must have an 8-hour continuing medical education course. It's provided by the Florida Medical Association and I believe the cost is about $1,000," Campbell said.

"... If there's a physician that chooses to [prescribe] medical marijuana, the expense and time involved is minimal compared to what they may be able to bring to their business based on a supply-and-demand model. When you look at the physicians that can prescribe and you look at the number of patients that may be eligible to receive that, it's not unreasonable," Campbell said.

Despite the legalization of medical marijuana in January, there are still only about 2,000 patients who have been put on the state registry to purchase the drug from one of the seven cultivation centers in the state.

The state still hasn't even decided how it will tax the drug and the number of cultivation center, dispensaries and surrounding stipulations could soon change.

Several production facilities are also gearing up to begin the process of opening dispensaries in various cities, including Jacksonville.

Also, State Sen. Rob Bradley, R-Fleming Island, has filed proposed legislation that could expand the medical marijuana growing system in the state. The proposed measure might not be addressed by the Legislature until March, but it outlines an expansion of the medicinal marijuana production facilities in the state for up to 20 more state-licensed cultivation operations if the number of registered patients wanting the drug in the state exceeds 500,000.

Bradley's proposed bill, if approved, would also provide easier access for the patients needing medicinal marijuana by eliminating the current 90-day observation period required under current law. Patients can't get on the state registry for access to the drug until they've undergone 90 days of observation by their physicians. The proposed measure would also allow patients to get a 90-day supply of the medicinal cannabis instead of the current limit of 45 days.

Given the potential changes versus the currently confusing regulations, Campbell said it's no wonder why most physicians are holding off on getting in on prescribing medical marijuana.

"It's very hard for a practicing physician – whether or not they're interested in prescribing marijuana – to really understand truly where we're at," Campbell said.

While regulation changes are being considered, the access to the dug is being delayed in substantial ways. A notable business that's been put on hold are consulting and observation centers that could speed up access and reduce costs for patients wanting the drug.

Kevin Kafka is the managing director of Canna Care Docs which is already operational in eight states that have legalized medicinal cannabis. Kafka said he actually approves of Florida's slow approach to revisiting, revising and eventually revamping its regulatory stipulations for medical marijuana.

"I would say Florida's actually doing a phenomenal job compared to the rest of the country," Kafka said.

What's essentially the stumbling block for Canna Care Docs and other businesses like it is the so-called "Compassionate Care Act" approved by the state legislature prior to the referendum in November. That act was what instituted most of the current stipulations such as the 90-day observation period between physician and patient because it was designed to heavily regulate medical marijuana akin to what's called "Charlotte's Web," which is low potency and low-THC marijuana designed to primarily help children with afflictions such a epilepsy.

A stipulation in that act allowed for higher potency medical marijuana, but only for patents with terminal conditions.

Once that act is minimized and regulations are more in line with the intent of the Amendment 2 referendum, Kafka said that's when his company will likely move into multiple locations in Florida.

Canna Care Docs basically is a medical marijuana evaluation center that hires physicians to provide consulting, guidance and prescriptions of the drug for patients at a cost of about $200, which is less expensive than most of the current fees that can range from about $450 to $500 per visit, Kafka said.

His business already has about 10 doctors waiting to work in as many as 10 different cities in Florida, including Jacksonville. Kafka said they could hire another dozen doctors in the state.

"We're not blaming Florida for not having regulations overnight," Kafka said. "The whole program is very confusing because we have an old set of regulations that people are working on under the Compassionate Care Act and now we have Amendment 2 and those regulations are being formulated as we speak."

Ultimately, Canna Care Docs is one of the new businesses that will crop up around the medical marijuana industry in Florida.

"We've been very prosperous in the last five years. We employ over 150 team members. And we currently have 47 physicians on staff," Kafka said.

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News Moderator: Katelyn Baker 420 MAGAZINE ®
Full Article: Duval County Physicians Struggle With Confusing Medical Marijuana Laws As Access
Author: Drew Dixon
Contact: (904) 359-4111
Photo Credit: Will Dickey
Website: The Florida Times-Union
 
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