Did you know the laws around medical marijuana have changed here in Florida? If the answer is no, you are not alone. Many people are not aware of the amendments the Office of Medical Marijuana Use (OMMU) and Gov. Ron DeSantis made.
And, of those who are aware of the changes, many are not sure of what those changes mean and include. Even providers are in the dark because the state has not taken steps to educate them.
The unfortunate part of this scenario is that you are still liable for the offense if you break the law, even if you didn’t know about the change. In this article, we will educate you about the new standards of practice so you can be well-informed and understand how they impact you.
We’ll start with the actual amendment as stated so that you have the details. Then, we’ll move on to how this will impact you.
Please note that this amendment applies to smoking medical marijuana only. Thus, if you don’t smoke it or plan to smoke it, then the modification shouldn’t impact you.
The Amendment
Rule 64B15-14.0131 is titled: “Practice Standards for the Certification of Smoking Marijuana as a Route of Administration.”
(1) Compliance
The standards of practice in this rule do not supersede the level of care, skill, and treatment recognized in general law related to healthcare licensure. All physicians who are authorized to issue a certification for the medical use of marijuana in a form for smoking as defined in Section 381.986(1), F.S., shall comply with this rule.
(2) Standards
The nature and extent of the requirements set forth below will vary depending on the practice setting and circumstances presented to the qualified physician. In addition to the requirements set forth in Section 381.986(4), F.S., the Board has adopted the following standards for the issuing of certifications by qualified physicians for the medical use of marijuana in a form for smoking:
(a) Evaluation of the Patient
The qualified physician must conduct a physical examination while physically present in the same room as the patient and a full assessment of the medical history of the patient, including family and social history with an emphasis on substance use disorder and mental health, and must document this information in the medical record. The medical record also shall document the presence of one or more qualifying medical conditions for the use of smokable marijuana and document previous treatments, if any.
(b) Treatment Plan
The written treatment plan shall indicate if any further diagnostic evaluations or other treatments are planned, including other medications and therapies if indicated. After treatment begins, the qualified physician shall adjust dosing, if necessary, to the individual medical needs of each patient.
(c) Informed Consent
The qualified physician will discuss and have the patient complete the “Medical Marijuana Consent Form” (DH-MQA-5026) set forth in Rule 64B15-14.012, F.A.C. In addition, the qualified physician shall discuss the risks and benefits of the use of smokable marijuana including the risk of abuse and addiction, the negative health risks associated with smoking marijuana as well as physical dependence with the patient, persons designated by the patient, or with the patient’s surrogate or guardian if the patient is incompetent. The discussion shall also include expected benefits, duration, options, and common side effects. Special attention must be given to those patients who are at risk of misuse or diversion of their medications.
(d) Periodic Reviews
A qualified physician must evaluate an existing qualified patient at least once every 30 weeks before issuing a new physician certification. Based on the circumstances presented, the qualified physician shall review the course of treatment and any new information about the etiology of the need to utilize smokable marijuana. Continuation or modification of therapy shall depend on the qualified physician’s evaluation of the patient’s progress. If treatment goals are not achieved, despite medication adjustments, the qualified physician shall reevaluate the patient and determine the appropriateness of continued treatment. The qualified physician shall monitor patient compliance of marijuana usage and related treatment plans.
(e) Consultation
The qualified physician shall refer the patient as necessary for additional evaluation and treatment in order to achieve treatment objectives. The management of patients with a history of substance abuse or with a comorbid psychiatric disorder requires extra care, monitoring, and documentation, and may require consultation with or referral to an expert in the management of such patients.
(f) Medical Records
The qualified physician is required to keep accurate, legible, and complete records to include, but not be limited to:
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- The medical history and a physical examination, including history of drug abuse or dependence, if indicated;
- Qualifying medical condition or conditions;
- Determination that the medical use of marijuana would likely outweigh the potential health risks for the patient; if the patient is younger than 18, inclusion of concurrence by second physician;
- Whether the patient is pregnant;
- Diagnostic, therapeutic, and laboratory results if performed by the qualified physician or received from another practitioner;
- Evaluations and consultations if performed by the qualified physician or received from another practitioner;
- Treatment objectives;
- Discussion of risks and benefits;
- Treatments;
- Medications (including date, type, dosage, and quantity prescribed);
- Document that the Prescription Drug Monitoring Program database was reviewed;
- Instructions and agreements;
- Informed written consent;
- Drug testing results if indicated;
- Periodic reviews. Records must remain current, maintained in an accessible manner, readily available for review, and must be in full compliance with Rule 64B15-15.004, F.A.C., Sections 381.986, 456.057, and 459.015(1)(o), F.S.
(g) Compliance with Laws and Rules
Qualified physicians shall at all times, remain in compliance with this rule and all state laws and regulations addressing the issuance of certifications for the medical use of marijuana in the form for smoking.
So, What Does This Mean for You?
- A certified provider must provide a comprehensive interview or health evaluation before you can get your medical marijuana card.
- Your provider may have to administer a drug test before they provide a letter of recommendation for medical marijuana. If you test positive for other controlled substances or addictions like alcoholism, your provider may deny you a medical marijuana card.
- If you are 18-20 years old, two different providers from two different practices must agree that you can benefit from smoking therapeutic cannabis and that it presents no apparent health risk to you.
- You must visit a provider in person. As of June 27, 202, the state no longer permits health evaluations for medical marijuana via telemedicine.
- Every 30 weeks, the state requires you to legally attend follow-up visits with the same provider that referred you originally.
- Your provider will give you a customized treatment plan with specific goals and milestones for symptom management. If these are not met during follow-up appointments, you and your provider will have to defend:
- The benefits of medical marijuana.
- Your right to have a medical marijuana card.
- Your provider must administer a new waiver form, which means the state requires you to sign a new waiver form. This waiver outlines the risks of smoking cannabis compared to other intake methods and the importance of disinfecting bongs and pipes.
Have Questions?
Medical marijuana can be a confusing topic that stirs up all kinds of questions about regulations and laws. Lastly, all laws aside, many patients find it to be an effective treatment for their health issues. Most importantly, if you think it could help you, reach out to us today!