While some members expressed concern about patients smoking medical cannabis, the Florida Board of Medicine has approved forms for doctors to use in ordering smokable cannabis.
The board Friday agreed to change its medical-cannabis rules so that physicians can certify that the benefits of smoking cannabis for medical use outweigh the risks. It also agreed to change mandatory informed-consent forms that physicians and patients must fill out together.
But not all Board of Medicine members were on board with the changes, which came after Gov. Ron DeSantis pushed lawmakers this year to approve a bill allowing smokable medical cannabis.
“Obviously, our society is moving in that direction, approving cannabis socially, and perhaps my issue is not so much the use of cannabis but delivering a medication via inhaling products of combustion,” board member Jorge Lopez, a physician from Maitland, told The News Service Florida after the meeting. “No other medication in the United States is delivered like that.”
Lopez said authorizing smokable cannabis won’t be a boon for the cannabis industry. Instead, he said he did not expect Florida physicians to sign off on smoking cannabis when it can be ingested other ways, and he predicted that it would be a “bust.”
Ed Tellechea, the Board of Medicine’s general counsel, said the changes had been fast-tracked because the issue is a priority for the DeSantis administration.
“This is kind of a big deal,” Tellechea said.
One form that will be filled out by physicians will document that smoking is an appropriate route to administer cannabis for patients. The second is a mandatory informed-consent form.
Florida voters approved a constitutional amendment in 2016 that broadly legalized medical cannabis. The Legislature in 2017 passed a law to implement the amendment but included in it a prohibition against smoking medical cannabis. The smoking ban was successfully challenged in circuit court, but then-Gov. Rick Scott’s administration appealed the decision.
Shortly after getting elected in November, DeSantis distinguished himself from his predecessor and came out in support of smoking medical cannabis. DeSantis gave lawmakers until March 15 to do away with the smoking ban. If they didn’t, he threatened to drop the state’s legal efforts to defend the ban.
DeSantis signed the legislation lifting the smoking ban March 18. Within days, some cannabis dispensaries began quickly selling whole flower smokable products.
While the Board of Medicine has worked on finalizing the changes, the state Office of Medical Cannabis Use issued a notice advising physicians they can use their existing informed-consent and attestation forms.
Before the Board of Medicine approved the new forms, staff members discussed some concerns that the Joint Administrative Procedures Committee had. The committee is an arm of the Legislature that reviews whether rules properly track laws.
Committee chief attorney Marjorie Holladay noted that the new documents to be used by doctors interchangeably use the words “cannabis” and “cannabis,” and include references to the vernacular “joint.” Holladay suggested a possible amendment to explain that a joint is a cannabis cigarette, which the Board of Medicine declined.
The committee also flagged some concerns with new language regarding children smoking cannabis.
When the Legislature passed the bill in March, it limited access to smokable cannabis by children under age 18. Under the law, only children who are terminally ill can have access to smokable cannabis. The mandatory informed-consent form has a specific section about authorizing access to cannabis for terminal children.
Holladay also questioned language that was being added to the form regarding cognitive and psychosocial development. The new language notes that cannabis and other substances used during adolescence could cause “relatively greater interference in neural social and academic functioning compared to latest developmental periods.” Holladay asked that the Board of Medicine to explain what comparison is being used in reference to “greater interference.”
Rulemaking is often long and laborious, taking months or even years to finish. But changes related to smokable medical cannabis moved quickly.
Tellechea told board members that he would contact the Joint Administrative Procedures Committee to let it know the Board of Medicine is moving ahead with the changes because of the “importance that has been put on it by the governor’s office.”
But he said that he’d advise the committee that the Board of Medicine would be willing to revisit the rule after it becomes effective to address any concerns.