Medical Cannabis

Has Florida Gone “Up In Smoke?”

June 26, 2018

I have written medical cannabis blogs for more than a year without referencing Cheech and Chong, the stereotypical pot smokers from the late 70’s and early 80’s movies. Now that the courts have ruled it unconstitutional for the State of Florida to prohibit qualified patients from ingesting medical cannabis by smoking it, I figured I would allow myself to “go there” and reference the movie, “Up in Smoke.”  Interestingly, though I have certified over 750 patients in the Florida Medical Marijuana Use Registry, I have yet to meet anyone who even remotely resembles the “stoners” portrayed in the movies.

When Florida’s legislature passed the State’s first medical cannabis laws in 2016, many ambiguities left doctors and patients trying to figure out how the law would be faithfully executed. Though many of these gaping holes were left to the Board of Health to regulate, some of these rules have still not been implemented, such as the maximum amount of THC or CBD a patient can purchase in a 70-day period.

Despite these ambiguities in the law, legislators were very clear about one thing: patients could not smoke medical cannabis. The courts, however, recently disagreed, finding the State’s prohibition on smoking to be unconstitutional. (See Florida’s Smoking Ban on Medical Marijuana Struck Down by Judge: http://www.tampabay.com/florida-politics/buzz/2018/05/25/floridas-smoking-ban-on-medical-marijuana-struck-down-by-judge/).

While this legal issue makes its way through the appeals courts, I have repeatedly been asked to share my thoughts on smoking medical cannabis.

Initially, I did not see the prohibition against smoking as problematic because people were able to achieve the same type of fast-acting effects by inhaling the cannabis through a vaporizing device. I have always advocated that people refrain from smoking anything, be it tobacco or banana leaves, because of its adverse effects on the lungs and respiratory system.

Undeniably, direct smoking of cannabis is the least healthy way to consume cannabis because it exposes the patient’s airway to heat, chemicals, and ash. Water pipes (i.e., bongs) are a somewhat healthier option because the water cools the smoke and filters out some of the harsh chemicals, but not entirely.

When cannabis flower is inhaled as a vapor, the temperature to which it is heated is high enough to cause activation and release of the cannabinoids, but not hot enough to burn the plant (when done correctly). This is what is currently available as single-unit doses in tamper-proof containers that are designed to stop people from getting the herb to smoke. So why would anyone smoke it?

There are documented cases where smoking cannabis “the old fashioned way” is the only way some people can get the desired therapeutic relief. For example, some patients find that the combination of all of cannabis’ plant-derived chemicals (phytochemicals) brings about the best clinical improvement because some of those chemicals do not get released unless the plant is burned. Additionally, some people cannot adequately metabolize or digest the types of oils commonly used as the base in many vaporized products (e.g., coconut/MCT oil); though newer high-potency concentrates are using 100% cannabis oil.

My Take on All ThisDue to the adverse impacts smoke has on the lungs, ​I strongly suggest patients try all other ​means​ of ​utilizing medical cannabis before inhaling smoke from the burnt plant.​ Ultimately, though, I believe it is an individual’s right to make the decision based on the patient’s particular circumstances. If smoking medical cannabis is the only way a patient can get the therapeutic benefits entitled to them under the law, then I support their decision to do so.​

About Wholistic ReLeaf

Wholistic ReLeaf, founded in 2016 by Dr. David Berger of Wholistic Pediatric and Family Care, empowers families and patients to choose the best treatment approach available for their medical condition. The mission of Wholistic ReLeaf is to evaluate and certify qualified patients who meet the State of Florida legal requirements for receiving medical cannabis, and provide medical cannabis management and dosing consultations to patients certified by other Florida physicians. Wholistic ReLeaf is committed to providing patients with the best possible care, while also complying with the ever-shifting legal landscape of medical cannabis in the State of Florida.

For more information, or to find out if you or a patient you know may be eligible to use medical cannabis as part of a customized treatment plan, visit www.WholisticReLeaf.com.

Dr. David Berger (“Dr. David”), a Board Certified Pediatrician with over 20 years of experience as a clinician, has developed a national reputation in wholistic pediatric primary care. Dr. David is considered Tampa Bay area’s leading authority on medical cannabis for adults and children, and is one of the nation’s most experienced pediatricians using medical cannabis to help facilitate the treatment of children with chronic conditions.

Dr. David graduated from The Medical College of Pennsylvania in 1994 and completed his pediatric residency at the University of South Florida/Tampa General Hospital where he first began utilizing wholistic therapies. Dr. David has been in private practice since 1997 and in 2005 opened Wholistic Pediatrics & Family Care, his medical practice in Tampa, Florida. In 2010, Dr. David was appointed Assistant Professor at the University of South Florida College of Nursing. In 2016, he launched Wholistic ReLeaf to help qualified patients become certified to use medical cannabis.