What treatment is the patient eligible to receive?
With the enactment of Florida’s Amendment 2, qualified patients with a Medical Marijuana Use Registry ID Card may be treated with a variety of low-THC (CBD) and THC- containing medical cannabis products. They are available in a variety of different forms such as vaporized, capsules, oral liquids and, transdermal creams. Currently a patient is not allowed to smoke “flower” but can vaporize flower sold in a sealed, tamper-proof receptacle.
What are cannabinoids (CBD)?
The brain and other nerve cells, as well as other organs, have natural receptors for cannabinoids. Our bodies also naturally make certain cannabinoids (endocannabinoids), which help regulate pain-sensation, memory, stress response, social behavior, mood, immune function, sleep, and appetite. Some patients may benefit more from one type of cannabis treatment, while others best respond to a combination of treatments, that vary based on ratio or time of use throughout the day. To learn more about cannabinoids, please visit:
How does cannabis interact with other medicines?
Because cannabinoids are metabolized by the cytochrome P450 system in the liver, they could change the effects of certain seizure medications, such as valproate and clobazam. Some seizure medications, such as carbamazepine and phenytoin, may also reduce cannabinoid blood levels. If a patient is taking these drugs, the patient may require higher doses of cannabinoids, although this has not typically been observed at the doses commonly used in the research. At FMCC, we will cross check all medications a patient is taking in a database of known interactions with cannabinoids.
What does the physician authorize for the qualified patient?
After verifying a patient has a qualifying medical condition to receive medical cannabis (as determined by the State of Florida), and having determined the benefits outweigh the risks, the physician provides certification that a patient is qualified. With this, a patient (and caregiver if needed) can obtain a Medical Marijuana Use Registry ID card and obtain product from a state-approved Medical Marijuana Treatment Center.
How does the patient get the medical cannabis?
Once all legal requirements have been met, the patient will receive a state-issued Medical Marijuana Use Registry ID card, at which time they may get their medical cannabis from a Florida-sanctioned Medical Marijuana Treatment Center. The Centers will have access to the patient’s certification to verify what they are allowed to distribute.
What about the Medical Cannabis Use Registry ID cards?
A valid ID card is required to purchase medical cannabis. Once a Medical Marijuana Use Registry ID number is provided to the patient, the ID card application may be submitted. The appropriate applications are found here:
What are physicians’ requirements for ordering medical cannabis?
Only Florida-licensed physicians who have successfully completed a 2-hour medical education course on medical cannabis and passed the examination may certify qualified patients to receive medical cannabis. This is explained in more detail on the Florida Department of Health’s website.
Do FMCC doctors evaluate patients for purposes of determining whether the patient has a qualifying medical condition?
At this time, FMCC does not perform evaluations to determine if an individual has a qualifying medical condition to receive medical cannabis in the State of Florida. To make an initial appointment with FMCC, a patient must attest to having a valid pre-existing medical condition. A consultation note or professional letter stating the qualifying medical condition documented by the patient’s healthcare, therapist, or mental health provider must be provided to FMCC prior to the qualified patient being certified to receive medical cannabis. FMCC will evaluate the patient’s medical history to determine if the risks of ordering medical cannabis are reasonable in light of the potential benefit for the individual patient. Current patients of Wholistic Pediatrics and Family Care may have sufficient documentation in their medical record to verify a qualifying medical condition. This will be determined on a case-by-case basis by our medical team.
Does FMCC provide after-hours/emergency care for its patients?
FMCC does not provide after-hours/emergency care or any evaluation or treatment beyond the scope of treatment detailed above. For any additional medical care/advice, the patient’s primary care physician or the treating specialist (e.g., neurologist or oncologist) should be contacted. Full medical care, including check-ups, after hours and urgent calls, nutritional evaluations, and biomedical treatments are available at WPFC. Any person interested in utilizing the services of WPFC must contact that clinic directly to acquire additional information.
Will a physician at Family Medical Cannabis Clinic serve as a second “confirming” physician?
Yes, for patients under 18 years old, a second physician must concur with the determination that the patient is qualified for the Compassionate Use Registry. In addition to serving as an ordering physician for entering qualified patients into the Compassionate Use Registry, FMCC also conducts evaluations as the “second physician” to fulfill this pediatric requirement under Florida law if there is another doctor who will be doing the actual ordering. To evaluate a patient for the purpose of confirming a qualifying medical condition, the patient must first present a consultation note or letter from the physician who made the diagnosis or is providing current treatment for that diagnosis. Assuming the patient meets all qualification criteria, only one chart-review appointment is required for an FMCC physician to provide documentation as the “confirming physician.” . FMCC physicians will not provide evaluations to make an original diagnosis, unless the patient is an established patient of Wholistic Pediatrics and Family care.
What if a pediatric patient seen by an FMCC certifying physician needs a second physician’s letter to complete the qualification process?
FMCC has more than one physician on staff and can provide a second, independent evaluation after his/her ordering physician has seen the patient. The physician can typically provide this evaluation by performing a review of the pediatric patient’s chart.
Will patients be able to purchase medical cannabis from any of the state-approved Medical Marijuana Treatment Centers?
Each Medical Marijuana Treatment Center is allowed to sell anywhere in the state, and they may have different products available. A patient can purchase products at any physical location or request home delivery via phone and internet orders. Individual cities are allowed to restrict Centers from opening physical locations within their borders but they are not allowed to prohibit delivery into their cities
How safe are the products that will be available?
All products must be tested for purity and standardized into known dosages. Additionally, they should be labeled appropriately to make it easy to differentiate between different products. Though not a legal requirement, we recommend only purchasing from Medical Marijuana Treatment Centers that clearly mark their products.
Are medical insurance companies required to cover the costs associated with the medical cannabis therapy?
No, insurance companies are not required to cover this therapy or pay/reimburse for medical cannabis evaluation consultations.
Does a patient have the legal right to use the medical cannabis while out of state?
No, Florida qualified patients are not protected if they were to transport medical cannabis across state lines or use it in other state.
If a patient qualified to use medical cannabis is able to work, is the employer obligated to allow the patient to use medical cannabis products in the workplace?
No, to the contrary, Florida law prohibits the use of medical cannabis at the patient’s workplace. The Americans with Disabilities Act does not require employers to allow medical cannabis use as an accommodation for a patient’s disability.
Does FMCC also provide primary care or other medication management?
FMCC is solely limited to the evaluation, certification, and treatment of qualified patients who meet the State of Florida statutory requirements for receiving medical cannabis. FMCC does not manage any medication or treatment for its patients other than those specifically recommended for that patient by a FMCC physician. The non-FMCC physician supervising that particular condition or treatment must manage all other medications and treatments. If non-cannabis medicine management is needed, a physician or nurse practitioner at Dr. Berger’s full service medical practice, Wholistic Pediatrics and Family Care (WPFC), can provide this service.
What are Florida’s medical cannabis laws?
The State of Florida strictly regulates medical cannabis. To maintain compliance with all applicable state laws, we will occasionally be required to update our policies. If such changes occur, we will make all reasonable efforts to keep our patients and families up-to-date and in compliance with all applicable laws. Additional useful legal information is also accessible in the following downloads:
*Some of these FAQ’s were provided by the Florida Medical Association’s “Florida Physician’s Low-THC” Continuing Medical Education Course, released 7/15/16.
Want to know more? Download our informational guide on medical cannabis.
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