The Florida Department of Health is working to implement Amendment 2 as soon as possible. But public hearings have been contentious across the state. The raucous meetings were standing room only, with crowds cheering and booing.
Health News Florida’s Abe Aboraya has been following these hearings across the state. He talked about them with WUSF host Lisa Peakes as part of a Florida Matters episode on medical marijuana.
PEAKES: So Abe, before we get into the hearings themselves, can you give us a little background and refresh us on what the state of medical marijuana was in Florida before Amendment 2?
ABORAYA: Florida passed a low-THC medical marijuana bill in 2014. This was a very limited program that tightly controls how much THC can be in the medicine and what conditions qualify. Putting that law into effect was mired with lawsuits and took years, but patients are now getting that cannabis.
Last year, the legislature passed another medical marijuana law. This lets the terminally get full-strength medical marijuana if two doctors agree the patient is terminal and he or she waits for 90 days.
PEAKES: So how is this last agreement different from what Amendment 2 is trying to do?
ABORAYA: Voters overwhelmingly approved Amendment 2, a much broader medical marijuana program, last November. It became effective January 3, 2017. Amendment 2 would allow doctors to recommend medical marijuana for 10 conditions like cancer, Parkinson’s disease and epilepsy. It also allows medical marijuana for conditions similar to the ones outlined in the amendment.
PEAKES: It sounds like the big challenge is implementation. How is the Florida Department of Health proposing to put this into effect?
ABORAYA: Well the state is basically taking all the definitions in Amendment 2 and redefining them to match the existing programs. So doctors would be able to use the current medical marijuana infrastructure for the new conditions. And they’re doing this to meet the deadlines imposed by the constitutional amendment.
Meanwhile, there are two big medical marijuana bills floating through the Florida Legislature. Senator Rob Bradley’s bill would keep much of the same infrastructure in place, but it would allow for 20 more growers when the state hits 500,000 patients. Senator Jeff Brandes has a bill that would completely throw out the current system, and it would only put caps on the number of retail outlets, not the number of marijuana growers.
PEAKES: We actually heard from some hearings in the Tampa Bay Area and also from our colleagues across the state. Really, what was standing out was the emotion, people talking about family members and breaking down in tears. What did you find was the outstanding issue in terms of the forums?
ABORAYA: I would say the biggest issue is the current cost of marijuana in Florida. Right now, there are about 3,000 patients registered to get marijuana in Florida. Seven dispensaries are licensed to grow and sell that product. And some patients are saying the price is prohibitive, at $100 a gram in some cases.
When you’re talking about $100 a gram, the actual marijuana is just one of the costs. The other issue that’s brought up too is that you have to have a relationship with a certified doctor for 90 days before he or she can recommend medical marijuana. So depending on which doctor you’re going to, just to get to the point where the doctor can recommend marijuana, you might be spending $500-600 out of pocket because insurance is not going to cover these doctor visits. And then you have the cost of the marijuana, and then you have follow-up visits with those same doctors, so there are a lot of costs for patients to be able to actually get legal medical cannabis in Florida.
James Fowler is a Central Florida resident who attended a hearing in Orlando. He says the dispensaries won’t come down on the prices just because patients can’t afford it.
“So that’s going to force us to go to illegal means and have to go to the illegal dealers [officials] are trying to combat,” Fowler said. “All you’re doing is promoting the illegal activities of the black market with what you’re doing, your asinine rules and regulations!”
PEAKES: So how do you keep the price down and stay legal?
ABORAYA: There a couple of ideas. Competition is one, for sure, allowing for more growers. If you have more growers, the price of medical marijuana should theoretically come down. And many patients at the hearings say they want the state to allow Floridians to grow their own medical marijuana to make it cheaper.
PEAKES: How are law enforcement officials reacting to these meetings?
ABORAYA: One police chief says they want tight regulations on doctors to make sure Florida doesn’t end up with a small number of doctors doing most of the recommendations. Law enforcement also wants 24-hour access to the registry of patients. That way if the police find you with marijuana at 3 a.m., they can check to see if you’re authorized to have it. Now, I should mention that there were several patients who objected to that database on the grounds that it violates their health privacy.
PEAKES: One of the issues could be racial profiling, and I understand there are complaints about the lack of diversity in the program that's in place now?
ABORAYA: Yes, and that’s primarily because the current growers had to be an existing nursery in operation for 30 years with at least 400,000 plants. Some suggestions were to require the growers to have a diversity plan on file, and to even have a diversity program for future growers. That would be similar to existing programs where women, minorities and veterans, for example, get a preference for government contracts.
PEAKES: What happens in terms of a cohesive approach, and how do you see that rolling out in terms of a timeline?
ABORAYA: So now the Department of Health will go back and digest all of these comments from people. These are draft rules, after all. They could finalize the rules as is and put them into effect. They could make changes, and they could either have more hearings on the changes or finalize those. And remember: The Florida Legislature is likely to pass a bill to implement Amendment 2, so this whole process may start all over again in a few months.