By Therin Miller | August 31, 2022
The limitations were imposed roughly six years after voters approved a constitutional amendment. Diversifying medical marijuana legalization and more than three years after the Legislature permitted smokable marijuana.
Florida health officials have issued a long-awaited rule establishing THC dose quantities and product supply restrictions for doctors to request for medical marijuana users.
The emergency rule imposes a total supply restriction of 24,500 mg of THC for non-smokable marijuana for a period of 70 days, as well as dosage caps for various modes of administration such as edibles, inhalation, and tinctures.
The guideline, emailed to patients and doctors on Friday and went into effect on Monday, also implements state legislation that puts a 2.5-ounce restriction on smokable marijuana purchases made during 35 days.
While the guideline establishes THC limitations for non-smokable items, the limits for whole flower and other smoked products depend on weight. They are not based on THC levels, the euphoric component of marijuana.
In addition, the emergency rule establishes a procedure for doctors to seek an override for patients they believe require exceeding the limitations. If the petitions are denied, there is no recourse for patients or doctors to appeal.
The dose and supply caps occurred nearly six years after Florida voters approved a constitutional amendment broadly allowing medical marijuana and more than three years after the Legislature permitted smokable marijuana at the request of Gov. Ron DeSantis.
When lawmakers established the structure for the medical marijuana program, they provided the Department of Health the authority to create restrictions using emergency rules. Emergency rules can be published without seeking public feedback, as non-emergency regulations must.
The usage of the emergency rule is "sort of the bee in my bonnet" about the dose and supply restrictions, according to Pensacola doctor Michelle Beasley on Monday.
"Regardless of the figures, what harm has been done, and what is the rationale for using emergency rule power and excluding the opinions of all physicians and patients in the state to do this?" stated Beasley, who works with MMTC of Florida.
The rule establishes supply limitations of 70 days for various modes of administration. It computes the comparable daily dose for the caps. Patients' daily THC doses are limited to 60 mg for edibles, 350 mg for vaporization, 200 mg for capsules and tinctures, 190 mg for sublingual tinctures, 190 mg for suppositories 150 mg for topicals, according to the rule.
According to many people interviewed by the News Service on Monday, only a small percentage of the state's approximately 800,000 medicinal marijuana patients would require overrides for the new limitations.
However, industry sources expect that the dose limits and supply constraints will raise the price of marijuana products for patients, who usually seek out deals when making purchases.
Patients must pay for all doctor visits and supplies because marijuana is still illegal under federal law.
"It's practically forcing individuals to purchase at Publix when they could go to Sam's Club and receive the bulk discount," Beasley explained, pointing out that many medical marijuana patients in Florida are retired or on fixed incomes. "They would have had that (knowledge) if they had followed the standard rule process, which included public discussion from patients and doctors."
The dose restrictions may also hinder patients who acquire medications that do not perform well for them from purchasing alternative products within the 70-day window.
Barry Gordon, a doctor at Compassionate Cannabis Clinic in Venice, slammed the regulatory process and the rule itself.
"I think this illustrates the absolute contempt that the DOH (Department of Health) has for not just the doctors who actively participate in the program with honor, honesty, and effort, trying to follow the rules of an already tough procedure to navigate," Gordon said. "However, sending this out on a Friday afternoon with no discussion, workshops, or anything else is outrageous misconduct." Who would do that?"
Patients can use the Office of Medical Marijuana Use's instructional materials and calculators to calculate how much they have purchased, how much they can buy, and when their orders can be renewed.
Beasley described the process as "unnecessarily difficult" for patients, particularly the elderly, who may be experiencing cognitive deficits.
"I do this full-time and have a medical Ph.D., so it's stressful on my head," she explained.
But, according to John Lockwood, an attorney who represents numerous medicinal marijuana providers, patients will adjust to the adjustments.
"I'm hoping that patients will be able to rapidly adjust to the changes, given that the industry was not given the advantage of a public workshop prior to rule passage," he said Monday.
Patients are facing additional restrictions just days after the launch of a ballot issue to allow recreational marijuana usage for Floridians 21 and older. Trulieve, the state's largest medicinal marijuana company, paid $5 million to get the proposal on the ballot in 2024.
Beasley suggested that state legislators' approach to cannabis regulation may help rally support for the endeavor.
"It just seems like there's this gap where certain lawmakers —- not all —- believe that developing a good medicinal program leads to legalization faster," she explained to the News Service. "In my opinion, the opposite is true. Suppose you irritate medical patients by limiting their access to their medication, making it more expensive and difficult to obtain. In that case, they will simply respond, "Screw this." I will sign the legalizing petition so I don't have to deal with all this."