CANNABIS

As of June 23, 2017, Florida Governor Rick Scott signed new medical cannabis legislation into law. The new legislation updates previous, temporary processes and regulations with more-permanent, patient-friendly solutions.

New legislative changes:

• 90-day waiting period removed

• Seasonal residents also now eligible to receive an order of medical cannabis.

• No more sales tax on medical cannabis related medical cannabis devices or products, or low-THC products.

• Physician orders have increased to up to 210-day supply (consisting of 3, 70-day orders)

• Additional qualifying conditions have been added, including AIDs, chronic nonmalignant pain, any terminal illness, and any condition similar in nature to the other qualifying conditions. 

• New routes of administration

• Telemedicine visits now permitted for follow-up visits.

• Pregnant women may only receive low-THC CBD

Medical Cannabis Licensing Process in Florida: A Guide for Patients
In Florida, qualified patients can access medical cannabis for therapeutic use by adhering to a structured licensing process. Here's a step-by-step guide:

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Qualifying Conditions:
Florida law lists specific medical conditions that qualify for medical cannabis use. Patients suffering from chronic pain related to a qualifying condition or comparable to the conditions listed may also be eligible. The current list of qualifying conditions is listed below:

• AIDs

• ALS (Lou Gehrig’s Disease)

• Any terminal condition

• Cancer

• Crohn’s Disease

• Chronic nonmalignant pain

• Epilepsy

• Glaucoma

• HIV Positive Status

• Multiple Sclerosis

• Parkinson’s

• PTSD

Paperwork
Once you confirm you have a qualifying condition, please fill out all of the necessary paperwork and return it to our office. You can access the paperwork HERE

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Consultation with our Qualified Medical Provider:
After your paperwork is completed, you can then call and schedule an appointment with a Neurotropic® medical provider who is registered with the Florida Office of Medical Marijuana Use (OMMU). During this appointment, the physician will determine if you have a qualifying condition and whether medical cannabis is an appropriate treatment option.

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Physician Certification:
If deemed suitable for treatment, your physician will enter your details and the recommended cannabis treatment into the Medical Marijuana Use Registry.

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Apply for Medical Marijuana Use Identification Card with State of Florida:
After receiving the physician's certification, patients must apply for a Medical Marijuana Use Identification Card. Once you are entered into the state registry, you can complete the necessary form and payment online at the OMMU’s registry, or you can download, complete, and mail in this form to the State of Florida at the address given in the form, along with all payment requirements to submit your information for your medical cannabis ID card. The current fee is $75.00 fee, but reduced fees may apply for certain individuals, such as those on government assistance programs.

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Approval & Card Issuance:
Once the OMMU has reviewed and approved your application, you'll receive your Medical Marijuana Use Identification Card number usually within 24-48 hours from your online payment. You must have your number, card, or a state-issued ID, must be presented at Medical Marijuana Treatment Centers (MMTCs) to purchase cannabis products.

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Purchasing Medical Cannabis:
With an active card, patients can visit any licensed MMTC in Florida to purchase medical cannabis products. The type and amount of cannabis will be based on the physician's recommendations entered into the Medical Marijuana Use Registry.

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Six Month Follow-ups:
Patients must revisit their qualified physician every six months to maintain active status in the Medical Marijuana Use Registry. Your doctor will review the effectiveness of the treatment and make any necessary adjustments.

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Florida Renewal:
The Medical Marijuana Use Identification Card is valid for one year. Patients will need to renew their card before it expires to continue accessing medical cannabis.

Benefits and potential risks of medical cannabis.

Cannabis, commonly referred to as marijuana, has been studied and used for medicinal purposes for centuries. Modern research has provided insights into its therapeutic potential and the biological systems it interacts with, namely the Endocannabinoid System (ECS). Spurred by positive outcomes during medical experiments conducted by doctors in India by during the late 1830s, pharmaceutical preparations of cannabis were then readily available in drug stores and pharmacies until government regulations put a halt to the use.  

Cannabis has natural receptors in the body through a network called the endocannabinoid system (ECS), which plays an important role in regulating several physiological processes, including mood; appetite; sleep; and immune function. When ECS is activated by cannabinoids, such as those found in marijuana, it can reduce inflammation and pain, improve mood, and promote deep stages of sleep. 

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The ECS consists of three main components: endocannabinoids (cannabinoids produced by the body), cannabinoid receptors located throughout the body, and enzymes to metabolize endocannabinoids for excretion from the body.

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Endocannabinoids are derived from arachidonic acid, a type of fatty acid. They are synthesized "on-demand" from cell membrane phospholipids in response to cellular activities or stimuli. Due to their lipid nature, endocannabinoids are not stored within cells but are made as needed and quickly degraded by specific enzymes.

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The cannabis plant contains over 100 distinct cannabinoids. The most well-known and extensively studied are tetrahydrocannabinol (THC) and cannabidiol (CBD). THC is mainly responsible for the psychoactive effects of cannabis, while CBD has garnered attention for its potential therapeutic benefits without the "high" associated with THC. These cannabinoids interact with the ECS, explaining many of the observed medicinal effects of cannabis.

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Endocannabinoids function as retrograde neurotransmitters. This means they move backward against the typical flow of neurotransmitters. When released, endocannabinoids travel back to presynaptic neurons, where they bind to cannabinoid receptors, influencing the release of other neurotransmitters. This process helps regulate various physiological and cognitive processes, including fertility, pregnancy, pre- and postnatal development, mood, appetite, pain perception, and memory.

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Overall, the ECS is an important regulatory system that helps to maintain balance and promote optimal health. Historically, there was plenty of research done on consuming cannabinoid supplements such as CBD (cannabidiol) or THC (tetrahydrocannabinol), but it was more recent studies that tie their interactions with the cannabinoid receptors in the body. 

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CBD has been shown to have a range of potential therapeutic benefits without producing the psychoactive effects associated with THC. Studies suggest that CBD may be effective in reducing inflammation and pain, improving mood and anxiety levels, and promoting healthy sleep patterns.

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Recent studies go beyond some of the simple health benefits and discuss how cannabis can improve other important areas of wellness, such as sexuality. Research from East Carolina University surveyed 811 participants ages 18-85 on cannabis and sexuality. They found that more than 50% used cannabis, 60% intentionally used cannabis prior to intercourse because the experience was better, and 73% of those surveyed were in a monogamous relationship. From a medical doctor’s perspective, this is quite opposite of alcohol, which is known to cause erectile dysfunction, fatigue, promiscuity, anger, and domestic violence. 

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Cannabis Legal Landscape: USA and Global Overview

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United States 
As of 2021, over 30 states have legalized medical cannabis to varying degrees. These states have established medical cannabis programs where patients with qualifying conditions can obtain cannabis products with a physician's recommendation. Furthermore, approximately 18 states, including the District of Columbia, have legalized cannabis for recreational use by adults, typically aged 21 and over. This allows for the possession, cultivation, and sale of cannabis, though specifics vary by state.

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Federal Status: Despite state-level changes, cannabis remains classified as a Schedule I substance under the Controlled Substances Act at the federal level, making its production, sale, and possession technically illegal. However, enforcement varies, and recent administrations have generally adopted a hands-off approach to states with legal cannabis programs. Several bills have been introduced in Congress to change its federal status, but none have been enacted into law as of 2021.

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Global Overview:
Many countries have recognized the therapeutic potential of cannabis and have implemented medical cannabis programs. Notable examples include Canada, Germany, Australia, and Israel. Regulations, qualifying conditions, and accessibility can vary widely. A few countries have also moved to decriminalize or legalize recreational cannabis use. 
For instance:

• Canada: In 2018, Canada became the second country after Uruguay to legalize cannabis for recreational use at the national level.

• Uruguay: In 2013, Uruguay became the first country in the world to fully legalize the production, sale, and consumption of cannabis for recreational purposes.

• Mexico: As of 2021, Mexico's Supreme Court decriminalized recreational cannabis use, but a comprehensive legal framework for commercial sale and production has yet to be established.