Tuesday, September 25, 2018

Smoking out a solution before '16

MOST FLORIDIANS FAVOR medical marijuana of some kind. A flamboyant Orlando lawyer, children with seizures and a presidential election have seen to that.

What type of system Florida might adopt — and when — remains a moving target.

Attorney John Morgan's United for Care group has launched another constitutional amendment campaign for 2016, after falling just shy last year of the 60 percent required for passage.

The Legislature, which took baby steps last session with noneuphoric pot, will consider a more extensive system this year, with Republican lawmakers leading the charge.

Adding to political pressure is next year's general election, where Florida could determine the presidency. Political observers say the prospect of a new constitutional amendment on that ballot poses a potential double whammy for conservative opponents of medical marijuana. Younger, more Democratic voters who turn out in presidential years could boost a pot amendment's chances of passage. And a new pot amendment that stirs up the youth vote could help put a Democrat in the White House.

"How many Republican voters are going to make this the No. 1 or No. 2 issue, pro or con? Probably not a lot,'' says Kevin Hill, political science professor at Florida International University. "But for some Democratic-leaning voters, sure — younger voters, or people who are sick and disabled and we have a lot of those people in Florida.''

Given Florida's typically thin presidential voting margins, Republicans may try to head off a new amendment by passing medical marijuana legislation this year.

"If they think an amendment is going to come automatically close to 60 percent,'' Hill said, "they will probably do something to keep it off the ballot.'' Susan MacManus, political scientist at the University of South Florida, agrees. United for Care's new proposed amendment closed "loopholes" that worried some voters last year, she said. That makes passage more likely while a Florida U.S. Senate seat and the presidency are up for grabs. An expensive medical marijuana fight, she said, "would just be draining away money from two very contentious races that neither party wants to lose.''

Twenty-three states and the District of Columbia now allow marijuana possession for medical purposes. Still, the prospect that Florida might endorse a full-fledged medical marijuana system represents a remarkable political and cultural shift. Republicans dipped their toes in the water last session by approving a limited system designed to help children with severe epilepsy. It allowed only nonsmoked pot with low levels of THC. Implementation is still months away.

This session, some Republicans are ready to push further. Sen. Jeff Brandes, R-St. Petersburg, has introduced Senate Bill 528, which would set up a more traditional medical marijuana system. Patients could smoke marijuana and it could contain high levels of THC.

The Brandes bill contains more restrictions than United for Care's current proposed amendment. Among other things, it would require physicians to have treated patients for at least 90 days before certifying them for pot use. It empowers county commissioners to establish the number and locations for dispensaries within their jurisdiction.

The amendment includes provisions for debilitating conditions where a doctor thinks the benefits of pot outweigh the risks.

The Brandes bill lists specific diseases and conditions. "This is an issue Florida needs to resolve,'' Brandes said last month. "I have asked the Senate president, House speaker and governor to keep an open mind. We all prefer that this be in the statutes rather than the Constitution.''

HB 683, filed by Republican Reps. Greg Steube of Sarasota and John Wood of Bradenton, would impose more restrictions. Only terminal illnesses and eight specific diseases could qualify a patient. The marijuana could not be smoked.

Under both the House and Senate bills, dispensaries would have to post a $5 million performance bond, revocable if they break the rules.

The biggest difference in the two bills relates to severe and persistent pain. The Senate bill includes it as a qualifying diagnosis if the physician attests that the patient has exhausted other reasonable treatment options.

The House bill would not allow chronic pain as a qualifying diagnosis. This tracks principles recently outlined by the Florida Sheriff's Association, which said it could not support legislation that included the pain diagnosis.

Chronic pain is the sweet spot — and a potential flaw — of a medical marijuana system. Most states include it as a qualifying diagnosis. In some, more than 90 percent of patients list it as a reason they need pot. The worry is that pain can be easy to fake. Florida's sordid history with prescription pill mills remains fresh in the minds of people who worry about pot. On the other hand, people with chronic pain often respond poorly to prescription painkillers. They build up tolerance and can become addicted. Marijuana can be an effective substitute, or at least help patients reduce their reliance on narcotics. A study published last year in the Journal of the American Medical Association reported a 25 percent reduction in predicted prescription drug overdoses in medical marijuana states.

United for Care would drop the 2016 amendment drive if legislators approve some kind of "comprehensive" medical marijuana system this session, executive director Ben Pollara said. But excluding patients with chronic pain is a deal-breaker, he said. "Too many people would not be able to get the help they need.''

Legislation needs to draw a line between medical and recreational use, said Pasco County Sheriff Chris Nocco. But beyond that, "it's imperative we get something passed'' to head off another amendment vote.

"If we don't find a solution, we are going to end up with something a lot of people are going to be unhappy with.''

Contact Stephen Nohlgren at [email protected] or (727) 893-8422.

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