TALLAHASSEE — Florida is now officially a medical marijuana state after a voter-approved measure legalizing the drug went into effect Tuesday, but state health officials remain unclear about how — or even if — patients can access the drug.
Amendment 2, which was added to the state Constitution with 71 percent of voters' support in November, allows doctors to recommend marijuana for patients with a long list of debilitating conditions, including cancer, HIV/AIDS and post-traumatic stress disorder.
The amendment went into effect Tuesday, starting the clock on a six-month deadline for the Florida Department of Health to set rules governing the program.
But the Health Department has been vague about who is currently allowed to use cannabis, causing confusion for doctors and patients.
"The Florida Department of Health, physicians, dispensing organizations and patients are bound by existing law and rule," Health Department spokeswoman Mara Gambineri said in a statement to the Times/Herald. "It is incumbent on the qualified ordering physician to follow the law when diagnosing patients and determining if medical marijuana is an appropriate treatment."
That includes both Amendment 2 and the laws governing two existing, narrower medical cannabis programs, she said. Those programs, passed by the Legislature in 2014 and 2016, allow terminally ill patients to buy full-strength marijuana and certain other patients, such as children with severe epilepsy, to have strains of cannabis low in the chemical THC, which causes the sensation of being high.
Yet the existing laws do not set out any requirements or options for the tens of thousands of patients who could become eligible under the expanded list of conditions voters approved in Amendment 2.
Gambineri did not provide clarity when asked if doctors could recommend cannabis for the additional patients and did not say what rules they should use to do so.
"Doctors should probably consult their legal representation to ask that question," she said in a telephone interview with the News Service of Florida.
The Department of Health has started writing rules for a broader medical marijuana program, Gambineri said, though it has not yet formally proposed them and did not put into place an emergency rule to give new patients access under the old system in the meantime.
State lawmakers made no moves to pass a law implementing the amendment when they came to Tallahassee for an organizational session. Both House Speaker Richard Corcoran, R-Land O'Lakes, and Senate President Joe Negron, R-Stuart, said they plan to address the issue during the regular legislative session that begins March 7.
Already, patients are going to doctors to seek cannabis. Silvia Bentancor, an internist who practices at CBD Clinic, which specializes in cannibis-based treatment in southwest Miami-Dade County, said she has had several patients come to her clinic to start building a relationship in hopes of being able to use marijuana later this year.
"There are many patients with cancer, neurological disorders or serious digestive problems that are waiting with hope of using a natural product," she said.
Tampa-based cannabis grower and dispensary Surterra, one of seven currently licensed in the state, reported no problems the first day of Amendment 2 going into effect. But dispensaries are not tasked with determining who can use the drug. That is left up to doctors, who enter patients into a statewide database maintained by the Department of Health.
"If you are in the system and we are able to verify you are who you say you are, we'll give you whatever it says you're eligible for," said Monica Russell, spokeswoman for Surterra. "We are ready to serve any patient that a doctor qualifies at this point."
Eventually, the Legislature and Health Department will have to act. But in the meantime, doctors, dispensaries and patients have been left confused.
"There's still a lot to do with implementation and what that means," Russell said. "I think we're all just sort of anxiously awaiting the 'What now?' "
Miami Herald staff writers Alex Harris and Joey Flechas contributed to this report, which also used information from the News Service of Florida. Contact Michael Auslen at firstname.lastname@example.org. Follow @michaelauslen.