PolitiFact Florida: Will doctors write prescriptions for medical marijuana if you have an itchy back?

As medical marijuana heads to the ballot in Florida in November, opponents like Senate President Don Gaetz have argued that it will be too easy for people who want to smoke pot recreationally to get their hands on it.

"It doesn't require a physician writing a prescription, and it can be for purposes as specious as having a back that needs to be scratched," Gaetz said in an interview on Feb. 13. "That's the legalization of marijuana that I oppose and will vote against in November." We wondered if Gaetz's specific claims about physicians and purposes was fully accurate.

The ballot summary that the Florida Supreme Court approved last month for the November ballot mentions doctors right off the bat: "Allows the medical use of marijuana for individuals with debilitating diseases as determined by a licensed Florida physician."

But if you read further into the amendment text, you'll see that technically patients wouldn't get a "prescription."

Instead, patients will get a "physician certification," which the amendment text states means "a written document signed by a physician" stating that in the physician's professional opinion the patient suffers from "a debilitating medical condition" and that the benefits of marijuana likely outweigh health risks. It may only be provided after a physical exam and a full medical history.

Robert Mikos, a Vanderbilt law school professor who specializes in drug policy, said there's a fine distinction between a certification and a prescription.

Doctors generally don't "prescribe" marijuana, because in order for a physician to be allowed to prescribe narcotics, the doctor must register with the Drug Enforcement Agency. If the practitioner were to prescribe a Schedule I drug like marijuana — which means under federal guidelines it is a dangerous narcotic, with no approved medical uses — they would lose their registration, and would no longer be allowed to prescribe drugs.

On the other hand, a 2002 federal court decision found that a doctor could simply recommend the drug, protecting the discussion with their patient under the First Amendment.

"In the legally relevant sense, it's no different than a doctor recommending jogging every day," Mikos said. The certification would document the discussion and create a paper trail similar to a prescription.

Once a patient gets that certification, the Department of Health will issue the patient an identification card, according to the ballot language. Approved patients would purchase marijuana from registered, state-regulated centers.

The amendment lists a number of qualifying "debilitating" conditions for medical marijuana, including cancer, glaucoma, and HIV/AIDs, among others. But it also says: "or other conditions for which a physician believes that the medical use of marijuana would likely outweigh the potential health risks for a patient."

The Supreme Court, in allowing the amendment to go forward, noted that "debilitating" conditions include those that "cause impaired strength, weakness or enfeeblement." We've previously reported that the ballot language suggests marijuana could be recommended for conditions like muscle spasms, neck pain, back pain or menstrual cramps, if the conditions were "debilitating."

Gaetz's spokesperson Katie Betta defended his choice of words on those grounds, calling the amendment "open-ended."

"The Supreme Court's ruling did not interpret the amendment for application and will not be bound by any interpretation that was advanced related to the ballot summary challenge," Betta said.

Still, Gaetz seems to be going too far using an example of "a back that needs to be scratched." Certainly, chronic itching can be a serious condition, but Gaetz's implication is that a condition with a simple remedy could be used to qualify for marijuana. The ballot language sets a higher bar than that, noting that the condition must be "debilitating."

Overall, Gaetz's statement suggests Floridians could get marijuana without a doctor being involved, but that's not the case. They won't get prescriptions, but they will get written certification. Also, the ballot language says that a condition must be debilitating. We rate this claim Half True.

Edited for print. Read the full version at PolitiFact.com/Florida.