Learning the ins and outs of medical marijuana

Medical marijuana is a fact in Florida.

Voters approved it in a 2016 referendum.

Lawmakers passed a law regulating it, effective January 2017.

Cities and counties generally are writing local ordinances in line with state law to permit dispensaries, but limit their locations.

Local governments, however, do have the option to ban them.

Pasco County commissioners are expected to vote on an ordinance in November that will treat medical marijuana dispensaries as pharmacies — and prohibit them from operating within 500 feet of public and private schools.

A display at a medical marijuana forum shows the many ways medical marijuana is delivered to patients. There are topical creams, vaporizers, oral syringes, tinctures and nasal sprays. (Kathy Steele)

The full impact of legalized medical marijuana, also known as medical cannabis, is a work-in-progress, with potential for legislators to tinker with the law in 2018.

A Community Awareness Series, hosted by the Pasco-Hernando State College’s Porter Campus, took on the issue at its “Medical Marijuana Legalization and Regulation Symposium” on Oct. 26.

About 100 people attended the seminar, which was open to students, faculty and the public.

The college wants “to bring dialogue and conversation to the issues that can affect our lives,” said Kevin O’ Farrell, provost at the Porter Campus.

Speakers included Keith Stolte, an ophthalmologist, who owns Stolte Eye Center in Spring Hill; and, Victoria Walker, media relations for Trulieve, one of 17 state approved dispensaries.

Stolte began treating patients with medical marijuana as soon as the state law took effect on Jan. 3.

He previously had researched medical marijuana and believed in its benefits for a host of ailments, in addition to glaucoma.

“We’re changing lives,” Stolte said. “If anybody told me we’d be getting the results we’re getting, I wouldn’t have believed them.”

His first patient was a teenage girl who was home-schooled due to a social anxiety disorder. “She couldn’t leave the house,” Stolte said.

Within a month of starting treatment, she enrolled in a local high school, and soon after, joined the cheerleading squad.

“That’s something else,” he said.

Laurie Oliver, practice manager at Stolte Eye Center, was a medical marijuana skeptic when she first learned of plans to see medical marijuana patients.

“I’m an old-fashioned Southern woman,” she said. “You were taught marijuana was awful.”

But, the patients changed her mind, including an elderly woman with tremors who shook so badly she couldn’t feed herself. The woman came by the office soon after starting medical marijuana to proudly display a blue shirt, without a food crumb or stain on it.

“She just wanted to feed herself before she dies,” said Oliver.

Patients’ success stories are starting to change everyone’s attitudes, Stolte said.

“We are starting to drift from demonization of marijuana, and this could be really good,” he said.

The stigma that attaches to marijuana use also leads to misconceptions about dispensaries, said Walker.

They aren’t “head” shops with hippies in sandals behind the counter selling weed and bongs. In fact, state law bans the sale of the whole marijuana plant, Walker said.

“There is no smoking,” Walker said, adding anyone who walks into a dispensary will find a professional, medical office environment.

Security measures are mandated by law.

Trulieve stores typically have about 40 cameras. The same tight security is maintained at its facility in Tallahassee, where the cannabis plants are grown and medical marijuana products are manufactured.

Engineers and scientists work in Trulieve’s laboratory to develop and test different strains of cannabis.

Plants are pesticide-free and are grown indoors.

Products are offered in a variety of forms, including vaporizers, nasal spray, tinctures, topical creams, oral syringes and capsules. They may contain two of the main ingredients found in marijuana plants – tetrahydrocannabinol (THC) or cannabidiol (CBD).

The more common ingredient is THC, which can produce the “high” associated with marijuana. But CBD, which can’t produce a high, is becoming more popular with doctors because it can produce fewer side effects, Stolte said.

Edibles are legal, but Walker said dispensaries are waiting on rules regarding packaging and size before introducing them.

When they come, she said, “It will be very anti-attractive to minor children.”

The state is closely monitoring this fledging medical marijuana industry.

Dispensaries are capped statewide at 17. Each one is allowed to own and operate 25 retail stores.

Trulieve has 10 locations, with stores opening soon in North Fort Myers and Orlando.

Stores are open seven days a week. “We treat them just like a pharmacy,” Walker said.

Because state law gives cities and counties the option to ban dispensaries, Walker said, “It’s really up to local communities and towns to let us in.”

Doctors and patients also have regulations.

Doctors aren’t permitted to dispense medical marijuana. Doctors are not allowed to write a prescription, either, because marijuana is considered a controlled substance under federal law.

Physicians also must take a state mandated two-hour course and register with the state before they are qualified to “recommend” medical marijuana.

With a recommendation letter in hand, patients visit a dispensary to receive their medication. Patients must register on a confidential state database, and they have to wait about 30 days to receive a card.

Medical marijuana is dispensed in 70-day increments. Once the 70 days expires, a patient can renew the recommendation for another 70 days. This can be done sometimes by phone but, about every six months, there must be a face-to-face visit with a doctor.

By law, 10 diseases are listed as eligible for medical marijuana including epilepsy, glaucoma, post-traumatic stress disorder, Crohn’s and Parkinson’s.

But, the law also includes “medical conditions of the same kind or class as or comparable” to those specifically listed.

That gives doctors some discretion in approving patients who don’t neatly fit any of the approved categories, Stolte said.

He also noted that medical marijuana could play a role in addressing the opioid epidemic.

“You can kill yourself with opioids. You can’t kill yourself with marijuana,” Stolte said. “It (marijuana) is not a gateway drug. It’s an exit drug.”

Research is beginning to show that medical marijuana reduces opioid prescriptions and overdose deaths, he added.

“We’re treating people who have failed on everything else out there,” Stolte said.

The next event in the Community Awareness Series will be “DUI (Driving Under the Influence) Awareness Seminar” on Nov. 15 from 11 a.m. to noon. It will be at Pasco-Hernando State College, 2727 Mansfield Blvd., in Wesley Chapel, in the Conference Center, Building B, Room 303.

For information, visit PHSC.edu.

Published November 8, 2017

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