On November 8, 2016, Florida voters passed Amendment 2, which greatly expanded who is eligible to receive medical cannabis treatment. Because of the numerous regulations that must be followed, Dr. Berger has established a second practice, Family Medical Cannabis Clinic (FMCC), to streamline the process of evaluating and treating eligible patients. All patients must have an appointment with FMCC before a medical cannabis order can be placed.
Amendment 2 goes into effect January 3, 2017, and over the past several weeks many of you have contacted us with questions regarding who qualifies under the new law and when treatment will be available to qualified patients. To answer these questions most effectively, we decided to send this letter to all Florida residents of our practice to update you on where things stand.
Who Is Eligible?
After considering legal and medical factors, Dr. Berger determined any active Wholistic Pediatrics and Family Care (WPFC) patient who has been a patient of Dr. Berger’s for at least 3 months, may qualify for medical cannabis treatment if:
- The patient is a Florida resident with a “Debilitating Medical Condition,” which has been defined as cancer, epilepsy, glaucoma, positive status for human immunodeficiency virus (HIV), acquired immune deficiency syndrome (AIDS), post-traumatic stress disorder (PTSD), amyotrophic lateral sclerosis (ALS), Crohn’s disease, Parkinson’s disease, multiple sclerosis, or other similar medical conditions.
- The physician believes the benefits of using medical cannabis would likely outweigh the potential health risks for a patient. Patients 17 years old and under must have a second physician agree with this statement and this must be in the medical record. We can help arrange this second physician’s independent medical assessment if needed.
- No other satisfactory alternative treatment options exist.
In the absence of further rules and regulations, Dr. Berger is interpreting the phrase “other” medical conditions by comparing the patient’s symptoms to those associated with the specific diagnoses listed in the law. For example, in Dr. Berger’s medical opinion, it is reasonable to consider medical cannabis for a patient suffering from debilitating anxiety, panic attacks, depression, or insomnia akin to that commonly experienced by PTSD patients. Under this analysis, Dr. Berger believes many patients with autism spectrum disorders will qualify for medical cannabis treatment. Qualifying medical conditions may also include rheumatologic/arthritic conditions, chronic pain syndromes, autoimmune diseases similar to those associated with multiple sclerosis, and chronic abdominal pain syndromes similar to those associated with Crohn’s disease.
In considering whether a patient qualifies, Dr. Berger will work with the patient and family to determine whether all other treatment options have been considered, the potential benefits outweigh possible risks, and adequate informed consent has been established.
Any of Dr. Berger’s active patients who have been working with him a minimum of three months may be evaluated at this time. Newer patients must wait until the required three-month time period has passed before potentially starting treatment.
Low-THC Cannabis (CBD) and THC-Containing Medical Cannabis
Low-THC cannabis has very low amounts of the psychoactive ingredient THC and does not usually produce the “high” commonly associated with cannabis. Medical cannabis can contain significant levels of the psychoactive ingredient THC and may produce the “high” commonly associated with cannabis.
Dr. Berger takes very seriously the use of THC as a medical treatment. Although he evaluates and develops treatment plans for each patient individually, he has developed a general approach to treating patients with mental health and neurological conditions, especially if the patient has no prior experience using cannabis. Dr. Berger’s general treatment protocol will entail gradually increasing the dose of low-THC cannabis and then making a decision whether THC-containing medical cannabis should be added to a particular patient’s treatment plan. Starting treatment with THC-containing medical cannabis may be a better treatment approach for patients with cancer and certain other conditions; however, higher doses of THC may be tolerated better if CBD is used simultaneously.
Getting Evaluated for Medical Cannabis Treatment
We request that WPFC patients who would like to be evaluated for medical cannabis send an email to Emily through the WPFC patient portal (ChARM) with “Medical Cannabis” as the subject line. In the message please state the following: (1) The debilitating conditions/symptoms, and (2) whether these debilitating condition/symptoms have already been documented in a WPFC consultation note or is in the patient’s WPFC chart as as part of documentation obtained from another licensed professional.
After receiving this information, at Dr. Berger’s sole discretion, we will notify the patient/family whether we have enough information in the patient’s WPFC chart to justify considering the use of medical cannabis. If not, we will request further evaluation via an additional WPFC consultation with Dr. Berger or ask the patient to provide adequate documentation from a qualified medical provider, mental health therapist, physical therapist, occupational therapist, speech/feeding therapist, behavioral therapist, or teacher.
If a patient or family member would like to have a consultation with Dr. Berger to determine if medical cannabis should be considered in the first place, that appointment should be made with WPFC. Specific dosing regimens, even if appropriate, will not be documented during that consultation. Dr. Berger will determine the dosing protocol and register the patient with the State of Florida only after he has seen the patient through FMCC.
Once Dr. Berger has authorized a WPFC patient to move forward in the process, the patient may contact FMCC to schedule an appointment. To fully understand the eligibility requirements for medical cannabis treatment, please visit the FMCC website and first review the Active WPFC Patients page and then Our Step By Step Process. If you would like to schedule an appointment, please complete the Contact Us form on the FMCC website.
Evolving Rules and Regulations
Under current law, Dr. Berger must treat a patient for at least three months before he can order medical cannabis as a treatment for that patient. Our current policy is that any active WPFC patient treated by Dr. Berger for a minimum of 3 months who also completes a consultation with Dr. Berger through FMCC, will be eligible to have a treatment plan developed during the patient’s initial FMCC appointment, assuming all Florida-mandated prerequisites have been satisfied.
If the State of Florida enacts new rules and regulations requiring additional consultations with the ordering physician, we will adjust FMCC policies and procedures to comply with all applicable laws. Additionally, although Amendment 2 goes into effect January 3, 2017, Dr. Berger cannot guarantee he will start ordering medical cannabis for eligible patients on that date, or immediately thereafter. Dr. Berger will only order medical cannabis after he is confident he is doing so in full compliance with Florida law.
We hope we have answered many of your questions regarding the expanded use of medical cannabis in the State of Florida. Please visit the FMCC website for further information and, as always, please do not hesitate to let us know if you have additional questions.
Take good care,
Your Wholistic Pediatrics and Family Care Team