Florida Explores THC Issue for Medical Marijuana

TALLAHASSEE — As the number of medical marijuana patients in Florida continues to skyrocket, Republican lawmakers are again exploring whether to impose caps on the level of euphoria-inducing THC in cannabis products.

Chris Ferguson, director of the Florida Office of Medical Marijuana Use, told a House panel on Tuesday that the number of qualified patients in the state — more than 485,000 — has “dramatically increased” over the past two years.

But the House Professions and Public Health Subcommittee also heard a lengthy presentation from Harvard University biopsychology professor Bertha Madras, a marijuana critic who warned of the dangers of high-potency cannabis. 

House leaders have pushed to put a limit on tetrahydrocannabinol, the mind-bending component of cannabis, since authorizing smokable medical marijuana in 2019 at the behest of Gov. Ron DeSantis. Florida voters in 2016 legalized medical marijuana, but the state didn’t initially allow the smokable version.

Tuesday’s meeting shed light on the House’s potential approach: The panel heard only from Ferguson and Madras, whose research is questioned by many medical-marijuana experts and industry insiders.

Under Florida law, doctors who are authorized by the state may order medical marijuana for patients once they have determined “that the medical use of marijuana would likely outweigh the potential health risks for the patient.”

Rep. Carlos Guillermo Smith, an Orlando Democrat who is sponsoring legislation that would legalize the use of recreational marijuana for people age 21 or older, asked Ferguson whether a Florida physician review panel has “identified any patterns whatsoever of harmful effects of cannabis on the half a million legal patients we currently have registered.”

“Unfortunately, I do not have that information,” Ferguson said.

Ferguson’s presentation relied on an annual Florida Department of Health report showing that medical marijuana is growing in popularity.

According to the report, the state had 2,700 physicians as of Sept. 30, 2020 who could certify patients — a 47 percent increase in the number of qualified physicians from 2018. 

The numbers of patients who have orders for medical marijuana also have grown since it was initially legalized, the new report shows. 

While there were 133,847 qualified patients as of Sept. 30, 2018, the number of patients using medical marijuana ballooned to 443,888 as of Sept. 30, 2020.

But Madras said marijuana, which remains illegal under federal law and has not undergone clinical trials by the U.S. Food and Drug Administration, poses a special hazard to adolescents. She pointed to studies linking schizophrenia and medical marijuana in young adults.

“We’re playing with fire, in terms of inserting into the developing brain … a drug which could influence the formation of brain development,” Madras said. 

But Smith appeared skeptical.

“There’s a lot in your presentation to respond to. I’m not sure if I should start running for the hills or running for a (medical marijuana) dispensary to relieve my anxiety around so much of what’s been presented,” he told Madras.

The discussion came two days before a joint committee of the Florida Board of Medicine and the Board of Osteopathic Medicine will meet to review practice standards for smoking medical marijuana as a route of administration.

Smith asked Ferguson if he was aware of a letter that more than 50 doctors sent to the medical boards, discouraging them from imposing a THC cap. 

“No, I have not seen that letter,” Ferguson said.

In the letter, the doctors noted that legislators over the past two years have attempted to limit cannabis flower to 10 percent THC.

“These recommendations are based on a single poorly designed study that purportedly showed increased psychosis in cannabis products over 10 percent THC,” the doctors wrote. “Despite the poor design and lack of reproducible results, the study is still being used by special interest groups opposed to medical cannabis to support the 10 percent limit.”

While studies show increased risk of psychosis with higher THC percentages in THC-only concentrates, whole flower “contains many other cannabinoids, some of which can reduce symptoms of psychosis and other mental health symptoms,” the doctors wrote in the Feb. 11 letter.

“This is another reason why whole flower potency should not be limited. These components work better together, and can be safer than other extracted products for mental health,” they argued.

The state’s medical marijuana operators agree.

Limiting the amount of THC in medical marijuana products “clearly upends the will of voters,” Trulieve CEO Kim Rivers told The News Service of Florida. Trulieve is the largest of what are called “medical marijuana treatment centers” in Florida.

“Placing an artificial cap on the concentration of THC will force patients to smoke more and buy more in order to receive the same dosage as recommended by their physician,” Rivers said.

Ron Watson, director of governmental affairs for MuV Florida, said his company is “focused on providing the best medicine for each patient’s unique needs.

“Florida closely tracks almost 500,000 patients, basically in a clinical trial, who utilize a wide range of medical cannabis options. Specific decisions on proper levels, types and strengths of medication should be between the certified patient and qualifying physician,” Watson told the News Service.

A law passed in 2017 after passage of the 2016 ballot measure also required the state to set up a “seed-to-sale” computer software tracking system to keep track of marijuana products from cultivation to retail counters.

More than three years later, however, the state lacks such a system, Ferguson told the House panel when asked about its status on Tuesday.

“The department has attempted twice to obtain a seed-to-sale system. Unfortunately, we’ve been challenged both times by prospective applicants. So we are in the process now and it is going through the department approval process,” he said.

— News Service staff writer Christine Sexton contributed to this report.

Source: Brian Bell / The Daytona Beach News-Journal