In the waning days of the 2014 legislative session, the Florida Legislature passed the Compassionate Medical Cannabis Act of 2014.  It is a very limited medical marijuana bill with very strict restrictions and conditions on use.  The bill allows access to only low-THC (tetrahydrocannabinol) cannabis (so-called "Charlotte's Web") for persons with cancer or another condition that produces seizures or severe and persistent muscle spasms.  Only physicians who are medical doctors (M.D.) or osteopathic doctors (D.O.) may order the low-THC cannabis for patients.

Among the bill's highlights are:

• Medical use does not include smoking but can include vaporizing;
• Patients must be Florida residents and added to a "compassionate use registry" by their physician;
• Physicians may order this drug for these patients beginning January 1, 2015 if
  • Patient is a Florida resident;
  • Physician has completed an 8-hour course on medical marijuana and passed an examination which must be retaken at license renewal;
  • Physician has treated the patient for one of the above conditions and "no other satisfactory alternative treatment options exist"
  • Physician determines the risks to patient are reasonable in light of potential benefits;
  • For patients under 18 years old, a second physician concurs and the concurrence is documented in the patient record;
  • Physician registers as an orderer on the compassionate use registry and lists the contents of each order on such registry;
  • Physician inactivates patient's compassionate use registration when treatment is discontinued;
  • Physician maintains a treatment plan to include dose, route of administration; planned duration, and monitoring of symptoms and reactions to treatment;
  • Physician submits the treatment plan to the University of Florida College of Pharmacy quarterly for research;
  • Physician obtains informed consent for the treatment;

The Florida Department of Health must establish an Office of Compassionate Use to regulate the medical marijuana procedures, including a secure online registry accessible to law enforcement and dispensing organizations. Up to 5 dispensing organizations – one for each region of the state – may be approved by the Department of Health in order to cultivate, process, and dispense  low-THC cannabis.  The dispensing organizations must:

• receive approval from the Florida Department of Health;
• employ a medical director who has completed a 2-hour course and examination;
• possess a valid certificate of registration issued by the Department of Agriculture and Consumer Services that is issued for the cultivation of more than 400,000 plants, be operated by a nurseryman, and have been operated as a nursery continuously for 30 years;
• have the ability to secure the premises and maintain accountability of the marijuana;
• have an infrastructure to dispense the low-THC cannabis;
• have the financial ability to operate for two years and post a $5 million dollar bond; and
• pass background checks on owners and managers.

A physician commits a first-degree misdemeanor if he or she orders low-THC cannabis for a patient without a reasonable belief that the patient is suffering from cancer or another condition that produces seizures or severe and persistent muscle spasms. 

Persons who fake an illness for the purpose of obtaining low-THC cannabis also commit a first-degree misdemeanor.

The bill also authorizes universities to conduct research on low-THC cannabis without violating drug laws.
 
Governor Scott is expected to sign the bill within the next few weeks. Although the bill allows physicians to begin ordering the low-THC cannabis on January 1, 2015, it is not clear if the Florida Department of Health will complete the rulemaking process to establish the Compassionate Use Registry and approve dispensing organizations by that date.  In the meantime, Florida voters will decide in November whether to more broadly legalize medical marijuana for the treatment of other medical conditions.