January 24, 2017

 

Day 89

Mark Moore, MD

Cancer is a terrible disease and cancer patients deserve access to their medications without unnecessary delay. In 2014, Florida passed its first medical cannabis law to help patients suffering from cancer and other debilitating diseases, receive medicines they need. Sadly, cancer patients had to wait two years for the first dispensary to open, then I was the first physician in North Florida to obtain certification to prescribe medical cannabis and our office MEDCAN opened its doors for this purpose in July 2016. 

Then we waited 90 days.

To be sure, the Florida medical cannabis laws are complex and painstaking for doctors and patients. Everyone understands the need to proceed with care when it involves controlled substances. The Florida Board of Medicine, the Florida Medical Association, the State of Florida and its physicians all desire to protect their patients from the dangers of overuse, addiction and diversion. And rightly so. Until recently, car wrecks were the leading cause of death for our youth—but now it is fatal narcotic overdoses. 

Part of the problem with the opiate scourge and the “pill-mills” of Florida was that many big businesses put profit before patients. And health care providers took a back seat, to the detriment of those patients.  Thankfully, Attorney General Pam Bondi took a strong stand on the indiscriminate prescribing of narcotics and closed many of the clinics.  She should be credited with saving the lives of so many of our citizens.

For most of our patients at the MEDCAN Office, a significant percentage of whom have cancer, medical cannabis is a godsend. I remember when one of my earliest patients reached her 90-day mark. We sat down at the computer to enter her data into the state registry, and then write her first recommendation for medical cannabis.  She cried. Then she laughed and hugged me. She has done well, and so have others.

But some stories do not end as well. One day in the clinic, I entered the exam room and sat down with a young woman with newly-diagnosed cancer. After our evaluation was complete, I reviewed the Florida laws with her. When I told her that there was a 90-day waiting period to receive her prescription, she looked at me tearfully and said: “that is ok…. if I’m still alive”.  She did not show up for her 90-day appointment at our office, so my office staff made a follow-up call to her home.  The family member solemnly said: “she died yesterday”. My patient literally died on Day 89.  We were heartbroken, not only because she died so soon, but because we were never able to fulfill her hope and desire to receive her medicine.   How can we explain to our patients that the same law that recognized the efficacy of deathbed medical cannabis created a 90-day roadblock to receive it?

Reasonable access to medicines under the Florida medical cannabis law is a pressing issue. A significant number of my patients that do receive prescriptions are told the dispensary is “out-of-stock,” or “out of that formulation,” or that there is not even a dispensary in their entire county. Amendment 2 and the Medical Marijuana Treatment Centers (MMTC’s) and caregivers designated in it were to allow more individuals and providers to be involved in growing and dispensing services to make these medicines available for patients. With the passage of Amendment 2, we have an opportunity and a mandate for change. 

Cannabis has been approved in Florida as medicine. It is in the Florida Constitution. It is not just any medicine, and it is not like alcohol. Cannabis is classified as C-1, the highest controlled substance in the U.S., categorized as such with highly-addictive, deadly narcotics and opiates. Local city and county officials would do better to simply designate dispensaries as “Medical Commercial,” instead of “Open Commercial,” thereby avoiding contentious battles over moratoria.

Our state and local legislatures work hard for our citizens and I applaud their efforts to help the people in Florida.  With this in mind, as they promulgate the rules for Amendment 2, I respectfully urge Florida’s lawmakers to eliminate the 90-day waiting period for all confirmed terminal cancer patients and reduce the waiting period for all other patients to 30-days. We all want to see patients get the care they need, when they need it.  Improved access to medical cannabis can be accomplished by allowing qualified physicians to own and open MMTC’s to help their patients.

Florida says cannabis is medicine. Health care providers should be actively engaged in the legislative process, the industry, and MMTC’s to help their patients.  Certainly, we doctors should--our patients are counting on us.

Mark Moore, MD is a board-certified anesthesiologist and founder of the MEDCAN Medical Marijuana Certifying Clinic in Tallahassee, Florida. MEDCAN was the first medical doctors office in the state entirely dedicated to the certification of patients to receive medical cannabis.

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