Recommending Cannabis in Florida

Florida law authorizes physicians to recommend “low-THC cannabis” to (i) treat cancer, severe seizures, or severe muscle spasms or (ii) alleviate symptoms of such disease, disorder or condition, if no other satisfactory alternative treatments exist for those symptoms.  “Low-THC cannabis” is defined as cannabis that contains “0.8 percent or less of tetrahydrocannabinol and more than 10 percent cannabidiol weight for weight.”

Florida law also permits physicians to recommend “medical cannabis” with normal THC content to patients with terminal conditions.

Initial Requirements

To recommend medical marijuana, physicians in Florida must:

  • Hold an active, unrestricted license as a physician under Chapter 458 of Florida Statutes or as an osteopathic physician under Chapter 459;
  • Have treated the patient for at least three (3) months prior to recommending and registering the patient for medical marijuana use; and
  • Have successfully completed a training course on medical marijuana.

Educational Requirements

Florida law requires all physicians who wish to recommend medical marijuana to successfully complete an 8‐hour course offered by the Florida Medical Association or the Florida Osteopathic Medical Association. In addition to increasing their knowledge on medical cannabis, physicians will earn 8 AMA PRA Category 1 CME Credits™ that can also be used towards licensure and accreditation requirements. Successful completion of this course fulfills the Florida state requirement for physicians who wish to order cannabis for their patients' use. The physician must successfully pass an examination upon completion of the course.

A link to the course and examination is available on the Physician's tab located on the Office of Compassionate Use website. Additional information concerning the course may be viewed at the following link: http://www.flcannabisce.com/

To remain eligible to recommend medical marijuana, each physician must retake the training course every time he or she renews the license.

Recommendation Requirements

In addition to the requirements described above, each physician who wishes to recommend medical marijuana must comply with the following requirements:

  • Must determine that the risks of treatment with medical marijuana are reasonable in light of the potential benefits; for all patients younger than 18 years of age, a second physician must concur with that determination, which must be documented in the patient’s medical record;
  • Must explain in sufficient detail to the patient or the patient’s legal representative the current state of knowledge concerning the efficacy of medical marijuana treatments, the potential risks and side effects of those treatments, and any medically acceptable alternatives;
  • Must obtain from the patient or the patient’s legal representative voluntary written informed consent to treatment with medical marijuana;[1]
  • Must maintain a patient treatment plan that includes the dose, route of administration, planned duration, and monitoring of the patient’s symptoms and other indicators of tolerance or reaction to the cannabis;
  • Must not order for the patient more than a 45-day supply of medical marijuana;
  • Must not be a medical director of a “dispending organization,” as defined in Chapter 381.986, Florida Statutes.

Compassionate Use Registry

In accordance with Florida law, the Department of Health created an online statewide registry, known as the “compassionate use registry.” This database provides the only means by which doctors in Florida can order medical marijuana for their patients who qualify for such medicine. Dispensing organizations will also use this registry to verify that a patient is eligible to receive medical marijuana.  

Physicians use the compassionate use registry to register themselves as the orderers of medical marijuana for their patients and to enter orders for medical marijuana as well as any cannabis delivery device to be filled by one of the licensed dispensing organizations.

In using the registry, the physician must comply with the following requirements:

  • must specify such amount of medical marijuana that will not exceed a 45-day supply per order;
  • must update the registry within seven (7) days of any change to the original order;
  • must deactivate patient’s or legal representative’s registration if treatment is discontinued.

Please visit the following link for more information on the compassionate use registry:

http://www.floridahealth.gov/programs-and-services/office-of-compassionate-use/compassionate-use-registry/index.html

Reporting Requirements

Physicians must submit quarterly reports on the progress of patients to the University of Florida. Physicians must also submit a report any time the treatment plan changes.

Penalties

Sections 381.986(3)(a) and (b) of Florida Statutes provide that any physician who orders medical marijuana without a reasonable belief that the patient is suffering from an eligible condition commits a first-degree misdemeanor, which is punishable by imprisonment for up to one year or up to $1,000 in fines.

Sections 381.986(3)(e) exposes physicians to disciplinary action if they receive compensation from a dispensing organization that is related to the physicians’ ordering of medical marijuana or a cannabis delivery device.

Physicians may be subject to disciplinary action under the practice act and section 456.072(1)(k), Florida statutes if they fail to comply with the educations requirements described above.

Related Forms and Applications

Sample templates for patient treatment plans are available at the following link: https://cca.pharmacy.ufl.edu/


[1] The requirements for obtaining written informed consent from terminally ill patients eligible for “medical cannabis” are set forth in Section 499.0295(2)(e) of Florida Statutes and may be viewed at the following link: http://www.floridahealth.gov/programs-and-services/office-of-compassionate-use/physician-requirements/patient-consent/index.html.