FAQs

Obtaining Patient Consent

Low-THC Cannabis Patient Consent

Section 381.986, F.S. requires physicians obtain voluntary, written informed consent from the patient, or the patient’s legal representative, to treatment with low-THC cannabis after sufficiently explaining: 

• The current state of knowledge in the medical community of the effectiveness of treatment of the patient’s condition with low-THC cannabis;

• The medically acceptable alternatives;

• The potential risks and side effects.

 

Terminal Patient Consent

For terminal patients ordered cannabis pursuant so section 381.96, F.S. and section 499.0295, F.S., Florida law requires physicians must obtain written informed consent as defined in section 499.0295, F.S. from the patient, or the patient’s legal representative, to treatment with medical cannabis. This consent must include:

• An explanation of the currently approved products and treatments for the patient’s terminal condition.

• An attestation that the patient concurs with his or her physician in believing that all currently approved products and treatments are unlikely to prolong the patient’s life.

• Identification of the specific investigational drug, biological product or device that the patient is seeking to use.

• A realistic description of the most likely outcomes of using the investigational drug, biological product, or device. The description must include the possibility that new, unanticipated, different, or worse symptoms might result and death could be hastened by the proposed treatment. The description must be based on the physician’s knowledge of the proposed treatment for the patient’s terminal condition.

• A statement that the patient’s health plan or third-party administrator and physician are not obligated to pay for care or treatment consequent to the use of the investigational drug, biological product, or device unless required to do so by law or contract.

• A statement that the patient’s eligibility for hospice care may be withdrawn if the patient begins treatment with the investigational drug, biological product, or device and that hospice care may be reinstated if the treatment ends and the patient meets hospice eligibility requirements.

• A statement that the patient understands he or she is liable for all expenses consequent to the use of the investigational drug, biological product, or device and that liability extends to the patient’s estate, unless a contract between the patient and the manufacturer of the investigational drug, biological product, or device states otherwise

Low-THC & Medical Cannabis

What is low-THC cannabis?

In Florida, low-THC cannabis is distinct from medical cannabis in that it contains very low amounts of the psychoactive component tetrahydrocannabinol (THC). Because of its low levels of THC, low-THC products do not have the euphoric properties of full-potency cannabis and typically do not result in patients experiencing the “high” commonly associated with cannabis.

In order to qualify as low-THC, the flowers, seeds, resin, and any other product derived from the cannabis plant must contain 0.8 percent or less of THC and more than 10 percent of cannabidiol (CBD) weight for weight.

What is medical cannabis?

In Florida, medical cannabis is distinct from low-THC cannabis in that it can contain significant amounts of tetrahydrocannabinol (THC). This is the chemical that causes the “high” commonly associated with cannabis. When consumed in large enough doses, medical cannabis can cause patients significant discomfort, and its use should be closely monitored by the ordering physician.

Under Florida law, the term medical cannabis includes all parts of a cannabis plant, its seeds, resin extracted from any part of the plant; and every compound, manufacture, sale, derivative, mixture, or preparation of the plant or its seeds or resin.

The medical use of medical cannabis does NOT include the following:

• The transfer of medical cannabis to a person other than the qualified patient for whom it was ordered or their legal representative.
• The use or administration of medical cannabis on any form of public transportation, in any public place, in a qualified patient’s place of employment, if restricted by his or her employer, in a state correctional institution, on the grounds of a preschool, primary school, or secondary school or any school bus or vehicle

What are Cannabinoids?

Cannabinoids are a group of active compounds found in marijuana.

While marijuana contains many different compounds, cannabinoids are undeniably the most important.

Cannabinoids are responsible for marijuana’s effects on the body — and the reason users get high. They’re also the reason why medical marijuana works to alleviate so many symptom-related ailments.

However, the relationship between cannabinoids and our bodies is complex.

Because so many people use cannabis for recreational or medicinal purposes, a little information on cannabinoids can go a long way towards understanding how marijuana affects your brain and body.

Cannabis and Cannabinoids

The cannabis plant, also known as marijuana, contains over 500 natural compounds. Cannabinoids happen to make up at least 100 of those compounds, according to recent research. And while some cannabinoids are psychoactive, others are not.

Out of the more than 100 cannabinoids, two stand out: tetrahydrocannabinol (THC) and cannabidiol (CBD). THC, known for its psychoactive properties, is the reason you feel buzzed after ingesting marijuana.

Most strains of marijuana sold on the market today are cultivated with higher levels of THC. While THC has medicinal benefits, too much can trigger anxiety and paranoia in some — particularly in novice users.

CBD is a non-psychoactive cannabinoid and actually works to calm your high.  It’s also believed that CBD has numerous medicinal benefits, such as anti-inflammatory properties and the ability to protect your neurons from injury or degeneration.

How Do They Work?

In the early 1990s, scientists discovered the link between cannabis and feeling high.

Your brain creates its own set of cannabinoids — similar to those found in cannabis — via the endocannabinoid system. The endocannabinoid system, named after Cannabis sativa, is responsible for many important functions, such as appetite, sleep, emotion and movement.

Cannabinoids work by interacting with specific receptors. These receptors are located within different parts of the body, such as the central nervous system and immune system.

Cannabinoids activate two types of receptors: CB1 receptors, located within the nervous system, the brain and nerve endings, and CB2 receptors, located within the immune system.

When marijuana enters your body, THC activates the endocannabinoid system by attaching to cannabinoid receptors. As a result, your reaction time slows, memory is affected, and judgment is impaired. Because of where CB1 receptors are located in the brain, you begin to feel high.

Common Cannabinoids

Tetrahydrocannabinol (THC) is the most common psychoactive cannabinoid. It is best known for causing the high you get from smoking marijuana. However, it also seems to have a number of medical applications, such as pain relief and the ability to improve appetite.

Cannabidiol (CBD) is the second most common cannabinoid. Although it has no psychoactive effects, it appears to improve mood and alleviate pain. CBD has received a lot of attention lately because of its antipsychotic effect that calms the nervous system. Studies suggest that it may help with epilepsy, schizophrenia and a number of other ailments.

Cannabinol (CBN) is created from THC when cannabis is exposed to air — through a process called oxidization. CBN on its own provides a mild psychoactive effect, but when combined with THC can make you feel drowsy and induce sleep.

Cannabigerol (CBG), a non-psychoactive cannabinoid, is the building block for THC and CBD. It has been shown to reduce intraocular pressure, making it ideal for glaucoma patients.

While each cannabinoids works independently, used together, they create an entourage effect, which multiplies the benefits of each individual cannabinoid

10 basic facts of Marijuana

 1. The cannabis plant (also known as hemp) usually grows about 8 to 12 feet high and can be grown outdoors or indoors.

The main active ingredient in cannabis — the part that gives the “high” feeling — is called THC, which stands for delta-9-tetrahydrocannabinol. THC acts on specific molecules in the body known as cannabinoid receptors, which are mostly found in the brain. Different cannabis products have different levels of THC.

The term “cannabis” can also refer to any drug that is derived from the plant, including the three major types: Marijuana, hashish and hash oil.

Marijuana is made from a mixture of dried and shredded flowers of the plant and is greenish-gray in appearance. Hashish is made from the resins of the plant and hash oil is a sticky, black liquid.

2. Marijuana has different strains

(Photo: Drug Policy Alliance)

Marijuana strains can be pure or hybrid varieties, usually derived from the two major species of cannabis: indica and sativa. Different strains have been bred to intensify certain characteristics of cannabis.

One of the most popular strains is OG Kush. It has the highest THC content of all Kush strains and is recognized as one of the strongest cannabis strains.

Sour Diesel is another well-known strain, which has a strong odor and mood-enhancing effects.

3. Marijuana can be consumed in a number of ways

(Photo: Drug Policy Alliance)

Marijuana can be rolled into a joint using rolling paper. When tobacco is mixed in — to add flavor and to make it burn slower — it’s called a spliff. Marijuana can also be smoked in a cigar shell, which is referred to as a blunt.

Another common method of smoking marijuana is with a pipe. A bong is a special type of pipe that passes smoke through water and is regarded by some as an effective way to reduce exposure to carcinogens in smoke.

Another method of consuming cannabis is by eating it in the form of edibles. Steeping it as a tea is also an option.

Out of all these methods, researchers and doctors agree that using a vaporizer is the safest way to consume marijuana. Vaporizers heat the cannabis to a point that vaporizes the active ingredients without burning it, thus eliminating the harmful effects of smoking.

4. Marijuana has physical and psychological effects

(Photo: NIH/Flickr)

The effects of marijuana begin within a few minutes after inhalation and can last a few hours. THC is absorbed more slowly when it’s taken as a food or liquid and the effects take longer to be felt.

The marijuana high can affect a user physically in a number of ways, including an increased heart rate, dry mouth, bloodshot/glazed eyes and an increase in appetite (often referred to as the “munchies”).

When a user is high, they most commonly feel euphoria and a sedative tranquility. Effects may also include lowered inhibitions, drowsiness, and silliness/giddiness. Some users also report anxiety and paranoia.

People who smoke marijuana may experience long-term effects, similar to that of a cigarette smoker, such as a cough, frequent chest colds and chronic bronchitis. Using a vaporizer has been shown to prevent these effects.

5. Marijuana has many street names

Street names for cannabis vary by region and demographic. Older slang terms for cannabis include pot, herb, Mary Jane, grass, reefer, dope and weed. Ganja, bud, chronic and skunk are also commonly used.

Other slang terms related to marijuana include pothead, which refers to a heavy user; headshop, which is a store that sells paraphernalia; and 420, which can refer to the time for smoking marijuana (4:20) or the unofficial holiday (April 20th).

6. The legality of marijuana varies by country

(Photo: muralswallpaper.co.uk)

Countries around the world have different laws about the use of cannabis recreationally and medicinally. There are also different regulations for possession and sale of the drug.

Possession of cannabis is legal in Colombia, Ecuador, Peru, Spain, Netherlands, North Korea, Uruguay and a number of states in the U.S.

Cannabis is decriminalized in many countries, meaning it’s prohibited but is not considered a criminal offence and would merit minor penalties.

Marijuana is legal in some U.S. states, including Colorado, Washington, Oregon and Alaska. It is medically legal in 25 states and decriminalized in 20 states.

Although cannabis is widely used in Canada, it’s illegal in all provinces and territories without a doctor’s prescription. However, a newly elected government is currently drafting legislation that would legalize and regulate marijuana for all adults nationwide.

7. Marijuana is commonly used

ding to the 2014 National Survey on Drug Use and Health, 22.2 million Americans used marijuana in the past year — a significant jump from previous years.

According to a 2015 Gallup poll, 44% of Americans have tried marijuana in their lifetime.

The percentage of Canadians who have tried the drug is also 44%, according to data from the Centre for Addiction and Mental Health. A 2012 survey found that 12.2% of Canadians used marijuana in the past year.

8. Marijuana is one of the world’s oldest crops

The cannabis plant is believed to be one of the oldest crops cultivated by humans. Records of its use date back over 6000 years. Early civilizations relied on hemp crops as a source of food, fibre, oil and paper.

A Chinese medical reference as old as 2700 BC is usually cited as the first mention of medical use of marijuana. The Ancient Chinese used cannabis to treat constipation, malaria, rheumatic pain and female disorders.

Consumption then spread to India and the Middle East, where Muslims used hashish. It eventually reached Europe around 500 BC.

9. Marijuana is safer than alcohol

The most commonly cited reason for this belief is that cannabis has never directly caused a death, while alcohol claims many lives each year. In fact, according to the World Health Organization, there were 3.3 million deaths attributed to alcohol in 2012.

Of course, alcohol poisoning is responsible for some of these deaths. On the other hand, no one has ever died from a marijuana overdose.

But the long-term effects of alcohol, such as chronic illnesses, cause the most deaths. Another argument is that marijuana has a number of proven medical uses, whereas no doctor would ever recommend alcohol to a sick patient.

10. Marijuana can be prescribed for many conditions

(Photo: Alex Proimos/Flickr)

The use of medical marijuana has become more and more common in the U.S. and around the world. Patients that are approved to use medical marijuana usually buy the drug from a licensed supplier.

Medical marijuana can be smoked, vaporized, eaten or taken as a liquid.

Cannabis is most commonly prescribed for pain. This could include anything from migraine headaches to spinal injury. It can also be helpful for patients experiencing nausea and appetite loss, such as those undergoing chemotherapy.

Some doctors also prescribe marijuana for Crohn’s disease, multiple sclerosis, epilepsy, anxiety, PTSD, depression and a variety of other conditions.