NAPLES – Voters will consider making Florida the 24th state and the first in the South to approve a comprehensive medical marijuana program, but opponents argue a synthetic form of marijuana already offers medical relief that’s controlled by the Food and Drug Administration.
The debate over medical marijuana in Florida has raged between supporters who cast it as a compassionate way to treat pain and suffering, and opponents who say it’s the opening of a Pandora’s box that cannot be controlled.
If passed, the law would allow medical use of marijuana for patients with debilitating diseases, including cancer, glaucoma, HIV, AIDS, hepatitis C, ALS, Crohn’s disease, Parkinson’s disease, multiple sclerosis. However, it also allows Florida physicians to certify it for any patient with conditions that could benefit.
The state Department of Health will set the regulations, including registering and regulating centers, dispensaries and farms, issuing identification cards to patients and caregivers — and keeping patients’ identities confidential.
After failing to get the state Legislature to place the measure on the ballot, advocates for medical pot took to the streets, exceeding the 683,000 petition signatures needed to put the issue to voters and, if approved, write it into the state Constitution.
Early polls suggested strong voter support for medical marijuana — beyond the 60 percent required for passage — but the numbers have dwindled in recent weeks and the campaign has grown more polarized.
Synthetic drug available
Opponents argue that medical marijuana isn’t needed because an FDA-controlled version is already available. State health records show Dronabinol, a synthetic marijuana pill marketed as Marinol and Drabinol and sold at pharmacies, was used extensively in 2012. A total of 9,847 patients statewide received 1.6 million pills, including 201 from Collier County and 253 from Lee.
That increased in 2013 to 10,956 patients statewide obtaining 1.74 million pills, with 152 patients in Collier and 285 in Lee. And usage this year likely will surpass that, with 1.33 million pills doled out to 9,588 patients as of Aug. 31.
Although the synthetic marijuana is available at pharmacies, it’s not the same as marijuana.
“Marinol does not relieve pain,” said Dr. Mark Markowitz of Florida Cancer Care Specialists and Research Institute. “It helps appetite and nausea — and it’s really not effective at making appetite better.”
Markowitz is among the doctors who won’t be pushing medical marijuana if Amendment 2 passes Nov. 4.
“It may be that marijuana might add to the power of analgesics but in my opinion, it certainly is not indispensable,” he said. “I never sat in my office and said, ‘God, I wish I could get some marijuana.’ I think it’s a bunch of nothing. I’m not against it, but if they think it’s some magical panacea, it’s not.”
Marijuana ‘works immediately’
The Florida push began with Orlando attorney John Morgan, who funded the petition drive to get the amendment on the ballot. Morgan, who has said he expects to spend $6 million on the medical marijuana campaign, disputes arguments that dispensaries and treatment centers would bring back the problems associated with pill mills here, noting doctors and patients will be monitored by state officials.
He also disputes opponents’ contentions that medical marijuana is dangerous, noting painkillers are far worse because they can kill. And, he scoffs at opponents’ arguments that pot pills are already available, adding that they do nothing for pain.
“Ask any chemo patient,” Morgan said. “They’ll tell you it doesn’t work, but marijuana works immediately.”
Medical marijuana advocate Sarina Nichols of East Naples contended tobacco, alcohol and prescription drugs are more harmful than marijuana, which she called a safer alternative than prescription painkillers.
“The states that allow medical marijuana have had 25 percent fewer prescription overdose deaths,” Nichols said.
In June, Gov. Rick Scott signed a bill that will make a non-euphoric strain of marijuana available for doctors to give epilepsy seizure patients beginning Jan. 1. Known as Charlotte’s Web, it’s high in cannabidiol, or CBD, but low in tetrahydrocannabinol (THC), which produces a high.
About 125,000 children statewide suffer from severe epilepsy and their families lobbied for its limited use, but it also would be available to adults.
Patients who are authorized by their doctors will use the drug in oil or vapor form, but not the smoked version — and that’s what Amendment 2 would allow, for a broader range of conditions.
who receives prescription?
Advocates and opponents also are parsing the language of the brief ballot summary that voters will see in the voting booth.
The ballot states the measure “allows the medical use of marijuana for individuals with debilitating diseases as determined by a licensed Florida physician.”
A key argument when the Florida Supreme Court contemplated the ballot proposal — the court reviews every constitutional amendment to ensure it covers a single subject and that the language is not misleading — was the contention that this first sentence is a ruse to permit much wider use.
In the full text of the amendment, spelling out in 1,600 words what would become Article X, Section 29 of the state Constitution, a debilitating medical condition is defined as a series of diseases including cancer, positive HIV status, multiple sclerosis, “or any other conditions for which a physician believes that the medical use of marijuana would likely outweigh the potential health risks for a patient.”
Ken Bell, a former state Supreme Court justice and amendment opponent, believes the language is confusing.
“When you look at the definition, it doesn’t talk about debilitating diseases, it says ‘debilitating medical condition,’” Bell said. “There’s a difference between a debilitating disease and a condition. I might have a sore shoulder due to arthritis. I may have a headache, or some other condition that’s not a disease.”
Proponents insist the ballot summary is clear, arguing the state Supreme Court ruled in January that the ballot title and summary “accurately convey to voters the chief purpose of the proposed amendment.”
The issue passed by a contentious 4-3 vote.
“Despite what the title and summary convey to voters, minor aches and pains, stress, insomnia or fear of an upcoming flight could qualify for the medical use of marijuana under the text of the amendment,” Justice Ricky Polston wrote in a dissent.
who helps patients?
The amendment on the ballot also states the measure “allows caregivers to assist patients’ medical use of marijuana.”
Opponents find troubling a lack of specifics about who may assist patients in using marijuana. The full text of the summary defines a personal caregiver as someone at least 21 who has agreed to help and adds some additional restrictions.
“It doesn’t have to be the person providing daily care to the patient,” said Bell.
Ben Pollara, a medical marijuana advocate, notes that the state Department of Health, along with the Legislature, must establish legislation implementing the constitutional amendment.
“This is another place where our opponents are going to take a logical leap to say that no further restrictions will be placed on this, and the state will implement this law in an irresponsible manner,” Pollara said. “A lot of the potential users of medical marijuana are sick and dying and aren’t able to take care of themselves and rely on a caretaker to do it, whether it’s their spouse, a close friend, a son or daughter.”
The amendment states “the Department of Health shall register and regulate centers that produce and distribute marijuana for medical purposes and shall issue identification cards to patients and caregivers.”
Opponents say the state will have difficulty regulating the pot industry.
“There’s going to be a lot of jockeying, lobbying for this, lobbying for that,” said Madelyn Butler, a Tampa obstetrician/gynecologist and a representative of the Florida Medical Association, which opposes Amendment 2. “There’s a lot of money tied up in that. A lot of people are going to be making a lot of money.”
Pollara again refers to the role of the Health Department and Legislature in crafting the rules.
“The only universe in which our opponents’ claims make any sense is in a universe in which you believe that lifelong public servants at the Department of Health are going to be criminally negligent in regulating this,” he said.
Contact Daily News reporter Aisling Swift, AASwift@naplesnews.com, 239-263-4730. Contact Tampa Tribune reporter jstockfish@tampatrib.com, 813-259-7834. The Daily News and Tampa Tribune are part of the Scripps-Tribune Capital Bureau.
Medical marijuana debate focuses on what is an approved drug, and language of proposed ...
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