What benefits do you see for patients throughout Florida within this space?

Cannabis has minimal side effects compared to many prescription medications. Cannabis is also much safer—not only because it doesn’t cause the potentially deadly respiratory depression caused by opioids and benzodiazepines, but it doesn’t damage the stomach or kidneys like NSAID’s do. Most importantly, patients can control their dose and means of administration to obtain maximum symptom reduction at the lowest dose and cost, and with the least side effects.

What motivates you to be a part of the cannabis Industry?

Cannabis medicine is currently where Emergency Medicine was in the 1960’s. There was a need, but it wasn’t a recognized specialty yet, and often the least qualified and least experienced physicians who were moonlighting in “emergency rooms” were taking care of the most seriously ill and injured patients.

In Florida, a physician can have virtually no knowledge of cannabis medicine yet can become approved as a qualified physician to certify patients to use medical cannabis. Florida law does not require a physician to demonstrate any level of cannabis medicine knowledge, or to educate patients who they certify about doses, frequency or means of administration. Having medical cannabis legal in Florida is a good start, but we can do better.

With the privilege of having medical cannabis in Florida comes responsibility for the certified patients, the dispensaries, and particularly for the qualified physicians. How is a patient to know that recreational doses are not appropriate for medical purposes if they haven’t been educated? Dispensaries can help educate patients, and some have very knowledgeable staff. But as with physicians, dispensary employees are only required to have a knowledge of the legal requirements associated with Florida’s medical marijuana law. There is no statutory requirement for clinical knowledge, which is why one young budtender instructed one of our patients not to inhale from a vape pen, because if could make her cough! As in every other field of medicine, isn’t it ultimately the responsibility of the MMJ physician to ensure that patients are receiving appropriate and optimal treatment?

And can that be accomplished during a 10-minute initial certification visit, or during an assembly line certification event in a hotel banquet room? All of us know this is happening, because patients tell us their horror story experiences when they transfer to us for recertification. Putting profit before good patient care has never been acceptable in medicine, and it shouldn’t be in cannabis medicine, either.

Working with like-minded medical cannabis physicians, I hope that cannabis medicine will evolve into the medical specialty that is needed to educate physicians, to partner with dispensaries and the Department of Health, and to advocate legislatively for patients, so that together we can help medical cannabis patients obtain the best results, at the least cost, and with the least side effects.

How did you get started within the cannabis industry?

When I first heard about “medical marijuana” 25 years ago, I was skeptical, assuming it was just an excuse for people to smoke legally. And when I was told that it actually could reduce pain and anxiety, I assumed it was only because people smoked themselves stupid. 

Years later, after multiple failed back surgeries and a decade of opioids which had escalated to 440 milligrams morphine equivalents per day, a family member asked about trying MMJ. She didn’t have the benefit of a cannabis medicine specialist to guide her, but over time figured out a regimen which not only allowed her to decrease her opioids by 91%, but also resulted in regaining her energy. She felt like she got her life back. Another family member with military PTSD couldn’t tolerate the side effects of the antidepressants and Xanax prescribed by the VA, turned to alcohol to self-medicate, and when that didn’t work tried recreational doses of MJ. After being educated on medical doses, he has been using a small fraction of the cannabis he used before, with better results, and with a feeling of having regained control of his life.

Once I learned about the existence of the endocannabinoid system and understood the science of cannabis medicine, I became a true believer and advocate. At a time in my career throughout which I was an employed emergency medicine and urgent care physician, when I should have been thinking about retirement, we opened a medical cannabis practice so that we could “Pay it Forward”—help others as we have been helped. It is also professionally rewarding to be able to help people with a treatment that is so much safer and better tolerated than the prescription medications that are traditionally used.