Weekly Roundup: How High Is Too High?

Recap and analysis of the week in state government and politics
By Ryan Dailey, The News Service of Florida

TALLAHASSEE — Medical-marijuana patients in Florida are facing new THC dosage amounts and supply limits on cannabis products they eat, vape or drop on their tongues.

The caps went into effect Monday after Florida health officials released a highly anticipated rule setting THC dosage and supply caps on products doctors can order for patients.

The state Department of Health rule sets different purchasing restrictions for non-smokable products such as edibles and tinctures, which will now be capped based on the amount of euphoria-inducing THC. The amount of smokable products patients can buy, meanwhile, is limited by weight.

The emergency rule sets a 70-day total supply limit of 24,500 mg of THC for non-smokable marijuana and establishes dosage caps for different routes of administration such as edibles, inhalation and tinctures.

Patients’ daily THC doses are now restricted to 60 mg for edibles; 350 mg for vaporization; 200 mg for capsules and tinctures; 190 mg for sublingual tinctures; 190 mg for suppositories; and 150 mg for topicals.

The rule, which was sent to patients and doctors before taking effect this week, also carries out a state law that imposed a 2.5-ounce limit on smokable marijuana purchases over a 35-day period.

Regulations that would put a ceiling on the amount of marijuana that patients can buy or limit the amount of THC in products have been a lightning-rod when it comes to discussions about the state’s medical pot program.

In setting up the framework for the medical-marijuana program, lawmakers gave the Department of Health the power to use emergency rules to craft regulations. Emergency rules can be published without taking public input, as is required for non-emergency regulations.

The use of the emergency rule is “kind of the burr in my bonnet” about the dosage and supply caps, Pensacola doctor Michelle Beasley told The News Service of Florida on Monday.

“Regardless of the numbers, what harm has there been, what is the rationalization that they need to use emergency rule power and exclude the comments of all the physicians and all the patients in the state to do this?” Beasley, who works for MMTC of Florida, said Monday.

The emergency rule also creates a process for doctors to seek an override for patients they believe need to exceed the limits, though only a fraction of the state’s nearly 800,000 patients would require such an exception, according to several people interviewed by the News Service.

The new rule comes nearly six years after Florida voters approved a constitutional amendment broadly legalizing medical marijuana. The state Legislature, at the behest of Gov. Ron DeSantis, authorized smokable marijuana more than three years later.

Industry insiders such as Beasley predict the dosage limits and supply restrictions will make marijuana products more expensive for patients, who frequently seek out sales when they make purchases.

Because marijuana remains illegal under federal law, patients must pay all costs for doctor visits and supplies.

Beasley called the process “unnecessarily burdensome” for patients, especially for older patients who may be experiencing cognitive declines.

“I do this full time and I have a medical doctorate and it’s taxing for my brain,” she said.

HAND ‘EM OVER

Florida’s beef with the feds now extends to an issue that’s connected to a piece of legislation that the governor held up as a major priority after he took office in 2019.

DeSantis’ administration this week sued the U.S. Food and Drug Administration over what the state alleges is an unfilled public-records request related to Florida’s proposed program to import cheaper prescription drugs from Canada.

The lawsuit, filed Monday in federal court in Tampa, came after state Agency for Health Care Administration Secretary Simone Marstiller submitted a request on July 6 seeking numerous records about drug-importation proposals by Florida and other states.

The 11-page lawsuit pointed to the Freedom of Information Act, or FOIA, arguing that the law requires the FDA to process records requests “promptly” or provide a “reasonably segregable” portion of records not subject to a FOIA exemption.

“The FDA has neither provided AHCA (the Agency for Health Care Administration) any responsive documents in response to its request, nor has the FDA claimed that any responsive records are exempt from disclosure. Therefore, the FDA’s failure to produce requested records or claim applicable exemptions violates FOIA,” the state’s lawyers argued.

The 2019 measure championed by DeSantis and then-House Speaker Jose Oliva, R-Miami Lakes, would make imported drugs available in government programs such as Medicaid, the prison system and facilities run by the Department of Children and Families. Drugs designed to treat conditions such as HIV and AIDS, hepatitis C, diabetes and mental illness at least initially would be among the medications imported using the program, the lawsuit said.

The lawsuit argued that the state submitted a proposal in 2020 seeking approval of the drug-importation program from the FDA, as the federal agency must sign off on its launch. The proposal remains pending.

The state’s legal challenge also alleged that the Biden administration has “unlawfully withheld a resolution” of Florida’s proposal and “unreasonably delayed” acting on the plan.

A LITTLE HELP FROM MY FRIENDS

An ousted prosecutor’s fight to get his job back ramped up this week, as more than 100 legal eagles from around the country decried DeSantis’ suspension of Hillsborough County State Attorney Andrew Warren.

DeSantis in August issued an executive order suspending Warren, a Democrat, accusing him of “incompetence and willful defiance of his duties.” DeSantis pointed to a letter Warren signed pledging to avoid enforcing a new law preventing abortions after 15 weeks of pregnancy. Also, the governor targeted a separate statement Warren joined condemning the criminalization of transgender people and gender-affirming care.

Legal scholars on Tuesday submitted a friend-of-the-court brief in a federal lawsuit in which Warren accused DeSantis of overstepping his authority and violating the twice-elected prosecutor’s First Amendment rights.

Warren’s suspension “for what can only be characterized as purely partisan reasons runs counter to professional standards of conduct, usurps the will and power of the electorate and eviscerates the carefully crafted separation of powers erected in the Florida Constitution,” the scholars wrote.

STORY OF THE WEEK: Florida health officials released a highly anticipated rule setting THC dosage amounts and supply limits on products doctors can order for medical-marijuana patients.

QUOTE OF THE WEEK: “It’s basically making people shop at Publix when they could go to Sam’s Club and get the bulk discount.” — Pensacola physician Michelle Beasley, referring to a new Department of Health rule setting THC dosage amounts and supply limits on products doctors can order for medical-marijuana patients.

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