Q&A: Dr. Kantilal Bhalani Addresses Fundamental Questions About Medical Marijuana In Florida

By Space Coast Daily

EDITOR’S NOTE: Amendment 2, the Florida referendum passed in the November general election last year that legalizes the medicinal use of marijuana, is now in the process of being implemented.

As expected, many specific details and nuances of implementation have evolved as the state, federal and even the county governments are hammering out rules and regulations associated with classification, production, distribution and dispensing of marijuana as a schedule 1 drug.

In the meantime, as the legal battles continue, many patients that are already in the current database are benefiting from tetrahydrocannabinol (THC) and cannabidiol (CBD) treatment based on each patient’s specific qualifying condition. 

Quality measurements and quality of life have improved for many patients and caregivers. We are delighted to welcome medical marijuana specialist, Dr. Kantilal Bhalani, to address some fundamental questions about medical marijuana in Florida.

SPACE COAST DAILY: Who is eligible to use medical marijuana (MM)?
DR. BHALANI: An individual with specific conditions or symptoms attested to by a certifying physician that qualify the patient for MM. The Florida Department of Health then issues an identification card to be shown at purchase of the MM, which officially informs law enforcement that the patient can possess amounts set by law.

SPACE COAST DAILY: What medical conditions quality for MM treatment?
DR. BHALANI: Specific diseases or other “debilitating” conditions for which the doctor thinks may benefit by MM use include: Cancer, glaucoma, HIV/AIDS, hepatitis C, ALS, multiple sclerosis, Parkinson’s disease, epilepsy, PTSD, Ulcerative colitis, and Crohn’s disease. Medical records establishing proof of diagnosis and traditional treatment are required for certification by a physician.

SPACE COAST DAILY: When may a patient start legally using marijuana?
DR. BHALANI: The effective date of the amendment is Jan. 6, 2017. After that date, the Department of Health was compelled to implement regulations within six months and begin issuing identification cards within nine months. If the department fails to issue cards within nine months, the doctor’s certification will serve as identification.

SPACE COAST DAILY: How much marijuana is a patient allowed to possess?
DR. BHALANI: The dose or amount of MM that each patient is allowed to have is determined by the Department of Health and based on what is “reasonably presumed to be an adequate supply.’’ Patients who think they need more can appeal.

SPACE COAST DAILY: How is a prescription for MM filled?
DR. BHALANI: Because marijuana is not an FDA-approved medicine with controlled doses it is not distributed by prescription. MM treatment is recommended by documentation by a certifying physician and the patient then purchases it at the certified dispensary of their choice. Certifying doctors must be licensed in Florida and perform a physical exam and “full assessment of a patient’s history.”

SPACE COAST DAILY: Where is MM sold?
DR. BHALANI: MM can be purchased only at state-licensed dispensaries called “Medical Treatment Centers,” with growers also licensed as treatment centers. The Department of Health must issue rules that regulate how dispensaries are monitored. Growing your own pot remains illegal, as it is under current law.

SPACE COAST DAILY: What if the Department of Health writes regulations so restrictive that usage is effectively banned?
DR. BHALANI: The department must issue “timely” and “reasonable” rules that “ensure the availability and safe use of MM by qualifying patients.” If the regulations are too restrictive, any Florida citizen can sue to enforce constitutional intent.

SPACE COAST DAILY: Can caregivers possess marijuana?
DR. BHALANI: A person over 21 can buy and handle the marijuana on behalf of up to five patients. Caregivers are required to have an identification card issued by the state for that purpose.

SPACE COAST DAILY: How old must a patient be to use MM?
DR. BHALANI: The amendment does not set age limits. In other states, use by minors requires parental consent, as with traditional medicinal treatments.

SPACE COAST DAILY: Does insurance routinely cover the cost of MM?
DR. BHALANI: There is no legal requirement for health insurance coverage of MM, so coverage would depend on the benefits offered by the specific insurer. Medicare does not cover nonprescription drugs and supplements.

SPACE COAST DAILY: What about using it at work or in schools?
DR. BHALANI: Schools and employers are free to prohibit on-site use. The amendment does not prohibit employers from requiring drug tests or imposing sanctions for positive results.

SPACE COAST DAILY: Would information on identification cards be public?
DR. BHALANI: No. The Department of Health must keep records confidential, even from employers or family members. But the information could be disclosed for “valid medical or law enforcement purposes.’’

SPACE COAST DAILY: Is the FL Legislature setting up its own system to regulate MM?
DR. BHALANI: Yes, but it could not contradict the amendment. For example, the Legislature could not make dispensaries illegal. However, it could permit home cultivation, which is now banned by statute.

SPACE COAST DAILY: Could the Florida Supreme Court ruling on the ballot language be appealed?
DR. BHALANI: Not successfully. Federal courts leave interpretation of state constitutions to state courts.

SPACE COAST DAILY:: Could pot-smoking in public be regulated just as cigarette smoking is regulated?
DR. BHALANI: Yes. Calling it medicine does not confer the right to use pot anywhere.

SPACE COAST DAILY: What about DUI?
DR. BHALANI: Driving under the influence of medical marijuana would still be illegal, as with alcohol or recreational pot.

SPACE COAST DAILY: Can you cross state lines with the product?
DR. BHALANI: Medical Cannabis is prohibited on federal property like state lines, airports, etc. Medical cannabis bought in the state must stay in the state. Therefore, no traveling outside the state. You may use your Dispensary cards in states that allow reciprocity like Colorado.

SPACE COAST DAILY: How many days of MM can a certifying physician recommend?
DR. BHALANI: A MM certifying physician can recommend based on his medical opinion the number of days he or she deems necessary to effectively treat the patient. However, the most the physician can recommend is up to a 70-day supply. Every 70 days the doctor and patient require re-consenting and updating of treatment documentation and forms.

SPACE COAST DAILY: How long does it take to get a MM card?
DR. BHALANI: It can take up to 30 business days or more to get a medical marijuana card. You may get a temporary email before the 30 days, but not all patients may get that. The card is good for one year and after which recertification by a physician is required.

SPACE COAST DAILY: Is the application for an MM card available on line?
DR. BHALANI: The application for the state can be on paper or online. A 2 by 2 passport photo, copy of identification and $75 check or money order to the state is required.

SPACE COAST DAILY: Can I have a concealed carry permit and medical cannabis card?
DR. BHALANI: According several current legal opinions, it is not recommended because of federal background checking.

SPACE COAST DAILY: Are certified dispensaries allowed to deliver?
DR. BHALANI: Yes, they do deliver. Some dispensaries may charge for that service.

SPACE COAST DAILY: Can I grow or use my own products?
DR. BHALANI: No, you can’t use the physician’s recommendation or card to use street products, buds, plants, or any products outside the state lines.

SPACE COAST DAILY: What routes of MM administration are authorized?
DR. BHALANI: MM can legally be administered via oil, tinctures, vapes, intranasal spray, liquid oral solutions, topical creams, nebulizers, and suppositories.

SPACE COAST DAILY: Which endocannabinoids are recommended?
DR. BHALANI: High THC, low THC, High CBD, and several ration of THC:CBD in premix ratios.

SPACE COAST DAILY: Which strains of the plant are available through dispensaries?
DR. BHALANI: Each dispensary has its own hybrids, Rick Simson oil, indica, and sativa strains. Some dispensaries have clear extract, which is clean oil and no terpenes. This is not a combustion reaction with the plant. This is oil that is heated to inhale like a nebulizer.

SPACE COAST DAILY: Can MM be smoked in the traditional manner of recreational use?
DR. BHALANI: No, presently by law MM can not be produced or distributed for use as a smoke inhalant.