Smokeable flower is now legal in Florida. Learn about the certification requirements, where to get it, and how it impacts your health.
Smoking medical marijuana is now legal in Florida after Governor Ron DeSantis signed Bill SB 182 into law. It’s been a long wait for Floridians who voted in favor of medical marijuana back in 2016, but have since faced a ban on smokeable flower.
When medical marijuana was first legalized in the Sunshine State with the passing of the Florida Medical Marijuanna Legalization Initiative, then-Governor Rick Scott deemed smokeable flower unsafe and limited consumption of cannabis to oils, sprays, tinctures, and vaping.
Under the new law, effective from March 18th, 2019 a qualified physician can now recommend smoking as an appropriate delivery system for medical marijuana. However, medical marijuana dispensaries must wait for the Florida Department of Health to finalize state regulations before selling smokeable products.
HOW MUCH SMOKEABLE MEDICAL MARIJUANA CAN I ORDER?
The new laws allow physicians to order a maximum of six 35-day supplies of smokeable medical marijuana for qualified patients at a time. A 35-day supply must not exceed 2.5 ounces, and patients cannot possess more than 4 ounces at any given time. For chronically ill people who rely on cannabis daily, this means substantially fewer trips to the doctors.
WHO CAN BUY SMOKEABLE MEDICAL MARIJUANA IN FLORIDA?
Adults must gain approval from one qualified physician.
For patients under 18 years old, the new law stipulates they only smoke marijuana if they have a terminal illness and receive approval from two qualified physicians, including a board-certified pediatrician.
Among other limitations, marijuana cannot be smoked in public places or private businesses where tobacco smoking is illegal under the Florida Clean Air Act. Qualified patients can, however, smoke medical marijuana on private properties at the owner’s discretion.
HOW TO QUALIFY FOR SMOKEABLE MEDICAL MARIJUANA
To qualify for smokeable flower, you must first qualify for medical marijuana and have a medical marijuana card.
Step 1: Qualify For Medical Marijuana
If you don’t already have a Medical Marijuana Card, the first step is to book an in-person appointment with a qualified physician to see whether you’re eligible for medical marijuana. The physician will conduct a physical examination and review your medical history, including previous drug prescriptions.
If the physician diagnoses you with at least one qualifying medical condition (such as chronic pain, diabetes, or cancer) and determines that the benefits of medical marijuana outweigh the potential health risks, the physician may issue a certification to place you on the state registry for medical marijuana. The physician must also provide the application board with details concerning your qualifying condition, maximum daily dosage, and recommended delivery devices.
Step 2: Book a Follow-Up Appointment
Current THC Physician patients who have been seen in the last 6 months can book a follow-up appointment to determine whether smoking medical marijuana is appropriate for them.
If you have a medical marijuana card and would like to find out whether you qualify for smokeable marijuana before booking an appointment, click here to fill out the assessment form. Once completed we will call you to book an appointment.
Please note: this visit will not renew your 6-month medical marijuana certification. If you need to renew your 6-month certification, we recommend waiting to add smoking medical marijuana until your next appointment.
Step 3: Additional Documentation
If the physician determines that smoking is an appropriate route of administration for you, the physician must also provide the following documentation to the Consortium for Medical Marijuana Clinical Outcomes Research:
- A list of non-smoking administration routes that you have tried, the length of time you have used these routes, and an assessment of the non-smoking route’s effectiveness in treating your qualifying condition.
- Evidence regarding the effectiveness of smoking is as a route of administration to treat patients who have a similar qualifying condition as you.
- A signed statement by the qualified physician outlining their professional opinion and that the benefits of smoking marijuana for medical use outweigh the risks for you.
Step 4: Informed Consent
Every patient at THC Physicians must provide written informed consent acknowledging that they have received sufficient explanation from our physicians regarding the adverse health risks of smoking marijuana. If you are under 18 years of age, a parent or legal guardian must sign the informed consent on your behalf.
Our physicians use a standardized consent form approved by the Board of Medicine and the Board of Osteopathic Medicine. The form clearly outlines the risks associated with smoking marijuana and important legal information, including but not limited to:
- Classification of marijuana as a Schedule I controlled substance as per the Federal Government.
- Approval status of marijuana by the Food and Drug Administration.
- Current state of research on marijuana’s capacity to treat certain conditions.
- Potential for addiction and drug interactions.
- Potential impact that marijuana may have on your cognition, coordination, and motor skills, including a caution against operating a motor vehicle, operating heavy machinery, or engaging in activities that require quick reflexes.
- Potential side effects of marijuana use, in addition to the negative health risks associated with smoking marijuana.
- A statement explaining that each patient’s de-identified health information will be stored on file with the potential to be used for research purposes.
In April 2019, the Board of Osteopathic Medicine, Board of Medicine, and the Joint Committee on Medical Marijuana will be meeting to begin the approval process for new informed consent forms.
WHERE CAN I BUY SMOKEABLE MEDICAL MARIJUANA IN FLORIDA?
Within the state of Florida, there are currently six dispensaries authorized to dispense smokeable medical marijuana:
However, as of April,Trulieve is the only dispensary with authorized smokeable product in stock.
IMPACTS OF SMOKING CANNABIS ON THE RESPIRATORY SYSTEM
While the legalization of smokeable cannabis is a win for the 70% of Floridians who voted in favor of medical marijuana, there is widespread concern regarding the safety of smoking as an administration route. While the public’s intention is to help patients gain effective relief for chronic conditions, such as multiple sclerosis, fibromyalgia, and leukemia, the inhalation of smoke, whether it be from tobacco or cannabis, is at odds with modern medicine.
Cannabis smoke can contain many of the same harmful chemicals found in tobacco smoke, including ammonia, formaldehyde, and hydrogen cyanide. When patients smoke medical marijuana, their respiratory system is directly exposed to these toxic chemicals. In one study, smoking cannabis was associated with a 5-fold higher level of carbon monoxide (which can damage the nervous system) and a 3-fold higher level of tar within the lungs when compared to smoking tobacco. 
Although cannabis smoke contains known carcinogens and tumor promoters, there are no long-term population studies to suggest smoking marijuana causes lung cancer.  But research has shown that long-term cannabis smokers have microscopic lung damage and pre-cancerous changes to the cells lining their airways.  A 40-year study published in the Cancer Causes & Control journal found that heavy cannabis users had a 2 times higher risk of developing lung cancer.
Chronic Bronchitis & Other Lung Diseases
Cannabis smokers often experience respiratory symptoms, such as chronic cough, phlegm, and wheeze, which are suggestive of progressive lung disease. Studies show that long-term cannabis smoking can lead to airflow obstruction, bullous lung disease and chronic bronchitis (inflammation and damage to the bronchial tubes).  As chronic cannabis use can suppress the immune system, several cases of pneumonia have also been reported in heavy cannabis smokers. 
Overall, the long-term consequences of smoking full flower are still not well understood, largely due to ethical reasons related to human trials and the difficulty of distinguishing between the effects of tobacco and marijuana in long-term studies. Although health professionals agree on one thing: smoke-free methods pose far fewer risks and are medically preferred.
NON-SMOKING CANNABIS DELIVERY SYSTEMS
If you’re looking for a more health-conscious way to consume cannabis, you’ll be pleased to know that there are many different administration routes. The following methods of consumption are not only legal in Florida, but are also much easier to qualify for and much better for you in the long run:
Vaporizing is a logical choice for those who prefer the sensation of inhaling, but want to avoid the harmful chemicals associated with smoking. A vaporizer gradually heats the marijuana to a temperature that is high enough to release active components, such as THC and CBD, without burning the marijuana (like when lighting up a joint). While there is limited supporting evidence, it is believed that vaporizing does not expose the lungs to harmful chemicals.
Tinctures are liquid extracts typically used by consumers who want fast-acting effects without the health risks of inhaling smoke. Tinctures also provide dosage control and are relatively discrete. When using a tincture, you generally place three to four drops of the liquid underneath your tongue. It’s then immediately absorbed into the bloodstream. As the liquid doesn’t pass through the digestive system, the effects are rapidly felt within 5-15 minutes.
Ingestibles are popular among health-conscious cannabis consumers looking for a discrete option. Available in oils, capsules, dissolvable strips, sprays, and snacks, ingestibles are swallowed, digested, and slowly absorbed into the bloodstream through the digestive tract. Oral consumption is also ideal for individuals looking for long-lasting pain relief, with effects usually felt with 30 minutes, and lasting from anywhere between 30-120 minutes.
Topicals are lotions, creams, and patches infused with cannabis that are applied locally to the skin. Most often, topical cannabis contains a high percentage of cannabidiol (CBD) and is used to relieve chronic pain and inflammation. However, you can get full-spectrum topicals, THC-only and CBD-only topicals, depending on your desired effects.
NOT ALL PATIENTS WILL BENEFIT FROM SMOKING MARIJUANA
While some patients may benefit from the rapid delivery and complete cannabinoid profile of smokeable marijuana, it’s important to understand that inhaling smoke can have harmful effects on your respiratory system. Marijuana smoke contains hazardous chemicals that are known to damage the lungs and cause long-term health issues.
THC physicians are committed to providing high-quality health care to all our patients who seek relief and strive to consider each patient’s individual medical needs. We, therefore, ask you to schedule an appointment so we can evaluate your specific situation and determine whether the benefits of smoking marijuana outweigh the risks.