References and Guidelines for Florida Prescribing Physicians.
Statewide information so far is not complete, but we will be using other states guidelines to develop and peer review our own until the official guidelines are handed down by the State of Florida. Here are preliminary findings from the Federation of State Medical Boards.
So far the federal government has allowed 0.3% THC within CBD Oils to be legally sold in all 50 states.
Floridas law as of 10/22/2017 is 0.8% THC in CBD oils to be prescribed and obtained at registered dispensaries in the state of Florida.
Treatment Agreement: A health care professional should document a written treatment plan that includes:
• Review of other measures attempted to ease the suffering caused by the terminal or debilitating medical condition that do not involve the recommendation of marijuana.
Advice about other options for managing the terminal or debilitating medical condition.
Determination that the patient with a terminal or debilitating medical condition may
benefit from the recommendation of marijuana.
Advice about the potential risks of the medical use of marijuana to include:
o The variability of quality and concentration of marijuana; o The risk of cannabis use disorder; o Exacerbation of psychotic disorders and adverse cognitive effects for children and
young adults; o Adverse events, exacerbation of psychotic disorder, adverse cognitive effects for
children and young adults, and other risks, including falls or fractures; o Use of marijuana during pregnancy or breast feeding; o The need to safeguard all marijuana and marijuana-infused products from children
and pets or domestic animals; and o The need to notify the patient that the marijuana is for the patient’s use only and
the marijuana should not be donated or otherwise supplied to another individual.
Additional diagnostic evaluations or other planned treatments.
A specific duration for the marijuana authorization for a period no longer than twelve
months.
A specific ongoing treatment plan as medically appropriate.
Medical Records: The physician should keep accurate and complete medical records. Information that should appear in the medical record includes, but is not necessarily limited to the following:
The patient’s medical history, including a review of prior medical records as appropriate;
Results of the physical examination, patient evaluation, diagnostic, therapeutic, and
laboratory results;
Other treatments and prescribed medications;
Authorization, attestation or recommendation for marijuana, to include date, expiration,
and any additional information required by state statute;
Instructions to the patient, including discussions of risks and benefits, side effects and
variable effects;
Results of ongoing assessment and monitoring of patient’s response to the use of
marijuana;
A copy of the signed Treatment Agreement, including instructions on safekeeping and
instructions on not sharing.
Qualifying Conditions: At this time, there is a paucity of evidence for the efficacy of marijuana in treating certain medical conditions. Recommending marijuana for certain medical conditions is at the professional discretion of the physician. The indication, appropriateness, and safety of the recommendation should be evaluated in accordance with current standards of practice and in compliance with state laws, rules and regulations which specify qualifying conditions for which a patient may qualify for marijuana.
Ongoing Monitoring and Adapting the Treatment Plan: Where available, the physician recommending marijuana should register with the appropriate oversight agency and provide the registry with information each time a recommendation, attestation, authorization, or reauthorization is issued [see Appendix 1]. Where available, the physician recommending marijuana should check the state Prescription Drug Monitoring Program (PDMP) each time a recommendation, attestation, authorization, or reauthorization is issued.
The physician should regularly assess the patient’s response to the use of marijuana and overall health and level of function. This assessment should include the efficacy of the treatment to the patient, the goals of the treatment, and the progress of those goals.
Consultation and Referral: A patient who has a history of substance use disorder or a co- occurring mental health disorder may require specialized assessment and treatment. The physician should seek a consultation with, or refer the patient to, a pain management, psychiatric, addiction or mental health specialist, as needed.
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