State Sets Rules for Caregivers of Medical Marijuana Patients
Editor’s note: This commentary is provided by the Medical Marijuana Education and Research Initiative (MMERI) of Florida A&M University.If you were the caregiver ofan elderly parent in Florida, you would be able to pick up prescription drugs and administer them to your mother or father as ordered by their physician. You also would be allowed to discuss their medical conditions and treatments with their healthcare providers. A caregiver, according to state statute, is someone who is “entrusted with or has assumed responsibility for the care or the property of an elderly person or disabled adult. ‘Caregiver’ includes, but is not limited to, relatives, court-appointed or voluntary guardians, adult household members, neighbors, health care providers, etc.In other words, a lot of adults —18 or older — can consider themselves caregivers, and the state doesn’t require them to undergo training or earn any certifications to be “entrusted” with this responsibility. But when it comes to overseeing the healthcare of someone being treated with medical marijuana— even your own child — the State of Florida takes a much stricter approach to the caregiver-patient relationship. The Florida Department of Health has issued rules on who can and cannot be caregivers of medical marijuana patients. “They have to actually receive a Medical Marijuana Use Registry Identification Card, just as the patient does, in exactly the same way,” says Donna Sachse, a certified nursing assistant and officer manager of Compassionate Cannabis Clinic, one of the largest medical marijuana treatment facilities in Florida. That’s just for starters. Founded by Chief Medical Officer Dr. Barry Gordon, Compassionate Cannabis Clinic has served more than 5,000 patients at its Venice and Fort Myers office locations. Dr. Gordon is a leading advocate of patient and caregiver education on all things medical cannabis, including the endocannabinoid system. Caregivers, he says, “need to have as much, if not more, education than the patient themselves in order to be a success in the program.” While Dr. Gordon sees the value in governing caregivers of medical marijuana patients as Florida does, he says the DOH rules don’t ensure a thorough introduction to cannabis as medicine. “Even in the test for caregivers, there's nothing that discusses the endocannabinoid system or the caregiver's knowledge of cannabis,” he says, referring to the “caregiver certification course” DOH requires would-be caregivers to complete. To become a registered caregiver of a medical marijuana patient (only one caregiver per patient, with some exceptions, such as parents or guardians of a minor), you have to be at least 21 years old, a resident of the state and fill out an application with DOH’s Office of Medical Marijuana Use. Applicants who aren’t a close relative of the patient must pass a background check.The rules also state that “a caregiver must not be a qualified physician and not be employed by or have an economic interest in a medical marijuana treatment center or a marijuana testing laboratory.”“Because that’s a conflict of interest,” explains Sachse.Dr. Gordon says one of the biggest challenges caregivers face is the “availability and the consistency of a product” a qualified physician recommended for the patient. “They want to be able to get that same product every single time. Percocet is the same Percocet whether at a CVS or Walgreens pharmacy, but that’s not quite so for a cannabis cultivar. It’s a plant.”A possible solution to this problem could be to allow for the private cultivation of cannabis plants. Some states already do, but not Florida. However, a proposed state constitutional amendment seeks to change that as well as make marijuana use and possession legal for adults 21 or older. The initiative, which could go before voters in November 2022, would permit “cultivating nine live marijuana plants per adult with eighteen plants maximum per household.”When a product is out of stock at a dispensary, whatever is recommended to replace it could have a different effect on the patient. Sachse says she fields a lot of calls from caregivers and patients who are concerned about having to change medical marijuana drugs because of inventory shortages. On a different but related point about caregivers, Dr. Gordon says he wants to see job protections for healthcare workers, including first responders, who use medical cannabis to treat post-traumatic stress disorder (PTSD). He says the COVID-19 pandemic forced healthcare workers to take care of too many patients at a time and comfort many of them in their dying hours because family members weren’t allowed at their bedside. “No healthcare worker is prepared for that,” he says. “They don't want alcohol, Ambien or Xanax or Wellbutrin or Prozac to help them. Many of our healthcare workers are going to carry this period of time with them for a long time. They're using cannabis already because they don't want the other substances.”Visit https://bit.ly/3Bub12k to watch MMERI’s Conversations on Cannabis Virtual Forum featuring Dr. Barry Gordon, chief medical officer and founder of Compassionate Cannabis Clinic, and Donna Sachse, a certified nursing assistant and officer manager of Compassionate Cannabis Clinic, on YouTube. For more information on medical marijuana and to sign up for the MMERI newsletter, go to http://mmeri.famu.edu.