FLORIDA BOARD OF MEDICINE FLORIDA BOARD OF …

FLORIDA BOARD OF MEDICINE FLORIDA BOARD OF OSTEOPATHIC MEDICINE

Physician Certification Pattern Review Panel

AnnualRe1-1ort January 1, 2019

HEALTH

TABLE OF CONTENTS

List of Tables

3

Physician Certification Pattern Review Panel

4

Report Definitions

5

Historical Review

8

Data Collection, Analysis, and Reporting

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Overview of Physician Certifications by Qualifying Condition

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Low-THC Cannabis Ordered

12

Medical Marijuana Ordered

13

Panel Recommendations

178

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List of Tables

Table 1. State and County Physician Certifications by Patient's Qualifying Condition from January 1, 2018 through September 30, 2018...........................................................................14 Table 2. State and County Physician Certifications, Average Dosage and Supply for all LowTHC Cannabis Ordered from January 1, 2018 through September 30, 2018 ............................16 Table 3. State and County Physician Certifications, Average Dosage and Supply for all Medical Marijuana Ordered from January 1, 2018 through September 30, 2018....................................18 Table 4. State and County Physician Certifications, Average Dosage and Supply for all LowTHC Cannabis Ordered, by Route, from January 1, 2018 through September 30, 2018...........20 Table 5. State and County Physician Certifications, Average Dosage and Supply for all Medical Marijuana Ordered, by Route, from January 1, 2018 through September 30, 2018...................22 Table 6. State, County, and Individual Physician Certifications by Patient's Qualifying Condition from January 1, 2018 through September 30, 2018...................................................................24 Table 7. State, County, and Individual Physician Certifications, Average Dosage and Supply for all Low-THC Cannabis Ordered from January 1, 2018 through September 30, 2018................56 Table 8. State, County, and Individual Physician Certifications, Average Dosage and Supply for all Medical Marijuana Ordered from January 1, 2018 through September 30, 2018 ..................86 Table 9. State, County, and Individual Physician Average Dosage and Supply for all Low-THC Cannabis Ordered, by Route, from January 1, 2018 through September 30, 2018 .................116 Table 10. State, County, and Individual Physician Average Dosage and Supply for all Medical Marijuana Ordered, by Route, from January 1, 2018 through September 30, 2018.................148

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Physician Certification Pattern Review Panel

The Florida Board of Medicine and the Florida Board of Osteopathic Medicine created a joint Physician Certification Pattern Review Panel (Panel) on medical marijuana in compliance with section (s.) 381.986 (4)(g), Florida Statutes (F.S.). The Panel is responsible for reporting its findings and recommendations annually on January 1 to the Governor, the President of the Senate, and the Speaker of the House of Representatives.

Physician Certification Pattern Review Panel Members:

Florida Board of Medicine Steven Rosenberg, M.D. ? Panel Chair Nicholas W. Romanello, Esq. ? Consumer Member Merle Stringer, M.D. Sarvam TerKonda, M.D.

Florida Board of Osteopathic Medicine Sandra Schwemmer, D.O. ? Panel Vice-Chair Michelle Mendez, D.O. Joel B. Rose, D.O.

Report Contents are specified by statute as follows: Section 381.986(4)(g), F.S. (2017): "The Board of Medicine and the Board of Osteopathic Medicine shall jointly create a physician certification pattern review panel that shall review all physician certifications submitted to the medical marijuana use registry. The panel shall track and report the number of physician certifications and the qualifying medical conditions, dosage, supply amount, and form of marijuana certified. The panel shall report the data both by individual qualified physician and in the aggregate, by county, and statewide. The physician certification pattern review panel shall, beginning January 1, 2018, submit an annual report of its findings and recommendations to the Governor, the President of the Senate, and the Speaker of the House of Representatives."

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Report Definitions

Average (AVG) dosage is the average of all daily dosages ordered within a physician certification.

Caregiver means a resident of this state who has agreed to assist with a qualified patient's medical use of marijuana, has a caregiver registry identification card, and meets the requirements of subsection (6) of 381.986, F.S.

Chronic nonmalignant pain means pain that is caused by a qualifying medical condition or that originates from a qualifying medical condition and persists beyond the usual course of that qualifying medical condition.

County means the physician's self-reported address of record (primary location) as identified in the Medical Quality Assurance Licensure database.

Dosage means the milligrams (mg) per dose and doses per day for each order a physician enters in the Medical Marijuana Use Registry as part of a certification for marijuana. "Mg per dose" refers to the maximum number of milligrams in a dose and "doses per day" is the maximum number of doses the physician recommended for use per day. The "total mg/day" is the sum of all doses for a given form and type of marijuana ordered.

Form is a term referenced in section 381.986, F.S., to describe the routes of administration, which is defined in rule 64-4.001, Florida Administrative Code (F.A.C.).

Low-THC cannabis means a plant of the genus Cannabis, the dried flowers of which contain 0.8 percent or less of tetrahydrocannabinol and more than 10 percent of cannabidiol weight for weight; the seeds thereof; the resin extracted from any part of such plant; or any compound, manufacture, salt, derivative, mixture, or preparation of such plant or its seeds or resin that is dispensed from a medical marijuana treatment center.

Marijuana means all parts of any plant of the genus Cannabis, whether growing or not; the seeds thereof; the resin extracted from any part of the plant; and every compound, manufacture, salt, derivative, mixture, or preparation of the plant or its seeds or resin, including low-THC cannabis, which are dispensed from a medical marijuana treatment center for medical use by a qualified patient.

Marijuana delivery device means an object used, intended for use, or designed for use in preparing, storing, ingesting, inhaling, or otherwise introducing marijuana into the human body, and which is dispensed from a medical marijuana treatment center for medical use by a qualified patient.

Medical marijuana means all products with levels of tetrahydrocannabinol higher than 0.8 percent.

Medical marijuana treatment centers (MMTCs) are licensed by the state to grow, process, and dispense marijuana to qualified patients who have active certifications and identification cards issued by the Office of Medical Marijuana Use.

Medical Marijuana Use Registry (MMUR) is a secure, electronic, online medical marijuana use registry for physicians, patients, and caregivers that is accessible to law enforcement agencies, qualified physicians, and medical marijuana treatment centers.

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