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Portfolio Project Medical Legal CasesMarijuana as a MedicineFrank SkwiercBryant & Stratton CollegeMAAT 111 Introduction to Health CareInstructor Portia BonnettJune, 18, 2016MARIJUANA AS A MEDICINEPROVING ITS MEDICAL NECESSITY CAN BE A LEGAL AFFAIR Florida along with twenty four other States have not yet passed a State law to legalize dispensaries for the distribution of medicinal marijuana, however this does not mean that an individual cannot grow or possess marijuana in the State of Florida for medicinal use. I have chosen two legal cases from Florida that changed the way the law is interrupted. While these two groundbreaking cases help set precedents to amend the law in Florida it was the several other cases that followed using the same defense that eventually led to Amendment II being placed on the ballot, as well as, changing legislation in the State of Florida.The first case to question the laws of Florida was the State of Florida versus Elvy Musikka who was arrested in 1988 for cultivating six cannabis plants. At her trial her physician who was a researcher for Bascom-Palmer Eye Institute testified on her behalf that research shows that marijuana actually impedes the progression of glaucoma and is quoted in the court records, “if marijuana were legal I would have prescribed it for Elvy Musikka’s medical use in the treatment of glaucoma” (Quiggle, 2014). The defense that Musikka’s attorney, Jason D. Sammis used, was an English Common Law that was adopted by many states dating back to July, 4, 1776. Which states, “A necessity defense is a justification, or exculpation, for breaking the law, and argues that a defendant should not be held criminally liable for their actions, because they broke the law in order to prevent an even greater harm” (Quiggle, 2014). With the help of her physician, Musikka, proved that she met the federal laws that govern medical necessity, and the charges against her were dismissed, she is now a federal marijuana patient as part of the FDA’s Compassionate Investigational New Drug program and is only one of four federal patients that still gets eight ounces of marijuana in the form of over three hundred joints a month (Quiggle, 2014). Currently Elvy L Musikka, who is now 76 years of age resides in Eugene, Oregon (Been Verified, 2016).The second case in Florida, that I would like to introduce is Jenks versus the State of Florida, after losing their case in Circuit court Kenneth and Barbara Jenks took their case in front of the Appellate court to re-argue their case for the possession of marijuana was due to their condition, (AIDS), and was a medical necessity and falls under the category of Florida’s English Common Law, and is in line with the federal laws that govern medical necessity. In this case, the condition that the Jenks were suffering from, (AIDS), currently had no studies being conducted by the FDA’s New Drug Investigational program (Quiggle, 2014).If such research was being conducted by the federal government it would supersede the State’s Laws and would allow the Jenks to petition to join a federal program that would exempt them from prosecution. Without, this backing the Jenks had to rely on the testimony of medical experts and physicians who were currently doing research on the effects of medications currently being used to treat their condition. Because of the Jenks Appeal the Laws in Florida were changed, while you could still be arrested for the possession of marijuana, you would have to go to court to prove that its use is a medical necessity. The Appeals Courts favorable ruling set judicial precedence in 1991. Shortly after that, the Florida legislature reclassified cannabis from a schedule 1D to a 1C7, which means that while it is still illegal it is also known to have a medicinal value (Quiggle, 2014). Right after their victory in court they applied to the federal governments IND program along with 300 other AIDS patients of which more than 30 were accepted into the program with them, however, in February, 1992, President George Bush Senior signed a bill cutting off funding for the IND program and director John Mason un-able to get public funding was forced to discontinue the IND prescription for cannabis. Ken and Barbara, who lost the will to live soon after the program was shut down succumbed to the ravages of AIDS. Barbara Jenks died in 1992 and Ken died in 1993 (Equal Rights 4 All, 2016).The Florida Criminal Codes that applied in these two cases consisted of:First case red/blueSecond case green/blue Florida Criminal Code § 893.03(c)(35)Florida Criminal Code § 893.13?Florida Criminal Code § 893.135?Florida Criminal Code § 893.13?Florida Criminal Code § 775.082(a) OffensePenaltyIncarceration??Max. Fine??Possession20 grams or less.Misdemeanor1 year$1,000More than 20 grams.Felony5 years$5,000Less than 25 grams.Felony5 years$5,00025 plants?or lessFelony15 years$10,000Sale20 grams or less without remunerationMisdemeanor1 year$10,00025 lbs. or less25 lbs. or lessFelonyFelony5 years5 years$5,000$5,00025 – 2,000 lbs. (or 300-2,000 plants)Felony3*-15 years$25,0002,000 - 10,000 lbs. (or 2,000-10,000 plants)Felony7*-30 years$50,00010,000 lbs. or moreFelony15*-30 years$200,000Within 1,000 feet of a school, college, park, or other specified areas.Felony15 years$10,000* Mandatory minimum sentence.ParaphernaliaPossession of paraphernaliaPossession of paraphernaliaMisdemeanorMisdemeanor1 year1 year$1,000$1,000Hash & ConcentratesPossession of less than 3 g.Misdemeanor1 year$1,000Possession of 3 g. or moreFelony5 years$5,000Selling, manufacturing or deliveringFelony5 years$5,000(Florida Medical Marijuana Laws, 2016).While the classification of marijuana change from being a schedule 1D to a 1C7 this did not change the possession laws that apply to those wishing to use it for medicinal purposes. The classification change did allow researchers to conduct tests on selected patients to determine marijuana’s medicinal effects. One of the first prominent individuals to advocate for legislative change in the state of Florida is John Morgan. In 2013, John announced his support of the campaign to legalize medical marijuana in Florida for use by the state’s seriously ill. According to John, the deeply personal cause is a step to not only provide safer pain relief and treatment methods for those with legitimate diseases, but also to help end the rampant problem of prescription drug abuse in Florida. In addition to his financial contributions, John has been the public face of the effort, openly recruiting volunteers to collect the thousands of signatures needed to place the initiative on Florida’s November 2016 general election ballot. To help drive his point home with the Florida State Legislature he solicited the aide of Sanjay Gupta who once opposed the use of marijuana for medicinal purposes (Samalot, M., 2016).Sanjay Gupta is an American neurosurgeon and media reporter. He serves as associate chief of the neurosurgery service at Grady Memorial Hospital in Atlanta, Georgia, and is the assistant professor of neurosurgery at the Emory University School of Medicine. On January 6, 2009, CNN announced that Gupta had been considered for the position of Surgeon General by President Barack Obama. At one time Gupta opposed the use of marijuana as a medicine, and believed it had no medicinal value, he retracted his opinion in 2013 after doing a two year independent study into the effects it has on individuals with neurological disorders, and those suffering seizures (CNN Profiles, 2016). In Oct, 2013 at the request of John Morgan, Gupta submitted a report acknowledging his own independent findings to the Florida State Legislature and in it he wrote “It’s been eight months since I last wrote about medical marijuana, and I feel I must apologize for having not dug deeply into the beneficial effects of this plant and for writing articles dismissing its potential in the past. I apologize for my own role in previously misleading people, and I feel very badly that people have suffered for too long, unable to obtain the legitimate medicine that may have helped them. Along with my independent research, emerging science not only shows, and proves what marijuana can do for the body, but provides better insights into the mechanisms of marijuana in the brain, helping us better understand a plant whose benefits have been documented for thousands of years.” (Florida Contacts, 2016).While Amendment II did not pass in Florida in 2014, the efforts that John Morgan and other prominent figures in both the Medical, and Judicial field, did not fall on deft ears in the Florida Legislature, and in November of 2014 new legislative amendments were made concerning proscribing, producing, and dispensing marijuana as a viable medicine. The following is a brief outline of how the amendment would be applied in 2014:Florida MEDICAL MARIJUANA (cannabis) LAW Status: CBD Specific, Law Signed: 2014 QUALIFYING CONDITIONS: Cancer, Muscle spasms, Seizures PATIENT POSSESSION LIMITS: State-qualified patients may possess cannabis strains containing ten percent or more of CBD and no more than eight-tenths of one percent of THC. HOME CULTIVATION: No STATE-LICENSED DISPENSARIES: Yes, up to five facilities to dispense high-CBD strains to state-qualified patients. STATE-LICENSED DISPENSARIES OPERATIONAL: Not yet CAREGIVERS: No RECIPROCITY: No CONTACT INFORMATION: Department of Health(Florida Contacts, 2016).As of June, 2016 there is presently 226 facilities in Florida solely related to developmental research, prescribing, producing, and the dispensing of marijuana for medical purposes, however the one thing that has not changed is the qualifying conditions (Florida Marijuana Dispensaries Map, 2016). So how does this change in Florida compare to those states who have passed Amendment II, as well as, the qualifying conditions these states recognize for its use as a medicine? As of June 2016, 25 states and the District of Columbia, starting with California in 1996, have legalized medical cannabis or effectively decriminalized it. The Chart below is a list of those States and the types of conditions that each State qualifies for the use of Marijuana as a Medicine.StateCancerGlaucomaHIV/AIDSParkinson's diseaseMultiple sclerosisEpilepsySeizuresWasting syndromeCrohn's diseasePTSDAlaska YesYesYesNoYesNoYesYesNoNoArizona YesYesYesYesYesYesYesYesYesYesCaliforniaYesYesYesYesYesYesYesYesYesYesColoradoYesYesYesNoYesYesNoYesYesYesConnecticut YesYesYesYesYesYesYesYesYesYesDelaware YesNoYesNoYesYesYesYesNoYesDistrict of Columbia YesYesYesYesYesYesYesYesYesYesHawaii YesYesYesNoYesYesYesYesNoYesIllinois YesYesYesYesYesYesYesYesYesNoMaineYesYesYesYesYesYesYesYesYesYesMarylandNoNoNoNoYesYesYesYesNoNoMassachusettsYesYesYesYesYesYesYesYesYesYesMichiganYesYesYesNoYesYesYesYesYesYesMinnesotaYesYesYesNoYesYesYesNoYesNoMontanaNoNoNoNoYesNoYesYesNoNoNevadaYesYesYesYesYesYesYesYesNoYesNew HampshireYesNoNoNoYesNoNoYesNoYesNew JerseyYesYesYesNoYesNoYesNoYesNoNew MexicoYesYesYesYesYesNoYesNoYesYesOregonYesYesYesNoYesYesNoYesNoYesPennsylvaniaYesYesYesYesYesYesNoNoYesYesRhode IslandYesYesYesYesYesYesYesYesYesYesTennesseeYesYesYesYesYesYesYesYesYesYesTexasNoNoNoNoNoYesNoNoNoNoVermontYesNoYesNoYesNoYesYesNoYesWashingtonYesYesYesNoYesYesYesYesYesYes(State Medical Marijuana Laws, 2016).In California, if you carry a Medical Marijuana Identification Card, you are not likely to be charged or even arrested for possessing marijuana. Florida is distinctly different. The Florida penal code does not provide exceptions for the possession of marijuana for medicinal purposes. Penalties for possession of medical marijuana are the same as those for possession of recreational marijuana. Depending on the quantity of marijuana possessed, you could be convicted of a misdemeanor or felony offense, be confined to the county jail or state prison, and receive a suspension of your driver’s license for up to two years. It might be frustrating for some that Florida has not yet caught up with other states that have enacted medical marijuana reform. However, the issue will be moot as long as state and federal laws conflict. Even though you can possess medical marijuana in California pursuant to state medical marijuana laws, you are still considered in violation of federal statutes. Marijuana is still illegal and prosecuted following federal regulations. If you feel that you absolutely need medical marijuana, you have two general options,?obtain medical marijuana illegally or establish a residence where medical marijuana is authorized. Before you choose the first option, you should understand all of the consequences associated with the illegal possession of marijuana, including medical marijuana. Similarly, before you uproot and relocate, you should review both the laws in states that authorize medical marijuana and overlapping federal statutes.On February 27th of 2013, Democratic Senator Jeff Clemens filed an act that was relating to the use of medical cannabis as authorized by a licensed medical practitioner. The state would be responsible for authorizing a qualifying patient to possess and administer medical cannabis and the authorization of a patient's caregiver to possess and administer medical marijuana to a qualifying patient. As outline through Senator Clemens' bill, the maximum amount of cannabis that a qualifying patients' caregiver may possess at a given time is four ounces of dry medical cannabis. Patient caregivers would also be permitted eight mature marijuana plants or eight immature marijuana plants. However, in Florida the only way to qualify for a Cannabis card is to be diagnosed with Cancer, Muscle spasms, or Seizures. First you must find a physician and an attorney who are willing to stake their license and reputations on your behalf, proving that such a drug will help control the spasms or seizures, or ease the pain you suffer, from these conditions better than the legal medicines available in Florida (Tiburcio et al., 2015), (Bing images, 2016).While federal law even today still stands firm in the way that it is written, that marijuana has no medicinal purposes, researchers from the government did find that for a select few cancer individuals it did aid in staving off the effects of certain cancer medicines that were being used between 1976 and to this date, and in 1985 developed the drug MariNol which was recognized and approved by the FDA to control nausea and vomiting associated with chemotherapy, and was actively prescribed to those individuals that did not respond to conventional anti-emetics that were designed to control this condition (Florida Medical Marijuana Treatment Center Institute, 2016). After almost 6 decades of research, both governmental, and independent, cannabis made its first major impact on the medical field in 1996, when California became the first state to challenge federal law by recognizing and implementing the use of marijuana for medicinal purposes on a commercial basis (Brown Jr., E., 2008) (Federal Marijuana Law., 2016).At the time Amendment II was passed in 1996 in California, the office of the Inspector General, both at the state and federal level, had very few compliance laws in place governing who can prescribe, administer, distribute, and produce the raw material needed for the production and distribution of derivatives made from this new form of medication. It is no secret that pharmaceutical companies have been using schedule 1 drugs to produce a variety of medications commonly used in the treatment of pain and other conditions a patient may suffer from. While the list of these drugs is far too extensive to list here, I have taken the liberty to mention just a few that most people recognize. Along with Cannabis, there is Opium, Heroin, Cocaine, Lysergic acid diethylamide (LSD), Gamma-Hydroxybutyric acid or (GHB) known as a date rape drug, and finally one of the most dangerous of all, N-(1-Phenylcyclohexyl)-pyrrolidine (PCPY) (Pyrrolidine analog of phencyclidine), known on the streets simply as (PCP), the drug that changes mere mortals to super human in nature (The Florida Senate, 2016) (Brown Jr., E., 2008) (Office of Inspector General of the U.S. Department of Health & Human Services (HHS), 2016).For over a century now, legal precedents concerning the use and distribution of medication derived from schedule 1 drugs, such as the two legal cases mentioned here, causes controversy and divides society in a whole, regarding their ethical beliefs and standards. At the root of it all, is determining, whether or not, administering such medications truly are a medical necessity. While most individuals can quickly identify the Allied and Public health care workers involved as being researchers, physicians, pharmacists, and nurses, very seldom do they mention the Allied and Public health care workers involved that ensure that medical necessity and compliance under the law is met, and today one very important position associated with that task, is known as, a medical coder (The University of Tampa, 2016) (Tiburcio, J. et all, 2015).The history of classifying and coding diseases and the causes of morbidity dates back to the 17th century. Today, most individuals think of a medical coder as being an individual that ensures that physicians get paid for the jobs they perform, while this may ring true we often fail to recognize the real reason that coding was developed in the first place, which is to record all the various types of drugs used, procedures performed, and treatments utilized by researchers and physicians around the world in the attempt to cure or control the life threatening conditions that plague our lives (World Health Organization, 2016).While Legal cases like Elvy Mussika, and Kenneth and Barbara Jenks, helped re-define our ethical views about marijuana as a medicine, here in Florida, they certainly were not the first, nor will they be the last time our ethical opinion of a schedule 1 drugs or the techniques and procedures that researchers and physicians deem necessary in the advancement of medical science will challenge our definition of medical necessity. And without, ICD records of researchers, physicians, and clinicians and their documented reports of past effects and results concerning their success and failures, there would be no progress at all in determining the use of certain drugs, or procedures, to validate them to be a medical necessity for the treatment of a patient’s condition (Office of Inspector General of the U.S. Department of Health & Human Services, HHS, 2016) (World Health Organization, 2016) (Federal Marijuana Law, 2016).Even now medical science has expanded into the field of genetics. This has challenged the public, as well as, the medical community’s ethical views about what is right and wrong, and asks the question, just how far do we let these researchers and physicians go when it comes to its use. While enacting laws preventing researchers and physicians from continuing work in medical science can be harmful, giving them a free hand to do as they please can be more harmful. While it will take time for society to accept and enact the laws necessary to ensure public safety, there will always be an Elvy Mussika, and Kenneth and Barbara Jenks, to remind us that this is a decision that affects all of us, and that we must consider those individuals who are in need, and those individuals that may have need in the future (Federal Marijuana Law, 2016) (Equal Rights 4 All, 2016).Portfolio Project ReferencesAlliance Legal, (2008). Alliance for Cannabis Therapeutics. Significant Legal Cases U.S. vRandall (1976) Randall v.U.S. (1978) In the Matter of Craig Reichart (1978) State of Washington v. Diana (1981) State of Florida v. Musikka (1988) U.S. v. Burton (1988) State of Florida v. Kenneth & Barbra Jenks (1990) State of Idaho v. Hasting (1989. (2016). Retrieved 19 May 2016, from (2008). Debunking the Hemp Conspiracy Theory. Retrieved 11 June 2016, from | The Association of Schools of Allied Health Professions. (2016). . Retrieved19 May 2016, from , E. P. (2015). Comprehensive Review of Medicinal Marijuana, Cannabinoids, andTherapeutic Implications in Medicine and Headache: What a Long Strange Trip It's Been Headache: The Journal Of Head & Face Pain, 55(6), 885-916 32p. doi:10.1111/head.12570Been Verified. (2016). . Retrieved 11 June 2016, from images. (2016). florida medical marijuana card - . Retrieved 13 June 2016, from Jr., E. (2008). GUIDELINES FOR THE SECURITY AND NON-DIVERSION OFMARIJUANA GROWN FOR MEDICAL USE. Office of the Attorney General/Department of Justice. Retrieved 11 June 2016, from Profiles - Dr. Sanjay Gupta - Chief Medical Correspondent. (2016). CNN. Retrieved 11June 2016, from , I. S., Albertson, T. E., Folan, P., Hanania, N. A., Tashkin, D. P., Upson, D. J., & Leone,F. T. (2015). Implications of Marijuana Decriminalization on the Practice of Pulmonary, Critical Care, and Sleep Medicine. A Report of the American Thoracic Society Marijuana Workgroup. Annals Of The American Thoracic Society, 12(11), 1700-1710 11p. doi:10.1513/AnnalsATS.201504-195AREd Quiggle, J. (2014). The Medical Necessity Defense in Florida - .. Retrieved 10 June 2016, from Rights 4 All. (2016). Ken and Barbara Jenks, AIDS activists, medical marijuana patient | Equalrights4all.us. Retrieved 11 June 2016, from Marijuana Law. (2016). Americans for Safe Access. Retrieved 11 June 2016, from CONTACTs, LINKS and More | a Medical Cannabis Resource Center (MERCY) InfoPage. (2016). . Retrieved 11 June 2016, from Marijuana Dispensaries Map Directory Finder Miami FL. (2016). Retrieved 11 June2016, from Medical Marijuana Laws. (2016). . Retrieved 11 June 2016, from Medical Marijuana Treatment Center Institute. (2016). Retrieved 11 June 2016, from minister 'outraged' by Supreme Court's medical pot ruling. (2016). Cbc.ca. Retrieved 19 May 2016, from v. State, 582 So.2d 676 - Fla.App. 1 Dist. 1991. (2016). . Retrieved 19 May 2016, from is Medicine. (2016). . 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Chapter 893 Section 03 - 2011 Florida Statutes - .Retrieved 14 June 2016, from University of Tampa - Allied Health Major - Allied Health versus Public Health. (2016).Ut.edu. Retrieved 19 May 2016, from 10,000-year World History of Hemp and Cannabis. (2016). .Retrieved 19 May 2016, from , J., Rosario, L., DeJoy III, R. W., Reich, J. D., Kadiyala, R., & Shah, S. (2015).Evaluating the Need for Marijuana-Specific Training and Licensure Programs for Currently Practicing Physicians. New York Family Medicine News, 24-27 4p.World Health Organization, (2016). History of the development of the ICD. Retrieved 17 June 2016, from ................
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