Report: Medical marijuana patients, daily dose amounts at an all-time high

Florida’s medical marijuana market continues to grow as more and more residents qualify for access.

Not only has the number of patients qualifying for medical marijuana increased in the last year, daily dose amounts ordered have, too, according to he Physician Certification Pattern Review 2023 Annual Report, which shows 546 million ounces of smokable marijuana was certified for patients between July 1, 2021 and June 30, 2022.

In all there were 757,600 patients who qualified or were eligible for medical marijuana, according to the report. That’s a 25% increase in the number of qualified patients from the previous fiscal year. The vast majority of the patients in fiscal year (FY) 21-22, 728,655, have smoking certifications.

Certifications for medical marijuana use contain orders for the type of marijuana — low-THC or traditional — as well as the route of administration for the delivery — edible, inhalation, oral, smokable, sublingual, suppository, or topical. They contain orders with a maximum duration of 35 to 70 days depending on route of administration.

In FY 21-22 83% of certifications were issued by 17% of qualified physicians. Those physicians certified at least 1,000 patients. By contrast 43% of the physicians certified between one and 50 patients during the 12-month span under review, accounting for 1% of all certifications for the year.

Current certifications have a maximum duration of 210 days, or three consecutive 70-day orders (six consecutive 35-day orders for smoking). Patients are allowed one current (active) certification and one pending (future) certification.

Florida lawmakers first authorized the limited use of non-euphoric, low-THC marijuana in 2014. 

Voters in 2016 overwhelmingly approved a constitutional amendment that broadly legalized medical marijuana and legislators passed a law the following year to implement the new constitutional requirement. As part of the law, the Florida Legislature required the state medical boards to create a physician certification pattern review panel that shall review all physician certifications submitted to the medical marijuana use registry. The Legislature directed the panel to track and report the number of physician certifications and the qualifying medical conditions, dosage, supply amount, and form of marijuana certified. 

The report initially contained a review of data from October 1 through September 30, but the medical boards requested last year that the data cycle dates for the annual report be changed to align with the fiscal year.

Low-THC cannabis average daily dose amounts ordered in FY 21-22 have increased from the previous fiscal year for edibles, inhalation, and oral routes by 7%. Suppository and topical routes both increased by 11%. The sublingual route increased by 8%, the report shows.

Increases also were observed for traditional marijuana, with edibles increasing by 10%. Inhalation and oral routes both increased by 9%. The sublingual, suppository, and topical routes showed increases of 11%, 13%, and 16%, respectively.

The report indicates there were 546 million ounces of smokable marijuana ordered in FY 21-22. The average order for smokable marijuana in FY 21-22 was for 2.47 ounces, up slightly from 2.46 ounces the previous fiscal year but under the statutory 2.5 ounce cap.

Baker, Bay, Brevard, Broward, Charlotte, Citrus, Collier, DeSoto, Duval, Escambia, Flagler, Highlands, Lake, Lee, Marion, Miami-Dade, Okaloosa, Okochobee, Osceola, Palm Beach, Pasco, Pinellas, Putnam, St. Lucie, Sarasota, Sumter, Volusia, Walton and Washington counties exceeded the statewide average of 2.47 ounces.

Eighteen of the counties averaged 2.5 ounces of smokable pot per order, the highest allowed under law.

And while the number of physicians qualified to certify patients for medical marijuana use dropped 4% to 2,144, the report indicates the number of qualified physicians who had certified a patient for medical marijuana use actually increased over the previous fiscal year by 4% to 1,725.

Qualified physicians on average provided 662 patients with certifications for medical marijuana treatment in FY 21-22, though the report shows one physician had 32,686 certifications.

In order to qualify for medical marijuana a physician must determine the patient has one or more of 12 qualifying conditions or that the patient suffers from a medical condition of the same kind or class of the 12 that are enumerated in the law.

Nearly 40% of the patients who qualify for medical marijuana were diagnosed with post traumatic stress disorder. Roughly 29% of the patients were categorized as having similar medical conditions as the same kind or class and 13.7% were diagnosed as suffering from chronic, non-malignant pain.

A physician certification can be issued only if the qualified physician conducts a physical examination while present in the same room as the patient, though exceptions to that requirement were made for certain persons during the COVID-19 pandemic and during Hurricane Ian. 

Additionally, physicians must complete a full assessment of the patient’s medical history; review the Prescription Drug Monitoring Program (PDMP) database; and diagnose the patient with at least one qualifying medical condition.

Qualified physicians are responsible for the determination that the medical use of marijuana would likely outweigh the potential health risks for the patient. Physicians must complete the medical consent form and, when appropriate, submit required documentation as part of the certification process.