‘Steady Increase’ In Florida Medical Marijuana Certifications Continued In 2023, State Report Shows

The number of registered medical marijuana patients continued to rise in Florida during fiscal year 2023, a state panel said in a new annual report—although the rate of growth slowed slightly from previous years as the system matures and attention turns to an adult-use legalization measure that may go before voters on the November ballot.

The number of individual patients enrolled in the program, for example, grew by 15 percent in fiscal 2023 compared to the previous year, down from 25 percent growth from 2021 to 2022.

Average daily doses, meanwhile, were lower during the most recent fiscal year (FY)—which spanned July 1, 2022 through June 30, 2023—due in large part to the state’s implementation of an emergency rule that set daily dosing limits. The report also found that, consistent with past years, a relatively small portion of doctors who were certified to recommend medical marijuana wrote a big share of certifications to patients.

Physician Certification Pattern Review, 2024 Annual Report

The 2024 Physician Certification Pattern Review annual report was produced by the state’s Physician Certification Pattern Review Panel, a seven-member body jointly created under statute by the Florida Board of Medicine and Board of Osteopathic Medicine. The panel is required by law to issue findings and recommendations about the state’s marijuana program by January 1 each year.

“Based upon a review of the data for FYs 2021, 2022 and 2023,” the report says, “the data have reflected a steady increase in the number of physician certifications, physician certifications containing at least one order for smoking as a route of administration, the distinct number of qualified patients with certifications, and the number of qualified physicians.”

Individual patient enrollment in fiscal 2023 was 859,026, up from 757,600 the prior year. In fiscal 2021, the number of patients in the program was 607,220. Year-over-year monthly enrollments, however, have recently decreased.

Comparing January 2020 to January 2021, the report says, new patient enrollment rose by 27 percent, then decreased by 6 percent between January 2021 and January 2022. Month-over-month enrollments then decreased by 3 percent the following year. In June 2023—the most recent monthly count—20,977 new patients joined the program.

In terms of qualifying conditions, the most common specific conditions were post-traumatic stress disorder (PTSD), comprising 40.2 percent of all reported qualifying conditions, followed by chronic nonmalignant pain (13.4 percent), multiple sclerosis (8.8 percent) and cancer (3.6 percent).

More than a quarter of patients qualified for unspecified conditions “of the same kind or class or comparable” to those specifically listed. The bulk of those, the report says, were anxiety and conditions related to “chronic pain from neuro or muscular degeneration or injury,” along with some for conditions related to the digestive system, infectious disease or connective tissue, among others.

Physician Certification Pattern Review, 2024 Annual Report

Physician certifications, which allow patients to participate in the state’s medical marijuana program, “continue to show a cumulative increase for each year of reporting,” the report noted.

The total annual number of certifications increased by 15 percent between fiscal 2022 and 2023—from 1,142,172 to 1,315,123—growing at a slightly slower rate than the 24 percent from fiscal 2021 to 2022.

Measured differently, another section of the document says, monthly certifications rose by 48 percent during from January 2020 compared to January 2021, then by 24 percent between 2021 and January 2022. Certifications increased at a slower rate during the most recent full year of reporting, from January 2022 to January 2023, rising by 21 percent.

The latest monthly count, for June 2023, was 117,313 certifications, up from 113,992 in January 2023.

The report also found that a minority of doctors were responsible for issuing the vast bulk of medical marijuana certifications, a trend continued from previous years. “This ratio has been increasing,” it said, “as a small percentage of physicians continues to see more patients and more patients continue with subsequent certifications each fiscal year.”

During fiscal 2023, 19 percent of qualified physicians issued 84 percent of all certifications, while the bottom 40 percent of qualified physicians issued just 1 percent of certifications for the year.

The report spends several pages listing the top five doctors recommending various forms of both low-THC products and medical marijuana across the state. Though the physicians themselves were anonymized with a unique two-letter identifier, the data show that some physicians issued tens of thousands of certifications for thousands of patients, sometimes for consecutive years.

Some politicians in the state have remained skeptical of Florida’s medical marijuana program. During a recent presidential campaign event, Gov. Ron DeSantis (R) recently suggested, for example, that the increase in medical marijuana patients in his state is partly due people using the law as a “pretext” for recreational cannabis use.

Separately, DeSantis signed a bill that took effect last summer that added restrictions to medical marijuana advertising and manufacturing, prohibiting any products or messages that promote “recreational” cannabis use, while adding more stringent eligibility requirements for workers in the industry.

The governor also approved a bill in June that expressly prohibits sober living facilities from allowing residents to possess or use medical marijuana, even if the patient is certified by a doctor to legally use cannabis therapeutically in accordance with state law. All other doctor-prescribed pharmaceutical medications may be permitted, however.

And in July, DeSantis banning sales of any consumable hemp products—including cannabis “chewing gum”—to people under 21, an expansion of an existing prohibition on young people being able to purchase smokable hemp.

Last week, DeSantis criticized marijuana legalization in Colorado, claiming that it has led to an increase in the size of the illicit cannabis market.

Meanwhile, amid an effort to put a marijuana legalization initiative on the state’s 2024 ballot, officials late last month arrested two paid canvassers, who were charged with allegedly falsifying petition signatures.

The organizer of a separate Florida ballot initiative to legalize home cultivation of medical marijuana by patients recently withdrew the proposal, explaining that the campaign raised barely more than $4,000 and couldn’t cover costs associated with trying to qualify the measure.

In the legislature, meanwhile, a Florida Republican senator introduced a bill last month to allow licensed medical cannabis businesses to take state tax deductions that they are barred from claiming at the federal level under an Internal Revenue Service (IRS) code known as 280E.

Another GOP lawmaker filed a separate bill last week to limit the potency of recreational marijuana flower to 10 percent THC if voters approve legalization.

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