Thursday, April 6, 2017

Going Green, a Journey of Medical Cannabis

On November 8th, 2016, Florida voters went to the polls and cast their ballots to pass medical marijuana as an alternative chronic pain treatment option. Amendment 2 under new Florida law states, a person may possess and use marijuana if he or she is doing so to treat a "debilitating medical condition," which includes but not limited to: PTSD, cancer, epilepsy, glaucoma, HIV, AIDS, ALS, Crohn's or Parkinson's disease and multiple sclerosis. Amendment 2 passed with an overwhelming 71% vote, and for the first time granting the state of Florida and board certified doctors to prescribe low-THC cannabis and other medicinal forms of the cannabinoid. Even though the 5 page document which embodies amendment 2 is relatively small, a lot of ground work is still needed by lawmakers and legislation to prepare the state for medical marijuana distribution. Patients with a valid state issued ID, medical documentation of "debilitating medical condition," and no previous drug/criminal history are eligible. This is where I come in.

I waited a few months after January 3rd, 2017, when the law took effect in Florida, to search for a certified doctor who prescribed medical marijuana that I felt comfortable with. The main reason for my delay was to follow up with my own research into the process, and understand how this new system works for patients from the outside. I am documenting my complete journey, in hopes of offering educational value and assistance to patients who are seeking the same level of care as I. After hours of my own investigating, I was finally able to settle on my doctor here in the Orlando, FL metro area. He is Dr. Jason Schultz, an Orlando based emergency medicine physician, and his practice under the Florida state-wide organization is called "Green Health." Green Health has multiple offices currently in Tampa, St. Petersburg, Orlando, Jacksonville, Miami, West Palm Beach and Fort Lauderdale.

So what exactly is the process for the state of Florida in obtaining a "medical marijuana" card? Getting an appointment is relatively easy, as they accept any appointments as new patients. The key, however, is that you must provide a primary or specialty doctor's summary stating your diagnosis on the outlined approved medical conditions for the state, which are outlined above. Let me be 100% clear, your medical insurance WILL NOT cover any of the treatment guidelines offered by the medical marijuana doctor's office. All visits to this office are $125 per visit, but we'll cover up front expenses later.

So, what does a medical marijuana doctor's office look like? If your first initial response was like mine, a 'hole-in-the-wall' building that just serves to hand out marijuana cards, you're poorly mistaken. Upon entering the building, which is home to many other medical companies like Vista Labs, and Simon Med radiology, I noticed it was very clean, and well maintained. Green Health is located on the second floor here in the Longwood, FL office. Upon entering the door, you're greeted with a Green Health insignia, and a rahter pristine establishment. I seriously had no gripes about the facility itself, and was very relieved to see the Green Health clinic office was actually more modern and upscale than I originally anticipated. One never knows what ordeals you're getting yourself into in going to these types of unknown and new places, especially one that prescribes cannabis.

The waiting room was very pleasant with low-lit ambient lighting, which was a perfect environment for those battling light sensitivity ailments. Again, very clean and modern. All patients fill out a 5-6 page questionnaire which are generalized insight into your medical conditions and the reason of your visit. The staff and nurses were all warm and welcoming, and greeted every patient with the same level of respect and sincerity. They also request your state issued ID which is used to determine your criminal status (if any), and validate your residency and home address. I had no hesitation in handing them my Florida state driver's license.

The exam rooms also followed suit with a modern feel, the floors were spotless. With any doctor appointment, I always can determine the caliber of establishment based on the overall cleanliness of the facility. Again, I'm thoroughly impressed with Green Health and the building facility. The nurse took my vitals, and politely asked me to wait as the doctor would be in shortly. The wait was less than 5 minutes, and Dr. James Schultz greeted me with a friendly smile and hand shake. His bedside manner was just remarkable, and super easy to talk to. He encourages patients to ask as many questions as you want, and that the time spent with him is truly valued. We spent about 20 minutes discussing my potential treatment plan and combination therapy for chronic pain management. I asked so many questions from cost, protocol, medical delivery etc.

So, let's get down to the real meat and potatoes of how Florida handles medical marijuana. Each doctor's visit with Green Health is $125 out of pocket, no insurance accepted. A minimum of two visits are required. Upon the second visit after 90 days, the physician can then legally recommend medical marijuana to patients. The 90 day waiting period is mandatory from your first visit. Every 45 days, a follow phone call is required to discuss dosing adjustments and any alterations to the treatment plan needed. This phone "check-in" is $20, and required every 45 days for medical delivery and marijuana card membership. After 90 days, the physician will then order the desired medications from one of the dispensaries located nearest to you within the state.

My local dispensary happens to be Knox Farms in Winter Garden, FL. So how much is it to purchase non-insurance based medical marijuana? A little more pricey than you think. With a limited number of dispensaries starting out, only seven currently in Florida, the prices are higher starting out. My doctor informed me that he would start me on a 24-hour chronic pain low-THC treatment plan. The regimen would be comprised 1 cannabis pill daily that lasts 12 hours for daytime activity, mouth drops for nighttime and a vapor for breakthrough pain related episodes. With these three medications from the dispensary, my total will range from $100-150 every 45 days out of pocket expenses for the first month. There is also a $20 dispensary deliver fee, in which my prescriptions will be delivered discretely to my house from Knox Farms. Dr. Schultz did advise me that I won't have to purchase some of the medications upon my follow up dispense, as some items are "as needed." Like the vapor, which is a 1-2 hour short acting treatment for breakthrough episodes. The main focus is the pill forms daily.

So, here we are. First visit is over, and I now await my post 90 day doctor visit to actually be able to purchase medical marijuana for my chronic pain. Let's recap all the overhead expenses you need to know about if you plan to pursue this treatment option for your medical conditions.
  1. Doctor Visit #1 (getting established) - $125
  2. Doctor Visit #2 (post 90 day approval) - $125
  3. Every 45 day Check-in (to maintain card as patient) - $20
  4. Medication Dispense (first shipment) - $100-150
  5. Medication Dispense (post first shipment) - $45-55
I do hope this helps to shed some light on the whole process here in Florida. It does have some intricacies to it, and the second 90 day waiting period is a bit of a pain, no pun intended. To keep your medications arriving monthly will generally cost about $70-100 according to the information I received at today's office visit. These prices, though on the higher end now, will gradually decline as more and more patients register, and more dispensaries arrive in the Sunshine State. 

I can't imagine a world living in little pain, and not having to rely on harmful opiods to manage my conditions. I truly excited to give this new option an try, and I plan to document everything here in my blog.