Dr. Natalie Ellis is one of the few doctors who do house calls these days. She serves a downtown community in St. Petersburg, visiting patients when they are sick or when young children make it inconvenient for them to come to the office.
Much like Dr. Quinn of Dr. Quinn Medicine Woman, Dr. Ellis is a pioneer. She is one of a growing number of Florida physicians licensed to treat patients with cannabis.
The newly licensed medical marijuana practitioners are learning as they go. “All of this is really new,” she says. “There’re a lot of people that still don’t know it’s legal.”
Marijuana is a Schedule 1 illegal drug under federal law, but the momentum is growing for full or partial legalization. Florida has joined 43 other U.S. states and the District of Columbia in allowing some form of medical marijuana, according to the National Center for Biotechnology Information, U.S. National Library of Medicine.
The Sunshine State passed a constitutional amendment to legalize medical marijuana in November 2016. Doctors have been undergoing special state training and 13 medical marijuana treatment centers have been licensed through the state Office for Medical Marijuana Use
In Florida, the term medical marijuana refers to all parts of the cannabis plant, including its seeds and resin, and any compound made from it and dispensed at a state medical marijuana treatment center. Legally, it can’t be smoked. However, a number of conditions can be treated legally, including cancer, epilepsy, glaucoma, human immunodeficiency virus or HIV, acquired immune deficiency syndrome or AIDS, Post-Traumatic Stress Disorder, Amyotrophic Lateral Sclerosis, Crohn’s disease, Parkinson’s disease, Multiple Sclerosis, and chronic pain related to medical conditions that qualify for treatment.
Medical marijuana in Florida may contain significant amounts of tetrahydrocannabinol or THC, which is responsible for the high associated with marijuana. Low-THC products, which rely on cannabidiol or CDB for its health benefits, don’t have the euphoric properties and are considered to be distinct.
Though some are familiar with the effects of recreational marijuana, medical marijuana is different because growers can crossbreed plants to make it more effective for treating specific symptoms, Ellis points out
Most of Dr. Ellis’ patients that use medical marijuana range in age from the late 20s to the 60s; a few are in their 80s. Some are military veterans like Ellis, a former Navy doctor. “I saw this as being a service that could help a lot of veterans,” she says.
The goal of treatment is to manage symptoms. “A lot of these people work. They are not sitting in the house dying,” says Ellis, whose practice at 2520 Central Ave., St. Petersburg, is a mix of home and office visits and telemedicine. “This is definitely helping with their lives.”
So far, the few patients on medical marijuana have been doing well. “I think it’s definitely beneficial,” she notes. “Ninety percent of my patients that are on it have all benefitted.”
Preparing to profit
From the doctor to the dispensary, people are learning on the job and from each other. Daniel Elias has set about to train people in Tampa and Orlando so the state’s industry doesn’t have to recruit workers from elsewhere.
Elias hails from Puerto Rico, where he’s been working in medicine-related agriculture. At King’s farm at Utuado, Puerto Rico, which he opened in 2009, he has grown aloe vera, green tea, moringa, chamomile and other products for the business market in the United States.
But Elias, who helped draft the medical marijuana law for the island, also owns a medical marijuana dispensary, the Caribbean Buds Dispensary in San Juan. Now, he’s bringing a three-track certification program to Tampa Bay through Pharmacology University Tampa.
Founded by Dante Picazo, the Austin-based university
has been training medical marijuana industry staff in Fort Lauderdale, Miami, Las Vegas, Dallas, Fort Worth, Houston, Austin, Arkansas, and Arizona, as well as in Puerto Rico. Elias secured a franchise to offer training in Tampa, where he is the lead professor.
“Many people from the black market want to get into the medicinal market, but it is not the same at all,” he says. “We have to be very cautious in how we grow that plant. It’s going to become a medicine.”
For the black market, marijuana might be grown in seclusion in a room or house. For medical use, it’s grown in a laboratory, possibly with organic products and purified water.
“You need to teach people the things you cannot do. The way the plant is produced is completely different,” he says.
The 10-week course, normally priced at $999, will be held on Saturdays at Hilton Garden Inn Tampa East/Brandon at 10309 Highland Manor Dr., Tampa, starting August 11. The three separate tracks cater to different industry groups: from 8 a.m. to 11 a.m., cultivators; from noon to 3 p.m., marijuana product manufacturers; and from 4 p.m. to 7 p.m., doctors and budtenders, the industry’s counterpart of a pharmacist.
Students must be at least 18. Patients receive a 50 percent discount. “Many patients take the courses just because they want to learn about the product,” he adds. ”We do want to make them feel safe.”
Another course aimed at potential medical marijuana dispensary workers is being offered in Tampa June 30 by Hempstaff
. The four-hour course, which includes a certification test, will be held at Hampton Inn and Suites Tampa Airport Avion Park, Westshore, at 5329 Avion Park Dr. Two sessions are being offered: one at 8 a.m. and the other at 1:30 p.m. That class costs $249.
Elias expects an increasing demand for employees within the industry in Florida, specifically five or six at each dispensary. That could amount to thousands over time. Robust salaries being paid in the industry, on average $150,000 to $200,000 annually nationwide for master growers that manage cultivation sites, can make working in the industry lucrative.
“The biggest hurdles are the pharmaceutical companies. They see us as a threat,” explains Elias, whose wife Natasha is a cardiologist. “A lot of people quit using opioids to get cannabis. It is better for them. From that point of view, you are competing against a giant.”
’ Transdermal Marijuana Patch, released in early March, is the first in a line of products intended to compete directly with pharmaceutical companies. The patch by Surterra Wellness, which operates in Tampa, North Point and other locations throughout Florida, is designed as a safe and natural alternative for pain management, putting it into direct competition with the Fentanyl Patch linked to overdoses statewide.
Cannamoms educating the public
While the marijuana business is a moneymaker for some, for Moriah Barnhart and others like her, legalizing marijuana for medical use was vindication.
“We felt heard and validated. We felt like our neighbors were on our side,” she recalls. “We also felt hopeful that now, the law was there, whether the politicians wanted it or not.”
Barnhart’s daughter, Dahlia, was diagnosed with brain cancer in 2013 – at the age of 2 1/2. Within six months, Dahlia had four emergency surgeries, and a port for chemotherapy. When they started her on cannabis, her world changed.
“She slept through the night for the first time in her entire life,” the Brandon mom says. “Overnight, she got her childhood back.”
The experience was a profound one. As Barnhart puts it: “You can’t unsee what you see with your own eyes.”
So the nonprofit Cannamoms
Its stated goal is to raise public awareness about special needs children and how they can benefit from cannabis. “My biggest regret in all of this is I didn’t know sooner,” says Barnhart, its CEO. “That’s needless suffering that we can avoid by raising awareness.”
Barnhart is working with Kim Edwards, VP of MariJ Pharmaceuticals Inc.
in Clearwater, on a product line called Dahlia’s Botanicals
. With its headquarters in Clearwater, the company relies on hemp grown in Tennessee and extractions done in Colorado. Its goal is to provide product lines that are consistent.
Today, Dahlia is 7 and stable, and living in many ways like other 7-year-olds. She attends private school. She does math. “She knows what she wants. She’s enjoying life. She wakes up excited in the morning,” Barnhart says.
She believes the cannabis is helping to restore Dahlia, whose brain suffered damage and some cognitive impairment because of the cancer treatment.
While Barnhart acknowledges there’s no getting around the psychoactive effects of THC, tolerances increase to the point that these are no longer an issue. “It’s not nearly the high that these little kids are getting for morphine,” she says.
To Edwards, Dahlia is amazing. “She’s a miracle,” Edwards says.
A lot of research needs to be done
Yet stories like Dahlia’s are regarded as anecdotal by scientists who have rigorous testing requirements. “There’s been very minimal research in Florida and around the country on the efficacy of medical marijuana for patients,” acknowledges Dr. Nagi Kumar, executive director of the Coalition for Medical Marijuana Research and Education
“There are reports of cannabis or medical marijuana being given to children who have severe forms of epilepsy,” she says. “Other than that, there are a lot of anecdotal reports.”
Its illegal status has hampered true scientific analysis, but progress is being made. The coalition, funded by the 2017 Florida Legislature, was formed at Moffitt Cancer Center
in Tampa last year to oversee science-based research on medical marijuana. It also is intended to educate professionals and the public.
What data they have is based on smoke, or vaporized marijuana, rather than the pharmaceutical grade made in states that have legalized it, says Dr. Kumar, a senior member of the cancer center.
The research process began with $750,000 in funding from the Florida Legislature to set up the coalition and establish the infrastructure needed to direct research. Full-fledged research could take millions to conduct field trials, something which ideally would be supported by national funding.
“We’re not being supported by any companies or any private enterprises,” she points out. “It is the state that has invested in research and education in this field, recognizing there are no standard guidelines for use of medical marijuana.”
While the coalition has begun its work, results won’t be available anytime soon. “This is not just about cancer,” Dr. Kumar adds. “What this board has been tasked with is to study the efficacy of medical marijuana on patients. That encompasses a lot of different things.”
The dispensary business
In the meantime, marijuana products are for sale in the marketplace through registered medical marijuana treatment centers like Trulieve
, which has been steadily growing its presence across the state since it opened the first state treatment center in 2016.
“We were the first license. That really allowed us to move quickly,” explains Victoria Walker, who works in Trulieve’s Community Relations Department. ”Our whole goal has always been patient access. We have always delivered across the state.”
It currently runs centers in Tampa, St. Petersburg, Clearwater, Bradenton, Orlando, Miami, Tallahassee, Jacksonville, Gainsville, Edgewater, North Fort Myers, Lady Lake, Vero Beach and Pensacola.
The company sells oral capsules, sublingual oils and topical creams. Their products are low and high THC. Products with the non-euphoric CBD also are available.
While the physician decides which one to order, a lot of patients -- who typically pay $100-$150 for a 30- to 40-day supply -- use both. Many people prefer to pick up at the center, but the company does offer next-day delivery.
“It can’t go through the mail,” Walker notes. “Every morning cars hit the road delivering to patients at their homes.”
Patients, who must wait for state approval before receiving products, also can’t take medical marijuana across state lines because of its federal status as a Schedule 1 drug.
Company operations are all in Florida, starting with the cannabis grown in Quincy. “It’s a big learning process for everyone involved,” she says.
From the ground up
At 3 Boys Farm
in Ruskin, they are growing a marijuana crop after becoming the eighth in the state to be given a cultivation license last summer.
“The state only allows a vertically integrated structure,” explains Greg Gerdeman, Ph.D., the farm’s Chief Scientific Officer. “We’ll be making everything from the soils to the oils. ... We have to grow. We have to process. I am in charge of the extraction and quality control lab.”
A long-standing nursery, it is a U.S. Department of Agriculture-certified organic facility being rebranded as a cannabis business. It still plans to produce food.
“We definitely have a keen interest,” he adds. “We are going to follow organic protocols.”
Their goal is to be sustainable, an important criterion when it can cost $30,000 a month or more for electricity. “I believe that cannabis is a really valuable thing for our society to be growing up about, but it can and should be grown in an environmentally sustainable way, with a low carbon footprint,” he asserts.