Florida Bans Medical Marijuana in Substance Abuse Treatment

As of July 1, 2023, the presence of medical marijuana on the premises of any substance abuse treatment provider licensed by the state of Florida is banned, and the use of medical marijuana on the premises of any certified recovery residence is banned. These bans have been enacted through statutory changes made by Senate Bill 210.?

This ban pertaining to substance abuse treatment providers is accomplished through revisions to the licensure requirements applicable to treatment providers. Treatment providers must now demonstrate “. . . a prohibition on the premises against alcohol, marijuana, illegal drugs, and the use of prescribed medications by an individual other than the individual for whom the medication is prescribed. For the purposes of this paragraph, “marijuana” includes marijuana that has been certified by a qualified physician for medical use . . . .” See, SB 210, lines 36-41. While a prohibition against on-premises possession of alcohol, illegal drugs, and prescribed medications that have been diverted from their proper patient might not have been specifically required by the statutes or regulations governing Florida-licensed treatment providers, in my experience all or nearly all treatment providers implement such a prohibition as part of their policies and procedures. However, the statutory ban on the presence of medical marijuana is new, overbroad, and not conducive to the successful treatment of substance abuse disorder. ?

? Florida’s medical marijuana law (FS §381.986) lists those conditions that qualify an individual to receive medical marijuana. Most of those conditions are physical conditions and not mental health conditions (e.g. cancer, epilepsy, glaucoma, Crohn’s disease, chronic nonmalignant pain). Conceivably, a person with one of the qualifying physical ailments could also be a substance abuse treatment patient. Denying a substance abuse treatment patient relief from the symptoms of a qualifying ailment through a treatment recommended by a Florida-licensed physician acting within the scope of Florida law is unreasonable, unnecessary, and not conducive to that patient’s recovery from substance abuse disorder. As part of her/his recovery, a substance abuse treatment patient who uses medical marijuana should be counseled, trained, and supported in a recovery that includes the use of medical marijuana.

There is no indication in S.B. 210’s legislative history that a less restrictive prohibition was even considered. A restriction that requires licensed treatment providers to examine and, if appropriate, re-qualify medical marijuana users who present for substance abuse treatment would have been more palatable and would better support the patient’s recovery. Ironically, treatment providers must consider each patient individually before ordering a toxicology screen but not before denying a patient a physician-recommended treatment that was in place prior to the patient’s seeking substance abuse treatment. Unnecessary toxicology screens will not harm an individual; cessation of a physician-recommended course of treatment will.

Interestingly, with respect to recovery residences, the ban imposed by S.B. 210 applies to the on-premises use (not possession) of alcohol, medical and other marijuana, illegal drugs, and the use of prescribed medications by an individual other than the individual for whom the medication is prescribed. The ban on use, and not possession, allows those who live in recovery residences to store their medical marijuana on premises as long as they use the medical marijuana off premises. Treatment providers should expect non-residential levels of treatment to include issues resulting from patients who resume their medical marijuana treatments after having had those treatments denied at the residential levels. Does anybody expect payors to authorize additional days of non-residential treatment to cope with these new issues? I didn’t think so.

Certified recovery residences are already equipped to comply with S.B. 210. Florida does not license or directly regulate recovery residences. Florida regulates recovery residences indirectly by restricting the manner in which licensed treatment providers are allowed to interact with recovery residences. See, Florida Statute §397.4873. A Florida-licensed treatment provider may only refer patients to and receive referrals from certified recovery residences. The Florida Association of Recovery Residences (“FARR”) is the organization that certifies recovery residences in Florida. In order to be FARR-certified, a recovery residence must implement policies that (i) prohibit the use of alcohol and/or illicit drug use and seeking, and that (ii) address residents’ prescription and non-prescription medication usage and storage. See, Core Principals of the National Alliance of Recovery Residences as adopted by the Florida Association of Recovery Residences.

The ban on medical marijuana imposed by Senate Bill 210 is overly broad and likely to thwart the treatment and sustained recovery of medical marijuana users and will likely discourage them from seeking treatment in the first place. It behooves substance use treatment providers and recovery residence operators in Florida to understand this new law and to ensure that their policies and procedures are in compliance.

This new law has been effective since July 1st!

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