The Florida Office of Medical Marijuana Office updated the rules of the medical cannabis program to include dosage limits last year. This post answers all of the most common questions we receive related to the new change.
When did dose limits go into effect?
Effective Monday, August 29th the OMMU enacted new dosage limits for all non-smokable routes of administration (RoA) when issuing a new or updated certification for a patient.
why did the ommu establish dose limits?
The OMMU was required by law to create dosage limits.
The Medical Marijuana law in Florida charges the Department of Health with establishing rules for certain aspects of the Medical Marijuana Use program. Under this law, the OMMU must create daily dose limits for all routes of administration (RoA) and provide physicians with an electronic process for requesting exceptions to these limits.
Were there limits previously?
Up until August 29, 2022, there were no dosage limit rules governing the FL MMJ program. They were set solely by the recommending physician. The Department of Health/OMMU had over five years to create these rules. To our knowledge, they last followed the public process for rule development in September 2018. Instead of following the public process for establishing these rules, the OMMU opted to use Emergency Rulemaking authority.
what are the non-smokable dose limits?
Patients can purchase up to a 70-day supply of non-smokable forms of cannabis medicine. A 70-day supply is calculated by multiplying the daily dose by 70.
Each Route of Administration (RoA) has its own daily dose limit in addition to an aggregate total dose limit across all routes. This means the daily dose issued by your physician cannot be greater than 350mg across all authorized RoAs. Please see the chart below.
The max daily dose amounts add up to more than the 24,500 mg aggregate dose limit. Who decides which routes and what milligrams I will be able to purchase?
Your recommending physician is required to enter specific daily dose amounts and routes of administration when entering medical cannabis (THC) and low THC orders. These amounts are multiplied by 70 to calculate your 70-day supply (purchasing) limit. Here at FMCC, we offer a number of different RoA/milligram combinations and will work with you to find the best fit.
Are there exceptions to the limits?
Physicians can request exceptions to the daily dose limit for all RoAs and for the Smokable Cannabis recommendation and possession limits. The Department has 14 calendar days to approve or deny the request. If the Department fails to respond, the request is considered approved.
how long are exception requests valid?
Each approved exception is valid for its corresponding certification period only. New requests are required for each certification, if a physician makes an update to an existing certification above the limits, and if a patient changes physicians.
Physicians must CLOSE the old physicians' certification and exception request within 7 days of accepting a transfer patient.
what is required for an exception request?
The OMMU may request copies of the patient's record with each exception request.
Non-smokable ROA increase requests require the following info:
The daily dose limit requested for each RoA
The daily dose that was insufficient to treat patients' symptoms for each RoA
The condition being treated
A brief description of how the patient will benefit from the increased amount
Flower Exception requests require the following info:
the amount of marijuana requested
the possession amount requested (1.6x dose amount),
the amount of flower that was insufficient
the condition being treated
a brief description of how the patient will benefit from an increased amount.
does the ommu really require medical records?
Yes, the OMMU can and has rejected initial RFE requests pending physician uploaded medical records to substantiate the approval.
are dosage limits in effect for everyone?
Depends when you are reading this. Certifications issued before the effective date (8/29/22) will remain valid for the duration of the certification period, even if they are in excess of the daily dose amount limits. However, physicians cannot make changes to these recommendations, or they will be subject to the new limits and exception requirements. Certifications issued on 8/29/22 or after will be subject to the new daily dose limits.
what is the rolling limit?
In addition to new dosage limits, all patients are immediately subject to ‘rolling limits’ on all routes of administration.
how is the 70-day rolling limit calculated?
70- day periods are based on your personal dispensation history and not pre-defined periods as they functioned previously. Each 70-day period is measured by looking back 70 days from the date of each dispensation. The MMUR has a dispensation calculator for all RoAs where you can track your personal history and see the date on which your history expires and your milligram allotment returns to you.
I think i need an exemption. what should i do?
Talk to your physician at your next appointment. Because certifications issued before 8/29/22 will remain effective through their expiration, the majority of patients will not be subject to these changes right away. Updating any certification issued prior to 8/29/22 will be subject to the new limits, so it’s best to wait until your next appointment before making any changes.
i’m ‘grandfathered in’ this certification period but I think it will impact me. what should i do?
Before your next appointment, get familiar with the MMUR and your purchase history.
Review your purchases within the OMMU. Use the OMMU instructional guides to learn how to use the MMUR.
Track your purchasing dates, milligrams dispensed, and routes of administration.
Record any times you are restricted or unable to purchase medication due to limits.
Note your purchasing frequency and consider if a different pattern could help free up milligram allotments.
Be prepared to discuss this information at your next certification appointment. Before your next appointment, we recommend you purchase enough medication to last for at least 2 weeks to allow time for processing exemptions. The OMMU has rejected initial requests and required that physicians submit medical records to justify the RFE before granting approval.
what about smokable cannabis? What are the dosage limits?
Physicians may not recommend more than 2.5oz of flower per 35-day period. Most physicians recommend the max of 2.5 oz, but they can recommend less when appropriate.
Patients are limited to both the 2.5 oz limit per any 35-day period and the contents of their physician’s recommendation. Each 35-day period is measured by looking back 35 days from the date of each dispensation. You can use the dispensation calculator to check your available allotment. Allotments will be added back the day after the expiration date shown.
can smokable cannabis limits be increased?
Yes, physicians can request an RFE for the 2.5oz flower limit. Approved requests will increase both the purchasing limit and possession limit for the patient.
how much cannABIS CAN I PURCHASE?
Login to the Medical Marijuana Use Registry and check your dispensation history on the amounts available calculation page. See the instructional guides available on the OMMU website for specific step-by-step instructions for navigating the MMUR and understanding your orders.
Post Written By: Kristina Risola, MA, CRC, NBC-HWC
