It’s taken a long time for medical marijuana to finally reach patients in Florida, but in late August, one of the first deliveries of low-THC cannabis was delivered to a person suffering from epilepsy in Shalimar. Despite this, a longtime sponsor of the bill authorizing the use of the drug, which can currently only be used by a very specific set of patients, says that there is still much work to be done.

“There is a lot of confusion out there; not just with patients, but with members of the medical community,” explained Rep. Katie A. Edwards (D-Plantation). “This process has gone through a lot of changes, and it’s made it difficult for healthcare providers to know exactly where things stand—some think that our Florida law is like those in Colorado or California, and it’s not like that at all. We took a very different approach.”
 
One of the most striking differences, according to Rep. Edwards, is that the Florida law takes a medical and science-based approach to the cultivation and dispensation of medical cannabis. “It was important to us that individuals know what they’re ingesting – that to the best extent, the product be kept as sterile as it can be, which is critical when you’re giving it to people who are already in fragile conditions.”
 
Florida’s Compassionate Medical Cannabis Act of 2014 was designed to help patients who suffer from epilepsy, seizure disorders or certain cancers. In a later legislative session, medical cannabis was added to the state’s Right to Try Act, which allows terminally ill patients access to experimental drugs not approved for general use. This coming November, Amendment Two on the Florida ballot, if passed, will broaden medical cannabis usage to those with debilitating medical conditions as certified by licensed physicians.
 
As part of the original bill, companies who are licensed to grow, process and dispense medical cannabis must meet special requirements, including having a plant nursey that has been in business for at least 30 years. “We wanted these licenses to go to plant nurseries because they are used to growing plants in a highly regulated environment, and know how to prevent mold, pests and plant diseases,” said Rep. Edwards, citing concerns for end-user health.
 
Patients must be enrolled in the Florida Department of Health’s Office of Compassionate Care program and have a written order from a physician in order to receive medical cannabis. “Medical directors at the dispensaries will be working with pharmacologists to review what treatments and medications the patient has used previously in order to find the right dosage for the patient,” said Rep. Edwards.
 
“Information will be compiled by the Florida College of Pharmacy, and their reports will be provided to lawmakers so that we can gather more than anecdotal evidence about the use of medical marijuana – to see, for example, if it helps to decrease the number of seizures a person has, or if they are able to stop taking or reduce their reliance on other pharmaceuticals.”
 
Research and development is key to the use of medical cannabis, according to Rep. Edwards, who has been frustrated by the restrictions put on those trying to learn more. “My goal is to generate interest in the field of medical cannabis research and development nationwide, and to convince the federal government to increase access to cannabis for medical research,” she said, noting that the federal government’s marijuana farm at the University of Mississippi is the only legal source of cannabis for scientists who wish to study it.
 
“Unfortunately, universities have not gotten involved because of money – they can’t risk federal grant funding to study a product that is still illegal under federal laws,” she added. “When they do a cost/benefit analysis, they still see it as too much risk.”
 
Some physicians have been slow to embrace the law as well, partly because of its delay due to numerous legal challenges, and possibly because it requires them to take an eight-hour course in order to receive the continuing medical education (CME) required by the Florida Medical Association and Florida Osteopathic Medical Association.
 
“If physicians need more information or have questions, they can contact the Office of Compassionate Care at (850) 245-4444,” said Rep. Edwards, adding that hospice providers wondering about the Right to Try Act can contact her office. “I’m also always willing to come to physician roundtables to explain the law, as well as to take input from doctors who have concerns. We need to bring physicians together with medical directors and dispensing organizations to engage, and to talk about what is happening in Florida and how it will affect patients.”


Very soon you will be hearing this inquiry from your patients. The role of delta 9 THC in the Endocannabinoid System in mammals has been defined since in 1964. I would suggest it be integrated as a part of every Medical School curriculum as are the Cardiovascular and the Musculoskeletal Systems, to name just two. As a Family Physician, I have sought out the expertise of my colleagues for some of the most difficult clinical cases. Gratefully, I, as well as my patients, have been rewarded by your expertise.
 
Many times, I have found that it is the lack of safe and efficacious treatments for these difficult cases that keep me awake at night. The following are clear indications for the usefulness and necessity for medical cannabis in the treatment of these conditions:
 
Alzheimer’s Disease: Cannabinoid receptors are important in the pathology of AD and the cannabinoids may succeed in preventing the neurodegenerative process. We do have safe modalities in cannabis to treat and hopefully prevent AD. The emotional and financial implications in doing so are enormous. It has been postulated that 1 in 4 Baby Boomers may suffer from some form of neurodegenerative disorder … who will take care of them? Who will pay for this care? Much smarter is to prevent the onset, if possible. I would ask that you undertake an internet search on the US Patent # 6630507. It will be very surprising to you as it was to me! The latest information is that the raw plant material of cannabis may provide the most neuroprotection with specific strains high in specific terpenoids.
 
End Stage Delirium: I have felt myself cringe upon entering a facility with patients who suffer severely and are in extremis as there is no pharmacological agent that is successful in management of this condition. Narcotics and anxiolytics, as we know do not succeed. There have been many cases in Israel that have been successfully treated and families who now demand that their loved ones be given cannabis to assist these patients.
 
PTSD: The suicide rate is said to be 22 Veterans per day, however, the number is likely higher as they utilize MVA’s to enable the survivors to receive insurance policies. There is no successful pharmacological treatment and most of the current treatment modalities include anxiolytics and opiates, with their own addictive properties. There are known CB1 receptors in the brain that modulate fear extinction. Yes, clinical studies are about to begin in Arizona and at John Hopkins with Dr. Sisley…., the other Veterans cannot wait. High delta 9 THC treatment has been very successful in modulating the night terrors and has also diminished the intake of opiates in these patients. Dr. Greg Gerdeman’s research sheds the ray of hope as there may be new neural pathways that can be created with cannabis therapy.
 
Glioblastoma Multiforme: Cannabinoids selectively inhibit proliferation and induce death of the GBM cells through effective down regulation mechanisms. The fact that these tumors do respond to cannabinoids should be first line therapy, before surgery and radiation. First, Do No Harm.
 
Multiple Sclerosis: There is so much literature about the efficacious use of cannabis to treat the spasticity and pain of this debilitating disease, I respectfully refer you to Dr. Ethan Russo’s work. The clinical trials of Sativex® for U.S. use is underway. Additionally, studies of whole plant extract have shown relief of neuropathic pain, spasticity, and bladder incontinence.
 
Diabetic Cardiomyopathy & Cardiac Ischemia: CBD attenuates cardiac dysfunction, oxidative stress, fibrosis, inflammation, and cell death signaling pathways. Acute administration of CBD suppresses ischemia-induced cardiac arrhythmias and reduces infarct size. It is not imagination that I would see part of ER protocol that an IV drip of specific cannabinoids be given for patients arriving with evidence of ischemia.
 
Traumatic Brain Injury: Cannabinoids protect against excitotoxic damage as well as provide anti-inflammatory effects. They inhibit the production and action of tumor necrosis factor and other cytokines. Another protectant and perhaps possible protocol to be developed with the High School Athletics, NCAA, and the NFL?
 
In closing, I hope that I have suggested the emanate possibility of safe and effective treatments for these conditions. Our patients will be asking …


 When I am asked to author an article or comment for a news segment etc., I generally am asked to comment from a lawyer’s perspective. In reflecting on what I wrote last month for the CannabisNewsFlorida.com I realized that I had drafted a piece that was just the facts and potentially for an audience that wanted to know just the facts. In retrospect, I questioned how much that audience actually knows about the day to day look and feel of the Cannabis Industry and its consumers.

With education comes understanding and perspective. I recently was invited to and travelled to Oregon. My time in Oregon was spent predominately in Portland and Salem where the particular client I was visiting has locations that I was able to view and experience. We did a fair bit of driving and I was able to observe different areas of the respective cities. My observation from a zoning perspective was that there was not a dispensary on every corner and that at times I had to be patient before seeing a dispensary during our drive. Of note in regard to the dispensaries that I did see, was some did use “cannabis” or “marijuana” in the name or associated with signage at the dispensaries, in addition to often a green cross. However, there were many that did not take as visible an approach. I recall seeing, pursuant to the rules of the Oregon Program, windows covered so that one cannot see in. What I noticed most was in part, the clean nature and presentation of the particular client’s storefronts versus what was presented on the outside of some of the dispensaries we passed. This may be highlighted in part based on viewing dispensaries through what one might consider an east coast bent. There are others that might argue that the perspective of east coasters, particularly in emerging markets, is much different than that which has been developed over time in the west coast markets, many of which have now gone recreational. Overall, like anything, what I saw ranged the gamut from a little unsightly to professional and clean looking. In particular, my client’s dispensary in Salem was in a retail shopping center along with a Little Caesars, Aaron’s Rentals, a nail salon, and other normal and expected retailers. Unless you poked your head inside the door, it would not be readily apparent that it was a dispensary.
 
My experience with the different types and looks of the dispensaries was mirrored by a particularly unique experience I had in viewing customers/patients. What was clear from very limited viewing was that it was impossible to pigeonhole the types of patients and ailments or, in the recreational setting, who the end user might be. On the Saturday morning of my visit, while viewing operations in Salem, I was approached and began to speak with an older gentleman with a long straggly gray beard who appeared to be in his late 60’s to early 70’s. During the course of our conversation he let me know that he is looking forward to taking it easy, and that he was a veteran. He had two friends with him and it looked like they were going to enjoy some time relaxing together, but he was also able to tell me that it was assistive to him at times when his anxiety got the best of him.
 
Within minutes after the gentleman left, the exact opposite walked into the store. Candidly, I was mildly surprised. For a moment I was transported from Salem, Oregon to any town in central New Jersey or main street USA. Decked out in what could have been any preppy outfit were two soccer moms. They had stepped out of the newest model of a particular German automobile manufacturer. Unfortunately, I did not have the opportunity to engage with the soccer moms in discussion, but it was clear through their knowledge of the layout and interaction with the employee behind the counter that this was not their first trip to this particular location.
 
So what does the foregoing illustrate? For me it illustrates the development of perspective through education. It remains to be seen what will happen in Florida should Amendment 2 pass. It also remains to be seen what will happen as the licensed nurseries under the Compassionate Medical Cannabis Act of 2014 come on line and start servicing patients. What is evident from my most recent trip is that any cannabis related business (or regulator) in Florida will need to make sure it consults and relies on those with real industry knowledge. Lastly, what strikes me most is unless a person sees how other states have implemented cannabis business and are actually functioning, one can’t possibly form an opinion one way or the other on Cannabis business, regulations, and perhaps even cannabis efficacy as medicine, that is properly supportable.


Over the past several years, the cannabis industry has evolved into a cultural, economic, and political revolution. As part of this rapid change, the legal cannabis industry has engendered one of the fastest growing sectors in the world. The cannabis industry shows growth characteristics similar to the internet industry in the 1990s, but demand for the internet had to be created as it was rolled out. The billions of dollars of existing demand for cannabis can be captured as states legalize the sale of cannabis products. Currently, legal cannabis sales are around $5 to $9 billion per year (estimates vary widely as California represents approximately 50% of the overall industry but lacks a comprehensive seed-to-sale tracking system to accurately measure sales of cannabis in the state), representing only a fraction of the overall demand in the country and leaving much room for growth.

Growth over the next five to ten years will depend largely on the timing of new states creating legal and regulated cannabis markets. The more states that enact medical or recreational markets and the faster these regulations lead to active markets (i.e. the shorter the time between the law being enacted and sales beginning), the faster the industry will grow. Estimates for the size of the cannabis industry in five years’ time (end of 2020) are between $15 and $25 billion, with most estimates falling near $20 billion. Estimates for the long-term size of the cannabis industry ten years from now, assuming most if not all states create regulated cannabis markets and the federal government changes its stance to allow for the creation of a national cannabis industry with interstate commerce, range from $15 billion to over $50 billion, with consensus falling around $35 billion. These figures only cover the sales of cannabis and cannabis-derived products; when including ancillary products and services provided to and supporting the cannabis industry, estimates for the total value added to the economy range from about $75 billion to over $100 billion.
 
Some of the biggest challenges we continually see in this space have to do with the people. While the cannabis industry is coming out of the black market and “into the light”, there remain several characteristics from the black market. Individuals previously engaged in illegal cannabis activities, as well as opportunists seeking to make a quick buck through stock scams or other less-than-legal initiatives, have made their way into this space. Because of this, finding and vetting management remains one of the most important facets in due diligence. However, while there have been some questionable individuals and groups in the industry, the industry is steadily becoming more professional as more sophisticated investors and operators enter the industry to capitalize on the high prospects for growth and profits.
 
We at Viridian Capital Advisors put forth extra effort seeking out the highest quality management teams in various sectors of the cannabis industry. Specifically, we search for personnel who bring to the cannabis space expertise they acquired and developed in industries tangential to this industry that can then be applied to cannabis operations. We have identified several executives in the cannabis space that exemplify the caliber of individual for which we are looking:
• Staffan Hillberg, the CEO of Heliospectra AB, an intelligent LED lighting manufacturer from Sweden, is an experienced venture capital investor and former executive of Apple, bringing to Heliospectra his experience as a technology entrepreneur and investor;
• Don Robinson, the CEO of Golden Leaf Holdings, one of the leading infused products manufacturers in Oregon, brings to Golden Leaf his experience in commercial food production that he acquired as CEO of Mars Canada;
• Derek and Terri Riedle, the founders of Civilized Worldwide, an up and coming digital media and publishing company targeting affluent gentlemen who enjoy cannabis culture, previously developed and sold successful media properties and are bringing that experience to their new venture in the cannabis space. Furthermore, alongside Terri and Derek is Mitchell Fox, the former publishing director of Conde Nast and former editor of Vanity Fair, who brings his own breadth of media expertise to the Civilized team.
 
These are but a few examples of the experienced operators that have entered the cannabis space from outside, albeit related, industries and who bring to their firms a level of professionalism and capability that is, today, uncommon in this sector.