This docum ent does not reflect the intent or official position of the bill sponsor or House of Representatives.
STORAGE NAME: h1269d.HHS
DATE: 2/13/2024
HOUSE OF REPRESENTATIVES STAFF ANALYSIS
BILL #: CS/HB 1269 Potency for Adult Personal Use of Marijuana
SPONSOR(S): Healthcare Regulation Subcommittee, Massullo and others
TIED BILLS: IDEN./SIM. BILLS:
REFERENCE ACTION ANALYST STAFF DIRECTOR or
BUDGET/POLICY
CHIEF
1) Healthcare Regulation Subcommittee 13 Y, 4 N, As CS McElroy McElroy
2) Health & Human Services Committee McElroy Calamas
SUMMARY ANALYSIS
Delta-9-tetrahydrocannabinol (THC) is the psychoactive chemical in marijuana. The full extent of the health
impact of consuming products with high concentration of THC is unknown; however, research indicates that
such use significantly increases the risk of marijuana-associated psychosis. Studies have found daily use,
especially of high-potency marijuana (over 10 percent THC), is strongly associated with earlier onset of
psychosis and the development of schizophrenia in marijuana users. Some studies have also shown that
marijuana with a THC concentration of 10 percent or less is effective for medical treatment, including the relief
of neuropathic pain and pain caused by conditions such as HIV/AIDS, multiple sclerosis, and post-traumatic
surgical pain.
Currently, 24 states and the District of Columbia have legalized the adult use of marijuana. Two states,
Connecticut and Vermont, currently have potency limits for adult use marijuana products. Both states prohibit
cannabis flower with a total THC concentration greater than 30% and solid or liquid concentrate cannabis
products with a total THC concentration of greater than 60% from being cultivated, produced or sold in the
adult use market.
Adult personal use of marijuana is not legal in Florida; however, there is a pending ballot initiative to legalize
adult personal use. Although Florida does not have an adult personal use program it does have a well-
established medical marijuana program, including 25 licensed Medical Marijuana Treatment Centers (MMTC).
Currently licensed MMTCs would be eligible to acquire, cultivate, process, manufacture, sell, and distribute
adult personal use marijuana products if the ballot initiative were to pass. The THC concentration of the
products currently offered by MMTCs varies by the route of administration from .4 percent to 90 percent THC.
CS/HB 1269 establishes THC potency limits for various adult personal use marijuana products. Marijuana in
the form for smoking cannot have a THC potency of greater than 30 percent and all other marijuana products,
excluding edibles, cannot have a THC potency of greater than 60 percent. Identical to the potency limits in the
medical marijuana program, the bill prohibits multi-serving edibles from containing more than 200 mg of THC
and a single serving edible from containing more than 10 mg of THC.
The bill has no fiscal impact on state or local government.
The bill provides an effective date of 30 days after passage of an amendment to the State Constitution
authorizing adult personal use of marijuana.
STORAGE NAME: h1269d.HHS PAGE: 2
DATE: 2/13/2024
FULL ANALYSIS
I. SUBSTANTIVE ANALYSIS
A. EFFECT OF PROPOSED CHANGES:
Background
Research on the Health Effects of THC
Although there are more than 100 cannabinoids in a marijuana plant, the two main cannabinoids are
Delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD).
1
THC is a mind-altering chemical that
increases appetite and reduces nausea and may also decrease pain, anxiety, and muscle control
problems.
2
Though CBD may also have an effect on the mind, it does not produce the high or sense of
euphoria associated with THC. CBD has been shown to help with anxiety, depression, reducing pain
and inflammation, controlling epileptic seizures, and possibly treating psychosis or mental disorders.
3
Marijuana has changed over time. The THC concentration in commonly cultivated marijuana plants
increased three-fold between 1995 and 2014 (4% and 12% respectively).
4
Conversely, the CBD
content decreased from .28% in 2001 to .15% in 2014. In 1995, the level of THC was 14 times higher
than its CBD level. In 2014, the THC level was 80 times the CBD level.
5
The marijuana available today
is much stronger than previous versions.
Some studies have shown that marijuana with a THC concentration of 10% or less is effective for
medical treatment, including the relief of neuropathic pain and pain caused by conditions such as
HIV/AIDS, multiple sclerosis, post-traumatic surgical pain.
6
Studies on the use of marijuana for pain
relief found that marijuana cigarettes with a THC concentration between 2% and 10% THC provided
sufficient pain relief,
7
with one study finding that medium-dose marijuana cigarettes with 3.5% THC
were as effective as higher dosed marijuana cigarettes at 7% THC.
8
A 2014 New England Journal of Medicine study warned that long-term marijuana use can lead to
addiction and that adolescents are more vulnerable to adverse long-term outcomes from marijuana
use.
9
Specifically, the study found that, as compared with persons who begin to use marijuana in
adulthood, those who begin in adolescence are approximately 2 to 4 times as likely to have symptoms
1
U.S. Department of Health & Human Services, National Center for Complementary and Integrative Health, Cannabis (Marijuana) and
Cannabinoids: What You Need To Know, available at https://www.nccih.nih.gov/health/cannabis-marijuana-and-cannabinoids-what-
you-need-to-know (last visited January 30, 2024).
2
Healthline, CBD vs. THC: What’s the Difference?, https://www.healthline.com/health/cbd-vs-thc (last visited January 30, 2024).
3
Id.
4
U.S. Surgeon General’s Advisory: Marijuana Use and the Developing Brain, https://www.hhs.gov/surgeongeneral/reports-and-
publications/addiction-and-substance-misuse/advisory-on-marijuana-use-and-developing-brain/index.html (last visited January 30,
2024).
5
ElSohly, M.A., Mehmedic, Z., Foster, S., Gon, C., Chandra, S. and Church, J.C. Changes in Cannabis Potency Over the Last 2
Decades (1995-2014): Analysis of Current Data in the United States, Biological Psychiatry. April 1, 2016; 79(7):613-619.
6
Igor Grant,1 J. Hampton Atkinson, Ben Gouaux, and Barth Wilsey. Medical Marijuana: Clearing Away the Smoke. Open Neurol J.
2012; 6: 18–25. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3358713/; Ellis RJ, Toperoff W, Vaida F, et al. Smoked
Medicinal Cannabis for Neuropathic Pain in HIV: A Randomized, Crossover Clinical Trial, Neuropsychopharmacology, 2009; 34(3):672-
680, available at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3066045/ (last viewed on January 30, 2024); Abrams DI, Jay CA,
Shade SB, et al. Cannabis in Painful HIV-associated Sensory Neuropathy: A Randomized Placebo-controlled Trial. Neurology. 2007;
68(7):515-521 available at https://pubmed.ncbi.nlm.nih.gov/17296917/ (last viewed on January 30, 2024); Wilsey B, Marcotte T,
Tsodikov A, et al. A Randomized, Placebo-controlled, Crossover Trial of Cannabis Cigarettes in Neuropathic Pain, J Pain.
2008;9(6):506-521, available at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4968043/ (last viewed on January 30, 2024); Wallace
M, Schulteis G, Atkinson JH, et al. Dose-dependent Effects of Smoked Cannabis on Capsaicin-induced Pain and Hyperalgesia in
Healthy Volunteers. Anesthesiology. 2007; 107(5):785–96, available at
https://pubs.asahq.org/anesthesiology/article/107/5/785/7080/Dose-dependent-Effects-of-Smoked-Cannabis-on (last viewed on
January 30, 2024).
7
Id.
8
Wilsey B, Marcotte T, Tsodikov A, et al. A Randomized, Placebo-controlled, Crossover Trial of Cannabis Cigarettes in Neuropathic
Pain. J Pain. 2008; 9(6):506–21, available at https://pubmed.ncbi.nlm.nih.gov/18403272/ (last viewed on January 30, 2024).
9
Volkow, N.D., Baler, R.D., Compton, W.M. and Weiss, S.R., Adverse Health Effects of Marijuana Use, NEW ENG. J. MED., June 5,
2014, available at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4827335/ (last viewed on January 30, 2024). STORAGE NAME: h1269d.HHS PAGE: 3
DATE: 2/13/2024
of marijuana dependence within 2 years after first use.
10
The study also found that marijuana-based
treatments with THC may have irreversible effects on brain development in adolescents as the brain’s
endocannabinoid system undergoes development in childhood and adolescence.
11
Heavy use of marijuana by adolescents is associated with impairments in attention, learning, memory,
poor grades, high drop rates and I.Q. reduction.
12
Though the full extent of the health impact of
consuming products with high concentration of THC is unknown, research indicates that use of such
products significantly increases the risk of marijuana-associated psychosis,
13
regardless of age at first
use or the type of marijuana used.
14
A 2019 European study showed that the use of high-potency
marijuana (over 10% THC) only modestly increased the odds of a psychotic disorder compared to
never using it; however, individuals who started using high-potency marijuana by age 15 showed a
doubling of risk.
15
The European study also found that daily use of high-potency cannabis increased the
risk of psychotic disorder nearly five times compared with never having used marijuana.
16
Another study found that frequent use of marijuana or use of marijuana with high THC potency
increased the risk of schizophrenia six-fold.
17
According to a literature review of studies on the impact
of marijuana use on mental health published in the Journal of the American Medical Association
Psychiatry, there is strong physiological and epidemiological evidence supporting a link between
marijuana use and schizophrenia. High doses of THC can cause acute, transient, dose-dependent
psychosis, which are schizophrenia-like symptoms. Additionally, prospective, longitudinal, and
epidemiological studies have consistently found an association between marijuana use and
schizophrenia in which marijuana use precedes psychosis, independent of alcohol consumption, and
even after removing or controlling for those individuals who had used other drugs.
18
Even though marijuana use may have been discontinued long before the onset of psychosis, studies
have found that the age at which marijuana use begins appears to correlate with the age of onset of
psychosis, which suggests that early marijuana use plays a role in initiating psychosis that is
independent of actual use.
19
Overall, studies have found that the association between marijuana use
and chronic psychosis (including a schizophrenia diagnosis) is stronger in those individuals who have
had heavy or frequent marijuana use, use marijuana during adolescence, or use marijuana with high
THC potency.
20
While studies have not shown that marijuana use alone is either necessary or sufficient for the
development of schizophrenia, studies suggests that marijuana use may initiate the emergence of a
lasting psychotic illness in some individuals, especially those with a genetic vulnerability to develop a
psychotic illness.
21
10
Id.
11
Id.
12
See footnote 9; see also The Influence of Marijuana Use on Neurocognitive Functioning in Adolescents, Schweinsburg AD, Brown
SA, Tapert SF, Curr Drug Abuse Rev. 2008;1(1):99-111, available at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2825218/ (last
viewed on January 30, 2024).
13
Robin Murray, Harriet Quigley, Diego Quattrone, Amir Englund and Marta Di Forti, Traditional Marijuana, High-Potency Cannabis and
Cannabinoids: Increasing Risk for Psychosis, World Psychiatry, 2016 Oct; 15(3): 195–204, available at
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5032490/ (last viewed January 30, 2024).
14
Di Forti et al. The Contribution of Cannabis Use to Variation in the Incidence of Psychotic Disorder Across Europe (EU-GEI): A
Multicenter Case-control Study. Lancet Psychiatry. 2019; 6:427-36, available at
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7646282/ (last viewed on January 30, 2024); High-Potency Cannabis and Incident
Psychosis: Correcting the Causal Assumption, The Lancet, Volume 6, Issue 6, June 2019, available at https://doi.org/10.1016/S2215-
0366(19)30174-9 (last viewed January 30, 2024); High-Potency Cannabis and Incident Psychosis: Correcting the Causal Assumption –
Author’s Reply, The Lancet, Volume 6, Issue 6, June 2019 available at https://doi.org/10.1016/S2215-0366(19)30176-2 (last viewed
January 30, 2024).
15
Id. at 430.
16
Id. at 431. The odds were lower for those who use low-potency marijuana daily.
17
Nora D. Volkow, MD; James M. Swanson, PhD; A. Eden Evins, MD; Lynn E. DeLisi, MD; Madeline H. Meier, PhD;
Raul Gonzalez, PhD; Michael A. P. Bloomfield, MRCPsych; H. Valerie Curran, PhD; Ruben Baler, PhD., Effects of Cannabis Use on
Human Behavior, Including Cognition, Motivation, and Psychosis: A Review. JAMA Psychiatry. 2016; 73(3):292-297, available at
https://core.ac.uk/reader/79505094?utm_source=linkout (last viewed January 30, 2024).
18
Id.
19
Id.
20
Id.
21
Id. STORAGE NAME: h1269d.HHS PAGE: 4
DATE: 2/13/2024
State Legalization of Adult Use of Marijuana
Currently, 24 states and the District of Columbia have legalized the adult use of marijuana, as indicated
by the map below.
22
State Potency Limits for Adult Use Marijuana
Two states, Connecticut and Vermont, currently have potency limits for adult use marijuana products.
Both states prohibit cannabis flower with a total THC concentration greater than 30% and solid or liquid
concentrate cannabis products with a total THC concentration of greater than 60% from being
cultivated, produced or sold in the adult use market.
23
Both states provided an exception to these
potency limits for pre-filled cartridges for vape pens.
24
Florida - Adult Personal Use of Marijuana
Adult personal use of marijuana is not legal in Florida; however, there is a pending ballot initiative to
legalize adult personal use. The proponents of the initiative were required to obtain 891,523 valid
signatures to qualify the initiative for the ballot. The proponents have met this requirement as there are
currently 1,033,770 valid signatures for the initiative.
25
The ballot summary of the initiative states:
26
22
Map Monday: Nearly Every State Redefining Cannabis Access, National Conference of State Legislatures available at
https://www.ncsl.org/resources/map-monday-nearly-every-state-redefining-cannabis-access (last visited on February 7, 2024). States
include: California, Alaska, Nevada, Oregon, Washington, Maine, Colorado, Montana, Vermont, Rhode Island, New Mexico, Michigan,
Arizona, New Jersey, Delaware, Connecticut, Massachusetts, Illinois, Maryland, Minnesota, New York, Ohio, Missouri, Virginia.
23
See CT ST s. 21a-421j and VT ST T.7 s. 868.
24
Id.
25
Adult Personal Use of Marijuana 22-05, Florida Division of Elections, available at
https://dos.elections.myflorida.com/initiatives/initdetail.asp?account=83475&seqnum=2 (last viewed January 31, 2024).
26
Constitutional Amendment Full Text, available at
https://initiativepetitions.elections.myflorida.com/InitiativeForms/Fulltext/Fulltext_2205_EN.pdf (last viewed January 31, 2024). STORAGE NAME: h1269d.HHS PAGE: 5
DATE: 2/13/2024
Allows adults 21 years or older to possess, purchase, or use marijuana products and
marijuana accessories for non-medical personal consumption by smoking, ingestion, or
otherwise; allows Medical Marijuana Treatment Centers, and other state licensed entities, to
acquire, cultivate, process, manufacture, sell, and distribute such products and accessories.
Applies to Florida law; does not change, or immunize violations of, federal law. Establishes
possession limits for personal use. Allows consistent legislation. Defines terms. Provides
effective date.
The State of Florida requested an advisory opinion from the Florida Supreme Court as to the validity of
the initiative specifically seeking guidance on whether the initiative and the ballot title and summary
comply with applicable Florida law.
27
Oral arguments occurred in November 2023, and the issue
remains pending before the court.
28
Florida Potency of Medical Marijuana Products
Although Florida does not have an adult personal use program it does have a well-established medical
marijuana program. Section 381.986, F.S., authorizes patients with any of the following debilitating
medical conditions to obtain medical marijuana from Medical Marijuana Treatment Centers (MMTC):
Cancer
Epilepsy
Glaucoma
Positive status for human immunodeficiency virus
Acquired immune deficiency syndrome
Post-traumatic stress disorder
Amyotrophic lateral sclerosis
Crohn’s disease
Parkinson’s disease
Multiple sclerosis
Medical conditions of the same kind or class as or comparable to those enumerated above
To obtain marijuana for medical use from a Medical Marijuana Treatment Center (MMTC), and maintain
the immunity from criminal prosecution, the patient must obtain a physician certification from a qualified
physician
29
and an identification card from the Department of Health.
As of January 26, 2024, there are 871,459 qualified patients, 2,781 qualified patients and 25 MMTCs
with 618 dispensing locations.
30
Currently licensed MMTCs would be eligible to acquire, cultivate, process, manufacture, sell, and
distribute adult personal use marijuana products if the ballot initiative were to pass. The THC
concentration of the products offered by MMTCs varies based on the route of administration, as
evidenced by the table below.
31
27
Advisory Opinion to the Attorney General Re: Adult Personal Use of Marijuana, SC2023-0682, 2023, available at
https://acis.flcourts.gov/portal/court/68f021c4-6a44-4735-9a76-5360b2e8af13/case/85dca015-d108-4595-8cdb-d4488890aa88 (last
viewed January 31, 2024).
28
Id.
29
To certify patients for medical use of marijuana, a physician must hold an active, unrestricted license as an allopathic physician under
chapter 458 or as an osteopathic physician under chapter 459 and comply with certain physician education requirements. See ss.
381.986(1)(m), F.S. and 381.986(3)(a), F.S.
30
Office of Medical Marijuana Use Weekly Updates, January 26, 2024, DOH, Office of Medical Marijuana Use, available at
https://knowthefactsmmj.com/wp-content/uploads/ommu_updates/2024/012624-OMMU-Update.pdf (last visited on January 29, 2024).
31
Florida’s Medical Marijuana Program Update, Office of Medical Marijuana Use, presented to the Health Care Regulation
Subcommittee on December 13, 2023. STORAGE NAME: h1269d.HHS PAGE: 6
DATE: 2/13/2024
Edibles are the only medical marijuana products currently subject to THC potency limits.
Effect of the Bill
CS/HB 1269 establishes THC potency limits for various adult personal use marijuana products.
Marijuana in the form for smoking cannot have a THC potency of greater than 30 percent and all other
marijuana products, excluding edibles, cannot have a THC potency of greater than 60 percent. Identical
to the potency limits in the medical marijuana program, the bill prohibits multi-serving edibles from
containing more than 200 mg of THC and a single serving edible from containing more than 10 mg of
THC.
The bill provides an effective date of 30 days after passage of an amendment to the State Constitution
authorizing adult personal use of marijuana.
B. SECTION DIRECTORY:
Section 1: Creates s. 381.9861, F.S., relating to the potency limits for adult personal use of
marijuana.
Section 2: Provides an effective date.
II. FISCAL ANALYSIS & ECONOMIC IMPACT STATEMENT
A. FISCAL IMPACT ON STATE GOVERNMENT:
1. Revenues:
None.
2. Expenditures:
None.
A. FISCAL IMPACT ON LOCAL GOVERNMENTS:
1. Revenues:
None.
2. Expenditures:
None. STORAGE NAME: h1269d.HHS PAGE: 7
DATE: 2/13/2024
B. DIRECT ECONOMIC IMPACT ON PRIVATE SECTOR:
None.
C. FISCAL COMMENTS:
None.
III. COMMENTS
A. CONSTITUTIONAL ISSUES:
1. Applicability of Municipality/County Mandates Provision:
Not applicable. The bill does not appear to affect county or municipal governments.
2. Other:
None.
B. RULE-MAKING AUTHORITY:
None.
C. DRAFTING ISSUES OR OTHER COMMENTS:
None.
IV. AMENDMENTS/COMMITTEE SUBSTITUTE CHANGES
On February 1, 2024, the Healthcare Regulation Subcommittee adopted an amendment and reported the
bill favorable. The amendment established a THC potency limit for marijuana in the form for smoking in the
adult personal use marijuana program. Such marijuana may not have a THC potency of greater than 30
percent.
This analysis is drafted to the committee substitute as passed by the Healthcare Regulation
Subcommittee.