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Florida Judge Suggests Medical Marijuana Patient Take Xanax Instead

A.J. Herrington

May 2, 2023

Florida Judge Sparks Debate by Recommending Xanax Over Medical Marijuana for Patient

A Florida judge is raising eyebrows among medical experts and legal scholars after ordering a defendant to abstain from using medical marijuana during probation and suggesting that she take the prescription drug Xanax instead. Dorothy Vaccaro, a Pinellas County Court judge, told the 21-year-old defendant that she probably did not have post-traumatic stress disorder (PTSD) or cancer and therefore should not use medical marijuana, according to a report from the Tampa Bay Times.

A Florida judge ordered a defendant to stop using medical marijuana and suggested she take Xanax instead. [-] GETTY

In January, the defendant appeared in Vaccaro’s 6th Judicial Circuit courtroom to face a DUI charge. After the defendant told the judge that she used medical marijuana to treat anxiety, the judge said that anxiety was not a sufficient reason to use medical marijuana, according to a recording of the encounter obtained by the newspaper. The judge then ordered the defendant to stop using cannabis medicinally as part of her probation and proceeded to offer medical advice to the defendant.

“Anxiety can be done a different way, through alprazolam, right? Xanax,” Vaccaro said, suggesting that the defendant visit a primary care physician, “So they can deal with that that way, and there’s a drug that they can give you.”

Vaccaro added that she might reconsider her order if the defendant got “all wiggy” on Xanax or if another physician wrote a letter recommending medical marijuana.

Xanax is the brand name for alprazolam, a medication commonly prescribed to treat anxiety. The drug is a benzodiazepine, a class of sedatives that work by slowing down the central nervous system and decreasing brain activity, according to information from the Centers for Disease Control and Prevention. Benzodiazepines can also cause a variety of side effects, including hallucinations, paranoia, aggression and depression, among others.

Vaccaro also ordered that the defendant undergo a drug screening and told her to stop using medical cannabis as part of her probation. She also threatened to have the defendant arrested without bond if she continued to use medical marijuana. At least three times, Vaccaro told the defendant, who was not identified by the newspaper to protect her medical history, that she was too young to use medical marijuana. Eventually, the woman’s attorney told the judge that she would start taking Xanax.

Although it is common for judges to require defendants to refrain from using drugs and alcohol while on probation, Judge William Burgess, who also serves in Florida’s 6th Circuit, said that he allows defendants with medical marijuana identification to use cannabis medicinally. He added that while he can only speak for his courtroom, he treats recommendations to use medical marijuana the same as prescriptions for other drugs.

Florida legalized medical marijuana in 2016 with the approval of an initiative that succeeded at the polls with more than 70% of the vote. Under the ballot measure, doctors may recommend medical marijuana for debilitating medical conditions including cancer, PTSD, epilepsy and glaucoma, among others. More than 812,000 patients have qualified to use medical marijuana in Florida, according to informationfrom the state Office of Medical Marijuana Use.

Stephen Thompson, a spokesperson for the 6th Judicial Circuit, said that Vaccaro was simply offering the defendant alternatives to using medical marijuana, noting that rules prevent the judge from commenting on the case directly.

“She didn’t order the defendant to take those drugs,” Thompson wrote in a statement.

The spokesperson also noted that anxiety is not a specified qualifying condition to use medical marijuana and that other judges in the 6th Circuit have sometimes required defendants to refrain from using cannabis medicinally while on probation.

Judge’s Order Concerns Medical And Legal Experts

Peter Grinspoon, a physician who is an instructor at Harvard Medical School and the author of the new book Seeing through the Smoke: A Cannabis Specialist Untangles the Truth about Marijuana, says that he has frequently recommended medical marijuana for anxiety patients with great success, noting that it is one of the most common uses for medicinal cannabis. After reading about Vaccaro’s order for the defendant to refrain from using medical cannabis, Grinspoon says that it “is presumptuous, inappropriate and dangerous for a judge to ‘play doctor’ in cases like these. They can truly harm someone as they are not medically trained.”

He also notes that medical marijuana is less likely to cause serious side effects compared to Xanax.

“Medical cannabis is far safer than alprazolam, which is far more addictive, and which has a life-threatening withdrawal syndrome, and which is thought to contribute to dementia risk, as well as falls and balance problems,” Grinspoon writes in an email. “Cannabis generally has milder side effects and is considered safer.”

Medical marijuana can be an effective treatment for anxiety and is safer than Xanax.


Jaggers Keene, a primary care physician in Largo, told the Tampa Bay Times that Xanax can have dangerous side effects for some people, including seizures and thoughts of suicide. He also said that the drug can be fatal when mixed with alcohol, noting that the defendant was in court on a drunk driving charge.

Bob Jarvis, a law professor at Nova Southeastern University who has written about Florida’s judicial rules, noted that Vaccaro should not have used the defendant’s age as a basis for ordering her not to use medical marijuana. He said that under Florida’s judicial canons, judges are prohibited from discriminating against defendants for any reason, including age. He added that it is inappropriate for a judge to decide a patient is too young to need a particular kind of medication.

“What’s to stop the judge from making all kinds of other assumptions?” Jarvis wondered. “And then the whole system falls apart.”

Charles Geyh, a professor in the Maurer School of Law at Indiana University Bloomington, told the Tampa Bay Timesthat it is not unusual for judges to question defendants during court proceedings or to make quick rulings. But he is concerned that Vaccaro “basically trumped the judgment of a physician without gathering all the facts.” He also said that judges have a duty to make rulings based on facts that can be proven and refrain from making decisions based on personal preferences.

“The judge was leaving her lane,” said Geyh.

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