It can be difficult to talk to your primary care physician about medical cannabis. This is one of the many good reasons why seeing a doctor who specializes in medical marijuana (and is open to recommending it) is a good idea. You will be less worried and feel more comfortable speaking about something that still has a lot of stigma attached to it. Here’s some questions you can ask a medical marijuana doctor, and some answers as well! What is a Medical Marijuana Certificate and Card? Basically, in order to qualify for a medical marijuana card, for most state mmj programs, you must be assessed by a licensed physician first. The medical marijuana doctor will then determine whether or not you qualify for the state’s medical marijuana program. Once qualified, you must then apply for a medical marijuana card via the appropriate state’s medical marijuana program (MMP) website. Every state is different – that’s why we’ve created a guide to each one for patients to help them through the application process. In California, this registration to the state MMP is voluntary, but it is mandatory in other states. In Texas, it is possible to qualify for CBD-rich medical cannabis, but medical marijuana cards are not issued. Leafwell does not provide medical marijuana cards directly – you must get certified, and then fill out an application form, and then submit it through the state website (some states still accept applications by mail) to get your cannabis card. Please note: your state medical marijuana card will not look like this! Is There a Difference Between Medical and Recreational Marijuana? If cannabis is well-grown and tested for cannabinoid-terpene content and safety, then it can be used for both medical patients and recreational cannabis enthusiasts. The cannabis itself is no different. The main difference between a medical marijuana patient and a recreational user is one of intent. A medical marijuana user is unlikely to be using cannabis purely for enjoyment. In fact, they may be seeking very little if any euphoric effect at all, and just want to remain functional throughout the day or be able to get to sleep easily at night. Medical marijuana patients are likely to be using cannabis at a specific dosage, at specific times of day, like they would with other medications. They will also have spoken to a medical marijuana doctor about what they want to achieve by using cannabis and may be following medical recommendations. A non-medical user, on the other hand, is likely to be using cannabis purely for enjoyment, and not necessarily paying attention to dosage or timing. However, recreational cannabis users may still be using cannabis as a health and wellness product – something to be used to reduce stress and anxiety, as a replacement for alcohol, and to be able to sleep and eat properly. This sort of use may not be for a specific condition, but does show that cannabis can be used as a way to improve one’s quality of life. Can I Use Medical Marijuana to Reduce Intake of Other Drugs and Medications? There is little definitive research on this subject, but there are many people who have used cannabis to reduce or replace painkiller intake. There are some classes of medications that cannabis seems to be particularly good at replacing. This includes: Opioids and opiate-based medications. Sedatives – particularly benzodiazepines and barbiturates. Non-steroidal anti-inflammatory medications (NSAIDs). Antidepressants. Cannabis (in particular the peppery terpene, beta-caryophyllene) may also be useful for the reduction of alcohol intake. What is the Endocannabinoid System (ECS)? You can read more about the endocannabinoid system (ECS) and what it does here. The endocannabinoid system is intimately involved in homeostasis, which is a series of checks and balances that helps keep the human body working correctly day to day. The ECS plays a role in appetite regulation, the sleep-wake cycle, pain detection, inflammation, the pleasurable effects of exercise, mood, memory and, of course, mediating the pharmacological effects of cannabis. Cannabinoids in general have potent anti-inflammatory effects. As almost every disease process involves inflammation in some way, using cannabinoids may help reduce this inflammation. Moreover, cannabis does so relatively safely compared to many other medications. How Safe is Medical Marijuana/Cannabis? For people aged 25 or over, when the brain is more fully developed, cannabis is perhaps one of the safest medications available today. Unlike many other medications, there has not been a case of a deadly overdose due to the use of cannabis alone. This is because naturally-derived cannabinoids are broken down by the body so quickly that dangerous levels of cannabinoids in the body aren’t built up. When it comes to medical cannabis for children, they may be more sensitive to psychoactive cannabinoids like tetrahydrocannabinol (THC), but non-psychoactive cannabinoids like cannabidiol (CBD) can be useful to minors and are unlikely to have any negative long-term effects for most children. How Addictive is Cannabis? You can read more about cannabis’ addiction potential here. Most people find that stopping cannabis use is relatively simple when compared to many other drugs and medications. However, some people may develop cannabis use disorder (CUD), where they use cannabis compulsively despite it having a negative impact. CUD affects about 9% of regular cannabis users, although the percentage jumps to around 18% for those who start using cannabis in their teens. For many people, reducing or stopping cannabis use is not too difficult (some may feel uncomfortable for a few days), and withdrawal is not extreme or dangerous. Pharmaceuticals and dollar bills. Many pharmaceuticals for pain control can be addictive. Which Product or Strain is Right for Me? As everyone has a different ECS, what works for one person may not work for another. This means that trying a few different products and going slow-and-low will likely be necessary to find something that works best for you. It is hard for a medical marijuana doctor to definitively say which is the best for you but they will be able to provide you with some general advice and recommendations because there are some patterns: THC has more sedative, analgesic properties. It is a potent anti-inflammatory. THC can beat anxiety in low doses, and increase anxiety in higher doses. CBD is non-intoxicating, and is anti-psychoactive. CBD is also a potent anti-inflammatory. CBD can have both relaxing and energizing effects, and may be used to improve mood. Equal amounts of CBD and THC produces mild but tolerable (for most) psychoactive effects. More CBD than THC produces little-to-no intoxicating effect. More THC than CBD produces psychoactive effects. Just THC can be very psychoactive, but short-lived. Adding a little CBD can buffer some of this psychoactivity, but also elongate THC’s effects to some extent. A combination of the terpenes myrcene, humulene and linalool generally lends to more relaxing or sleepy effects. A combination of beta-caryophyllene, limonene and pinene can have more up or energetic effects. Cannabinoids are biphasic, meaning they can have two different effects at different dosages. Low doses of tetrahydrocannabivarin (THCV) are anti-psychoactive. Higher doses are psychoactive. THCV generally has a more uplifting psychoactive effect compared to THC. A mixture of cannabinoids and terpenes is usually best, called the entourage effect. Even small, non-psychoactive doses of THC can be medically beneficial for the treatment of chronic pain, nausea and insomnia. A mixture of cannabinoids and terpenes has two benefits: 1) It increases the efficacy of individual cannabinoids; 2) It minimizes the negative effects of individual cannabinoids (e.g. using pinene and CBD can reduce THC’s negative effects on short-term memory). In some instances, certain cannabinoids should be avoided. Those suffering from schizophrenia or bipolar disorder ought to avoid THC, but CBD could be helpful. Those suffering from diabetes or obesity may want to focus more on CBD and THCV than THC. THC can be useful for the treatment of chronic pain, nausea, insomnia and the side-effects of chemotherapy. Those who suffer from cancer and are undergoing immunotherapy should avoid cannabis and cannabinoid treatment. Dosing cannabis. Check out our guide on dosing cannabis if you would like to learn more. Generally speaking, if you want to know what effect a particular cannabis product or strain will have, it is best to look at what it actually contains. Leafwell’s cannabinoid-terpene table can help with this as well. Are There Any Conditions Medical Marijuana is Particularly Useful For? Although cannabis can work well for many conditions, there is better quality evidence that it works for some conditions where more research has been carried out. Medical marijuana could be of particular help for the treatment of: Autoimmune disorders – in particular Crohn’s disease, type-1 diabetes, lupus and rheumatoid arthritis. Both THCV and CBD may be of particular use. Inflammatory bowel diseases (IBDs) – there are a huge number of cannabinoid receptors in the bowel, and these are not working properly in those with conditions like irritable bowel syndrome. Cannabis can prevent inflammation and restore balance to the gut, allowing healthy bacteria to grow. Neurological disorders – there is some good evidence that cannabinoids could be of particular help for neuroinflammatory disorders like epilepsy, multiple sclerosis (MS), Parkinson’s disease and Alzheimer’s disease. Some kinds of cancer – not all kinds of cancer respond to cannabinoid treatment, but many do. Cannabinoids’ anti-inflammatory properties could make it very useful for the treatment of bowel and stomach cancers, breast cancer, blood cancers, skin cancers, liver cancer, and glioblastoma (brain or spinal cord cancer). Glaucoma – THC can reduce intraocular pressure (IOP, or eye pressure). If you have another question that needs answering check out our Frequently Asked Questions page. For more information and FAQs on medical marijuana specifically, we have a cannabis-focused FAQ page. If you have a personal question and would like to speak to a qualified medical marijuana physician about it (and qualify for an MMJ card, too), then you can do so online with Leafwell! See a doctor today and get a physician’s recommendation for a medical marijuana card.