We have lots of detailed information throughout this website answering people’s questions about medical marijuana, but we thought it would be best to give some answers to the most frequently asked questions by patients. We will also give a short, simple overview of some of the science and other issues surrounding these questions … Or head to our Ultimate Guide to Getting a Medical Marijuana Card for a step-by-step walkthrough.
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Table of Contents
- What Conditions Does Medical Marijuana Work For?
- Why Does Medical Marijuana Work for So Many Conditions?
- How Do I Get an MMJ Card and Speak to a Medical Marijuana Doctor Online?
- What Documents Do I Need to Qualify for a Medical Marijuana Card?
- What Benefits Are There in Having a Medical Marijuana Card and Physician’s Cannabis Certificate or Recommendation?
- What Are the Easiest and Most Difficult states to Get a Medical Marijuana Card In?
- The Expansion of Telehealth/Telemedicine into Medical Cannabis Qualification
- The Endocannabinoid System (ECS) – What Is It?
- What Makes Marijuana Medicine?
- What is Tetrahydrocannabinol (THC)?
- What is Cannabidiol (CBD)?
- What’s In a Cannabis Plant?
- What Effect Does Cannabis Have?
- What’s the Difference Between an Indica and a Sativa?
- What is Cannabis ruderalis?
- Is Cannabis a Drug or a Medicine?
- Does Removing the Psychoactive Components of Marijuana (e.g. THC), Make it a Medicine?
- What’s RSO (Rick Simpson Oil) or BHO (Butane Hash Oil)?
- Is Cannabis Addictive?
- Can You Overdose on Cannabis?
- How Do I Dose Medical Cannabis? What Is the Entourage Effect?
- Which Medicines Does Cannabis Have a Negative Interaction With?
- How Many Ways Are There to Consume Cannabis?
- Is There a “Best” Way to Ingest Cannabis?
- Pros and Cons of Medical Cannabis
- Why Should I Get a Medical Marijuana Card?
What Conditions Does Medical Marijuana Work For?
This is difficult to answer with any certainty, as the evidence is mixed for many different conditions. Where cannabis and cannabinoids seem to work particularly well is in autoimmune conditions (e.g. lupus, Crohn’s disease, type 1 diabetes), where the immune system becomes overactive and causes inflammation; and in neuroinflammatory conditions (e.g. epilepsy, Parkinson’s disease, multiple sclerosis), where the brain, spinal cord and nervous system are figuratively “on fire”. Cannabis seems to be of particular use for chronic and neuropathic (nerve) pain as well.
Here is a list of conditions where cannabis could be useful for, many of which are qualifying conditions in many medical marijuana states:
- Addiction Treatment – especially as a replacement for opioid-based painkillers
- Amyotrophic Lateral Sclerosis (ALS), aka Lou Gehrig’s disease
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- Attention Deficit Disorder / Attention Deficit Hyperactivity Disorder (ADD/ADHD)
- Autism/Asperger Syndrome
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- Chronic Pain, Muscle Pain and Other Kinds of Pain
- Cystic Fibrosis (CF)
- Eating Disorders (e.g. Anorexia, Bullimia, Obesity)
- Eczema & Psoriasis
- Headache & Migraine
- Irritable Bowel Diseases (IBDs), including Crohn’s disease, ulcerative colitis and irritable bowel syndrome (IBS)
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- Multiple Sclerosis (MS)
- Nausea & Vomiting
- Parkinson’s Disease (PD)
- Peripheral Neuropathy (PN)
- Post-Traumatic Stress Disorder (PTSD)
- Pre-Menstrual Syndrome (PMS)
- Tourette Syndrome (Tourette’s, TS)
- Traumatic Brain Injury (TBI) & Stroke
- Trigeminal Neuralgia (TN)
Terminal illness and those with 12 months or less to live are also qualifying conditions in many states.
Why Does Medical Marijuana Work for So Many Conditions?
The main reason why medical marijuana works for so many different conditions is because it contains a multitude of compounds, including cannabinoids (internal effect), terpenes (smell) and flavonoids (flavor), that can battle many different kinds of inflammation. As inflammation can cause or advance many different kinds of disease, cannabis can help dampen this inflammation, and do so in a multitude of ways by using different cannabinoid-terpene-flavonoid profiles. The endocannabinoid system (ECS) – which is a network of receptors found all around the body – is fundamentally involved in homeostasis. That is, keeping the body in balance. An out-of-whack ECS can cause inflammation. Cannabinoids derived from the cannabis plant (phytocannabinoids) have anti-inflammatory effects.
Cannabis is essentially a pharmacy in a plant.
How Do I Get an MMJ Card and Speak to a Medical Marijuana Doctor Online?
Click on one of the following links to find out more on how to get a medical marijuana card online and start speaking to a physician online:
- Arkansas Medical Marijuana Card
- California Medical Marijuana Card
- Connecticut Medical Marijuana Card
- Florida Medical Marijuana Card (renewals only)
- Illinois Medical Marijuana Card
- Louisiana Medical Marijuana Card
- Maine Medical Marijuana Card
- Maryland Medical Marijuana Card
- Massachusetts Medical Marijuana Card
- Missouri Medical Marijuana Card
- Montana Medical Marijuana Card
- New Hampshire Medical Marijuana Card
- New Jersey Medical Marijuana Card
- New York Medical Marijuana Card
- North Dakota Medical Marijuana Card
- Ohio Medical Marijuana Card
- Oklahoma Medical Marijuana Card
- Pennsylvania Medical Marijuana Card
- Rhode Island Medical Marijuana Card
- Utah Medical Marijuana Card
- Virginia Medical Marijuana Card
- Washington, D.C. Medical Marijuana Card
Some states are more strict than others. In general, the main difference between states is the point at which you will need to register for the medical marijuana program. In some states, you have to register before your physician’s appointment, in others it is afterwards once you have your medical cannabis certificate/mmj recommendation. In some states, registration to the state medical marijuana program is done during the appointment. It is only in California where registration to the state medical marijuana identification program is voluntary, but it is recommended you do so to take advantage of the tax benefits and to avoid issues with law enforcement.
COVID-19 has meant that many states have implemented telehealth and telemedicine for medical cannabis certification.
What Documents Do I Need to Qualify for a Medical Marijuana Card?
Again, the requirements differ from state-to-state. Here’s a set of documents that will serve you well for a medical marijuana card application in most if not all states:
- Photographic ID – driving license, state-issued ID card, US passport. For minors, a birth certificate is suitable as well.
- 2 x Proof of address from within the last 3 months, such as a letter from a hospital or state department, bank statement, utility bill (not cell phone), insurance letter, or rental/mortgage agreement.
- Medical records – this can include doctor’s notes, medical images (e.g. MRI, X-rays), and medication lists.
- A passport-style and -sized photograph, saved onto your computer (and in hard copy as well if the application is being mailed in).
What Benefits Are There in Having a Medical Marijuana Card and Physician’s Cannabis Certificate or Recommendation?
This can depend on the state, but these are the potential benefits of having a valid physician’s medical cannabis certificate and MMJ card:
- In medical-only states, it is the only way to consume cannabis legally.
- In states where recreational cannabis is available, having a medical marijuana card can usually save some money on taxes.
- Having a medical marijuana card can give you access to a wider range of products and dispensaries.
- Possession amounts for medical marijuana patients are usually higher.
- In some states, having a medical card is the only way you are allowed to grow cannabis for yourself, or to grow a greater number of plants.
- Some states’ medical marijuana cards are seen as valid by other states (reciprocity), meaning it can potentially gain you access to another state’s medical marijuana program.
What Are the Easiest and Most Difficult states to Get a Medical Marijuana Card In?
Some states are more strict than others when it comes to conditions that qualify one for medical marijuana. California, Colorado, Illinois, New Mexico and Oklahoma are some of the most liberal medical marijuana states, whereas Florida, Arkansas, Utah, , Louisiana and Virginia are more conservative with their medical marijuana laws. States like Alaska and New York could be said to be in-between.
It is difficult to say for sure which state is easiest or most difficult to get your medical marijuana card from, as they all have their advantages and drawbacks. New Mexico, Illinois and California are arguably the easiest, whereas Virginia, Louisiana and Utah are arguably some of the most difficult. Some states like Georgia, Texas, and Kentucky have very restrictive medical marijuana laws, where it is nigh-on impossible to access medical cannabis in a genuinely legal manner at all.
One of Leafwell’s missions is to give medical cannabis patients access to the medicine they need in as simple, straightforward and legal manner as possible.
The Expansion of Telehealth/Telemedicine into Medical Cannabis Qualification
Since the outbreak of COVID-19, many states have expanded their telehealth services and allowed for medical marijuana doctors to qualify patients online. However, some states and territories still require an in-person appointment in order to qualify for an MMJ card, at least for now. These include:
Now, here are some more FAQs regarding the medical properties of the cannabis plant.
The Endocannabinoid System (ECS) – What Is It?
Before we go into the other questions, it is essential to understand the science behind cannabis and its effect on the endocannabinoid system. The ECS has a relationship with the nervous system, in particular the autonomic nervous system. Everyone also has their own unique ECS. You can read our article on the endocannabinoid system (ECS) for more details.
The human body produces its own cannabinoids (“endo” meaning “internal; within”). The ECS is involved in various physiological processes, including appetite, pain sensation, mood and memory. The ECS can decrease the rapidity of information a nerve fires or decrease inflammation by opening up blood vessels, for example.
There are two main endocannabinoid receptors: CB1 and CB2. These receptors (synapses) work like a baseball glove, catching and transporting information throughout the body. Although THC, THCV and CBD all have an effect on CB1 and CB2 receptors, this is by no means the only part of the nervous system these cannabinoids have an effect upon.
Cannabinoids that enter the body from outside the use of plants (e.g. from marijuana use) are called “phytocannabinoids” (“phyto” meaning “of a plant”). These phytocannabinoids are numerous in number, and can either block or promote the transmission of information, depending upon the plant’s cannabinoid profile.
This is the reason why so many different strains (or,more accurately, “chemovars” of cannabis) have such a wide array of effects and uses. This is also one of the main reasons why marijuana has so many medical applications – it helps patients regulate their ECS to “normal” levels that make their lives better. For example, a person who suffers from multiple sclerosis (MS) has an over- and/or under- abundance of information released into their nervous system causing spasms, and marijuana can help control these spasms.
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What Makes Marijuana Medicine?
Basically, when there is a shortage of our bodies own natural endocannabinoids, or if the ECS is damaged or dysregulated in some other way, we could be said to be suffering from a clinical endocannabinoid deficiency (CECD). Phytocannabinoids can help replace these lost cannabinoids, and return our bodies to their ideal state by dampening inflammation.
What is Tetrahydrocannabinol (THC)?
You can check out our article for a more detailed explanation as to what THC is. For a basic overview:
- THC is a CB1 receptor partial agonist. This means that it has psychoactive effects, and can bind to CB1 receptors in the brain. THC is a partial mimic of the endocannabinoid, anandamide.
- THC is the most prominent cannabinoid in the cannabis plant.
- THC can be useful for treating chronic pain, multiple sclerosis (MS), cancer, insomnia, headaches/migraine and nausea.
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What is Cannabidiol (CBD)?
You can read more about how CBD works here. For a basic overview:
- CBD is a partial antagonist of the CB1 and CB2 receptors, meaning it can be used to block or dampen THC when used in equal doses.
- CBD is thought to be non-psychoactive, but this is not entirely accurate. CBD affects serotonin and dopamine receptors, and also “talks” to opioid receptors. CBD is not addictive, but certainly has physiological effects, and therefore could be seen as have psychoactive effects of sorts.
- CBD could be very useful for neuroinflammatory disorders such as Alzheimer’s disease, epilepsy, and neuropathic pain, as well as diabetes and chronic pain.
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What’s In a Cannabis Plant?
Cannabis is sometimes known as the plant of one thousand and one molecules. Of these, around about 150 are cannabinoids, 220 terpenes/terpenoids (smell), and 20 are flavonoids (flavor). The unique combination of these compounds is what will give cannabis its unique effects. Different combinations can have different effects and be used for many different purposes and conditions. This is why we call cannabis a pharmacy in a plant.
The main big six cannabinoids are:
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Download Free Guide to CBN
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The peppery terpene beta-caryophyllene is a cannabinoid as well, as it is a partial CB2 receptor agonist that can help battle inflammation and reduce pain. It is sometimes also included on the list of big cannabinoids.
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What Effect Does Cannabis Have?
Cannabis can have quite contrasting effects, depending on several factors, including:
- The cannabinoid-terpene-flavonoid profile.
- How much was taken.
- Personal physiology
The most common way of determining the effect of a particular tincture is by looking at its THC:CBD ratio, which is usually expressed in numbers like 1:1, 2:1, 3:1 etc. In general, CBD-rich tinctures will have a non-intoxicating effect, THC-rich tinctures will have a distinct psychoactive effect, and a balanced 1:1 CBD:THC may have some psychoactivity, with many reporting low to moderate psychoactivity that is far more tolerable than THC alone. It is worth remembering that other cannabinoids like CBC, CBN, CBG and THCV will also determine the effect cannabis can have.
Terpenes also influence the effect a particular strain or product has. Flower or any other product high in a mixture of THC, THCV, pinene, beta-caryophyllene, limonene (and possibly CBD as well) can have more energizing effects. A mixture of THC, low doses of CBD, CBN, linalool, humulene and myrcene is more likely to have relaxing or sleepy effects.
CBD is often thought to have more down or relaxing effects, but this is not entirely true. In fact, CBD can have more energizing effects, with its relaxing effects more likely to be due to its stress-busting and anti-anxiety properties as opposed to being sedative-like. CBD seems to be more conducive to sleep when used earlier in the day, or when used in low doses alongside higher doses of THC at night, combined with the appropriate terpenes.
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What’s the Difference Between an Indica and a Sativa?
In the classic way of defining and grouping cannabis:
- Sativas grow big and tall, with thin leaves. They tend to have more “up” or “energetic” effects. They are usually high in THC and contain little-to-no CBD. Sativas tend to be found in equatorial regions, and may contain more THCV (tetrhydrocannabivarin). Prominent terpenes tend to include pinene (which is found in most cannabis varieties), limonene and beta-caryophyllene. The effect is intense but short-lived.
- Indicas grow short, squat and bushy, with broad leaves. They tend to have more “relaxing”, “couchlocking”, “down” effects. They can be high in THC, but also contain more CBD compared to sativas. Indicas are found in countries like Afghanistan and areas of high altitude. Prominent terpenes tend to include linalool, humulene and myrcene. The effect is longer-lived than sativas, but more gentle. An indica is a subspecies of Cannabis sativa, so issometimes written as Cannabis sativa sub. indica.
However, if we look at the chemical makeup of what is labelled “sativa” and “indica” under the microscope, we can see that an indica can have the same cannabinoid-terpene profile as a sativa, and vice-versa. This means that the old distinction of labelling by growth patterns, and then assigning an effect based on this, is not entirely accurate.
Some people have thought to differentiate cannabis varieties by geography than by growth patterns. The suggested taxonomy (method of organizing biological organisms) is:
- Cannabis indica – Cannabis from India.
- Cannabis afghanica – Cannabis from Afghanistan, what would have previously been called Cannabis indica.
- Cannabis sativa – Feral or wild cannabis that is found in East Europe, Russia or Central Asia, including hemp varieties.
You can read the Leafwell take on the cannabis classification system here, but the general gist is that both systems above leave something to be desired, as they don’t classify according to chemical makeup, but rather growth patterns and geography. Now, there may be some difference in cannabis types from around the world, but hybridization has made this difficult to say so for sure. However, even if the distinction is rough, there are cannabis varieties that have grown in specific locations without any others being crossed into the gene pool (a landrace strain). These varieties may have distinct cannabinoid-terpene profiles
Mislabelled varieties (whether by breeders or dispensaries) can also make it difficult to say for sure what differences there are between a sativa and indica. The Leafwell view is that it is the cannabinoid-terpene-flavonoid profile that should be used to classify cannabis, rather than overly-generalized geographic or growth pattern labels (although identifying unique landrace strains and listing the genetic background of the plant can be helpful).
However, this is a debate that will likely rage on for quite some time, as the taxonomy of species has always been a contentious issue that’s been argued over for quite some time. In the meantime, if you want to know what sorts of effects a particular variety of cannabis or cannabis product will have, then look at the test results, focusing on the cannabinoid and terpene profile (as well as the safety results), not the name or the “indica” or “sativa” label.
All cannabis and hemp plants are essentially Cannabis sativa, the main difference being whether it has been bred and grown for its flower or its stalk.
What is Cannabis ruderalis?
Cannabis ruderalis is a low-THC subvariety of Cannabis sativa that is native to Central and Eastern Europe and Russia. It is an autoflowering plant, meaning that it reaches maturity based on age rather than the light cycle, i.e. the flowering period starts at a certain age, rather than triggered when it gets 12 hours of light and 12 hours of dark. Some argue that these attributes make Cannabis ruderalis a different species entirely.
However, ruderalis has been bred with Cannabis sativa successfully, and also shares many of the same chemical compounds, suggesting that the two are related but distinct, not necessarily a completely separate species. CBD is found in high amounts in ruderalis. Cannabis ruderalis has been crossed with many varieties of cannabis to make it easier for beginners to grow cannabis, increase CBD content, and to increase the vigor of the plant.
Is Cannabis a Drug or a Medicine?
A “medicine” is something you take to treat an ailment. A “drug” is something you use to produce a specific physiological and/or psychological effect, with or without the “medical” attribute attached. Many consider marijuana a “drug” used for recreational purposes because of its psychoactive properties – euphoria, elation etc. If one uses marijuana for the purposes of getting “stoned” or “high”, they are said to be using marijuana as a recreational drug.
An accurate description of substances like cannabis would be to call it both a drug and a medicine, in the same way many prescription medications are. Hence, the ideal situation would be to treat cannabis as a medicine, with both pros and cons, and a distinct scientific approach.
Does Removing the Psychoactive Components of Marijuana (e.g. THC), Make it a Medicine?
By definition, it is THC that is a “drug” as it is one of the cannabinoids that directly affect CB1 receptors and has a psychoactive effect. By this definition, high doses of tetrahydrocannabivarin (THCV) could also be considered a drug. Therefore, if one gets rid of THC, it could be said that cannabis is medicinal. However, THC does also help other phytocannabinoids do their jobs properly (the “Entourage Effect”), on top of having medical applications of its own, e.g. as a painkiller or to beat nausea (antiemetic). THC also has significant anti-cancer properties.
This makes the view that “THC = Drug, CBD = medicine” a rather arbitrary one, and is a good reason why we ought to treat marijuana (or “cannabis”, which is the preferred nomenclature here on Leafwell) as a whole. If all of the components of marijuana has medical use, we can definitely say that marijuana has definite medical value. Essentially, saying THC is the “non-medical” part is simplistic and wrong, as it does have significant medical applications. Sure, it may not be the ideal cannabinoid for everybody, or some people may only need small amounts of it, but THC is also medicinal. There are many medicines that are also “drugs”, many far more dangerous or psychoactive than cannabis. To treat cannabis so differently does not really make sense.
On a related note, this makes the Drug Enforcement Agency’s (DEA’s) stance on marijuana as a Schedule I drug anti-scientific and completely illogical.
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What’s RSO (Rick Simpson Oil) or BHO (Butane Hash Oil)?
Both RSO and BHO are extracts of cannabis flower and/or trim, where highly purified butane (or any other alcohol-related compound) is used to separate plant material from the trichomes of the plant. The trichomes of the plant are where all the plant’s cannabinoids and terpenes are produced, so using the RSO or BHO extraction methods results in a highly concentrated, potent, viscous, thick oil-/honey- like substance that can be used in a variety of ways. You can eat it, vape it in an appropriately-designed vaporizer, mix it into a tincture or topical, or even use it as a suppository.
Is Cannabis Addictive?
First, we must define what addiction is. There are two specific types of addiction: physical and psychological. Physical addiction can overlap with psychological addiction, but not necessarily the other way round.
Physical addiction is notable by the fact that the body physically needs the drug or substance the person is ingesting. Opiates/opioids, barbiturates & benzodiazepines (and other types of sedatives), and alcohol are perfect examples of physical addiction – the addict’s body literally needs the substance in order to stave off withdrawal and potentially even death.
Psychological addiction is most notable for the symptom of “craving”. Drugs like cocaine and amphetamine are both capable of producing psychological addiction rapidly, although they are not necessarily physically addictive. However, addiction to such drugs can produce medium- to long- term physiological changes. This is both due to the lifestyle associated with amphetamine or cocaine abuse, and the effects they have on the nervous system, in particular serotonin and dopamine receptors.
Marijuana is not addictive in the same manner as amphetamines, cocaine, opiates/opioids and even long-term alcohol use are, although there is a condition known as “Marijuana Use Disorder”. There is some amount of dependence, but there is not a huge level of physical or psychological withdrawal for most people. Prolonged use may stop the body from developing its own cannabinoids, but the human body does not “crave” phytocannabinoids in the same manner it would opiates or other drugs when usage stops. The body returns to its “base level” of endocannabinoid production before marijuana treatment within a few days.
With that being said, it is suggested that around 9% of cannabis users suffer from Marijuana Use Disorder. For those who start using cannabis in their teenage years, this rises to about 18%. Much of this could be due to overuse of high-THC cannabis which dominates the black market, and there is also a difference between recreational and medical use, where therapeutic doses are more likely to be used in a more controlled manner. Younger people seem to be more sensitive to THC, whereas older people may benefit from using small amounts of THC.
Many do not tend to suffer any major withdrawals when stopping cannabis use, but there can still be some withdrawal symptoms. Irritability, rebound dreams, appetite changes, sweating, and sleep disturbances may occur when withdrawing from high THC use. When it comes to other cannabinoids with little or no psychoactivity (e.g. CBD), there is little research into their addictiveness, but it seems unlikely that they would be addictive or cause withdrawal to any major degree. It may be possible to use a broad range of cannabinoids and terpenes to mitigate the psychoactive effects of THC, as well as reduce the need for too much THC.
Perhaps what is interesting is that cannabis can actually be used as an exit drug, and there is research showing that cannabis may actually help reduce voluntary intake of alcohol and opioids. The cannabinoid-terpenoid beta-caryophyllene is of particular interest for the treatment of addiction.
Can You Overdose on Cannabis?
No, you cannot overdose on cannabis alone (unless you consume extreme amounts), although it may contribute to overdose via interactions with other medicines and drugs. For example, mixing marijuana with alcohol is generally a bad idea. Meanwhile, mixing high CBD with benzodiazepines may cause problems, as both work on CB2 receptors in the liver. You can also have a sort of “temporary overdose” (aka “whiteying/white-out” or “getting a greenie”), although this is short-lived and recovered from quite easily with food, water and/or rest.
Those who have bad reactions to cannabis tend to have taken too much in one go. This is particularly common when it comes to edibles. The best way, regardless of ingestion method, is to go slow-and-low and to a level where you feel comfortable but functional. When it comes to edibles, use around 5mg of THC or less, wait an hour or two, then use a little more as needed.
You can also build tolerance over time, so what may have been an uncomfortable dosage at one point becomes more tolerable as you go along. This can be both a benefit and a curse. One of the benefits is that you can start tolerating more without too much impact on your everyday functioning. Another is that some people may need higher amounts of THC for pain relief or to beat cancer.
A disadvantage is that becoming too tolerant can diminish efficacy over time. Fortunately, thanks to the body being able to breakdown and clear cannabinoids quite quickly, a small break of a few days or switching to a different strain or cannabinoid -terpenoid profile (if possible and a specific profile is not needed) can help reduce tolerance.
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How Do I Dose Medical Cannabis? What Is the Entourage Effect?
Check out our guide to dosing medical marijuana for a more detailed and comprehensive look at this subject. Here’s some key information to remember:
- Microdosing is usually ideal, especially when it comes to THC, where a starting dose 1 – 5 mg for beginners, going up in small increments only when necessary. You can always use more, but not less.
- If the THC proves overwhelming, you can use CBD to reduce its psychoactivity.
- What works for one person may not work for you. Cannabis can be a very individualized medicine, as everyone has a unique endocannabinoid system. Yes, there are some patterns according to condition and physiology, but there can still be some variations. You have to find what works best for you.
- Take into account all the conditions you suffer from, and which symptoms you’re trying to reduce or overcome. This can help inform you about which cannabinoids and terpenes you ought to use, and which to avoid.
- Ask yourself, “What do I hope to achieve with cannabis?” Is it sleeping 6+ hours? Is it being able to eat a proper meal? Is it to walk a mile without any pain? This can help you set goals and a target to achieve.
- A product with a wide range of cannabinoids and terpenes is likely to be the most well-tolerated, as they all balance each other out and can mitigate some of the negative effects whilst still providing some therapeutic benefits. This is known as the entourage effect. However, some people may require a particular cannabinoid or set of cannabinoids for their condition. Utilizing multiple cannabinoids and terpenes can both increase a plant’s potency as well as reduce psychoactivity.
- Cannabinoids are biphasic. This means that they can have two different effects at different dosages. THC, for example, can beat anxiety in low doses but cause anxiety in higher doses. The cannabinoid THCV (tetrahydrocannabivarin) can inhibit the psychoactivity of THC in low doses, but increase the psychoactivity of THC in higher doses.
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Which Medicines Does Cannabis Have a Negative Interaction With?
Cannabis can have a negative interaction with several classes of medication, in particular:
- Opioids and opiates – mixing cannabis with such drugs can increase the CNS-depressant (CNS = central nervous system) effects, causing breathing to become even shallower. Those who use cannabis to overcome painkiller addiction ought to reduce opioid/opiate use over time (called tapering) in order to reduce the chances of negative interactions, withdrawal symptoms, and long-term complications.
- Benzodiazepines, barbiturates and other sedatives – similar reasoning to opiates above. In the case of benzodiazepines, CBD desensitizes the liver enzyme that metabolizes it, called cytochrome P450 (CYP 450). This means that benzodiazepines are not processed and stay in the blood, increasing the chances of an overdose. Benzodiazepines may be prescribed for epilepsy and anxiety.
- Some types of antidepressants, such as sertraline (Zoloft) and fluoxetine (Prozac), may have negative interactions with cannabis. Older antidepressants and mood disorder medications such as amitryptyline, dosulepin and monoamine oxidase inhibitors (MAOIs) such as monoclobemide and phenezine tend to have more negative effects than newer antidepressant medications.
- Steroids – CBD desensitizes the action of the liver enzyme CYP3A4 (a subtype of CYP 450), meaning it can inhibit the processing of drugs like prednisone.
- The desensitizing of the liver enzyme CYP2E1 also makes a cannabis user more sensitive to alcohol (ethanol).
- Cannabinoids can effect the immune system, dampening inflammation. Cannabinoids can therefore act as a immunosuppressant. Combined with its liver enzyme desensitizing properties, CBD in particular can interfere with immunosuppressant drugs.
- The immunosuppressant effects of cannabinoids must also be taken into account for those undergoing immunotherapy for cancer, as this can be a negative interaction.
How Many Ways Are There to Consume Cannabis?
Put simply, plenty! Here are some of the ways to consume cannabis:
- Vape pens
- Smoking using rolling papers.
- Pipes and chillums
- Bongs and water pipes
- Dab rigs – used to heat concentrates
- Hot knives
- Rick Simpson Oil (RSO) – a readily-carboxylated, highly concentrated, viscous cannabis extract that can be ingested. Often taken in small doses.
- Tinctures – cannabis-infused oils, usually olive, coconut or MCT (medium chain triglyceride). Canna oil is essentially a tincture. Tinctures can also be alcohol-based.
- Pills and capsules
- Transdermal patches
- Suppositories – usually used for the ingestion of RSO, when the patient finds the effects too overwhelming
- Inhalers – could be useful for people who suffer from asthma
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Is There a “Best” Way to Ingest Cannabis?
This can depend very much on the conditions you are trying to treat. For someone who suffers from a condition like Parkinson’s Disease, for example, where tremors can occur suddenly, an ingestion method that provides immediate effects (e.g. vaping or an inhaler) may be necessary. For those who need long-term pain relief, an edible may work (be careful with edibles, and go very slow if you decide to use it this way).
Tinctures are generally considered most approachable as they can be used by a broad range of people, do not require smoking or vaping, are relatively easy to measure (assuming the labelling is accurate), take effect relatively quickly when used sublingually (usually within 30 minutes), and have long-lasting effects. Generally, most people seem to use cannabinoid-based medications in more than mode of ingestion, preferring to use both tinctures and another with more immediate effects.
Check out our article on ingestion methods if you would like to know more about the huge varieties of ways you can consume cannabis, the pros and cons of each, and how it affects you.
Pros and Cons of Medical Cannabis
Medical Marijuana Pros
- Unlike many other medications, including ones as commonplace as ibuprofen or paracetamol/tylenol, natural cannabinoids derived from the cannabis plant are far safer and are extremely unlikely to lead to a deadly overdoe when used alone.
- Cannabis can help reduce or replace the need for more addictive and dangerous medications, or medications that can make a patient feel uncomfortable in any other way. This includes medications like opioids/opiates, sedatives (benzodiazepines and barbiturates), antidepressants, anti-anxiety drugs, steroids, stimulants (e.g. Adderall), and non-steroidal anti-inflammatory drugs (NSAIDs).
- Cannabis could be particularly useful for the treatment of neuroinflammatory and autoimmune conditions, where the immune system if often out-of-control.
- Low doses of THC, balanced out with CBD, could be very useful for depression and anxiety.
- Cannabis could be very useful for the treatment of insomnia, which in turn can reduce pain, depression amd anxiety.
- Cannabis could be useful for treating PTSD.
- The cannabis plant contains up to 150 cannabinoids, many of which could have a variety of therapeutic effects, and many of which are not psychoactive. You do not have to get stoned or high to use cannabis medically.
Medical Marijuana Cons
- Although cannabis can work for many different conditions, it does not mean it is suitable for everybody. Everyone has a different endocannabinoid system, and what may work for one may not work for another. Someone with schizophrenia, for example, ought to avoid THC entirely.
- Children may be more sensitive to THC, so it should be carefully used in instances when a young person needs THC-rich cannabis. Older people,meanwhile, may find THC-rich cannabis more tolerable.
- Some people may find that cannabis’s effects are overwhelming.
- Cannabis may be suitable for chronc pain, but in some instances it may increase sensitivity to acute pain.
- Too much THC may be a negative for anxiety or depression, and prove to be more anxiety-inducing than relaxing.
- In some, rare instances of long-term, high-THC cannabis use, cannabinoid hyperemesis syndrome (CHS) can occur. In CHS, chronic use of THC can result in nausea/vomiting (the opposite of its usual effects), abdominal pain, lack of appetite and unhealthy weight loss.
Why Should I Get a Medical Marijuana Card?
There are several good reasons to get a medical marijuana card, including:
- Less tax to pay on products at a dispensary.
- It’s the safest and most legal way to purchase cannabis in most states.
- In some states, you get access to a greater number of products and dispensaries.
- Your medical marijuana card may prove to be useful in another state via their reciprocity program.
- Many dispensaries set aside products for medical marijuana patients specifically, so they are less likely to lose access to a variety of cannabis or cannabis-based product that they need.
- Dispensaries are also more likely to hold sales for medical marijuana patients.
- Medical cannabis dispensaries are considered “essential”, whereas recreational ones are not.
- Far less hassle from law enforcement.
- Although employers are still within their right to refuse employment to a medical marijuana patient in some states, those with a valid medical need may be looked upon more sympathetically.