cannabis

Is Medical Cannabis Right For You?

Four experts answer common questions about the popular and controversial remedy.

Sabine Morrow Current PSL, Health & Wellness

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PHOTOGRAPH BY GETTY IMAGES

Jack Herer, OG Kush, Chocolate Hashberry, Sunset Cookies. Cannabis has come a long way since the days when we called it Mary Jane, reefer, grass, and ganja. When California legalized it for recreational use in 2016, the plant — with its healing cannabidiol (CBD) — morphed from public enemy to holistic remedy for everything from muscle aches and pain to stress and anxiety.

The history of the cannabis extends for centuries. In 1619, King James I insisted Jamestown colonists plant and export hemp to back to England to produce rope and rigging and to spin into yarn for clothing. In the United States, it was essential to commerce until the Marihuana Tax Act of 1937 essentially ended its cultivation.

It is stupefying to think the fiber with so many uses would be prohibited, but back then, lawmakers didn’t know THC from ABC.

Hemp and marijuana are varieties of the same plant species, but one property sets them apart: THC, or tetrahydrocannabinol, the psychoactive cannabinoid that gets you high. It is prevalent in marijuana, but not in hemp. CBD contains the medicinal benefits touted for marijuana. It was isolated in the 1940s and proven effective to treat epileptic seizures in the 1980s. However, it was only two years ago that the FDA approved the first cannabis-derived drug to ease severe epileptic conditions.

Today, if you need a remedy for pain and other ailments, you can find CBD in edible and topical products at a local dispensary. You can also enjoy a healthy meal or massage with CBD-infused ingredients. The options continuously expand with innovation in the industry.

We asked four experts — Elisabeth Mack, nurse and founder of Holistic Caring; Ruth A. Hill, Coachella Valley cannabis nurse navigator; Paul Cotterell, general manager of The Leaf on El Paseo in Palm Desert; and Carolyn Kates, community outreach specialist for Columbia Care — to answer some frequently asked questions about using recreational and medicinal cannabis.

What ailments do clients seek help for?
RAH: There’s a wide range. Pain of all kinds, insomnia, anxiety, and cancer treatment are the most prevalent reasons.

Medicinally, what’s the difference between cannabis and hemp CBD?
EM: The major difference is that 0.3 percent THC or less can be sold as hemp CBD, and over 0.3 percent THC is marijuana or cannabis CBD. Cannabis CBD must be sold in dispensaries. Medicinally, hemp CBD is for mild conditions like anxiety and inflammation. Cannabis CBD is the preferred starting point for people with chronic and complex diseases because a little more THC will help heal the body by activating the cannabinoid receptors.

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How can I tell if cannabis is tested and certified?
CK: Only cannabis sold in dispensaries licensed by the Bureau of Cannabis Control is considered legal. There are not certifications, such as organic or non-GMO, for cannabis. All cannabis and cannabis products sold in licensed medical dispensaries must be tested for cannabinoids, heavy metals, and pesticides.

What does it mean when the label says it’s testing at 15 to 35 percent?
CK: It is usually talking about the percentage of THC in the product.

What are the delivery methods available for cannabis, and does each offer a different reaction?
EM: There are several methods for taking cannabis into the body. Inhalation, where you could use a vape pen or smoke a joint. Inhalation has a short onset, meaning you feel the effects immediately if there is THC in the product. Inhalation wears off the quickest — so you only feel it for a couple of hours. Oral, a delivery method where you eat edibles or take capsules, has a 30- to 90-minute onset. The duration is longer, and it stays in the system for four to eight hours, depending on the dosing. Sublingual tinctures have an onset of 15 to 30 minutes, and the duration is going to be about two to six hours. Topicals are applied to the skin and absorbed through the dermis to help alleviate pain, soreness, and inflammation. Onset for a topical is a few minutes and lasts for about three to four hours. Topicals don’t enter the bloodstream.

What is the best cannabis delivery method for medicinal purposes?
EM: I prefer to begin patients with a tincture because it’s easy to calculate exactly how much of the medicine they receive. When the patient takes the tincture dropper and places it under their tongue, they should hold it in the mouth for about 30 to 60 seconds. This way the cannabis tincture gets into the systemic bloodstream with relief in about 15 minutes.

“I prefer to begin patients with a tincture because it’s easy to calculate exactly how much of the medicine they receive.”
— Elisabeth Mack,
Holistic Caring

When a client sees you, do you recommend a particular strain of cannabis during that first meeting?
RAH: Yes, I do recommend a particular chemovar or strain. For example, for [the neuromuscular disease] myasthenia gravis, the best strains are Sour Diesel, Blue Dream, or Granddaddy Purple.

Can I drink alcohol when I’m using cannabis?
EM: CBD and THC relax and open up your blood vessels, which lowers your blood pressure. Alcohol can also do the same initially, though long-term drinking will constrict the vessels and cause hypertension. Take the cannabis product, such as a tincture, and then wait an hour or two to have any alcohol. This is a medicine, and you need to keep yourself safe.

What do you tell people who see cannabis as a gateway drug?
RAH: There are as many people in the United States ingesting cannabis as smoking tobacco. Where are all the overdoses? In 2014, the Journal of the American Medical Association found that simply passing a state medical cannabis law on average reduced opioid overdose deaths by 24.8 percent.

I’ve never been to a dispensary. Can someone there answer my many questions?
PC: At The Leaf, guests are welcome to ask any questions they might have in order to learn more about the efficacy of cannabis. There are no silly questions.

How much cannabis can I legally buy from your store?
PC: Individuals above the age of 21 with a valid photo ID are allowed to purchase up to 28.5 grams of cannabis flower and up to 8000mg of THC that is packaged in either a concentrate or edible form.