Taking Cannabis as Medicine: What You Should Know

CANNABIS CULTURE- Here at CCHQ (Cannabis Culture Headquarters), we are always after the most in-depth, expert analysis to help you, our tribe, get all the facts. In this spirit, meet the newest columnist to harmonize in the Cannabis Culture chorus, Doctor Frank.

Whether we like it or not, and regardless of the evidence, many people still find putting the words “medical” and “marijuana” together difficult. Images of colorfully-dressed people sitting in a circle, passing joints and laughing uncontrollably isn’t most people’s idea of “medicine”.

Yet, the evidence is there and the numbers of people suffering from all sorts of conditions raising their hands and saying, “Yes, medical marijuana does help me feel better,” is rising. Many of these people were once ardent sceptics as well, pushed to trying out cannabis after years of pain and balking at the idea that marijuana could indeed be medicine.

However, sceptic or not, there are still lots of things you should know about cannabis as medicine. Here we answer those questions you might be asking …

I don’t want to get high – I just want the CBD

Ever since it came out that CBD had just as many – if not more – medical applications as THC and didn’t have the same psychoactive effects, many people thought, “Well, that’s great. I don’t need THC anymore.” Well, those people are to put it bluntly, wrong. Cannabinoids work best together, not separately, in what is known as the “Entourage Effect.”

Essentially, THC helps CBD do its job properly. Why this is precisely the case, nobody knows, but many suspect it’s because THC “opens up” and allows CBD to pass through cells a lot more easily. There is also the fact that THC has significant therapeutic properties of its own, such as being a very good painkiller and potentially even fighting away plaques – abnormal clusters of protein fragments – caused by neurological conditions like Alzheimer’s.

I don’t want to smoke medical marijuana. Can I use edibles instead?

The number of times first-timers have made a trip to hospital after a bad experience with edibles is countless. Even ardent marijuana enthusiasts who have been using cannabis for decades have been known to be put down by edibles.

Why is eating marijuana so much stronger? Marijuana is a lot stronger when eaten, as delta-9 THC is converted to 11-hydroxy-THC when it is metabolized by the liver. This form of THC passes through the blood-brain barrier a lot more easily, and the effects can last several hours due to the THC making its first pass through the liver and then the brain – smoked or vaporized marijuana bypasses the liver and goes straight to the brain.

Microdosing edibles is seen as a way of avoiding the negatives of edibles, but it is by no means necessarily the best way to ingest cannabis for everyone. First-timers really ought to try out vape pens and the like first, as the effects just aren’t anywhere near as overwhelming for most people. There is also no evidence so far linking smoking cannabis without tobacco to the chances of developing cancer, so don’t be afraid of smoking it’s the method of ingestion that suits you best.

Should you insist on edibles, tinctures might be the better choice: they can be measured easier, you can take small amounts at a time to test the waters, and you can cook with them, too! Another thing to remember is that the fat- or oil- base (e.g. butter, olive oil, MCT oil, coconut oil etc) in edibles and tinctures also has an effect on how cannabinoids are absorbed by the body, with people preferring one oil base over another.

Why should I use medical marijuana? What makes it better than pharmaceuticals?

Whilst it is important to state that medical marijuana will not necessarily replace all of your prescription medications, it can definitely help with replacing or reducing the intake of addictive opioids, barbiturates, benzodiazepines and amphetamines that are being prescribed at the moment. Medical marijuana may also be faster acting as a mood stabilizer than antidepressants.

Furthermore, medical marijuana is significantly safer than many of these substances – there haven’t been any deaths caused by a cannabis overdose alone, whereas there are plenty of deaths associated with prescription pharmaceuticals. If you want to check out some of the conditions MMJ can help with read them here.

What is the endocannabinoid system (ECS)?

Everyone has a different endocannabinoid system (ECS), which is a group of receptors located in the brain and peripheral and central nervous systems. The ECS is intimately involved with homeostasis – that is, keeping the human body in balance.

The ECS has a role to play in the functioning of the immune system, pain-sensation, appetite, mood regulation, exercise and memory. There are two main receptors: CB1 and CB2. Though there is still lots of debate surrounding where these receptors are found in the human body, it is thought that CB1 receptors are found in greater concentrations in the brain, and CB2 receptors in the digestive and immune systems.

What is the right ratio of CBD to THC?

Seen products labeled with ratios like “20:1 CBD:THC”, “1:1 CBD:THC”, “0:5 CBD:THC” and so on? These are cannabinoid ratios. You will sometimes see other cannabinoids (e.g. CBN, CBG, CBC) listed as percentages, but these other cannabinoids are not found in as great concentrations as THC and CBD are. These other cannabinoids also determine the effect a strain or extract has.

With everyone having a different ECS, it stands to reason that different strains and cannabinoid ratios will have different effects for different people. Though there may be some “general rules”, we haven’t got the research yet to state what sort of cannabinoid ratios work for whom and for what condition. On the most part, it seems that the general rules are:

​•​High THC:Low CBD = significant psychoactive effect
​•​Equal THC:CBD = some psychoactive effect, depending upon percentage of THC. CBD “graduates” the high caused by THC, and many people report this ratio as being useful therapeutically
​•​Low THC:High CBD = little to no psychoactive effect, although it must be stated that having some THC helps CBD work more effectively

Don’t forget about the terpenoids and flavonoids

In all the talk about cannabinoids, people often forget about the effects the smell and flavor of medical marijuana have. Moreover, they also influence the way in which cannabinoids behave and the effects they have, even when CBD:THC ratios are the same.

This is one of the reasons why whole plant extracts are often considered to be so much better quality – they retain all of their natural cannabinoids, terpenoids and flavonoids without the need to add synthetic flavorings and the like. Whole plant extracts also seem to be more effective than synthesized/semi-synthesized cannabis extracts as a medicine, although more research needs to be done in this area.

What about hemp extracts?

Hemp has lots of beneficial cannabinoids. However, most hemp extracts come from hemp that is industrially farmed, meaning heavy metals, pesticides and all sorts of nasty pathogens getting on them. Extracts from hemp are also often made using the sticks and stalks of the plant, whereas the oils and extracts you see in good dispensaries are made from marijuana flowers. The difference in quality is striking, and most people will hesitate to call any industrially-farmed, hemp-based extract medicinal in any way.

How do I choose a good dispensary?

Dispensaries in California can often find themselves between a rock and a hard place. They are targets for law enforcement agencies, and the complex rules in different jurisdictions can make setting up a dispensary difficult. Sadly, some use this lack of regulation to make a quick buck. Should you suspect that a dispensary doesn’t look after its products properly (e.g. bad/misleading advertising, moldy flowers, lack of lab testing), let your money talk and walk away. There are plenty of dispensaries doing a good job who need your support.

What are the negative side effects of MMJ?

Though there is little to no chance of dying from cannabis ingestion, and opium- or alcohol- like withdrawal symptoms or overdoses are near on impossible (the ECS prevents the “overloading” of THC via a feedback system), there are some negatives.

Ingesting too much at once could see you end up over the toilet bowl, and long-term marijuana users may (rarely) form a condition known as Cannabis Hyperemesis Syndrome (CHS). CHS causes nausea, cramps and abdominal pain. The only known cure for Cannabis Hyperemesis Syndrome is stopping cannabis use, although topical capsaican cream could help as the heat activates proteins in the stomach that prevent vomiting.

Hopefully, this answers your main questions and concerns about medical marijuana. Should you want to know more and/or want to get yourself a medical marijuana card, feel free to check out doctorfrank.com!


About Doctor Frank:
Dr Frank D’Ambrosia is one of the US’ leading voices for medicinal cannabis policy reform. Through his medical practice, he aims to empower and educate people on the benefits of the substance for countless ailments.

Five years ago, Dr Frank became fascinated with the science of cannabis and it’s success in relieving medical conditions such as depression and head trauma. He began to explore the possibilities of marijuana as medicine. After 30 years of treating and operating on patients, many of whom would never find relief from their chronic pain, Dr Frank decided to dedicate his practice to helping patients through medical cannabis. His practice now counsels patients all over the country, daily, on the use of marijuana to manage pain.

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