Saturday, February 29, 2020

March 1, 2020 Medical Marijuana/Cannabis in Utah -


I put this document together for patients and caregivers. I'm sharing here. And yes, I am an advocate for Medical Marijuana, and I use CBD (which has been legal for some time) regularly. As for THC, I am a believer. It certainly has a lot fewer side-effects than pharmaceutical pain meds.

Cannabis Fact Sheet

As legal use of marijuana grows, it is important to understand the medical benefits and medicinal qualities of marijuana, particularly the difference between CBD (cannabidiol) and THC (tetrahydrocannabinol). These are 2 compounds found in marijuana.

CBD comes from the cannabis plant as well as the hemp plant. Typically, CBD that is ingestible comes from the hemp plant. THC comes from marijuana (Indica, Sativa, and Ruderalis). THC is the psychoactive compound that provides the “high.” Both interact with the body’s own endocannabinoid system, with different effects. However, CBD from hemp and cannabis both have the exact same chemical structure. The molecular arrangement means they each have a different impact on the body, particularly with the neurotransmitters in the brain (responsible for transmitting messages between brain and body cells). With that said, below is a simple graph explaining CBD and THC.

CBD                                                                                                         THC

Cannabidiol – Hemp or Marijuana (Can produce a minute amount of THC), no more than 0.3% THC.
Marijuana (Average strain has 15% THC; although marijuana sold on the street is typically 2-5%)
Non-psychoactive (No High)
Psychoactive (High)
Suppresses
Enhances
Legal in all states (although whether hemp or cannabis derived may cloudy the picture).
Legal in 29 states + DC for medical, 9 + DC for personal use.
Legal in Utah (however, cultivating, processing, selling most be licensed).
Legal to use medicinally in Utah, at a medicinal marijuana pharmacy, with a cannabis letter.
Typical ratio is 10 parts CBD
To 1 part THC
Used for: seizures, inflammation, pain, nausea, migraines, depression, anxiety (does not increase appetite).
Used for: pain, muscle spasms (not seizures), insomnia, appetite enhancement, nausea, anxiety (to enhance the effects of CBD).
Available in: gels, gummies, oils, supplements, vape.
Available in: edibles, tinctures, capsules, oils, vape, “weed.”
Reactions: Zero to minimal drug-to-drug interactions with medications.
Reactions: Increased heart rate, coordination, dry mouth, red eyes, slow motor abilities, memory loss. Also increases risk of psychiatric disorders.
Stored in the body’s fat; can show on a drug test for several days or weeks after use.
Stored in the body’s fat; can show on a drug test for several days or weeks after use.
Considered safe when used properly.
Considered safe when used properly.

Buying CBD and THC:

In Utah, anyone can purchase hemp-derived CBD products, yet marijuana-derived THC products can only be purchased from a state-approved dispensary. Whether hemp or cannabis (marijuana) based, CBD is CBD is CBD. A simple web-search for “CBD to purchase” brings up more than 45 million results. So, be careful. The best way to find credible sources is to glean information from friends and family, and of course, your healthcare provider. Make sure your healthcare provider knows you are using/interested in using CBD and/or THC. You may be able to receive a letter/cannabis card from your physician. This letter suggests that you may receive benefits from CBD/THC. This letter holds no legal value, yet may be a safety device for you, as well, it gives you the opportunity to purchase from a medicinal dispensary as opposed to a recreational dispensary. This letter will be valid through 2020, with a card being the only form of “prescription” beginning in 2021.

In order to get the correct compound for your needs, you will need to understand the strength and concentration of the product as well as other additives (terpenes, essences, oils) to the compound. Oils, edibles, topicals, and vaping are the most popular forms of CBD compounds.

Some things to be aware of when looking for a product are:

1.       Marketing of Rick Simpson Oil (RSO). This oil cannot be purchased. It can be made at home, growing a particular strain of cannabis and following a rigorous step-by-step process (more about RSO can be found on Simpson’s YouTube documentary, “Run From the Cure”). Rick Simpson does not sell his product, and Simpson oil is not associated with any organization that sells “Rick Simpson Oil.”

2.       Ratio of CBD to THC, and CBD to a carrier/base product, whether oil or sugar or ethanol, and if topical, is there an emulsifier/carrier added.

3.       There are many folks getting on the band-wagon of marketing and selling CBD products. Do your research. Pricing is not always an indication of quality.

Sources for Further Education:

Cannabinoid Clinical, cannabinoidclinical.com
National Cancer Institute, cancer.gov, “Cannabis and Cannabinoids”
Leafly.com
Differences between CBD and THC, echoconnection.org
Primer on CBD: Projectcbd.org
Primer on CBD/Hemp: zatural.com
Primer on Marijuana: honestmarijuana.com  
https://www.youtube.com/watch?v=0ygtX2nyexo – David Casarett TED Talk
https://www.youtube.com/watch?v=3bZb10ZxpBk The Inside Story of Cannabidiol – What are the Benefits of CBD?

Products and Resources:

Nuleafnaturals.com
Charlotte’s Web (oldest dispensary in Colorado; expensive, potent, produced by the Stanley Brothers) cwhemp.com, stanleybrothers.co
Variety of CBD products – https://www.purecbdvapors.com
Gummies – 10mg CBD with .57 THC – Pioneer Squares; Craft Elixirs; http://craftelixirs.com/products.html#edibles  Purchase in person in WA
Liberty Lixir – 1 oz. High CBD Tincture; 1 pump is 2.2 grams   https://libertylotion.com/
Hemplucid brand: https://www.hemplucid.com  Available to purchase locally
Topical – CBD based, https://apothecanna.com
Topical for Pain, Inflammation, Neuropathy – SoundLightBody.com
Good CBD Oil: https://mysoulcbd.com/

Frequently Asked Questions Regarding Medical Cannabis  2/2020

Where can I go to learn about the State of Utah and Cannabis policies and procedures?

What is the difference between Cannabis and Marijuana?
Marijuana is Cannabis; Cannabis is Marijuana. There is no difference. Typically, for healthcare purposes the term Cannabis is when talking about medical marijuana. Marijuana is recreational marijuana.

What is the best way to consume medical cannabis?
Volcanic vaporizer
Edibles, or Gummies (not gummy bears – cannot be shaped like a candy)
Sub-lingual Tinctures; typically mixed with carrier such as coconut oil or alcohol; place under tongue for absorption
Other methods include: transdermal patches, suppositories, topical creams, fresh/bud cannabis, e-cigs/vaping.

How does cannabis taste?
Do not expect any cannabis to taste good. Just like most medicines don’t taste great, cannabis carries a strong flavor of its own and often an after-taste. Anything used to cover up this taste and smell may affect the delivery and efficacy of cannabis. Even a blueberry flavored gummy is going to still have a marijuana taste to it.

Is medical cannabis covered by my insurance?
No, and medical grade cannabis is not inexpensive.

What are the side effects of using cannabis?
Often a relaxed feeling will come within several minutes of taking the cannabis. You may have a bit of sleepiness or drowsiness. You may have dry/cotton mouth, a slower reaction time, and some difficulty with problem solving. There is a possibility that your heart rate could increase. There have been very few reports of someone “taking a trip” while using medical marijuana. Just as with other medications, be careful, don’t drive, have someone with you the first time you use to monitor reactions.
The positive side effects include decreased pain, nausea and vomiting relief, increased appetite, relaxation, and reduced anxiety.

Can I overdose on medical marijuana?
Typically, there is no exact dosage; there are so many variables when it comes to choosing and using cannabis. Start low and go slow. Be mindful of your initial dose and how your body reacts to it. It is best not to use this when you are also using a new medication. There are several ways to detox if too much cannabis has been consumed; these include: drink lots of water, take a shower, sleep to wear it off, make sure there is someone with you, take a high-dosage of CBD. If you find yourself having a full-blown panic attack, difficulty breathing, chest pains, or psychiatric symptoms, get to the emergency room, and bring the cannabis with you.

Is it safe to drive while using cannabis?
Probably not. Using CBD and driving may be fine, but just like opiates, THC/cannabis can affect your reaction time and impair your judgment skills and reflexes.

So marijuana is legal then? Can anyone buy it?
Medical Marijuana is legal in the state of Utah, for use in the state. You must have a doctor’s letter and show it at the pharmacy. You must buy your medical marijuana at a state-designated pharmacy, not at the vitamin shop, herb shop, dispensary, from your friend’s friend, or online. You must have proof of residency for Utah in order to qualify for a card. Patients under 21 must be approved by the “Compassionate Use Board,” and patients under 18 must have a parent or guardian apply for a Guardian Card in addition to the Medical Marijuana Card for the patient. This card must be renewed on a consistent basis.

If I have a card, can I take cannabis with me on my flight to another state or out of the country?
No! It is acceptable to fly, nationally, with CBD. It is legal to drive with CBD in your car from state to state. It is legal to drive with THC in your car, in state, and between states that also have legalized marijuana, if you have your letter or card. However, you cannot fly nationally with THC (even with your letter), or internationally with CBD and/or THC.

Is cannabis addictive?
While addiction does exist, medical cannabis has shown to be safe for long-term use. Often there are fewer side-effects and less risk of addiction than with some other prescription pain medications, including opioids. It is nearly impossible to overdose on cannabis. However, usage and safety become lessons in addiction versus dependency. Ask your healthcare provider for differentiation.

Can I pass a drug test? If I have a card, will my employer be legally held to employing me?
Most drug tests screen for marijuana; you may test positive. It is best to let your employer know prior to having a drug test that you are taking it for medicinal reasons and show your medical cannabis card to your employer. However, this does not mean that just because you have a card, and if your employment requires you have a clean drug screen, there will not be repercussions.

Some people say marijuana is marijuana, legal or not, and that it is a gateway drug to the use of illicit and illegal substances. Is it?
As stated above, learn the difference between addiction and dependency. As well, marijuana is often not the first drug of choice; alcohol, tobacco, and prescription drugs are more favored than marijuana as gateway substances. A recent study showed that medical marijuana use reduced the opiate overdose rate by nearly 25%. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4392651/)



Volcanic Vaporizer
There are may ways to vape, and several products that are vapable. The cannabis flower and cannabis concentrates can be vaped. You must have a specific vaporizer designed for the product to be vaped.
·         Pros: Instant relief, easier on the lungs than smoking, doesn’t smell
·         Cons: Price, battery recharging, time to warm
o    Digital vaporizer, using Keurig-like pods and phone app
Inhaler
·         Pros: Discrete, self-contained, instant relief
·         Cons: Price (for cartridges), temperature sensitive, initial use, potential respiratory issues
o    Drug delivery system using pre-measured doses or cartridges (similar to an asthma inhaler)
o    Plant-based inhalation system using buds
E-pens
·         Pros: Small, inexpensive, prefilled or refillable cartridges, light taste and reduced odor
·         Cons: Typically use a high-heating system;  inexpensive models may have carcinogens that can irritate the lungs
o    Must have a low-heat
o    Made specifically for medical marijuana


My favorite CBD products and company. I've purchased from several; this company is the best. MySoulCBD.com.


Here are a couple of products some friends recommend (need to be purchased out of state).
  


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