Your MM Card Arrives: What Next?
Your medical marijuana card just came in the mail. You’re legal. You can get the cannabis you need to alleviate your pain, however, your card defines it. You rush to your favorite medical marijuana provisioning center.
But once there you can only gaze at the quantity and variety of tinctures, topicals, oils, capsules, edibles, lotions, and other cannabis-infused products on display on the walls and in jewelry cases surrounding you.
- Which will be of best benefit to you at the most cost-efficient price?
- Which will miss your ailments entirely?
- What is the proper ratio of CBD to THC that you need within each product to obtain the best healing benefit?
- And what’s with these other beneficial cannabinoids that you never heard of until today: Δ8 [Delta 8] THC, THCA, CBGA. CBC, and others?
- You want to buy a sufficient quantity of the meds you need at a price that your limited budget can afford. You’re worried about how they might interact with the meds you’re already taking.
So Many Options, So Little Expertise
What do you do?
Julie Barron is the cannabis counselor and dosing specialist at Blue Sage Health Consulting, the resource and education center created by Bloom City Club in 2016 to answer these questions.
She meets me in the lobby at Bloom, where I sign in, as all guests do. She leads me to her office and I sit in one of two plush sofas. Julie sits across from me in the other. An unused sofa chair in one corner enhances the comfortable scene. The Singer sewing machine next to the chair is “just for decoration.”
Typically clients come for their first visit with a support person, she begins. Often it’s a spouse or parent. “If they’re here as cancer patients, they may bring the whole family as a support team. If they’re here for a child, they often don’t bring the child because they assume that legally they can’t. I explain to them that in the future they can.”
But not every child shows interest. She recalls one teenager who spent the session playing games on his phone while his parents consulted with her.
The consultations are conducted in five parts, beginning with a review of the information they submitted on their initial consult questionnaires. “I ask them why they are looking to cannabis. What are their qualifying conditions? What symptoms are they looking to alleviate with the cannabis?”
She notes that PTSD, added last year to the list of qualifying conditions, was the first psychological diagnosis to make the list. Parkinson’s was among the eleven or twelve new conditions that were added in July. Surprisingly, attention deficit hyperactivity disorder (ADHD) has not cracked the list because it has not been the subject of enough research, despite plenty of anecdotal evidence suggesting that it belongs there.
Next she educates them. She hands me the packet that she gives to every patient. Inside are flyers, brochures, and postcards with a dizzying amount of information on terpenes, cannabidiol, edibles, and cannabinoids. I flash back to the seventies when all we cared about was the THC. A two-sided piece offers “helpful hints for your medical cannabis journey” on one side and “common ailments & treatments” on the other. A 4″ x 6″ pocket notebook provides a format to take “marijuana tasting notes” on each page.
It’s easy to see why patients new to medical cannabis are easily confused. To begin, she explains,
There are hundreds of cannabinoids from the cannabis plant, all with effects that can vary depending on how they are used. Some cannabinoids are so new to scientists that they aren’t even named yet.
- CBD can help lessen the frequency and intensity of seizures but doesn’t always eliminate them; sometimes adding THC is recommended.
- THC is good for pain and can ease the spasticity of the muscles.
- THCA and CBDA also help.
- Δ8 THC is an aged cannabinoid that is harder to get.
- CBG comes from young cannabis plants and it may inhibit cancer cell growth and help with IBD [irritable bowel disease] and Crohn’s disease.
- CBC reduces pain and inflammation and I’ve heard it is ten times better for anxiety than CBD.
But if the cannabinoid name ends in “A,” she explains, it is raw. THCA has incredible health benefits but has no intoxicating effect. “Smoke or cook THCA and it becomes THC.”
In step three, she recommends a cannabinoid profile for each client, including her suggestions for dosing and protocol. For instance, she says, suppositories heavy with THC are sometimes recommended for patients who need the medical effects of THC but don’t want the intoxicant effect. The reason: The meds are applied to the beginning of the rectum where there is a lot of skin membrane, bypassing the liver. Applying topicals directly onto the skin also does not produce a high and is often recommended for pain.
“I’ll pick the combination of cannabinoids that would be most beneficial to the client based on the client’s needs,” she explains. “Every profile is different.”
Whether or not patients heed her advice is up to them. She recalls the girl whose seizures stopped when she used full-spectrum cannabis. Unfortunately her parents stopped using it and began using the less-expensive CBD isolate, which didn’t contain the other terpenes and cannabinoids found in full-spectrum cannabis. The seizures returned until the parents went back to full-spectrum cannabis.
By the time you come in for your first session, Julie already knows what other meds you are taking because you’ve included that information on your questionnaire. She also knows how they will interact with cannabis—the topic of the fourth step in the consultation—because she has checked them against her go-to sources.
Finally, she escorts patients next door to Bloom for their first dispensary visit so she can introduce them to the staff and also give them an overview of what is available there.
In follow-up visits, which can occur any time after the initial consultation but normally occurs at the one-month point, she may adjust dosages and fine-tune her recommendations based on client experience and feedback.
Reaching Out to the Community
“There is a lack of education about cannabis in the health field,” she maintains, noting that most medical students are not trained in cannabis therapeutics. Indeed, on my way into the center, I happened to talk to a doctor who had just met professionally with Julie. “My patients are asking me about cannabis when to use it, how it will affect their meds, what to use,” she told me. “I knew I had to learn more.”
And so Julie is reaching out to the community giving workshops and lectures to share what she has learned through her research and consulting. On July 12 she presented her Cannabis 102 workshop at the monthly meeting of Women Grow.
Upcoming workshops at Crazy Wisdom Bookstore in Ann Arbor:
- Saturday, August 18 Cannabis 101
- In the Fall look for the popular CBD 101 & CBD 102 class series
- Currently in development: “Cannabis for Veterans” & “Cannabis for Seniors.”
In September, she will speak on “Natural Alternatives to Pain Relief” at Rochester Hills Library.
For more information about consulting or inviting Julie to present a workshop to your organization, contact her at firstname.lastname@example.org. To schedule a consultation, get class information, or learn more, go to bluesagehealth.com.
Follow Julie & Blue Sage Health on the web at:
Facebook page at Bluesagehealth/Facebook
Twitter at Canna.Curious @Bluesagehealth
Share with other people interested in learning more about Medical Cannabis in the ‘Healthy Living With Cannabis’Facebook Group
Ken Wachsberger, editor of Bloom Blog, is an author, editor, and book coach and the founder of Azenphony Press. He is the author of the just-released Ken Wachsberger’s Puns and Word Plays for the Job Seeker.