This guide is intended to help patients who are new to using cannabis therapeutically to treat a medical condition. Topics covered include the following:
- Qualifications to become a medical marijuana patient
- Conditions treatable with medical marijuana
- Health care providers who can legally recommend marijuana
- Steps to take after receiving a cannabis recommendation
- What is a medical marijuana card
- Why you should get a medical marijuana card
For starters, it’s important to know that many terms are used for cannabis, yet all generally mean the same thing: marijuana (used interchangeably with cannabis throughout this article and the United Patients Group site), weed, pot, ganja, and herb, just to name a few.
If you have a medical condition that is not being effectively treated with traditional drugs, medicines or therapeutic interventions, your doctor may recommend or you may be considering using cannabis for pain and symptom relief. Many questions come up for new patients. Here we will cover all of the basic ones. If you still have questions, check out the resource section of our website, or feel free to contact us directly.
Medical cannabis refers to the use of the bioactive compounds that are found in the cannabis plant to treat a host of medical conditions. This includes phytocannabinoids, terpenes, and flavonoids which science is now revealing have significant therapeutic potential. Medical marijuana use has now been legalized in 36 states in the United States. Patients in these states can access medical cannabis through legal marijuana dispensaries under the compassionate program. Each state stipulates the medical conditions that qualify for medical cannabis treatment. The Endocannabinoid System was discovered by scientists who were trying to establish the reason why the human body has specific receptors that bind phytocannabinoids. Over time science has been able to piece up the components that make up the ECS and the far-reaching effects that this system has on different physiologic functions of the mammalian body. This has taken diligent research, patience, and in some cases trial and error. Now we have enough scientifically proven evidence to confirm that the ECS plays a key role in establishing homeostasis and preventing the progression of disease in the mammalian body. When the ECS is not functioning properly, numerous other physiologic processes from the nervous to peripheral systems are consequently affected.
The ECS is made up of three basic components comprising of:
- Cannabinoid receptors
- Metabolic enzymes
Any time homeostasis is destabilized, the ECS triggers the release of enzymes that synthesize endocannabinoids to restore physiologic stability.
Cannabinoids, both endogenous and phytocannabinoid, interact with receptors to create a state of homeostasis. These receptors are embedded in cell membranes spread throughout the body. The body has different kinds of cannabinoid receptors, the CB1 and CB2 receptors are the most studied. CB1 receptors are mostly found in the central nervous system of your pet. You can also find them in connective tissues, glands, and organs. It is here that they are stimulated to alter physiological processes.
CB1 receptors are found in the following regions:
- The cerebral cortex: controls memory, thinking, and alertness
- The hypothalamus: controls metabolic processes and appetite stimulation
- The amygdala: controls emotions
- The hippocampus: aids in short term memory
- The basal ganglia: controls motor skills
- The cerebellum: controls coordination
The brain stem has a low concentration of cannabinoid receptors; this partly explains the reason why fatal overdose from cannabis ingestion is a rarity.
CB2 receptors are abundant in peripheral tissues, mostly affecting the immune system and inflammation. The process of inflammation is believed to be significant in the progression of most chronic diseases.
The major endocannabinoids in the body are Anandamide and 2-arachidonoylglycerol (2AG). These endocannabinoids bind to receptors in the brain and throughout the body. Once they bind they set off a chemical process that helps in restoring homeostasis.
Endocannabinoids are synthesized on a need basis and are quickly degraded by metabolic enzymes afterward. The ECS may get destabilized by disease processes; in this case, it may be necessary to introduce phytocannabinoids to restore homeostasis. Phytocannabinoids are similar to the body’s endocannabinoids, but they occur naturally in the cannabis plant. They abound in the resin produced by cannabis plant trichomes.
The marijuana plant has over 100 different phytocannabinoids. Delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) are the most abundant and most studied. THC binds to CB1 receptors and is able to act on the brain to cause euphoria. CBD on the other hand has a weak affinity for both CB1 and CB2 receptors.
Phytocannabinoids work together with other bioactive molecules in marijuana such as terpenes and flavonoids to produce powerful and sustained healing effects. This is referred to as cannabis synergy. Medical marijuana comes in different formulations. However, your medical marijuana state laws will dictate how you can consume cannabis for medical purposes in the state. Most states permit the following consumption methods:
- Tablets and capsules
- Transdermal patches
- Gelatinous cubes
Most states prohibit smokable forms and marijuana edibles such as infused cookies, candies, and brownies. You will need to check with your state laws for up-to-date information on what is allowed and what is not. In manys definitions, Medical marijuana, unlike CBD, contains a significant amount of THC. Both CBD and THC have significant therapeutic properties that are harnessed in medical marijuana. However, the two primary cannabinoids interact differently with the endocannabinoid receptors. Because THC binds to CB1 receptors in the brain it is able to cause euphoria. CBD, on the other hand, does not cause euphoria.
Some medical cannabis patients prefer CBD over THC because it is non-psychoactive and will not cause a cerebral high. CBD is well tolerated by most people, including children because it causes fewer adverse effects. However, this does not make CBD superior. Medical cannabis contains several bioactive molecules and is, therefore, able to offer entourage benefits.
Medical cannabis may contain THC, CBD, or a mix of cannabinoids. Your doctor or medical professional will assess your condition and provide medical advice on the most suitable cannabis products for you.
Perhaps you have heard of CBD without knowing that its full name is cannabidiol, one of the many compounds found in cannabis. Cannabis has three main compounds: cannabinoids, terpenes, and flavonoids. CBD is the second most common cannabinoid found in cannabis, following closely after the psychoactive compound THC.
CBD oil is an extract that contains CBD predominantly. It is usually available in the form of tinctures, capsules, gummies, and pills. CBD oil can also be added directly to beverages, cold salads, or foods.
CBD has a good number of therapeutic benefits, which explains why it’s attracting a lot of attention from all quarters including Big Pharma. And it has been a solid 79 years since Dr. Rodgers and his team stumbled upon this wonder molecule. Of course, years of cannabis prohibition did a lot to deter scientists from studying cannabinoids, it’s a great relief that we are nowhere. Research has led us to the point of understanding that CBD is able to exert its therapeutic benefits by interacting with the endocannabinoid system (ECS). CBD modulates the release and action of various neurotransmitters, such as serotonin, and in this way has shown possible benefits in treating the following medical conditions:
- Chronic pain
- Gastrointestinal distress
- Alzheimer’s disease
- Mood disorders
- Sleep problems
- Multiple sclerosis
- Parkinson’s disease
It is not clear whether CBD binds to any particular receptor in the endocannabinoid system; it neither binds the CB1 nor the CB2 receptor. It appears that CBD prevents the breakdown of endocannabinoids. In this way, it supports the function of the endocannabinoid system as a whole.
CBD acts like a class of psychiatric drugs known as serotonin reuptake inhibitors (SSRIs). These drugs are involved in controlling anxiety and depression because they normalize serotonin levels. Because CBD does not interact with the CB1 receptor which is found in the central nervous system, thus, it cannot cause euphoria or psychedelic effects. This comes as a huge relief for patients seeking to buy CBD oil for anxiety; you do not want to get “spacey” after taking your meds.
This may also explain why CBD has been legalized for medicinal use in many countries, unlike THC. People looking to buy CBD oil for anxiety often struggle with one pertinent question, “is CBD as addictive as benzodiazepines?” Fortunately, this is not the case. Drugs that typically cause addiction work on higher centers in the brain. CBD works in the peripheral system, away from the brain, hence it has little chance of causing dependence, tolerance, or addiction. This is why CBD oil can be a suitable alternative for traditional anti-anxiety medication. A good number of studies have been conducted to investigate the safety of CBD. Patients can now rest knowing that CBD is safe even in doses as high as 1,500 mg daily. Putting this into perspective; the recommended daily dose for CBD is about 20mg-160mg per day.
On very rare occasions, CBD may cause liver injury. Patients with pre-existing liver conditions need to get approval from a physician before starting any CBD treatment. You may have seen elsewhere on the internet that CBD, unlike THC, does not cause any side effects. This is not entirely true unless what was stated is that the side effects caused by CBD are not comparable to those caused by THC.
When buying CBD oil for anxiety, you should expect to have any of the following side effects:
- Stomach upsets
- Low blood pressure
This may not always happen, especially when you are consuming low doses of CBD. However, some patients have reported the above symptoms after taking CBD. If you or your loved one is suffering from anxiety, there are a few things that you need to consider before you buy CBD oil for anxiety. First, you get the approval and guidance of your health care provider before starting on CBD oil or any cannabis products, especially if you are treating a major ailment or are new to cannabis..
CBD interacts with a number of drugs and this may present some problems for you. So make sure you get a go-ahead from your healthcare provider. With this sorted, consider the following five factors: CBD can be sourced from hemp or cannabis. CBD sourced from cannabis may have high levels of THC.
Make sure you know the exact THC content in your CBD oil, it should be less than 0.3% if the CBD is sourced from hemp.
But, please don’t be deterred that THC or any of the other cannabinoids are bad…they all play a role in bringing the body back to homeostasis aka balance. CBD oil from plants grown inorganically may be contaminated with heavy metals, microbial, and pesticides. You should ask to view a certificate from a third-party lab that confirms that the CBD oil is free from the above-mentioned contaminants. If the producer cannot supply a recent certificate of analysis (COA), then find another product or company that can. Remember, this is YOUR body and health. Potency refers to the concentration of CBD in CBD oil. The third-party certificate is the standard proof for the CBD potency in any given CBD oil.
(I.e. 500mg, 1500 mg, 3000 mg and so on). Full-spectrum CBD is infused with terpenes that add to the therapeutic benefits of CBD. For example, a terpene called beta-caryophyllene has anti-anxiety effects. When infused into CBD oil, the anti-anxiety effects will be amplified. This is referred to as the entourage effect. Studies have shown that full-spectrum CBD produces greater therapeutic effects as compared to pure CBD isolates. When deciding on where to buy CBD oil for anxiety, you should look for customer reviews. Look at what other customers are saying about the product and their experience with the company selling CBD oil. What was their experience with customer service? What about the product, did it work? This will help you settle on the best CBD oil for anxiety that will work for you. Any individual suffering from a serious or chronic medical condition in which other traditional measures and medicines have not been effective can see a qualifying health care professional who can write a recommendation for medical marijuana or give guidance on dosing, formulations, and hand-holding as part of ongoing treatment of the patient’s terminal or debilitating condition. The physician, after completing a physical examination and documenting the medical condition in the patient’s record, will provide a written recommendation stating the patient would benefit from treatment using medical cannabis.
A recommendation is different from a prescription from a doctor that could be filled at a pharmacy. Cannabis is classified by the federal government as a Schedule I drug and therefore doctors are not allowed to prescribe it (in most cases – Epidiolex is available), but they can supply patients with medical marijuana recommendations that comply with state law, allowing patients to either buy from a dispensary or supplier or grow themselves, in specified quantities.
Besides having a medical marijuana recommendation by a state-licensed health care professional, some states also require that you show proof of residency and be 18 years or older. If you are under 18, a parent or guardian must accompany you. In California, the following conditions qualify:
- Anxiety disorders
- Chronic pain
- Crohn’s disease
- Chemotherapy Side Effects
- Weight loss in terminal illness
- Eating Disorders
- Post-traumatic stress disorder
- Lyme Disease
- Migraine Headaches
- Multiple Sclerosis (MS)
- Radiation Therapy Side Effects
- Variety of Other Chronic, Debilitating or Terminal Illnesses
Licensed medical professionals can recommend medical marijuana if you have a qualifying medical condition (now some states are adult use, meaning 21 and over, but we still recommend a medical professional being involved when it comes to properly and safely using cannabis as an option). It can be more time-efficient and is generally suggested to the first talk with your primary or treating physician, however, if this fails, there are some doctors who exclusively see patients for medical cannabis evaluations (often referred to as medical cannabis doctors). Here’s a good read on “Tips for Finding a Reputable Marijuana Clinic.”
Below is a list of various healthcare providers who can write medical marijuana recommendations in legal states (Please note: Each legal state may have varying forms of this list).
- Medical Doctor (MD)
- Physician Assistant (PA)
- Osteopathic Physician (DO)
- Osteopathic Physician Assistant (OA)
- Naturopathic Physician (ND)
- Advanced Registered Nurse Practitioner (ARNP)
Once you receive a recommendation for medicinal cannabis use, you are qualified to buy, possess, consume, transport (not across state lines or internationally), and grow cannabis, up to limits specified by each state. You are also entitled to apply for a Medical Marijuana Identification Card, although it is not required.
The next step is to find a nearby dispensary, which can be done by using the search tool on our website. On your first visit to a dispensary, you must bring in either the doctor’s recommendation or a Medical Marijuana Identification Card (MMIC) along with an I.D. that verifies proof of identity as well as state residency. With a recommendation, most dispensaries, upon your first visit, will call the recommending physician for verification.
The next step after finding a dispensary is deciding which type and strain or method of medical cannabis options are best for treating your condition and needs. There are hundreds of different types and strains of medical cannabis as well as different products, such as edibles, tinctures, tonics, etc. Again, our recommendation is to meet with a ‘qualified’ medical cannabis professional who can properly guide you. Cannabis is NOT a one size fits all type of medicine. Age, weight, current health condition, sensitivities, along with drug to drug interactions should be addressed. You will not get this with a dispensary staff members. In California and many of the states that have approved the use of medical marijuana, the State has created a Medical Marijuana Program (MMP) that is run and operated by the state Department of Public Health and/or County Health and Human Services Department. Once you qualify with a doctor’s recommendation and apply, you will be issued a medical marijuana identification card (MMIC) – (not always needed, depending on the state’s cannabis laws – California for instance in Adult Use – 21 and older). This card places you on an online state registry in which doctors, dispensaries, and law enforcement agents can easily access and verify your approval to use marijuana medicinally (many citizens prefer not to go this route). In California, cardholders who are in possession of or cultivating marijuana, up to restricted amounts, are protected under the Compassionate Use Act of 1996 (Prop 215) and SB420. An MMC can be used to validate you are legally allowed to possess medical marijuana in your qualified state. In some cases, law enforcement encounters you in possession of the approved amount of medical marijuana or less, you can show your marijuana ID card and they can immediately check its validity against the national online registry.
Note that a card provides some legal protection at the state level, however, you still are not protected from federal prosecution as the government still classifies it as a Schedule I drug. No, if you are a qualifying patient, a valid written recommendation from your health care provider is enough. As mentioned before, however, upon your first visit to a dispensary, the letter has to be verified by the physician either by phone or online. 36 states have so far put measures to legalize medical marijuana while 18 states have legalized recreational use. Other states are having similar discussions to approve cannabis medicine. However, cannabis use is still prohibited at the federal level. The federal government classifies marijuana under schedule 1 which makes it a controlled substance. This class includes compounds that do not have any known medical use and at the same time, they have a high potential for abuse. Increasingly more research is showing that most Americans are in favor of making marijuana legal for medical purposes in the U.S. Cannabinoid medicines have proven to be useful in alleviating debilitating symptoms in chronic illnesses that cause much suffering to patients. We hope that this guide to medical cannabis has provided a basic understanding of an overview of the first steps to using medical marijuana. Please consult with your medical professional who can provide medical advice on medical cannabis treatment. We encourage you to check back frequently for new health information as we continuously update our website or to contact us directly with any further questions.