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Currently, 26 states have legalized medical marijuana, with New York being the first state to require physicians to be trained and certified in prescribing cannabis. So what conditions can cannabis treat and how does it work?
The cannabis plant has over 100 cannabinoids, naturally occurring substances that can be purified out from the plant and made into various forms – pills, oil for vaporization/inhalation, oil for sublingual use, and creams for topical use. The human body actually has an endocannabinoid system with receptors for these cannabinoids!
The two most important cannabinoids for medical use are Cannabidiol (CBD) and delta-9-tetrahydrocannabinol (THC). THC is the component that gives you a mental “high” most associated with marijuana use, but it also has powerful medicinal properties such as decreasing pain, nausea and stimulating the appetite.
CBD, however, does not give you a “high” yet has powerful anti-inflammatory and anti-anxiety properties. Some studies point to its cancer-fighting properties as well.
A list of conditions approved for medical marijuana treatment in NY state can be found here:
If you have a prescription for medical marijuana in NY state, there are several forms available to ingest, as well as options for CBD vs THC content.
FORMS OF INGESTION:
In NY state it is still not legal to smoke the actual marijuana plant. Instead, laboratories refine the compounds from the plant into oils. These oils are then made into pills, oral tinctures, or oils for vaporization. Your local dispensary pharmacist can help you decide which form is best for you, as there are advantages and disadvantages to all of them.
Refined oils are available and commonly inhaled with vapor pens that are given at the dispensary along with the oil cartridges. Vaping cannabis oil has the benefit of giving relief within minutes of inhaling. The downside is this relief only lasts about 2 hours.
As opposed to smoking marijuana, vaporization only heats up the oil and there is no combustion of the oil. Vaporizing cannabis eliminates the creation of potentially toxic and carcinogenic compounds created by smoking the same product.
Capsules (pills) are available with different CBD:THC ratios as well (see below). When you ingest a capsule, it needs to be digested through the stomach and intestinal lining, so the effects will take anywhere from 45 minutes to 2 hours to be felt. The upside to capsules is the longer-lasting effects, which can be felt up to 6 hours after ingestion.
Oral tinctures are available to place drops of the solution under the tongue(sublingually). This route provides relief within minutes since the medicine does not need to be digested and is instead absorbed directly into the bloodstream from the mouth. This route is ideal for seriously ill patients in need of immediate relief or patients with inflammatory bowel issues or other intestinal maladies that prevent adequate digestion from the GI tract.
CBD TO THC RATIO:
Oil is refined from the marijuana plant and then reconstituted to contain the appropriate level of THC or CBD depending on the condition being treated. Typically there are 3 forms: equal CBD:THC ratio, high CBD with little THC, and high THC with little CBD. The same patient may require different ratios depending on the time of day or how they feel.
For example, anxiety may be treated with the high CBD form, as a patient would be able to take it during the day without having the “high” that would interfere with daily activity. Those patients with anorexia/decreased appetite or PTSD preventing sleep may take the high THC form at night in order to eat or sleep better.
Chronic pain is the #1 condition cannabis is prescribed for in NY state. Many of these patients find that the balanced ratio of THC:CBD works best for them. Moreover, statistics show that cannabis treatment is lowering our need for powerful and potential addictive prescription pain medication like opioids.
Most patients will have to try various dosages to find out what works best for their particular symptoms. The dispensary you bring your prescription to will offer you the various forms and discuss what may work best for your condition(s). It is possible to purchase all 3 concentrations as well as in different forms (vapor, pill) so you can find out what works best.
Your “correct dosage” can only be determined after you have tried different forms and ratios and report back to your dispensary. Then your local dispensary pharmacist can fill your needs on a monthly basis.
Of note…
Medical marijuana is still not legal federally, so you may not bring your product across state lines. Within NY state, patients should always carry their medical marijuana license with them in their wallets, just as you would your driver’s license. This federal restriction also means that your insurance will not cover cannabis, with the monthly cost averaging around $300-$400 a month depending on usage.
We expect this powerful medical treatment to be legal federally eventually, which will make cannabis not only more available for those in need but covered by medical insurance in due time.
“START LOW AND GO SLOW”
Regardless of the form or CBD:THC ratio you choose to begin with, the mantra “Start low and go slow” is important. Always begin with the lowest dosage (i.e. one puff, one pill, one drop) and wait to see how you are affected. This is the safest way to determine how much will help your condition. You can always take more if needed.