Medical Cannabis Info

Patient Education

Cannabis, also referred to as marijuana, is a plant that has been used for many different purposes for thousands of years.

Medicinally, the mature plant’s flowers and leaves have been used in a variety of forms for many years. They contain a resin filled with terpenes and cannabinoids, such as THC and CBD.

THC, or delta-9-tetrahydrocannabinol, is the main cannabinoid responsible for the psychoactive effects of marijuana, THC is what gets users ‘high’. Cannabidiol, or CBD,  is non-psychoactive and is among other things a powerful anti-inflammatory, antioxidant, and antidepressant. CBD does not act on the same pathways as THC and does not cause a ‘high’.

 

Cannabis Strains and their Uses

Medical cannabis is available in more than one hundred varieties, all of which offer unique combinations of effects. Therefore,  physicians may recommend that their patients test different varieties to find the one that most suits their needs.

There are four main categories of strains: sativa, indica, sativa/indica hybrids and high-CBD varieties which are usually indica derivatives. The specific concentration of each cannabinoid is different by plant and strain. It is important to note that much of the information on strain-specific effects is anecdotal. Studies are now being designed that will shed new light on the following generally-accepted strain specific effects.

SATIVA

The sativa strain, native to tropical climates, is tall and tree-like with thin leaves. Sativa strains tend to mentally stimulate and energize the patient, making it suitable for use during daytime hours. Patients may also experience feelings of euphoria when taking sativa cannabis.  The sativa strain is thought to be helpful for treating problems such as:

  • General abdominal complaints
  • Depression
  • Headaches
  • Fatigue
  • Lack of Appetite

INDICA

The indica strain was first grown in temperate climates. Indica strains are shorter and have broader leaves than their sativa counterparts. Those who take an indica strain may experience a sedated or relaxed feeling, so patients usually get the best results when taking it at night. Indica can be very useful in treating:

  • Anxiety
  • Insomnia
  • General Pain
  • Muscle Spasms

SATIVA/INDICA HYBRIDS

The most commonly used cannabis strains are sativa/indica hybrids. Growers created various hybrids to give medical cannabis patients the benefits of both sativa and indica for optimal results. Each hybrid is typically either a sativa or indica dominant crossbreed. Hybrids tend to work well for treating:

  • Lack of Appetite
  • Nausea
  • Auto-immune disease
  • Insomnia
  • Depression

HIGH CBD

The cannabis varieties in this strain have been laboratory tested and were found to have high cannabidiol, or CBD, levels. High-CBD strains offer several health benefits without a large degree of psychoactive effects, allowing patients to work and drive while taking therapeutic doses. Medicinal high-CBD strains are an excellent option for people who need to treat:

  • Anxiety
  • Inflammation
  • General Pain
  • Seizures

Products and Consumption Methods

There are multiple dosage methods for cannabis usage including: inhalation, ingestion, and topical applications. Each method produces a unique medicinal effect.

Using Medical Cannabis:  Start Low and Go Slow

The basic principal for dosing medical marijuana is to start with a low dose and to go slow in taking more until the effect of the first dose is fully realized. The effects of cannabis are not always immediately felt.  Starting low and going slow allows patients to accommodate for the different experiences they may have.

Cannabis has a wide margin of safety and there is very limited risk of overdose. However, caution is warranted until a patient fully understands the effect the cannabis may have. Dosage varies greatly among patients, even when treating the same condition.

There are many factors that impact the effect, including:
  • Dosage
  • Strain used
  • Method of consumption
  • Environment/setting
  • Experience and history of cannabis use
  • Biochemistry
  • Mindset or mood
  • Nutrition or diet

Inhalation

Takes Effect in 1-5 Minutes
Effects Last 1-4 Hours

Many patients choose to inhale cannabis via a rolled joint, pipe, or vaporizer because these dosage methods are convenient and fast acting. However, respiratory tract irritation may be a short-term side effect. Current research finds that the long-term side effects of smoking cannabis are minor, however habitual and heavy smoking of cannabis may cause phlegm production, bronchitis and chronic coughing. Cannabis smoke is known to contain substances that may cause cancer, called carcinogens. However,  when studied at a molecular and cellular level, the cannabinoids in marijuana are shown to lower the effect of the smoke’s carcinogens and no verified cases of lung cancer or other lung diseases have been found in cannabis smokers.

Kief and hashish (or hash), are two popular popular cannabis products. Kief is a powdered substance made from the resin glands of marijuana plants. Kief is compressed to create hash. Hash has a paste-like texture and a THC content that rages from 15 to 70 percent. Kief and hash may be inhaled or ingested.

Extracted from mature cannabis foliage, hash oil is a combination of the resin and other essential oils. Hash oil ranges in THC content from 30 to 90 percent. This oil can be added to food or smoked in a joint, pipe or specialty hash pipe.

Ingestion

Takes Effect in 1-2 Hours
Effects Last 6-8 Hours

Cannabinoids reach maximum potency when heated, and they are fat-soluble. Therefore, cannabis may be added to many drinks and foods. Heat is necessary to create active THC and CBD. Since ingested cannabis is processed by the body’s liver, patients may experience stronger and longer-lasting psychoactive effects, especially when using products high in THC. The most common ways to ingest cannabis are through:

  • Edibles come in many different forms, including cookies, gummies, brownies, chocolate bars, granola and more.
  • Cannabis butter, which is cannabinoid-infused butter;
  • Cannabis oil, which is made in a similar manner to cannabis butter, but it is a blend of cooking oil and cannabinoid resins;
  • Cannabis beverages, which includes coffee and tea. Since the cannabis resins are not soluble in water, some form of oil must be added to coffee or tea to ensure that the resins dissolve in the beverage.

Another ingestion method is via a cannabis tincture. As concentrated cannabis liquids, cannabis tinctures take effect in 5-30 minutes with effects lasting 1-6 hours. The fastest way to introduce a cannabis tincture to the body is by holding a few drops under the tongue for one minute before swallowing the liquid. This product has a low odor, and it is easy to dose. Tinctures also come in sublingual sprays.

Medical cannabis is also available in pills and sprays, with effects that are very similar to those resulting from the preparations above.

Topical

Takes Effect in Varying Times
Effects Last for Varying Times

The plant and its oil extracts can be added to lotions, salves and balms to make topical products. Topical cannabis does not create psychoactive effects in patients. These products are effective at reducing pain and inflammation. Topical cannabis can treat numerous ailments, such as:

  • Allergic Skin Reactions
  • Inflammation
  • Muscle Strains
  • Post-Herpetic Neuralgia
  • Swelling

Additional Notes:

Although cannabis has an extraordinary record of safe and effective use spanning many centuries, it is important to use as little as is needed to achieve the medical benefits for which it was recommended by your doctor. Less may well be more when using medical cannabis. Bear in mind that cannabis has a biphasic dose-response curve, which means that symptoms that are improved by using cannabis at low doses may be exacerbated, or made worse, when it is used in high doses. Nausea is a good example of this. At low doses, marijuana can prevent nausea, while in high doses, it can create nausea or make it worse.

Storing Medical Cannabis

Proper Storage of Medical Cannabis is an absolute must to maintain potency.  The freshness and potency of your medical cannabis will rely on four important items:

  1. Handling: Too much handling of medical cannabis will cause trichomes to fall off, minimize handling only to time of consumption.
  2. Light: Trichomes can be destroyed by light, store your medical cannabis in a dark place.
  3. Air: Medical cannabis will dry out when exposed to air.
  4. Heat and Moisture: Heat will dry out medical cannabis and moisture will promote bacteria growth which can be dangerous.

One of the best storage methods for medical cannabis is an airtight mason jar with a good seal. If you do not have access to a jar and must use a bag, the best suggestion is to put medical cannabis in a brown paper bag and then in a plastic bag. It is also helpful to remove as much air as possible.

Store your medical cannabis jar in a cool dark place. Medical cannabis can be stored in the refrigerator but the freezer is not recommended. The freezer will actually freeze your medical cannabis and make the trichomes fragile thus making it easier for them to fall off.

Another suggestion is to create both short and long term storage containers for your medical cannabis. Separate your typical daily supply from your long term supply.

Medical Cannabis Safety and Resources

Additional safety and responsible cannabis use resources from the Illinois Department of Public Health can be found with the links below.

Drug Facts – Marijuana (National Institutes of Health)

Mind Your Meds – Basic Medication Safety Tips