Medical Cannabis (Marijuana) Frequently Asked Questions, St. Louis, Missouri

For very sensible and valid reasons the medical cannabis (marijuana) healthcare space produces a number of frequently asked questions, especially throughout Greater St. Louis, Missouri.  This section below speaks to the more popular questions or concerns about medical cannabis.   However, first it should be acknowledged that medical cannabis can be an effective medication used by patients across the globe to alleviate symptoms that sometimes do not respond to conventional healthcare treatments. Multiple studies have shown cannabis has unique therapeutic properties and tends to result in far fewer and less severe side effects than many commonly prescribed pharmaceuticals or over the counter drugs.

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What is marijuana?

Marijuana, which can also be referred to as weed, pot, dope, or cannabis, is the dried flowers and leaves of the cannabis plant. It contains mind-altering (psychoactive) compounds like tetrahydrocannabinol(THC), as well as other active compounds like cannabidiol(CBD), that are not mind-altering.  Marijuana comes from the cannabis sativa plant’s dried buds and leaves. It can be ingested in multiple ways: smoking, vaping, oral liquid(tincture), oral spray, topical ointment, edibles, tea, pill form, or concentrate. 

The term “medical marijuana” refers to the plant’s whole, unprocessed use or using extracts of the plant to treat specific health conditions and their symptoms. Depending on why you need this medicinal herb, your treatment can be short-term or long-term.

How Does Medical Marijuana Work?

The amazing healing properties of marijuana come from the 200 or more biologically active compounds in the plant.  This includes flavonoids and terpenes as well as CBD and THC. Typically, the combination of these diverse compounds produces an “entourage effect” which allows a synergistic relationship between various cannabis plant compounds and your body’s endocannabinoid system.  

While the plant’s psychoactive compound THC is what recreational users are typically after, it’s the “entourage effect” in medical marijuana that makes it therapeutic and beneficial to those suffering from chronic illnesses. Medical strains also tend to have higher CBD:THC ratios. 

To accommodate the needs of medical patients, growers are starting to produce higher CBD-level and lower THC-level cannabis plants for use through seed exchanges and plant breeding techniques.

Before you start medical cannabis therapy, it helps to learn more information about ithe plant and how your own endocannabinoid system functions. The following are some of marijuana’s compounds and their effects:

  • CBD: This is one of the more important compounds for medical use in cannabis. It some cases it can relieve anxiety and nausea, reduce inflammation, help treat chronic pain, and can sometimes reduce severity and frequency of seizures.
  • CBC: This can help relieve pain when combined with THC due to its mild sedative effect.
  • CBG: This compound has a sedative effect and antimicrobial properties.
  • CBN: Can have neuroprotective effects. CBN can also sometimes reduce seizure frequency. However, it may produce a mild “high” sensation.
  • THCV: A newer compound discovery that may help with type 2 diabetes and metabolic disorders.

Breeders are continuously adjusting their hybrid blends to balance out different compounds in each marijuana type. These adjustments help breeders to create medical cannabis that targets specific symptoms and types of therapy.

Will I Get Addicted to Marijuana?

If you’re using medical cannabis for your disabling and chronic symptoms, you may question whether this medication is safe for long-term use and/or if it’s addictive. Conducted studies show cannabis is be safe for long-term use with fewer adverse side effects and less risk of addiction when compared to chronic use of prescription drugs like opioids.

We recommend using medical cannabis under the direction of a cannabis physician, following micro-dosing practices and re-evaluating tolerance and side effects periodically in order to limit medication dependence and prevent withdrawal.

Marijuana dependence does exist but withdrawal tends to be milder than many other addictive prescription medications, such as opioids.  Many people describe it as being similar to caffeine withdrawal- if they experience withdrawal at all. Withdrawal symptoms can include irritability, sleeplessness, lack of appetite, cravings and anxiety. 

When using the medication on a regular basis, it can become part of your routine and  some patients develop psychological dependence. According to the National Institute on Drug Abuse, individuals who start to use cannabis before they turn 18 years old are four times more likely to depend on the drug than adults.

Warning signs of an unhealthy dependence on medical cannabis may include:

  • Missing out on work or activities because of it
  • Not being able to function without it
  • Causing you to engage in troublesome behaviors(making illogical decisions, taking on risks you wouldn’t normally accept, etc).

It is important to note while no deaths have occurred due to marijuana overdose, moderation is essential. You can avoid this type of dependency by working a treatment plan out with your cannabis-trained physician. Also, keep in mind those using medical marijuana responsibly to treat their health conditions like chronic pain show an improvement in their quality of life and are typically able to stop use of other more addictive medications like opioids.

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Is Cannabis a Gateway Drug?

You may have heard claims cannabis use is likely to come before the use and addiction of other illicit and licit substances. In fact, you’ve probably already heard of the marijuana gateway drug theory from those supporting this misconception. These people claim smoking cannabis naturally leads to harder drug use, but what they didn’t mention is marijuana isn’t the first drug of choice by teens.  While marijuana is typically the first “illegal drug” teens (and others) use, it is still fourth on the choice of drug list they use. And, looking at this “Gateway Theory”, you’d see pot isn’t the guilty party here. The order of use is:

  1. Alcohol: Teens abuse alcohol the most and more than 26 percent of 12th-grade high school students report getting drunk in the last month.
  2. Tobacco: Next on the list is tobacco which follows closely behind alcohol.
  3. Prescription Medications: Not surprisingly, teens tend to favor prescription drugs. Popular prescription medications used include:
  • Vicodin
  • OxyContin
  • Sedatives
  • Cough Medications
  • Adderall
  • Ritalin

They’re probably third on the list since many teens can easily get them from their medicine cabinets at home.

  • 4. Cannabis: Coming in fourth on the list is cannabis. Public perception of the drug does seem to have an influence, but since the legalization laws in some states, teen use appears to be dropping significantly.

Some studies even show cannabis can serve as an “exit drug.”  In a California study of 350 people, 40% of people used cannabis as  a substitute for alcohol use. Considering alcohol withdrawal can result in death, we consider this to be a step towards harm reduction.- Reiman, Amanda. “Cannabis as a substitute for alcohol and other drugs.” Harm Reduction Journal 6.1 (2009): 35

What about Medical Marijuana vs. Opioids?

Among the biggest public health issues facing Americans is the opioid crisis. Opioids not only serve as a gateway drug to harder drugs like heroin, but they can also lead to addiction — and worse, overdose. Every day, health officials are searching for a solution to this ever-growing problem, and medical marijuana may be part of the solution.

It only took a little more than an hour for the mention of medical application of marijuana as a solution to the opioid epidemic by subcommittee members in a Senate hearing. A cited NIH study found states legalizing medical marijuana showed an almost 25 percent reduction in annual opioid overdose mortality. 

Citation: Bachhuber MA, Saloner B, Cunningham CO, Barry CL. Medical Cannabis Laws and Opioid Analgesic Overdose Mortality in the United States, 1999-2010. JAMA InternMed. 2014;174(10):1668–1673. doi: 

Since the legalization of medical marijuana in the U.S., the drug hasn’t shown any signs of being a gateway drug. Numerous studies show criminalization and prohibition are primary factors leading to the use of harder drugs. Prescription medications seem to be the most harmful step toward drug abuse. Prescription drug fatalities, in general, are greater than firearm and vehicle accidents combined. More than 130 people die every day from opioid overdose in the US- Source: NIH website 

What Are the Side Effects of Medical Marijuana?

Regardless of whether people use it for its euphoric or therapeutic properties, it has the potential of producing a variety of psychological and physical side effects. Not all people experience the same effects. The reactions often depend on what type of marijuana you consume and the way you consume it. Still, it’s a good idea to have some knowledge of potential side effects of the drug in case you do experience any.

Marijuana’s main effect many people are already familiar with is its euphoric “high” which is a psychoactive response to the THC in it. The cannabinoid THC gets into your bloodstream, eventually interacting with your brain cell receptors. If you don’t want this euphoric side effect, you can find strains low in THC and high in CBD.  Cannabis strains containing high THC amounts may:

  • Impair body movement and slow reaction time
  • Cause dizziness, disorientation and alter your senses
  • Cause sleepiness and drowsiness
  • Cause memory issues and difficulty problem solving
  • Create “cottonmouth” — the term used for dry mouth
  • Increase heart rate and blood pressure

The amount of cannabis you consume with THC impacts the length of time it takes you to develop these effects. For those who are seeking marijuana’s natural health benefits without the psychoactive effects, they can choose strains with little or no THC.  The CBD cannabinoid is also commonly found in cannabis and hemp, and it does not have psychoactive properties like THC. The side effects of medical cannabis tend to be mild. However, black market synthetic cannabinoids are another story. Synthetic weed typically imports from Asian countries and sells by the names:

  • Herbal incense
  • Potpourri
  • Plant food
  • K2
  • Spice
  • Joker
  • Black Mamba
  • Kush
  • Kronic

Synthetic weed is not natural like regular marijuana. Rather, it’s a synthetic powder manufactured in a lab and imported to the United States where retailers then spray it on spices, herbs or leaves. You smoke it just like you would weed. It also binds to your body’s cannabinoid receptors like marijuana, but it can be up to 1,000 times stronger than regular weed, making it very dangerous. While you can’t overdose on genuine marijuana, you absolutely can overdose on synthetic weed.

Is Medical Marijuana Legal in My State?

Even though marijuana continues to remain federally illegal in the U.S., numerous states including Missouri have made the drug legal for valid medical reasons.  With a doctor’s recommendation and a state-qualifying medical condition you can:

  • Get a Missouri medical marijuana card
  • Gain authorization and entry into medical cannabis dispensaries
  • Buy medical cannabis products

California was the first state in the union to legalize medical use of cannabis as voters in the state passed Proposition 215 in the year 1996. The Institute of Medicine, responding to California’s Proposition 215, issued a report analyzing marijuana’s potential therapeutic uses. According to the report, there was potential therapeutic value found by scientific data of cannabinoid drugs, especially THC, for:

  • Controlling nausea and vomiting
  • Relieving pain
  • Sedation
  • Stimulating appetite

Cannabis continues to be a Schedule I substance at the federal level under the Controlled Substances Act. Under this act, Schedule I substances are believed to have no accepted medical use and a higher potential for addiction. This makes cannabis distribution a federal offense. However, in 2009, the Obama Administration encouraged federal prosecutors in a memo to not prosecute individuals distributing cannabis for medical reasons conforming to state law.

Attorney General Sessions, in January 2018, issued a memo regarding marijuana enforcement allowing federal prosecutors the ability to decide how they’d like to prioritize federal marijuana law enforcement. They encouraged U.S. attorneys to weigh all relevant factors such as:

  • The seriousness of the crime
  • The cumulative affect the crime has on the community
  • The Attorney General’s federal law enforcement priorities
  • The criminal prosecutions deterrent effect

To stay safe, go over your legal medical cannabis laws and state qualifications thoroughly. Each state legalizing medical marijuana has its own process involving how you obtain your medical marijuana card. Each state has rules involving its medical marijuana program and whether you can benefit from — and are approved for — medical cannabis to treat your health condition and improve your quality of life.

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What Conditions Can Be Treated With Medical Marijuana?

People are increasingly recognizing the benefits of medical marijuana and are using it to relieve their suffering and improve their quality of life. Those struggling with a chronic medical condition may finally get the relief they need with cannabis products, after failing to improve on traditional treatments.

Many ailments and conditions have been approved by states for the use of medical marijuana. Some common conditions medical marijuana helps treat include:

  • Arthritis

Many arthritis patients are now seeking out medical pot to help relieve their symptoms. With marijuana treatment, they are experiencing outstanding results, including:

  • Improved movement
  • Less pain
  • Less need for other medications
  • Chronic Pain

Many conditions can cause chronic pain, including:

  • Back and neck pain
  • Fibromyalgia
  • TMJ disorder
  • Chronic regional pain syndrome
  • Sciatica

Doctors usually prescribe opioid narcotics like Percocet and Vicodin to treat severe chronic pain. Narcotics and opiates can relieve severe pain effectively, but they come with significant harsh side effects and are highly addictive. Medical marijuana is an effective treatment for chronic pain, is much safer than opioids and works synergistically with opiates to reduce or eventually stop use of opiate medications. 

  • Cancer

Strong studies researching medical cannabis show it has promising results as an adjunctive treatment for cancer-related symptoms. This includes treatment of chemotherapy-induced nausea and vomiting, pain, weight loss, appetite loss, and anxiety.  

Although there are interesting studies exploring medical cannabis and anti-cancer properties, there is much left to be discovered.  At this time, medical cannabis is not a replacement for conventional cancer treatments such as radiation or chemotherapy and should only be used as an adjunctive therapy to conventional treatment reigmens. 

Other Conditions

Some conditions aren’t as common, but medical marijuana might still provide relief for:

  • Neuropathy
  • Tourette Syndrome
  • Amyotrophic Lateral Sclerosis(ALS)
  • Insomnia

The list of common and uncommon medical conditions cannabis treats goes on and on. You can refer to our comprehensive list to see if you can relieve your symptoms of your health condition with this powerful plant.

How Do I Consume Medical Marijuana?

Once you obtain your recommendation and/or card, you’re qualified to enter marijuana dispensaries and purchase cannabis products. With so many consumption options available to you, you might be wondering, how do you ingest medical marijuana?  While smoking cannabis is a popular method of treatment delivery, there are various other alternative methods of delivery.

Ways to take medical marijuana include:

  • Edibles
  • Topicals
  • Tinctures
  • Vapors
  • Transdermal patches
  • Suppositories
  • Dabbing
  • Ingesting fresh cannabis
  • Cannabis beverages

If you are searching for a healthy way to consume cannabis, there are some things to consider:

    • Smoking: We do not recommend this ingestion method. When you smoke marijuana, you need to burn it, and this produces waste products. Usually people smoke through a pipe, bong or joint.  When you smoke, tar and other harmful by-products get into your lungs. Inhaling hot air is harmful to your lungs and throat, too. Mucous membranes line these organs and are supposed to stay moist. Hot air, however, dries them out, causing irritation. Dry mucous membranes can become damaged easily allowing infections to set in.  In patients who smoke cannabis we can see recurrent laryngitis and bronchitis. The good news is with cessation of smoking cannabis, this damage usually heals itself. Onset: 2-3 minutes. Duration: around 2-3 hours.
    • Vaporizing: We do not recommend this ingestion method. When vaporizong you’re not breathing in hot smoke, but rather moist vapor.  However, cheap products and black market products have made vaping dangerous and has resulted in severe lung damage. This is likely linked to cutting agents that are used in catridges but the CDC is still investigating the safety of vape products. If you insist on vaping, we recommend switching to dry herb vaporizers. Onset: 2-3 minutes.  Duration: about 2-3 hours.  
    • Edibles: Beverages and edibles are also healthier methods of consuming medical weed. However, these ingestion methods tend to be unpredictable with titration and dosing.  If you can find a good source of edibles with consistent dosing this is a good alternative to smoking or vaping. Onset: 30-90 minutes. Duration: 4-6 hours. 
    • Topicals: Topicals are a good option for localized pain.  They come in creams, salves or transdermal patches.
  • Tinctures and Sublingual Sprays: As an alternative to smoking or eating your legal medical marijuana, many dispensaries offer products such as sublingual sprays and tinctures. This is the ingestion method we typically recommend to patients. Tinctures are small bottles of alcohol or another solvent infused with cannabinoids that can be ingested orally. Sublingual Spray onset: 5-15 minutes.  Duration: 2-3 hours. Tincture onset: 30-90 minutes Duration: 4-6 hours

The overall theme with medical cannabis dosing is “START LOW AND GO SLOW”

When first beginning your medical marijuana treatment, start slow using low doses at first. Gradually titrate up your dose until you reach your desired effect. This is called micro-dosing and is based on the principle that cannabis is a biphasic medication(see below).  

Since you don’t always feel the effects of the herb immediately, going slow with smaller doses is a good way to “get a feel” for your new treatment and gradually work your way up to a regular treatment plan. Medical marijuana is safe overall with little to no risk of overdose. But, you still need to be cautious until you completely understand its effects and find the right dose for your symptoms.  

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Does marijuana affect sleeping or dreams?

Some strains of marijuana greatly improve sleeping conditions for a wide variety of individuals. With that in mind, legal medical marijuana can cause patients to experience side-effects that they should be made aware of before beginning use. High THC strains can cause patients to have increased anxiety. For some, marijuana can suppress various cycles of Rapid Eye Movement (REM) sleep which can make dreams hard to recollect, if they are not forgotten entirely. Be sure to talk to your doctor and perhaps do some independent research to be aware side effects. Keep in mind, not a single person has died from the use of marijuana, which is more than can be said for the majority of prescription drugs used for sleep and anxiety.  

Is it possible to “overdose” or have a “bad reaction” to marijuana?

A fatal overdose from marijuana has not been documented, but that doesn’t mean marijuana is harmless. The signs of using too much marijuana are similar to the common side effects of using marijuana but more severe. These signs may include extreme confusion, anxiety, paranoia, panic, fast heart rate, delusions or hallucinations, increased blood pressure, and severe nausea or vomiting. In some cases, these reactions can lead to unintentional injury such as a motor vehicle crash, fall, or poisoning.  That is why we recommend not partaking in any driving, watching minors, operating heavy machinery or partaking in high risk activites while under the influence of medical cannabis.  

What are the effects of mixing marijuana with alcohol, tobacco or prescription drugs?

Using alcohol and marijuana at the same time is likely to result in greater impairment than when using either one alone. Using marijuana and tobacco at the same time may also lead to increased exposure to harmful chemicals, causing greater risks to the lungs, and the cardiovascular system.

Also, be aware that marijuana may change how prescription drugs work. Always talk with your doctor about any medications you are taking or thinking about taking and possible side effects when mixed with other things like medical cannabis.  Since this is not an FDA approved medication we do not know all of the interactions, side effects or consequences of using medical cannabis at this time.  

Is it safe for a breastfeeding mom to use marijuana?

We do not yet know. Chemicals from marijuana can be passed to your baby through breast milk. THC is stored in fat and is slowly released over time, meaning that your baby could still be exposed even after you stop using marijuana. However, data on the effects of marijuana exposure to the infant or baby through breastfeeding are limited and conflicting. We also do not know the long term effects on infants at this time. 

Our stance at Canna Therapy MD is we do not recommend patients for medical cannabis who are currently pregnant, plan to become pregnant while on medical cannabis or who are currently breastfeeding.  

Can secondhand marijuana smoke affect nonsmokers, including children?

Secondhand marijuana smoke contains tetrahydrocannabinol (THC), the chemical responsible for most of marijuana’s psychological effects, and many of the same toxic chemicals in smoked tobacco.6-8

Smoked marijuana has many of the same cancer-causing substances as smoked tobacco.

At Canna Therapy MD we do not recommend smoking cannabis as first line treatment.  If you choose to still smoke, we do not recommend exposing non-smokers, especially children, to secondhand marijuana smoke.  

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Legal Waiver: This article contains general recommendations only and is for informational purposes only. It does not serve as a guideline for any specific patient, is not a prescription and should not be used to determine your treatment plan unless under the guidance of a cannabis-trained physician. Cannabis has not been evaluated or approved by the United States Food and Drug Administration for safety or efficacy in treatment of ANY medical condition. Please visit a physician who has training in cannabis to determine if this is a good treatment option for you and to discuss any potential side effects. If you experience any negative side effects while taking medical cannabis, you should stop use immediately and seek care by a physician as soon as possible.