Today more and more physicians are recommending the use of medical marijuana for their patients. For many, pharmaceuticals have failed them, leaving them with few options for pain relief or other disorders. But, how is medical marijuana different from recreational marijuana, and how is it used might be questions you are asking yourself. 

This HighHello guide is for the beginner to better understand the use of medical cannabis and how to use it. But first, let’s answer that question: How is medical marijuana different? 

The answer is it is not. Medical cannabis and recreational cannabis are two different legal categories of the same substance. Medical cannabis requires a doctor’s recommendation. Recreational cannabis is available to anyone aged 21 or over. Now that you understand that little detail let’s dive into some of the basics, so you know your options when using marijuana for medical purposes.

Cannabis 101 – The basics.

Cannabis is a complex plant. Once it is grown, matured, and ready for harvesting, the buds (flower) become rich with trichomes. Some people refer to these as “crystals.” These tiny glands are filled with resinous oil containing cannabinoids and terpenes. These two components work together to provide psychoactive and physical effects, often referred to as feeling “high.” 

Main cannabinoids of medical marijuana 

There are hundreds of different terpenes and cannabinoids in the cannabis plant. Each plant varies in its concentration of these elements, giving each strain its unique properties. You could have high CBD, high THC, or a combination of both. Let’s explore some of these popular cannabinoids.

THC: The most popular of all cannabinoids is THC (delta-9-tetrahydrocannabinol). This produces the “high” effect that cannabis is known for. 

CBD: The cannabinoid cannabidiol (CBD) has been taking the cannabis industry by storm for its ability to fight inflammation, reduce anxiety, treat nausea, and control PTSD without the same “high” effects as THC. In fact, when combined with THC, it can counteract the psychoactive effects altogether. 

CBN: Cannabinol (CBN) produces a mild psychoactive effect. CBN may help treat eye conditions like glaucoma, which causes vision loss and blindness. CBN can also be effective in reducing seizures. 

CBC: Cannabichromene (CBC) accentuates the pain relief of THC. It can also produce a calming effect for people with anxiety and sleep issues. 

CBG: Cannabigerol (CBG) is another cannabinoid that is effective for treating glaucoma by lowering the pressure in the intraocular nerve. It can also be sedating. 

THCV: Tetrahydrocannabivarin (THCV) is being used to treat type 2 diabetes and other metabolic issues. 

But cannabis is more than cannabinoids. There are two other very important players to consider–Flavonoids and terpenes. These two things are responsible for the scent and flavor of the plant. These flavonoids and terpenes combine with THC to provide physical and psychoactive results. The entourage effect is the different parts of the plant all working together in perfect harmony. 

How will cannabis affect me? 

Cannabis affects everyone differently. While one person could have a mildly sedating experience, another could become excited. Finding the correct strain and combination of cannabinoids and terpenes could take a while. Here are some elements that can affect your experience in either a positive or negative manner. 

• Dosage
• Type of strain
• Consumption method
• Environment
• Tolerance 
• Your body chemistry
• Your mood 
• Your diet

Species and strains? 

There are two main species of cannabis. Most people confuse these with strains, so let’s define them both.  

Sativa: Provides a more psychoactive “head” high. 

Indica: Provides a more “body” high, which is good for pain relief.

A strain refers to the named variations of cannabis that differ in appearance, aroma, and effect. 

Hybrids: Hybrids are strains made by crossing Indica and Sativa together. They are often Indica dominant, Sativa dominant, or a balanced blend of the two. Breeders of cannabis have come up with thousands of different combinations, but we won’t go into all of those here. 

There are some widespread effects of the cannabis plant that most medical users experience. Effects include increased appetite, pain and nausea relief, and improved sleep.

But on top of that, different strains can behave differently depending on their cannabinoid and terpene combination. 

Sativa: It’s all in your head

Because Sativa primarily affects thoughts and feelings, people often use it for daytime use. 

The pros of Sativa:

• Stimulating and boosting creativity
• A sense of wellbeing
• Elevates mood
• Pain and nausea relief
• Increases appetite (the munchies)

The cons of Sativa:

• Increased anxiety and paranoia
• Possible restlessness 

Indica: It’s all about the body

Indicas are known for their mellow body effects. It can produce a sedated, sleepy feeling, making it ideal for nighttime use. 

Pros of Indica:

• Relaxation
• Stress reduction
• Reduces muscle spasms
• Reduces pain and inflammation
• Promotes restful sleep
• Anxiety relief
• Stimulate appetite
• Reduces nausea
• Reduces intra-ocular pressure in the eyes
• Anti-convulsant

Cons of Indica:

• Tiredness
• Clouded thinking

Hybrids: Best of both worlds

Cannabis cultivators have made creating hybrids an art form. By cross-pollination different species of the cannabis plant (Sativa and Indica), specific effects can be achieved. Usually, one species is dominant, such as a Sativa-dominant hybrid. The overall medical effect is considered regarding strains explicitly produced for medical marijuana. 

The many forms of medical marijuana 

Cannabis comes in many different forms. From smokable flowers and concentrates to the all-powerful edible, there is an option for everyone. 

Cannabis concentrates and extracts While in the US, consuming cannabis by combustion (smoking) is the most popular way, concentrates are quickly gaining in popularity. Concentrates are made by extracting cannabinoid-rich trichomes from the plant. There are many methods of cannabis extraction. The resulting products are wax, shatter, budder, and hash oil, to name a few. 

These cannabis concentrates can be consumed alone, referred to as “dabbing” or they can be added to joints or bongs for added potency. 

Kief

Kief is a cannabis powder that is taken from the dried leaves of the cannabis plant. It can be compressed into little blocks, known as hash, or sprinkled in powdered form in a pipe. 

Hash

Hash is a compressed block of kief. It contains the same active cannabinoids as the loose flower and leaves, with higher concentrations due to its consistency. The THC content of hashish can be anywhere from 15-70%. You can smoke it, bake it into edibles, vaporize it or mix it into joints. 

Hash oil Hash oil is essentially the essential oil and resin of the cannabis plant. It is extracted from the foliage using a variety of extraction techniques. Oil extracted from the cannabis plant tends to have a 30-90% cannabis concentration. It can be vaporized, smoked in a specialty pipe made for oil, or added to any loose cannabis bud. It can also be added to edibles. 

Edibles

Edibles are the perfect solution for patients wanting a non-inhalable solution to their cannabis consumption. Edibles are made by first extracting THC and other cannabinoids from the plant by heating the leaves. This is done by a process called decarboxylation. The ground-up flower and activated THC are then infused into oil or butter and used to make a variety of edibles, from gummy bears to chocolate bars. 

Edibles do take longer to digest than other modes of consumption. They are also felt differently in the body due to the processes that take place in the liver. People often describe a more mellow sensation with the effects lasting 2-4 hours, depending on many factors. 

Oils Cannabis oil is made by infusing the cannabis plant into a cooking oil such as coconut or olive oil. This is usually done by infusing the plant material into the oil by slow cooking over time. The oil can be digested alone or mixed into cakes, brownies, cookies, and other baked items. 

Butter

Yep, you guessed it. Cannabutter is made by infusing the activated cannabis flower into butter using low heat. Like oil, it can be spread on a cracker or infused into other baked goods. 

Tinctures A cannabis tincture uses ethanol alcohol to extract the cannabinoids from the plant. It is often administered into the body through mucus membranes in the mouth. Drops are placed under the tongue and held for a few minutes to allow absorption into the body. 

Sprays Similar to tinctures, cannabis sprays use ethanol alcohol to extract the cannabinoids. Instead of a dropper, it is sprayed under the tongue to enter the bloodstream. 

Topicals

A topical is a salve, cream, or lotion applied to the skin. This type of application allows for direct application to areas affected by pain. These topicals often contain THC and CBD cannabinoids due to CBD’s anti-inflammatory and pain reduction traits. Cannabis used as a topical does not produce a psychoactive effect. 

Topicals are great for:

• Psoriasis
• Fever blisters and herpes
• Cuts and scrapes
• Acne
• Arthritis 
• Muscle pain and cramps
• Hemorrhoids
• Menstrual cramps

Pharmaceutical cannabis

If taking a pill is what you are accustomed to, there are also those options. Cannabinoid drugs (medications) have been standardized in their dosage and formulations. This option lets you know how much you get with each dose. These products meet all regulatory requirements for prescribing physicians. 

The most common pharmaceutical cannabis

Dronabinol (Marinol) This drug is prescribed as a capsule and is classified as a Schedule III drug. It treats nausea, vomiting, and weight loss in cancer and AIDS patients. It is a synthetic version of THC that does not include CBD. 

Sativex This mouth pray is used to reduce symptoms of multiple sclerosis. Its formulation reduces neuropathy pain, spasticity, bladder issues, and other common issues related to MS. This product utilizes both psychoactive THC and inflammation-fighting CBD. 

Safely using medical marijuana. 

Safety is of paramount importance when it comes to using any cannabis product. These tips will help you choose the proper consumption method for you. 

Eating Edibles A safe way to consume your cannabis is by ingestion. There is nothing to inhale, and no damage is done to your lungs this way. If you consume edibles, know that it takes longer to enter your bloodstream, and the effects may be more pronounced, lasting for more extended periods. The golden rule regarding edibles is to start low and go slow. You will have to experiment a bit with what works for you. But, once you find your sweet spot and get used to how to use them, this could be a simple, effective, and safe method of consumption. 

Topicals Another incredibly safe way to consume your cannabis meds is to apply them directly to the source of the pain. Using salves and creams alleviates discomfort without producing any psychoactive effects. 

Smoking For medical marijuana users that need immediate relief, smoking or vaping is most effective. The effects are felt immediately due to passing from the lungs immediately into the bloodstream. If you are worried about the impact of smoking cannabis leaves compared to smoking tobacco, there is good news for you. Research shows that smoking cannabis leaves does not increase the cancer risk in the lungs. It can, however, irritate the lungs. If you have a pre-disposition or family history of lung disease, you might want to consider ingesting cannabis instead. 

Vaping If you choose the immediate onset inhalation method but are worried about irritants in your lungs, vaping might be a good option. Vaping heats the cannabis oil creating vapor without the harshness of other plant materials that come with combusting through the smoke. Vaping also reduces the odor associated with lighting up. 

Be informed! Know your cannabis.

Using cannabis safely requires a solid understanding of your product. Clearly, knowing the difference between Indica and Sativa is a start. You will want to know the pros and cons of both of these strains and how they react in your body. For example, Sativas may not be for you if you struggle with severe anxiety. 

Many strains are designed for specific purposes within the three categories of Sativa, Indica, and Hybrids. Can’t sleep? There is a strain for that. Chronic pain? Another strain. PTSD, an Indica dominant hybrid with added CBD, might be what you need.

Regardless of your ailment, talk to your budtender (and your doctor) about your needs.  

Drug Interactions

At this time, no significant known drug interactions have been identified. Be sure to talk to your medical doctor and doctor prescribing medical marijuana about any concerns about the pharmaceuticals you are taking. 

Alcohol and Cannabis

While it is not necessarily dangerous to consume alcohol with cannabis, it is not recommended. Alcohol is a nervous system depressant. Combined with cannabis, this effect can be amplified, producing unpleasant and sometimes dangerous side effects. 

Use safely

While cannabis is now medically legal in many states, it should still be used cautiously. Indicas, as well as Sativas, can cause drowsiness. Any drug that alters perception and creates psychoactive effects can impair motor coordination. Do not drive while using cannabis. 

Monitor your progress

Keeping a diary of your progress, especially if you are a new cannabis user, is highly recommended on your medical marijuana journey. Getting the dosage right requires experimentation with different strains, consumption modes, and even the time of day. Keeping a log will be helpful as you navigate your way to your optimal dosage and product. 

Some things to take note of:

• How do you feel physically?
• How do you feel emotionally?
• Dosage
• Type of product (flower, edible, concentrate)
• Species (Indica, Sativa, Hybrid)
• Terpene information
• Cannabinoid content – Percentage of THC / CBD / CBN etc.
• How did you feel it resolved your medical issue? 
• Side effects

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