By PATRICK NEUSTATTER
WHEN a good friend asked me, “What do you think of marijuana?” I thought telling him “it’s the best thing since sliced bread” might hurt my seriousness as a doctor. But he’s been battling cancer and was really asking my opinion on medical marijuana as a treatment and not my personal tastes.
Medical marijuana is a hot topic that this friend’s oncologist, Dr. Chris Vaughan, is exploring. He asked me to watch two episodes of Vaughan’s “Cancer Shop Talk” podcasts, available on the Hematology Oncology Associates of Fredericksburg website.
My friend told me he wanted something to manage pain, anxiety, and insomnia, and was interested in trying cannabis products, but was put off by the logistics for get it.
I told him that I wasn’t well informed on the whole subject, but that I was interested and happy to do a little research – although it turned out that he kind of jumped on tear.
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Wired to get high?
I know cannabis contains a bunch of different cannabinoids that have different properties and are used to treat various symptoms. CBD, for example, has become popular and is available without a prescription because it doesn’t contain that other baddie, cannabinol, THC, the ingredient that gets you high.
What has always puzzled me is why do our bodies have cannabinol receptors? Are we naturally programmed to get high? Smoke some weed ?
The answer is that we have a whole endocannabinoid system, receptors and neurotransmitters involved in pain/mood/appetite control, cognition, memory and certain functions of the immune system. It turns out that exogenous cannabis acts on the receptors.
Recently there has been a lot of interest in medical cannabis, although a few products, such as Marinol, have been used since the 1980s for AIDS patients to treat anorexia, nausea and vomiting from chemotherapy . But Marinol’s approval helped pave the way for the legalization of the use of other cannabis products.
The accessibility of medical cannabis products has become easier since July 1, when the requirement to register with the Virginia Board of Pharmacy was dropped. Now all you have to do is see a licensed physician, physician assistant, or nurse practitioner, in person or via telemedicine. There are many options for this, including Dr. Vaughan’s office, or find one on the Virginia NORML website. Once you have a certificate, you can go to a dispensary.
This should make life easier for the many “patients who are unclear about the legal requirements,” Vaughan told me. Although he notes, doctors are often not well informed either, not only about the legality, but about the properties of medical cannabis. “And some consider it a bit of a taboo,” although there are many organizations that promote the training of doctors and nurses.
Although I was not much help in informing this friend on the subject, he had already obtained a certificate and visited a dispensary by the time I was able to speak to him again.
Since receiving radiation treatment in Richmond, he decided to go to the Green Leaf Dispensary, “well located among Richmond’s old tobacco warehouses”, he noted – a warehouse itself, with a large production operation behind, and a sales store in the front (a list of other dispensaries can also be viewed on the NORML website). “My ID and certificate were checked by security, then I was sent to speak to Rusty,” he told me.
Currently, it seems that people in dispensaries are some of the most knowledgeable about corresponding symptoms such as nausea, pain, insomnia, anxiety, and inflammation with the alphabet soup of different cannabinoids (CBD , CBG, CBN, THC) or other components such as terpenes. . Or help decide whether sativa or indica properties will be best. Also, advising if dried flowers, concentrates, oil filled cartridges, tinctures, tablets or chews would be the right choice.
Although becoming a respectable medical product, the exotic names that Green Leaf – and other dispensaries – give to their products, like Blackberry Kush III, Pure Vida, Rum Cake, Sour Ghost. Or the Love Affair, 3 Popcorn Buds, SuperMaxII, or Wipe-Out products my friend showed me he bought at the dispensary—looking like a kid from a candy store—suggest there’s a little overlap, at least in the naming of medical and recreational products.
Hopefully that’s not enough to piss off the FDA and other powers that be, who are a bit nervous about allowing intoxicants as well as drugs, which also include opioids, amphetamines, and cocaine. .
Cannabis is very safe and does not cause the same physical dependence. And, as Dr. Vaughan pointed out, its use can reduce the craving for more dangerous and addictive substances, like opioids.
Now we just need to convince the entire medical profession that medical cannabis has real merit, and that patients are not just looking to get high, but want access to an ever-growing range of effective therapies.
Dr. Patrick Neustatter of Caroline County is the author of “Managing Your Doctor: The Smart Patient’s Guide to Getting Effective Affordable Healthcare”.