Leaf411 Question of the Month: Does Cannabis Interact with Other Medication?
Medically reviewed by Katherine Golden, RN
Written by Denise Rustning
Approximately half of all Americans take at least one prescription drug every day, according to a Consumer Reports study. Many more people take non-prescription, over-the-counter painkillers, antacids and other medications.
Not surprisingly, a fair number of these people are seeking alternatives to their medications. In many cases, people are turning to cannabis—either marijuana (cannabis containing >0.3% THC, which is sold legally in dispensaries), or cannabidiol (CBD) hemp products that are sold in retail stores and online.

Thinking About Adding Cannabis to Your Medicine Cabinet?
We always suggest that you talk to your healthcare provider before taking any new medication. That includes CBD hemp or marijuana. Our Leaf411 cannabis-trained nurses can provide education and guidance as well as how to discuss the possibility of adding plant medicine into your regimen with your healthcare team via our free hotline: 844-LEAF411 (844-532-3411).
Also, it’s important to talk to your healthcare provider before stopping any prescription medication. It is imperative that your prescribing physician should always be the one who guides you with stopping or weaning off any pharmaceuticals.
Understanding How Cannabis Interacts with Other Medications
Have you ever wondered why you’re told to not drink grapefruit juice with certain prescription drugs?

When you take medicine by mouth, it passes through your digestive system. The digestive system’s enzymes metabolize (break down) the medicine in your liver so that some of it can enter your bloodstream. The medicine dose takes into account normal digestive processes.
However, grapefruit juice affects several digestive enzymes. It blocks the enzymes’ action, and can result in too much or too little of the drug entering your bloodstream.
What does this have to do with cannabis? Well, the cannabinoids in cannabis—especially CBD—affect your digestive enzymes in a similar way that grapefruit does. In fact, scientists have found that CBD has an even stronger effect on the cytochrome P450 enzyme than grapefruit.
Cannabis, Statins, and Blood Thinners: Use Caution
An emerging area of concern is with cardiovascular medications, including statins and blood thinners. Many of these medications are metabolized by the same liver enzymes as cannabis. As a result, people who use cannabis while also taking statins or blood thinners may end up getting a higher dose of their prescription medicine than they intended, since the liver is breaking down the drug differently than normal.
Does this mean you cannot use cannabis? Not necessarily. The key is to talk with your provider and discuss any changes that need to be made to your medication dosage, frequency or timing. You might consider sharing the link to this article from the Journal of the American College of Cardiology which provides very conservative guidance for doctors to use as a screening tool who have no experience or knowledge about cannabis.
The Benefit of Starting Slow with Cannabis
Not all drugs are metabolized by the same liver enzymes. However, even if you’re taking medications that are not directly impacted by cannabis in your digestive system, it’s worth it to start with a low dose of marijuana or CBD, and to go slow. By starting slow, you can see how the addition of marijuana or CBD impacts your ongoing medications (after checking with a healthcare provider, of course!).
Also, Dr. David Gordon (Dr. Dave), founder of 4Pillars Health & Wellness, notes that people usually only need a small dose of cannabis for therapeutic benefits. This minimizes the risk of side effects. Dr. Dave explains that as an integrative physician, “We start with just a small amount, just to stimulate our own internal system. These are dosages that often don’t cause any intoxication or have any significant interaction.”
Dr. Dave is experienced at looking up potential interactions with medicinal cannabis. He’s found that most drug interactions don’t preclude someone from using cannabis, though he notes that drug doses may need to be adjusted. (You can read more from our recent interview with Dr. Dave here.)
Getting Answers to Your Cannabis Questions
Our Leaf411 hotline nurses have special training on cannabis-medication interactions. They also have access to a robust database of research.
We encourage you to call our free hotline at 844-LEAF411 (844-532-3411) with your questions about how CBD or marijuana may interact with other medications you are taking.
Do You Need a Medical Marijuana Card?
Medically reviewed by Katherine Golden, RN
Written by Denise Rustning
“Should I get a medical marijuana card?” We hear that question a lot on the Leaf411 cannabis nurse hotline, as callers seek out the best way to access legal cannabis.
We can help you sort out your options based on your needs as well as what options exist where you live. Check out our Leaf library for your state’s current cannabis laws.
Is Legal Recreational Marijuana an Option for You? Then You Might Not Need a Med Card
Many of our callers are just starting out using cannabis and only require small doses of THC. Lower dose products are more easily found in recreational dispensaries. You don’t need a medical marijuana card (often called an “MMJ card” or “med card”) to visit recreational (rec) dispensaries, though you’ll need a state-issued ID as proof that you are 21 or older.
Also, it’s worth noting that cannabidiol (CBD hemp) containing less than 0.3% THC is federally legal. (Each state still has the authority to allow CBD hemp sales or not). CBD hemp products are available over-the-counter and online in nearly every state, no med card required! We’ll talk more about CBD later in this post.
If you’re just starting out with cannabis and live in a fully legal state that has both rec and medical marijuana, we suggest reaching out to a cannabis-trained clinician first for advice on the best routes, ratios and products. Our free Leaf411 hotline is a good resource!
In many cases, these products will be available to you without a med card, saving you both the time and cost of applying for a card.
David Gordon, MD, a Leaf411 advisory board member and integrative medicine practitioner notes that, “In Colorado, a lot of the products that we might use for medicinal purposes are only available on the rec side. Companies aren’t making as many products for the medical side because it’s not as profitable.”
While it can be challenging to find products made specifically for the medical market, we’re proud to have incredibles brand as one of our supporting members. The incredibles brand is committed to providing consumers with safe, consistently high-quality products.

Understanding Med Card Qualifications
Before we get into cases when a med card makes sense, it’s important to talk about the qualifications for getting a medical marijuana card. Covered conditions vary from state to state. For example, in Colorado, the state list includes specific disabling or debilitating conditions. Oklahoma, on the other hand, is one of the least restrictive states. Their law leaves it up to the doctor to determine if cannabis is a good treatment option.
Check this link for an updated list of different states’ qualifying medical conditions.
When a Med Card Makes Sense
Some states only legalized medical marijuana, not recreational use. If you live in one of these states, then your only option for accessing legal cannabis is by qualifying for a med card.
Med cards are also the only option for people under the age of 21 to access legal cannabis.
Keep reading for information on how to get a card, as well as how it’s different from getting a prescription for other medications.
It’s important to know what a med card gets you, as well as what protections it does not provide (you might be surprised!).
What a Med Card Provides in Some States
- Access to products at lower cost than recreational dispensaries
- Lower sales taxes when buying at a medical dispensary
- Higher doses and higher limits on how much you can buy in a day
- The ability to legally grow your own cannabis for personal use in some (but not all) states
What the Med Card Doesn’t Do
It’s important to remember that all marijuana—medical and recreational—remains federally illegal, even when legalized at the state level.
- A med card doesn’t give you the right to smoke in your rental if prohibited by lease
- A med card doesn’t prevent your employer from firing you for positive drug test results. However, some states including Colorado are proposing legislation to address this concern.
- Holding a med card may disqualify you from certain jobs or impact your career or educational options, though many states are also enacting legislation on this front.
Other Considerations Before Getting a Med Card
Will a med card restrict your right to own firearms? The answer is a tricky one.
Cannabis is federally illegal, and the feds oversee gun licensing and ownership. By the letter of the law, anyone using a federally illegal drug, or addicted to an illegal drug, is prohibited from owning or buying firearms.
If you’re buying a gun, you typically must complete a background check—specifically, the Firearms Transaction Record, or Form 4473. This form includes a question specific to marijuana use, and reinforces the federal prohibition, asking:
Are you an unlawful user of, or addicted to, marijuana or any depressant, stimulant, narcotic drug, or any other controlled substance?
Warning: The use or possession of marijuana remains unlawful under Federal law regardless of whether it has been legalized or decriminalized for medicinal or recreational purposes in the state where you reside.
In other words, if you answer truthfully (and you should—lying on Form 4473 is considered a felony offense!), then your background check may fail.
At Leaf411, we’re nurses, not lawyers. We recommend that you consult with an attorney if you have concerns about whether your cannabis use will impact your right to own or buy firearms.
A number of law firms now specialize in marijuana law. In fact, our board member David Wunderlich, Esq., Senior Attorney at McAllister Garfield, P.C., played a key role in improving Colorado’s laws around medical marijuana, and regularly speaks on cannabis and hemp issues.
Medical marijuana use may also impact state-administered public assistance benefits such as Temporary Assistance to Needy Families (TANF) in states that drug test welfare recipients. Interestingly, in Missouri, having a med card can actually protect your benefits. However, the rules vary from state to state and are frequently being updated. We strongly suggest you ask your social service agency whether holding a med card would impact your public assistance benefits.
How to Apply for a Med Card
You’ve weighed the pros and cons, as well as options available in your area, and have decided to get a med card. Where do you start?
- Search online using “med card” and your state to find state-specific information for obtaining a medical card in your area. Our Leaf411 nurses can also help via our free anonymous hotline at 1-844-LEAF411 (844-532-3411).
- Check your eligibility, making sure you have a qualifying medical condition.
- Confirm any special requirements, such as if you’re applying as the legal representative of another adult or someone under 18.
- Note the process for obtaining a card, including required fees. In some cases, discounts may be available for specific patient groups. For example, Oklahoma provides a discount to 100% disabled veterans.
- Find a doctor who provides medical marijuana evaluations. Your regular primary care provider may provide this service, though many primary care doctors may be unfamiliar with the med card evaluation process. Some states require that evaluations take place in-person, while other states allow phone or online evaluations.

How a Med Card and a Prescription Are Different
You may think that the med card evaluation process will be a lot like getting a prescription from your primary care doctor. In fact, that’s rarely the case! The doctor’s certification simply tells the state that you qualify for a med card based on their assessment of your health history and conditions. It doesn’t tell you which products to start with or how much to take.
When you schedule a med card consultation, it’s worth asking whether the provider provides guidance on using cannabis to treat your health condition. If they do not, you may want to seek out a cannabis doctor who provides this service, such as Dr. David Gordon, who we recently interviewed.
You can also reach out to a resource like the cannabis-trained nurses at Leaf411 for suggestions on where to start.
A Note for Patients Living in States Without Legal Cannabis
Cannabis containing over 0.3% THC remains completely illegal in 17 states. However, federally-legal CBD hemp products containing less than 0.3% THC are legal in almost all states. Full spectrum CBD hemp products contain many beneficial plant compounds shown to impact a variety of health conditions. In fact, even in states with legal cannabis, we sometimes suggest starting with CBD hemp products for certain health concerns.
At Leaf411, our cannabis nurses emphasize the safe legal use of cannabis. When you call, we listen to your specific needs and concerns. We will help find options and guide you to resources that best fit your lifestyle and health goals.
Call our free anonymous hotline today at 844-LEAF411 (844-532-3411).
Leaf411 Supporter Spotlight: Dr. David Gordon, MD, 4Pillars Health & Wellness

An integrative medicine perspective on why patients turn to cannabis, the biggest medical cannabis myths, and how to talk to your doctor about cannabis as a treatment option
Medically reviewed by Katherine Golden, RN
Written by Denise Rustning
The Leaf411 cannabis nurse hotline partners with healthcare providers and cannabis industry members to expand our education outreach and increase awareness around the safe use of legal cannabis. We’re proud to periodically spotlight our supporters here.
David Gordon, MD, founder of 4Pillars Health & Wellness, was an early supporter of Leaf411, and serves as one of our Advisory Board members. Dr. Gordon, better known as “Dr. Dave,” is the creator of the 4×4 Lifestyle Plan, offering patients an alternative to conventional medical treatment. His approach addresses food, movement, relaxation, and community to help patients transform their lives.
At Leaf411, we take our ethos (kindness, professionalism and caller loyalty) very seriously. Dr. Dave fits in with our organization so perfectly, from his devotion to his profession to his loyalty to his patients. We are honored to have Dave be a member of our Advisory Board and give him this spotlight.
Leaf 411 COO Jennifer Axcell recently sat down with Dr. Dave learn more about what brings patients to cannabis, the questions and misconceptions he hears most often, and what he wishes other providers knew when it comes to advising patients on how to use cannabis.
Q: When do people typically come to you? How many other treatment options have they tried beforehand?
People have definitely already tried a lot of other options. This is true not only with cannabis, but also with an integrative approach in general.
In the cannabis space specifically, far and away chronic pain is the most common thing that we see. These are people who are still in pain despite them getting opioids or other medications. They’re still in pain despite going to physical therapy. They’re still in pain despite having surgeries and injections. They’re still suffering.
They’re definitely also tired of the risk and side effects of some of the other therapies when it comes to chronic pain. Certainly opioids—we hear about that a lot. But the risks and side effects of less toxic pain medications are underappreciated, whether it’s the ibuprofen class of meds or even Tylenol for that matter.
The biggest thing for people with chronic pain is that they’re not getting better. They’re not trying to avoid medicine. They’re really just trying to get relief that they haven’t had with other things.
If opioids were allowing people with chronic pain to feel great and be pain-free with high quality of life, these people wouldn’t be searching out cannabis.
We also see patients for lot of other conditions that standard medicines don’t treat well, be it sleep, mood disorders, or psychological symptoms. These are things that our current meds don’t do a very good job with.
Q: Is there a certain type of person who’s more likely to come to you? Is it the senior group, because they have more chronic conditions? Younger people who might be more open to cannabis? Or does it run the gamut?
The people who come to me really run the gamut, but they fall into a few categories.
A lot of people have figured out through experience that cannabis works better for them than other things. They’ve done the research and they know it’s safe. This is the average healthy person who has pain from sports injuries. It’s also the waiter or waitress or auto mechanic who comes home exhausted with pain and stiffness from work. They just want something to help their pain, help them relax and get to sleep easier. They don’t want to take a bunch of ibuprofen and Benadryl to go to sleep. They find that with a little bit of cannabis, they can relax, their pain is gone, and they fall asleep easily. This population just uses a small amount of cannabis in the evening. They know it’s more effective and safer than a lot of alternatives.
There’s also a big group of patients who have been dealing with various issues for years, and who are just sick of all the side effects and drug interactions. They want safer options. They might have been told they can’t take a variety of medications, or they’ve had side effects. These patients are looking for something they haven’t tried before because they have low quality of life. This is typically the senior population.
There’s a third patient group, the chronic pain population. The chronic pain may be related to an injury from a car accident or disc injury, or it could be non-injury related. Some patients have central pain issues like fibromyalgia, irritable bowel, irritable bowel syndrome, chronic pelvic pain, these kind of nebulous pain syndromes. That’s where you get the patient who says, “I haven’t had a good day in 25 years no matter how many meds I’ve taken.”
Q: What are the top three questions about cannabis that you get from patients?
These days, one of the top patient questions is about the different chemicals in cannabis, specifically THC and CBD. What is CBD? What is THC? What’s the difference?
Another common question is how best to administer cannabis, whether you’re talking about inhaling or eating or topical. People always want to know what’s the best.
Also, for patients who are new to cannabis, their questions involve safety, side effects, and interactions with other medications.
Q: What are some of the biggest misconceptions you hear from people, when it comes to using cannabis for health purposes?
New users often assume that using cannabis means that they’re going to be so high that they can’t function. That’s far and away the biggest misconception. I might explain to them that we’re going to use certain cannabis compounds that don’t cause any intoxication. Even if we’re using THC, the one compound that can cause intoxication, we might be starting it at a dose that they’ll barely notice or not notice it at all.
Also, a lot of the cannabis propaganda that people have heard over time is just wrong. The perfect example is when someone asks, “Is cannabis going to cause me to lose my brain cells?” Or they are worried it will cause early-onset Alzheimer’s. No, actually, the science shows that cannabis is probably going to protect your brain. We know that both the cannabis THC and CBD compounds protect brain cells. And there’s good evidence suggesting that they may reduce the risk of dementia.
Another misconception I hear is that cannabis is super-addictive. People just assume it’s a highly dangerous, addictive drug like heroin or cocaine, based on the propaganda they’ve heard. I share the actual information that’s out there in the research showing this propaganda is not true.
People also tell me, “My doctor told me there’s no research. There’s no science showing cannabis works.” (Dr. Dave responds to this misconception below.)
There are a lot of myths about cannabis—the list goes on. But those are some of the main ones that people come in with preconceptions about.
Q: At Leaf411, one way we’re answering that concern about research is with our online Leaf Library. How do you answer questions about research, beyond saying “trust me”?
My response varies between patients based on how they learn and what they want to know. We have different levels of research. You know, we have research that’s done in the lab that shows how and why cannabis works. And then we have research in animals showing its benefit. We also have research in humans, but the research in humans often isn’t as robust as we have for other medications because of the restrictions.
But I also remind people that most of what happens in a regular conventional medical office is also not supported by gold standard research using large-scale double-blind trials. Most conventional providers’ practice is based observational studies or recommendations, the exact same kind of research we have for cannabis, as well.
Evidence-based medicine is not just picking one study and saying, “Here’s the evidence. This is what we do.” Evidence-based medicine is combining the best research and science we have with our patients’ experiences, and with physicians’ experiences. And using those three aspects to make decisions that are best for a given patient. That is true evidence-based medicine.
Q: From the patient perspective, when is the best time for someone to talk to a cannabis physician?
I am a little biased, but I think early on is best. In a perfect world, everybody would get guidance, even people who are knowledgeable about cannabis.
When I see a patient who tells me they’ve used cannabis for 25 years, there’s still information that I can provide to really optimize their treatment.
When we’re talking about the person who is new to cannabis, I think early is best, ideally before they use it or within the first month.
My biggest concern with a new cannabis patient is that they’ll have a negative experience early on due to the product they tried or using too much.
It’s not dangerous but they felt uncomfortable. That creates a negative association. We know in all treatments, someone’s initial experiences play a huge role. We want to avoid negative experiences early on, because that makes future treatment more difficult.
I think all people need some education early on how to use appropriate dosing and appropriate products to minimize negative experiences. And a lot of that’s just starting really low. I don’t think the industry facilitates that in the way they package and label products, and I don’t think budtenders facilitate that. Most people working in dispensaries are cannabis users, and probably have higher tolerance than someone who is new to cannabis. They may not understand low dose concepts like building up the dose slowly.
I don’t think someone necessarily has to see a doctor, but they should get guidance on the concept of starting low. This could come from an educational resource like Leaf411.
Obviously, seeing a cannabis doctor can increase the likelihood that the first thing the person tries will be effective. Talking to any knowledgeable healthcare provider makes it more likely that someone will find the most effective dose or product sooner.
Q: How do you guide patients to talk to their primary care doctor, knowing that there is resistance and lack of knowledge among some providers?
I recommend that patients start by sharing their personal feelings and goals.
Don’t just say, “I’m using cannabis, deal with it.”
Instead, maybe say, “Hey, I’ve been really struggling with this. You know that we’ve tried many things and I haven’t been getting optimal results. I’ve tried this new thing. It’s really helping me. I’d really like to stick with this because I’m feeling better.”
If the doctor hears the patient articulate that they’re doing well and they’re achieving their goals, but they’re not willing to support that—I mean, I usually tell patients that’s the time you need to think about getting a new doctor.
If a doctor doesn’t know something and says, “Okay, I’d love to learn more. How can I support you?” that’s okay. They don’t need to be a cannabis expert.
I wish that every doctor understood the low dose concept. If a patient said, “I want to try cannabis,” the doctor’s response would be, “I don’t know anything. But all I know is that you start with one or two milligrams and go up every few days.” If every doctor just knew that, that would be outstanding.
Q: Many people in the cannabis space have a story. What’s yours?
My story is not so much a personal story. For me, it’s really just seeing what worked with patients and what didn’t work.
I always wanted to be a doctor and enjoyed the sciences, and started on a pretty straight path going to medical school. I had no exposure to integrative medicine or anything beyond standard medicine throughout my training.
I started my own practice right out of residency, a general internal medicine, primary care practice. Paying attention to patients and how they were doing, I realized what I was taught didn’t work very well. I was doling out medicines left and right, and yet people were not getting better. Even if their numbers got better, I would see them keep coming in with side effects and new issues.
Within the first year or two of practice, I decided that I needed better tools. I started learning more about nutrition and root causes of health issues, and expanded into integrative practice where I had a bigger toolbox. I partnered with patients, spending more time with them to find out what their triggers were. Then, I incorporated new tools, using other practitioners, chiropractors, psychologists, physical therapists, and acupuncturists. I also taught myself more about nutrition and incorporated that piece as well. Patients really got better using those modalities.
Once cannabis was legalized in Colorado, I immediately had patients coming to me and saying, “Oh, I’ve already been using cannabis for my pain,” or “I’ve been using cannabis for sleep,” or for other conditions. Patients asked, “Will you authorize my medical card?” These were patients I knew and trusted, and so I signed off on that.
After hearing similar stories from many patients, I thought I should try to learn about cannabis beyond just signing off on it. When I looked into things, I was blown away by how much information was already out there about the endocannabinoid system and cannabis. At the time, there were a few decades of research showing what cannabis does, why it works, and how people were benefiting from it.
I saw this firsthand in my practice, as well. When patients were struggling, I looked at using cannabis as a bridge to help them get better so we could implement other dietary and lifestyle measures. Cannabis was just one part of my toolbox.
My story has really been focused on what’s best for the patient. That’s what led me to general integrative medicine, and to cannabis specifically.
This interview has been edited for length and clarity.
For More Information
You can learn more about Dr. Dave and 4Pillars Health & Wellness here. Dr. Dave provides in-person, phone, and video consults for people seeking guidance and education on cannabis as well as other integrative health practices to improve overall health. He also offers office appointments for Colorado residents seeking a medical marijuana card.
The Leaf411 cannabis nurse hotline is proud to have supporters like Dr. Dave. Our nurse team depends on our medical advisors to take our callers to the next level of care that is outside our scope of practice and Dr. Dave can do just that. He takes in-person, phone, and video consultations from all over the country. We are proud to list his practice as a resource for our callers.
We recognize that not everyone may have the resources to visit a cannabis doctor. That’s a big reason why we set up our hotline as a free service available to anyone, anywhere, regardless of their insurance coverage or ability to pay.
Do you have questions about using cannabis for a health concern?
Would you like to learn more about the low dose concept?
Call 844-LEAF411 (844-532-3411) for answers from our cannabis-trained registered nurses.
How to Use Cannabis
From Edibles to Vapes, Leaf411 Has Your Questions Covered
Medically reviewed by Katherine Golden, RN
Written by Denise Rustning
When we first started taking calls on the hotline, one of the biggest surprises was hearing how many people thought marijuana has to be smoked to be effective. In fact, we even featured this misconception as our first Question of the Month!
Many different types of marijuana (cannabis containing >0.3% THC – sold in dispensaries in states that have legalized recreational or medical marijuana) and cannabidiol (CBD) hemp products are available today, designed to fit a wide variety of needs. Your decision on how to use cannabis may be driven by personal preference. You might also consider factors such as how quickly a product will take effect, how long the effect will last, and what issues you’re targeting.
Our cannabis-trained registered nurses are always happy to answer your questions at no cost when you call our free, anonymous Leaf411 hotline 844-LEAF411 (844-532-3411).
However, we know you might not have specific questions yet. In our guide below, we provide information on different options for using marijuana and CBD products. You’ll also find tips for getting the right dose of this plant-based medicine.
Keep reading, or skip ahead using the links below.
Tinctures
CBD hemp oil tinctures contain full spectrum, broad spectrum or CBD isolate in a plant-based carrier oil.
Tincture blends are also available with combination of THC and CBD, giving a nod to the science that shows THC can play an important role in symptom relief as well.
Tinctures are available in different strengths and typically come in glass dropper bottles, making it easy to adjust your dose. They can be used by placing drops under your tongue. Some of the plant compounds will be absorbed directly into your bloodstream as a sublingual if the product is designed that way, but most of the product is absorbed through swallowing. Tinctures also work well mixed into already prepared foods like sauces and soups, or warm beverages like coffee or tea.
When it comes to tinctures, think of the carrier oil as the vehicle that the cannabinoids travel in to enter your system. The more efficient the carrier, the more easily the CBD and THC will be absorbed.
Coconut or palm medium chain triglyceride (MCT) oil are both highly effective carriers for tinctures, because they contain smaller fatty acid molecules which are easily absorbed. Olive oil is another popular carrier oil option. It is a great alternative for people who are allergic to coconut. Olive oil naturally contains antioxidants and oleic acid which has anti-inflammatory properties.
It’s important to note that tinctures are not designed for vaping! We’ll talk more about CBD and THC for vaping below.
Tablets & Capsules
Tablets and capsules containing THC or CBD provide a discrete, highly portable option. These products include soft gel capsules containing THC and CBD hemp in carrier oil, similar to tinctures. The carrier oil becomes especially important in these products, impacting how much of the CBD will be absorbed after the soft gel enters the digestive system. Products containing MCT oil or olive oil are especially effective.
Tablets are another popular option for using marijuana or CBD. In fact, you can even crush up marijuana or CBD hemp tablets and mix them into applesauce, if swallowing a pill is difficult for you.
There are also sublingual tablets that dissolve under your tongue. Sublingual tablets work faster than swallowed pills since they are designed to be absorbed directly into the bloodstream.
Edibles
Gummies, mints, chocolate and infused beverages—what’s not to love? Edibles are fun, colorful and tasty.
Unfortunately, edibles face challenges moving through our digestive systems. The THC, CBD and other plant compounds in edibles take time to reach the endocannabinoid’s CB1 and CB2 receptors via the intestinal tract.(Check out this link for more information on the endocannabinoid system, CB1 and CB2 receptors).
When someone eats THC or CBD, less than 10% gets into their bloodstream. Cannabinoids are metabolized into active molecules: THC turns into 11-OH-THC, which appears more intoxicating than THC, while CBD is converted to 7-COOH-CBD, a molecule proposed to have an anti-epileptic effect. Eating a meal affects the absorption of CBD. A recent study from pharmacologists at the University of Minnesota examined how eating a meal affects the absorption of CBD.
Also, edibles take longer to kick in. Many new users quickly decide that a single dose didn’t work and eat more. This can lead to an unwanted “high” several hours later when multiple doses suddenly take effect. We suggest that you wait at least two hours after eating an edible dose before deciding whether you need more.
Also, double-check the product label for dosage. In the non-cannabis realm, we’re used to the idea that one candy bar equals one serving. However, when it comes to products containing THC or CBD, the serving size is often a lot smaller. You’ll find more information on edible dosing at the end of this post.
While edibles have certain drawbacks, they provide a familiar mode of ingestion, don’t require special equipment or skills, and are both portable and easy to use. This makes them a favorite for people who are looking for an easy, discreet and enjoyable ingestion option.
Topicals
Topicals encompass a rapidly growing category that includes creams, gels, salves, and beauty products.
You’ve probably seen CBD topical products at your local grocery store, or even in your favorite salon.
CBD topicals may work well for you if you are concerned about medication interactions. It’s also a popular option for people with arthritis who are seeking relief, as well as athletes looking for post-workout recovery.
Topicals that combine CBD and THC are also a popular choice, as well as THC-only products. These are only available at dispensaries in states that have legalized cannabis.
Many of these products include a blend of essential oils and plant terpenes designed for localized pain relief, inflammation or improved pleasure with intimacy. THC topicals may include bath salts, massage oils, and lubes.The cannabinoids in topical products interact with CB2 receptors in your skin but are not absorbed deeply enough to impact CB1 receptors. This means that they are very unlikely to deliver intoxicating effects. (One exception to this is when topicals containing THC are considered “transdermal” or applied to mucous membranes—think mouth, nostrils, vulva or rectal tissues. More on transdermal below.)
Transdermal Patches and Pens
You might think that transdermal patches or gels are topical, since the medicine is absorbed into your skin. However, transdermal products provide a unique delivery method that provides controlled release of cannabinoids directly into the bloodstream over a set period of time.
Transdermal drug delivery has a great advantage over oral administration. It avoids digestion and absorption of the gastrointestinal tract. As a result, transdermal delivery largely reduces drug toxicity and bypasses the first effect of drug absorption. This improves the local drug concentration.
Transdermal delivery is of particular benefit for patients who struggle to swallow oral medications and those experiencing nausea or vomiting.
Inhaling Marijuana and CBD Hemp Flower
For many people, the first image that comes to mind when they hear “cannabis” is the plant flower (buds) that are smoked. In fact, the odds are that if you’re over the age of 30, your first experience with cannabis was smoking plant flower.
The cannabis plant has been smoked by humans since ancient times. Its status as an illegal substance in the United States is a tiny blip in time, when compared to its use throughout history. For many people, marijuana or CBD hemp flower remain their top choice for consumption.
Marijuana flower and CBD hemp flower is minimally processed and provides a range of plant benefits. Many different flower strains are available in the states with legal cannabis. Cannabis strains (chemovars) offer different ratios of THC, CBD and other minor cannabinoids. In addition, marijuana and hemp flower strains provide a range of terpene profiles that can add to the plant’s synergistic entourage effect.
Inhaling marijuana or CBD hemp flower, whether through smoking or vaping (which we’ll explain below) provides a quick onset of the plant benefits. Smoking is also an integral part of cannabis culture used as a ritual for community to come together socially. In fact, etiquette expert Emily Post’s granddaughter recently published Higher Etiquette, a guide on cannabis etiquette in social settings.
Smoking Marijuana and CBD Hemp
How do you smoke cannabis? Flower can be smoked with a bong or hookah, with the flower placed into a bowl and ignited by flame. The smoke then passes through water, which cools it before being inhaled. Flower may also be smoked with a pipe.
You can roll cannabis flower into joints or buy pre-rolled joints. Pre-rolls provide a cheaper, easier option for sampling different strains, though there may be a tradeoff in quality.
Pay attention to any added ingredients as well. Some pre-rolls include added hash oil or kief (resin glands containing cannabinoids and terpenes) to increase potency.
You may already know some of the drawbacks of smoking flower—the smell can be obvious to everyone around, and smoke may irritate lungs and cause a fit of coughing.
When you put a flame on a joint or bowl, you heat the flower to a point where the plant cannabinoids and terpenes are vaporized so they can be inhaled. However, you’re also creating other combustion byproducts that carry their own side effects. Also, there’s no easy way to control the temperature for optimal release of plant-based compounds.
Vaping Marijuana and CBD Hemp
Vaping provides many of the benefits of smoking cannabis, without the concerns about combustion-related byproducts.
“But wait,” you might be wondering, “aren’t vapes dangerous?”
Vaping-associated illnesses were in the headlines throughout much of 2019. The source of illness was narrowed down to illegal/black-market vape cartridges which often contained vitamin E acetate or other contaminants. We previously shared our insights into the crisis on this blog post.
At Leaf411, we believe that vaping can provide a highly effective, fast-acting option for some people in need of a breakthrough treatment option for pain or anxiety/panic attacks. However, we encourage you to seek advice from a qualified cannabis clinician for specific dosing recommendations.
Desktop and portable dry herb vaporizers are designed specifically for flower. These vapes don’t ignite the plant material with flame. Instead, they instead cook it, releasing the cannabinoids, terpenes and other plant compounds in a vapor mist instead of smoke. This creates a smoother inhalation experience for many people. Many dry herb vaporizers also let the user control the temperature, which impacts which cannabinoids and terpenes are released.
Vape oil devices provide an even more customized experience, with a wide range of products available. Some vapes even connect to smartphone apps, much like a FitBit, allowing you to track your favorite products, temperature ranges and doses.
The oils used in vape cartridges may include THC, CBD and additional cannabinoids, as well as either natural or artificial terpenes. Even though these ingredients may sound the same as the ones in tinctures, these two products are completely different and cannot be used interchangeably!
Vape cartridges may also contain additional additives and thinning agents to improve performance in vape devices. It’s important to check vape cartridge ingredients to ensure that the cartridge doesn’t contain vitamin E acetate, polyethylene glycol (PEG), propylene glycol (PG), MCT oil, coconut oil or any other emulsifiers or synthetic agents. You can find additional tips for selecting a safe vape here.
What’s in your Product?
Regardless of the product you choose, you’ll want to take a close look at the product label. You may find that other herbs or ingredients have been added.
For example, many sleep products contain melatonin as well as cannabinoids such as CBD, CBN or THC. This may not be a concern to you; however, you certainly wouldn’t want to take your normal nightly melatonin dose in addition to a cannabis product containing melatonin.
Understanding Product Doses
You may remember a few years ago when the U.S. government sought to simplify food labeling to make the connection between serving sizes and calories clearer. Confusion around serving size was causing many people to eat or drink a lot more calories than they realized!
We’re at a similar spot when it comes to cannabis products, especially edibles. Some manufacturers put the per-dose strength on the product label—for example the package might say “10 mg CBD/5 mg THC.” However, other manufacturers may put the total amount of THC and/or CBD for the entire package instead.
Also, laws restricting the amount of THC per edible vary between states that have legalized cannabis. Limits may also be different depending on whether the product is designed for recreational or medical consumer sales.
How do you get the dose you want?
- If you’re unsure about the product strength, ask your budtender for help. Does the package labeling shows the amount of THC and CBD per dose, or does it show the amount in the entire package?
- Check in with our Leaf411 hotline nurses at no cost. We’ll help answer your questions about product labels and doses. We can also suggest a good starting point based on your individual needs and goals.
- Start slow and go low when trying any new product. The Leaf411 nurses always suggest starting with an amount below the suggested serving size for safe consumption. You may not feel an immediate change or symptom relief. However, starting low and moving up slowly will ensure you do not over consume for your body’s tolerance or specific needs.
- Understand that some product types act more quickly than others. For example, vaping provides more immediate short-term impact, while edibles can take a few hours to take effect. We’ll explain this in detail as we review different types of products below.
It may take some trial and error for you to find your favorite method of consuming marijuana or CBD hemp.
What’s the Best Way to Use Cannabis for Relief?
What method of ingestion works best for you? If you ask budtenders, friends, or people on internet forums, they will likely recommend what has worked best for them—and that may not match your needs.
Also, high quality marijuana and CBD hemp products can be expensive. Many of us cannot afford to spend a lot of money testing different options that may or may not work.
Our Leaf411 cannabis-trained nurses have extensive knowledge on how to best use marijuana and CBD hemp for specific conditions. We provide balanced guidance and education that takes into account your individual needs, whether you have a limited budget, live someplace where you cannot access state legal cannabis, or are trying to find alternatives to conventional medications.
Call our free anonymous hotline today at 844-LEAF411 (844-532-3411) for help with your marijuana and CBD hemp questions.
CBD Hemp 101: Full Spectrum, Broad Spectrum, Distillate and Isolate
Medically reviewed by Katherine Golden, RN
Written by Denise Rustning
Are you confused by all the different types of CBD? Don’t worry, we’ve all been there before!
All cannabinol (CBD) starts off as a compound in either hemp or cannabis plants. The plants undergo various processes to extract CBD, resulting in a range of CBD products. We break down the main types of CBD below, along with the pros and cons of each type.
Full Spectrum CBD: Wide-Ranging Hemp Benefits
Full spectrum CBD oil contains most of the of the hemp plant compounds, including terpenes, flavonoids, essential fatty acids, CBD, cannabigerol (CBG), and trace amounts of tetrahydrocannabinol (THC), staying below the 0.3% federal limit for CBD hemp products. The plant compounds work together to create a synergistic entourage effect that can boost the benefits of the CBD hemp plant. Full spectrum CBD oil is often a green color, reflecting the presence of those compounds. The color and flavor can even change between product batches due to variations in the plants.
- Pro: Full spectrum CBD provides all the power of the hemp plant, available in a variety of product types from topicals, tinctures and edibles to vape concentrates, as well as crumble that can be dabbed (smoked with a special rig). It’s less processed than other CBD concentrate types, as well.
- Con: Full spectrum CBD contains trace amounts of THC (under 0.3%). While it’s not enough THC to be intoxicating, the verdict is out on whether it’s enough to trigger a positive drug test result. Also, because full spectrum CBD retains the original plant compounds, it has a natural flavor that some people may find off-putting. Many manufacturers add fruit or mint flavoring to their full spectrum products to balance out the flavor.

Broad Spectrum CBD: A THC-Free Option Loaded with Hemp Power
Broad spectrum CBD is similar to full spectrum CBD, except that the product goes through additional refinement to remove all THC. It’s important to note that the terms “full spectrum” and “broad spectrum” sometimes get confused, even by product manufacturers and marketers. Furthermore, past research has shown that product labeling can sometimes be inaccurate. Be sure to check the manufacturer’s test results on the product Certificate of Analysis (COA) to confirm this!
- Pro: Broad spectrum CBD maintains most of the plant benefits while eliminating THC, and can be used in the same ways that full spectrum is used. This may be an appealing option for people who want or need to avoid THC due to workplace drug testing; however, given the confusion around labeling, a safer option would be CBD isolate, which we discuss below.
- Con: Removing trace amounts of THC requires additional refinement which also pulls with it additional minor cannabinoids and lessens the CBD content in the process, moving CBD further away from its full plant form. Also, given the concerns around inaccurate labeling and testing, broad spectrum CBD is not the ideal choice for athletes and professionals who are subject to drug testing.
Distillate CBD: A Powerful Hemp Concentrate
Distillate CBD is a concentrate containing between 80% – 90% CBD. In order to make distillate CBD, additional steps take place to filter out impurities and remove most of the non-cannabinoid compounds, including terpenes, flavonoids and essential fatty acids. This process results in a product with a honey-like consistency that is odorless and tasteless.
- Pro: Distillate CBD retains the plant cannabinoids, including minor cannabinoids and THC (less than 0.3%). Distillate is often used in vape products, edibles and topical products given its high concentration, purity and lack of odor or taste. This results in a more consistent product.
- Con: Distillate CBD undergoes additional post-processing extraction. Also, it provides a narrower range of plant-based benefits when compared to full spectrum products.

Isolate CBD: Pure Cannabidiol
Isolate CBD is the purest form of CBD available, consisting of approximately 99% CBD in white powder form. Unlike distillate, CBD isolate doesn’t contain any other cannabinoids or plant compounds. This makes it a favorite among people, such as professional athletes, who cannot risk ingesting even trace amounts of THC. Products made with isolate CBD are often labeled as “No THC,” though you’d want to check the Certificate of Analysis (COA) test results to ensure this is true.
Our Leaf411 nurses recommend using isolate CBD consumer products that are designed to provide consistent, pre-dosed administration, and which are manufactured by reputable companies, such as our member partners. While isolate CBD is also sold as bulk powder, we have concerns about product quality and dosing.
- Pro: Isolate CBD does not contain any THC, making it the safest bet for people who cannot risk positive drug tests. Manufacturers use isolate CBD that they mix into their drink products, foods (edibles), topical products or tinctures, while isolate CBD wax can be dabbed but should be used with caution.
- Con: The drawbacks are similar to those we discussed with distillate CBD. Isolate CBD’s purity means that many other beneficial plant compounds have been stripped out.

How to Choose the Best Type of CBD
We wish there was an easy cheat sheet or quiz for finding the best type of CBD. Beyond a few basic considerations, though, it can be a process of trial and error.
We encourage you to continue your journey into finding reliable, accurate CBD information from reputable sources. One of our favorite sources is ProjectCBD. You can find more CBD 101 information that we stand behind at this link.
Our Leaf411 cannabis-trained nurses are happy to provide guidance on the different types of CBD and how they might help address your specific needs. Call our free, anonymous hotline at 844-LEAF411 (844-532-3411) for medically-sound answers to your cannabis and hemp questions.

Your New Year’s Resolutions – And How Cannabis Might Help
Medically reviewed by Katherine Golden, RN
Written by Denise Rustning
Look at the top New Year’s resolutions and you probably won’t be surprised. Most goals are focused on healthy choices—eating better, sleeping more, exercising. At their core, our resolutions are about finding better balance in our lives.
You might be surprised to learn that legal cannabis and hemp CBD can support your goals for better balance. The key is to use these products in moderation together with other positive lifestyle changes.

You Have an Endocannabinoid System – And It’s Made for Balance!
Your body already has a built-in system for maintaining internal balance (also called homeostasis)—the endocannabinoid system (ECS). This system exists in humans and most animals. It plays an important role in regulating metabolism, sleep, mood, and immunity, along with other functions.
Your body’s ECS contains two types of cannabinoid (CB) receptors: CB1 and CB2.
- CB1 receptors are found in your central nervous system—primarily your brain and spine. These receptors play a role in memory, behavior, appetite, motor control, and perception of pain.
- CB2 receptors exist throughout the body, helping to control inflammation and immune response.
Your body makes endocannabinoids which bind to the CB1 and CB2 receptors, signaling when your body’s system needs to take action to maintain or restore internal balance.
You can also use products which contain cannabinoids that interact with these same CB1 and CB2 receptors to help bring balance.
There are many different cannabinoids. These include cannabidiol, better known as CBD, and tetrahydrocannabinol, or THC. Both are present in cannabis. THC provides the “high” that many people associate with cannabis, while CBD doesn’t have any Intoxicating effects.
When thinking about the connection between your ECS and cannabis, it’s helpful to look at how you already use medicines to help your body. For example, your body generates pain-killing endorphins in response to pain, but you can also take ibuprofen to reduce pain and inflammation. With cannabis, the difference is that endocannabinoids (produced by your body) and cannabinoids (produced by the cannabis plant) are very similar to one another, which minimizes unwanted side effects.
Kickstarting Your Resolutions with a Good Night’s Sleep
Better sleep may not be on your list of New Year’s resolutions. However, being well-rested will definitely help you achieve your goals!

While many of us get the recommended amount of sleep each night, the quality of that sleep isn’t great for a lot of folks. The National Sleep Foundation reports that over a third of Americans report low-quality sleep.
Many people are discovering that cannabis and CBD hemp products help them relax, fall asleep, and wake up more well-rested. However, finding a product that works for you may take time, and the options can feel overwhelming!
If you are interested in using flower (the plant buds), start with indica-dominant or hybrid cannabis strains that are known to promote good sleep. These strains also contain beneficial plant compounds called terpenes that help with sleep as well.
Cannabis edibles designed for sleep are also an appealing option for many people. While edibles take longer to kick in than smoking or vaping, their effects also last longer. This means that if you wake up in the middle of the night to use the restroom, you might feel unexpectedly high. Edibles also have a reputation for causing brain fog in some people when they wake up, though this isn’t the case for everyone. Timing is key when consuming your product. Our nurses at Leaf411 can help guide you in the right direction for the best edible dosage and timing.
Also, you’ll want to check the label on any edibles or tinctures for the full list of ingredients. Manufacturers sometimes add melatonin, valerian or other herbs to boost their product’s sleep-inducing power. It’s up to you to decide whether those added ingredients are needed or not.
Our founding members at 1906 have put exhaustive research and refinement into their formulation, Midnight, because sleep issues are one of the most prevalent health problems Americans face. Midnight’s key ingredient, corydalis, has been used for millennia, and works in several crucial ways which maybe why it’s 1906’s best-selling product!
Cannabis plays a useful role in improving sleep quality, though too much THC and CBD can be counterproductive, increasing alertness or anxiety, or leaving you feeling groggy the following day. If you experience any of these symptoms, you may want to look for a product with lower THC and CBD concentrations or try CBD hemp products instead.
Some people prefer products that don’t contain THC, either due to employment-related concerns with drug testing, anxiety or personal preference. CBD isolate products provide a great alternative—but make sure you ask for a COA (Certificate of Analysis) prior to purchasing to ensure it has zero THC.
It’s important to note that CBD is not a sedative. It will not knock you out like a prescription sleep medication. Instead, CBD’s power comes from its potential to reduce anxiety and pain while also helping to regulate sleep. Hemp-based products are widely available online and in retail stores, eliminating the need to visit a dispensary (though many dispensaries may carry CBD products as well). Remember to look for reputable manufacturers who provide COAs to back up their product quality.
Our founding member Altus’s mission is to empower you to make the most educated and personal choice when selecting a cannabis product. They created helpful Pillars to categorize their products based on users’ needs. Their Ritual products are low-dose thc or non-intoxicating products designed for daily lifestyle needs. That includes maintaining endocannabinoid system balance, managing minor issues, and helping to get better rest.
If you’ve ever talked to our Leaf411 nurses, you’ll know that cannabis is only part of the picture when it comes to better sleep. We also encourage you to look at underlying issues and bedtime habits that may be keeping you up at night. Even the strongest indica can only do so much, if your nighttime routine includes scrolling through drama-filled threads on Twitter, Facebook or Instagram
Our Leaf411 hotline nurses are happy to discuss the pros and cons of different cannabis sleep products with you. Call our free, anonymous hotline at 844-LEAF411 (844-532-3411) for guidance specific to your needs.
CBD-Powered Workout Recovery
Exercise tops many peoples’ lists of resolutions. Sadly, it’s a resolution that many people quickly abandon for well-known reasons: the goal isn’t specific enough; it’s not stated positively; or it doesn’t answer the “why”—that is, why the goal is important to you. Many articles provide helpful tips for sticking with your exercise goals (like habit tracking or setting specific goals or identifying why you’re doing it).
We have an additional suggestion for keeping your exercise resolutions: CBD. Waking up early on cold, dark winter mornings is hard enough without fighting against soreness from the previous days’ workout. Many professional athletes use CBD products for pain and post-game recovery. You don’t need to be a pro player to tap into the benefits of CBD, though!
Our founding members over at Arcanum have been dedicated to producing products that complement active lifestyles. They were the first company to sponsor a professional sports team in the United States and know a thing or two about recovery!
Arcanum Edge’s Sarco Freeze topical cooling gel comes in two different strengths, and combines CBD with arnica, menthol and other herbs to provide immediate post-workout relief while also soothing sore muscles. Sarco Freeze received a positive review by the Athletes for Care Tastemakers program, which is made up of professional athletes.
They also offer Sarco Skin, the first CBD and menthol-infused kinesiology tape and The Coil family of tinctures which are terpene-infused for more benefits and bioavailability.
Arcanum Edge’s best-selling product is The Quill transdermal gel delivery pen. The Quill provides patented transdermal delivery of a precise microdose of full spectrum extract and terpenes. Leaf411 is proud to support Arcanum Edge as a trusted source for performance-driven CBD products. Arcanum Edge products are third-party tested with their COAs available online. They also provide a 30-day, 100% money back guarantee.
Out of Balance: Too Much Cannabis?
Cannabis is a tool, not a magic cure-all. While we enthusiastically support the benefits that this plant provides, we also caution that you can overdo it with any medicine, including cannabis. If you would like help cutting down on your marijuana use or switching to different types of products (for example, switching from smokable flower to edibles), our Leaf411 cannabis-trained nurses can help by providing non-judgmental, balanced guidance. We also provide resources at our online library.
Are you interested in exploring cannabis or hemp CBD’s health benefits in 2020, but not sure where to start? Our nurses can help! Call our free, anonymous hotline at 844-LEAF411 (844-532-3411).
The Leaf411 cannabis nurse hotline provides free, anonymous education and directional support to the general public about the safe use of legal cannabis. We partner with select business members who meet our rigorous standards to extend our education and outreach efforts.