Do You Need a Medical Marijuana Card?
By Katherine Golden, RN – Founder and CEO of Leaf411
“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 adult use or recreational (rec) dispensaries. However, 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. CBD hemp (may also CBDa, CBN, and CBG) products are available over-the-counter and online in nearly every state, no med card required! Check out a list of Leaf411 nurse vetted Hemp members here.
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 Leaf411 hotline is the perfect first-step 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, there are brands that do a great job creating products specifically for medical use. One of our supporting members, Wana Brands, is a great example.
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.
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.
- 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 tricky.
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.
- 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.
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 or check out the Leaf411 vetted cannabis clinician on this page.
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.
The Leaf411 cannabis nurse hotline, chat and scheduled nurse guidance call services provide 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.
How Cannabis May Help with Different Types of Pain
From acute to chronic pain, cannabis can be a path towards restored function
By Katherine Golden, RN – Founder and CEO of Leaf411
Much like any other medicine, cannabis is not a magic pill, it is a tool. From the available research and our own experiences working with patients, we have found that the cannabis plant may be an effective alternative or adjunct therapy to potentially lower the doses of opiates or nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and acetaminophen that can cause unwanted side effects.
Cannabis Can Be a Powerful Tool For Pain
When it comes to pain, everyone is different. How you experience pain, as well as your pain tolerance level, is shaped by a lot of different factors. In the same way, people respond to medicines differently.
Cannabis is emerging as a different option, proving to be a powerful new tool for managing pain. The cannabinoids in the cannabis plant, especially cannabidiol (CBD) and tetrahydrocannabinol (THC), have been shown to reduce inflammation and pain. Other cannabinoids (CBDa, THCa and CBG) plus plant compounds like terpenes may also play a role in reducing pain.
Federal restrictions in the United States continue to limit research on how cannabis impacts pain. However, other countries such as Israel have completed considerable research on cannabis’s therapeutic benefits.
What Are the Different Types of Pain?
Understanding the different types of pain and their sources can help you find the best cannabis options.
- Acute pain usually comes about as the result of an injury, overuse, or medical procedure. While the initial pain can be mild or severe, it gets better over time as your body heals. Slamming your finger in a door results in acute pain. Post-workout soreness, broken bones and surgery recovery also fit into this category.
- With chronic pain, “the pain itself becomes the disease,” explains Eduardo Fraifeld, MD. Doctors typically categorize pain lasting over 3-6 months as chronic pain. Chronic pain can be associated with arthritis, migraines, diabetes or multiple sclerosis (MS), among other conditions. It can also be a side effect of chemotherapy or other long-term medical treatments. In addition, when an injury heals yet the pain remains, that fits the description for chronic pain.
Pain can also be broken down into the following categories:
- Nociceptive pain: Pain in soft tissues, tendons or joints caused by injury, overuse, stress or illness. Arthritis and other types of inflammatory pain also fit in this category. Nociceptive pain tends to get better over time, except for arthritis. With this type of pain, inflammation triggers nearby nerves, resulting in aching or throbbing pain.
- Neuropathic pain: Neuropathic pain, or nerve pain, originates in the nervous system. This type of pain is chronic in nature. It often feels like pins and needles, an electric shock, or a burning sensation. Some common causes of neuropathic pain are carpal tunnel syndrome, sciatica, diabetes, and chemotherapy.
- Nociplastic pain: Is a relatively new category for pain that doesn’t fit well into the other two categories. Fibromyalgia, non-specific low back pain and irritable bowel syndrome are a few examples. Also, pain associated with and exacerbated by centralized and peripheral sensitization is an example of nociplastic pain.
THC or CBD? It Depends on the Person and the Type of Pain
Cannabis plant compounds (cannabinoids) work on the CB1 and CB2 receptors in your body’s endocannabinoid system.
Everyone’s endocannabinoid system is different, just like everyone has their own pain tolerance levels. Keep this in mind if a product ends up not working for you, there may be a better product or dose for you. You can always call our registered nurses at Leaf411 for guidance.
CBD: Many people successfully use CBD products to reduce inflammation-based pain. Full spectrum products containing all the plant compounds, including some amount of THC (including CBD hemp that has THC, tend to be the most effective. Primarily because minor cannabinoids, terpenes, flavonoids and essential fatty acids work together to create the “entourage effect.”
By helping to reduce inflammation, CBD may indirectly help reduce pain. However, it doesn’t bind directly to the receptors that control pain like an opioid does. For that, you need a different cannabinoid, THC.
THC: A lot of people immediately rule out products with THC because they’re concerned they will become impaired or “high.”
It’s important to know that small amounts of THC may have little to no impairing effects. At the same time, THC—even small amounts—can be a gamechanger when it comes to pain.
THC can act on the same receptors in your body that opioids do. However, you don’t get some of the problematic side effects that opioids can bring—nausea, constipation, and risk of physical addiction.
Cannabis plant compounds (cannabinoids) work on the CB1 and CB2 receptors in your body’s endocannabinoid system.
Everyone’s endocannabinoid system is different, just like everyone has their own pain tolerance levels. Keep this in mind if a product ends up not working for you, there may be a better product or dose for you. You can always call our registered nurses at Leaf411 for guidance.
CBD: Many people successfully use CBD products to reduce inflammation-based pain. Full spectrum products containing all the plant compounds, including some amount of THC (including CBD hemp that has THC, tend to be the most effective. Primarily because minor cannabinoids, terpenes, flavonoids and essential fatty acids work together to create the “entourage effect.”
By helping to reduce inflammation, CBD may indirectly help reduce pain. However, it doesn’t bind directly to the receptors that control pain like an opioid does. For that, you need a different cannabinoid, THC.
THC: A lot of people immediately rule out products with THC because they’re concerned they will become impaired or “high.”
It’s important to know that small amounts of THC may have little to no impairing effects. At the same time, THC—even small amounts—can be a gamechanger when it comes to pain.
THC can act on the same receptors in your body that opioids do. However, you don’t get some of the problematic side effects that opioids can bring—nausea, constipation, and risk of physical addiction.
Cannabis Compared to Opiates
Ironically, long-term use of opioids for chronic pain can make you more sensitive to pain—an effect called opioid-induced hyperalgesia. What’s the recommended protocol in response to opioid-induced hyperalgesia? To wean off of opioids(with help from your prescribing physician) and find a safer alternative for managing pain. Interestingly, cannabis has shown promise on this front, based on emerging research.
Cannabis does not cause pain sensitization but in fact can help treat it. THC and other cannabinoids work through the same receptors that opioids do. However, the way that they reduce pain (their chemical process) is different.
Neuropathic pain is difficult to treat even with conventional pharmaceuticals. Generally, opioid use for chronic neuropathic pain is ineffective. One study considered the risk and benefits of opioids for the treatment of neuropathies. It stated that “long-term opioid therapy didn’t improve the functional status but rather was associated with a higher risk of subsequent opioid dependency and overdose.”
The Goal: To Restore Function
We wish that we could tell you that CBD or THC products will completely eliminate all pain. However, that is not the case. If there were a magic one-size-fits-all cure for pain, the pharmaceutical companies would have discovered and patented it!
Instead, we always set the goal to reduce pain to a manageable level and restore function. When you restore function, you open the possibility of adding on additional supportive activities such as exercise and relaxation that further promote healing.
Can’t wait to get started? Our Leaf411 quick question hotline and one-on-one scheduled nurse guidance calls are available now to answer your questions about using cannabis to manage pain. Call us at 844-LEAF411 (844-532-3411).
The Leaf411 cannabis nurse hotline provides 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.
Timing Your Dose: How Different Cannabis Products Reduce Pain
by Katherine Golden, RN – Founder and CEO of Leaf411
You have options when it comes to cannabis dosing
Whether you’re looking at CBD hemp or cannabis containing higher levels of THC, you have several different routes of administration to choose between:
- Inhalation (smoking, vaping): Takes effect immediately and lasts 2-4 hours. This is a great choice for instant relief and for treating breakthrough pain (a flare-up in pain). You can also layer inhaled cannabis with a longer-acting method to help get you through the night.
- Transdermal (patches, gels): Extended release option that takes effect quickly, since the cannabinoids are absorbed directly into your bloodstream. The time of onset is rapid, sometimes within 20 minutes. Transdermal products provide a consistent dose of medicine for up to 12 hours. The transdermal patch or gel is used on an area where the veins are near the skin’s surface—like the inside of your wrist or on your ankle.
- Sublingual (placed under the tongue): Sublingual administration can provide rapid relief, however, there are few true oromucosal (sublingual) products on the market. Cannabinoids are fat-soluble and, in their natural state, do not absorb well into the oral mucosa. Moreover, cannabis products are often extracted into oils, and these products are not water-soluble. Patients often expect rapid onset when using tinctures, only to wait 1-3 hours for the dose to take effect. Many products marketed as tinctures will end up being swallowed and absorbed via the digestive system, regardless of how long they are held under the tongue. A true sublingual (a product in which the cannabinoids are formulated to be more water-soluble) absorbs rapidly into the mouth. The effects can be perceived in 15-20 minutes and can last 4-6 hours.
- Edibles (gummies, capsules): Edibles take effect in between 30 minutes and 2 hours. You’ll feel their effects between 5-8 hours. They provide a discreet, portable long-acting option.
- Topicals (creams, salves): Topicals provide short-term localized relief. They can take effect within minutes, and may last for up to an hour.
It may take some trial-and-error to determine just which type of product works for you. In fact, you may discover that there are different routes of administration for different symptoms you are experiencing. For assistance identifying what works for you, contact a cannabis-trained nurse at Leaf411.
The Leaf411 cannabis nurse hotline, chat and scheduled nurse guidance call services provide education and directional support to the general public about the safe use of cannabis. We partner with select business members who meet our rigorous standards to extend our education and outreach efforts.
How to Dose Cannabis: Start Low and Go Slow
Dose sizing can be complicated
by Katherine Golden, RN – Founder and CEO of Leaf411
You may remember when the U.S. government sought to simplify food labeling. This was done to make the connection between serving sizes and calories more clear. Confusion around serving size was causing many people to eat or drink a lot more calories than they realized.
Today, we are at a similar spot when it comes to cannabis products, especially edibles. Some manufacturers put the per-dose strength on the product label and some do not. For example, the package might say “10mg CBD/5mg 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. For example, Colorado’s suggested serving size for an edible is 10mg which would be far too much THC to consume for a first time user.
How do you get the dose you want?
- If you are unsure about the product strength, ask your budtender for help understanding the amount that is in the product before purchasing. Does the package labeling show the amount of THC and CBD per dose, or does it show the amount in the entire package?
- Check in with our Leaf411 nurses. 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 low and go slow 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 exploring for you to find your favorite method of consuming cannabis or CBD hemp.
Cannabis Vaping Update: Are Vapes Safe in 2022?
Three years following the vape lung disease outbreak, consumers should still use caution when selecting a cannabis vaping product
By Katherine Golden, RN
Understanding the Vape Crisis
Our mission at Leaf411 is to provide balanced information and guidance for the safe and effective use of cannabis. When thousands of U.S. citizens became ill and hospitalized with a lung injury associated with vaping in 2019, consumer concern about cannabis vaping increased dramatically. The illness, which became known as “e-cigarette or vaping use-associated lung injury” (or EVALI) resulted in 68 reported deaths by February 2020. Researchers determined the likely cause of the illness was additives in the vape cartridges. This included additives like vitamin E acetate, MCT oil and others that were being used in some THC-containing vape cartridges, primarily in the illicit market. Leaf411 wrote about the issue at the height of the crisis to give consumers the best information on how to use vape products safely.
Today, the U.S. Centers for Disease Control (CDC) reports that emergency room visits due to EVALI have sharply declined. They cite increased public awareness of the issue, the removal of vitamin E acetate and other additives from products and a law enforcement crackdown on illicit products. However, that does not mean the risk to consumers has disappeared completely.
Tips for choosing a safe cannabis vape
Leaf411 wants to remind consumers to use vigilance and common sense when purchasing cannabis vape products to ensure they are only utilizing safe, legal products. The following are tips you should consider when purchasing a vape product:
- Purchase vape products only sold through state-licensed cannabis retailers or licensed delivery services–never from the illicit market. Licensed retailers are required by the state to have their products lab tested to ensure safety.
- Do not consume cartridge concentrates that contain additives such as Vitamin E acetate, polyethylene glycol (PEG), propylene glycol (PG), MCT oil, coconut oil or any other emulsifiers or synthetic agents. While some of these ingredients are safe to eat, they are not safe to vaporize and inhale.
- Only consume concentrates that are third-party lab tested and designed specifically for vaping.
- Ask the dispensary retailer or product manufacturer to provide the certificates of analysis (COA) for the products purchased. The lab results on a COA include the cannabinoid profile, pesticide testing and other critical information about the contents of the cartridge. Budtenders, clinicians and Leaf411 nurses can help answer your questions about the COA.
Remember that the vast majority of products implicated in vape-related illnesses and deaths were purchased from illegal vendors. In addition to problematic additives, many illicit vape pods and cartridges were found to contain dangerous synthetic marijuana instead of actual CBD or THC. So never buy vape products sold through illegal market sources or from non-licensed dispensaries. These products are likely not tested and can be easily counterfeited. To find a trusted manufacturer or dispensary, please review the Leaf411 member directory.
The Leaf411 cannabis nurse hotline, chat and scheduled nurse guidance call services provide 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.
How to Use Cannabis
From Edibles to Vapes, Leaf411 Has Your Questions Covered
by Katherine Golden, RN – Founder and CEO of Leaf411
You have options when using cannabis
When we first started taking calls on the hotline, one of the biggest surprises was hearing how many people thought cannabis has to be smoked to be effective. In fact, we even featured this misconception as our first Question of the Month back in 2019!
Many different types of cannabis and CBD hemp products are available today. These different products are designed to fit a wide variety of needs. You should 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. Give us a call at 844-LEAF411 (844-532-3411) or schedule a one on one call through our scheduling link.
In our guide below, we provide information on different options for using cannabis and CBD products. You’ll also find tips for getting the right dose of this plant-based medicine.
Tinctures
CBD hemp oil tinctures contain full spectrum, broad spectrum or CBD isolate in a plant-based carrier oil. If you’re purchasing a tincture through a dispensary, read the label. Some of these tinctures may contain the medical yet psychoactive cannabinoid THC.
Tinctures are available in different strengths and typically come in 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. That being said, 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. Tinctures are only for oral consumption.
When it comes to tinctures, think of the carrier oil as the vehicle that the cannabinoids travel in to enter your system.
Coconut or palm medium chain triglyceride (MCT) oil are both highly effective. These are the most common carriers for tinctures because they contain smaller fatty acid molecules which are easily absorbed.
Myriam’s Hemp Tincture (MCT oil carrier)
Tablets & Capsules
Tablets and capsules containing THC or CBD provide a discrete, highly portable option. Soft gel capsules contain 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. Capsules containing MCT oil or olive oil are especially effective.
Tablets are another popular option for using cannabis or CBD. This option is great because it resembles medications that patients are used to, like ibuprofen. Tablets and capsules are easy to use, discreet and familiar.
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
Edibles are a broad category containing anything…edible. This includes gummies, mints, chocolate, infused beverages and more.
Edibles face challenges moving through our digestive system. The THC, CBD and other plant compounds in edibles take time to reach the endocannabinoid’s CB1 and CB2 receptors via the intestinal tract.
When someone eats THC, only 4% to 12% gets into their bloodstream. Eating a meal also affects the absorption of cannabinoids. A 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.
Topicals
Topicals encompass a rapidly growing category that includes creams, gels, salves, and beauty products. The name implies that they are topically applied to your skin.
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 spot relief, as well as athletes looking for post-workout recovery.
Topicals that combine CBD and THC are 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 creams. 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 impairing effects. One exception to this is when topicals containing THC are considered “transdermal” or applied to mucous membranes. This includes mouth, nostrils, vulva or rectal tissues. Read more on transdermal products 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 through the skin. This method 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 means more cannabinoids make their way into your bloodstream.
Inhaling cannabis and CBD Hemp Flower
For many people, the first image that comes to mind when they hear “cannabis” is the plant flower that is 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, cannabis or CBD hemp flower remain their top choice for consumption.
Cannabis 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 cannabinoids. In addition, cannabis and hemp flower strains provide a range of terpene profiles that can add to the plant’s synergistic entourage effect.
Inhaling cannabis or CBD hemp flower, whether through smoking or vaping, provides a quick onset of the plant’s benefits. Smoking is also an integral part of cannabis culture used as a ritual for communities to come together socially.
Flower can be smoked with a bong or water pipe, 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.
Pay attention to any added ingredients as well. Some pre-rolls include added hash oil or kief to increase potency.
When you put a flame on a joint or bowl, you heat the flower to a point where the plant cannabinoids and terpenes combust into smoke so they can be inhaled. However, you’re also creating other combustion byproducts that carry their own side effects. While smoking is effective, it carries more risks and side effects than other methods of consumption.
What is CBN and Can it Help With Sleep?
by Katherine Golden, RN – Founder and CEO of Leaf411
As sleep research advances, so does the understanding of how various cannabinoids like CBD and THC may support improved rest. Below, we’re sharing a quick primer on sleep. Then we will take a look at CBN, a cannabinoid that’s being widely talked about as beneficial for sleep.
Understanding sleep cycles is important
Sleep should be simple, right? Lay down, close your eyes and naturally drift into restful, rejuvenating sleep.
Unfortunately, sleep is a battle for many of us. From tossing and turning to experiencing physical discomfort as we settle down for the night. Even once asleep, some people struggle to stay asleep long enough to get the benefits of a good night’s rest.
A basic understanding of major sleep cycles can help when it comes to choosing the best hemp or cannabis products for your needs.
- Non-REM sleep: This takes up the first three phases of sleep. Non-REM sleep occurs when you drift into a light sleep then move into deeper rest.
- REM sleep: This follows non-REM sleep. Most dreaming occurs at this stage of sleep. However, REM sleep’s importance goes well beyond good dreams. REM sleep is also connected to overall brain health and is believed to boost the immune system.
For treatment, clinicians often start by identifying where a patient is encountering difficulty. Is there difficulty falling asleep or staying asleep for the desired length of time? That information can provide valuable clues into the hemp or cannabis product -formulation that may work best. It can also help identify the specific cannabinoids to focus on.
So what exactly is CBN?
Cannabinol (CBN) is created from THC that has been exposed to UV light and oxygen. This exposure leads to a chemical breakdown that transforms the THC into CBN. As cannabis flower ages, its THC will slowly and naturally convert to CBN. Cannabis extractors have also created processes for speeding up the conversion of THC into CBN oil.
Recently, consumers have reported CBN is a useful nighttime remedy. This has fuelled its use in more and more products. Now, cannabis and hemp manufacturers are creating new products that feature CBN because of CBN’s potential natural sedative effects.
But does CBN actually work for sleep?
At Leaf411, we believe the anecdotal research supports many manufacturers’ claims about CBN.
For example, one of our members, Myriam’s Hope Hemp, shared anecdotal data with us based on their customer feedback. Their customers found higher doses of CBN (between 15-40mg) to be helpful for falling and staying asleep. This is just one of many reports Leaf411 has found around CBN’s value.
Tips for finding the right CBN, CBD, or other cannabis product for falling asleep and staying asleep
Falling asleep is one challenge. Staying asleep is another.
Difficulty falling asleep?
Consider using a fast-acting product. You’ll want to use the product about 30 minutes before you want to fall asleep. Examples of fast-acting products from our members include Wana Optimals Fast Asleep Gummies with THC, CBD, CBN, CBG and melatonin. Also, Impact Naturals Rest capsules with CBD, CBN and melatonin.
Difficulty staying asleep?
Consider taking a longer-acting product that is not labeled as fast-acting. Elixinol’s Sleep Good Night capsules containing CBD and melatonin are a great example. These hemp capsules are longer lasting with a slower onset. While these products take longer for effects to kick in, those effects also last longer through the night.
Find the combination that works for you
You may find it helpful to layer CBD or CBN with different natural over-the-counter sleep products. In fact, many products like those listed above already stack several different beneficial compounds.
Always ask your doctor about prescriptions
If you’re already taking prescription medications that make you drowsy as a side effect, talk to your doctor. We strongly recommend you check in with your prescribing clinician before adding CBD or THC products to the mix, to avoid any unwanted effects. This also includes sleep medications like Lunesta (eszopiclone), Sonata (zaleplon), or Ambien (zolpidem).
CBN is only one of several cannabinoids that may help with sleep. Both CBD and THC as well as plant terpenes can also play an important role in your sleep routine. Check out our past blog on THC, CBD and sleep to learn more, as well as our blog on finding the best cannabis product to support sleep goals.
Finding sleep-focused hemp and cannabis products you can trust
Our Leaf411 business members have all been through our vetting process, which includes ensuring their products are fully tested and reliable. We’ve included a list of our members below. Most of them offer products geared toward a good night’s rest, including some who offer products which contain CBN.
Keep in mind that effects may vary due to individual differences in people’s endocannabinoid systems. If you don’t get the result you’re seeking, please reach out to our Leaf411 nurses. Our nurses are knowledgeable about how different cannabinoids may impact sleep onset and duration. You can schedule a guidance call at this link.
Leaf411 can help with your questions about using hemp and cannabis
Our Leaf nurses can guide you to new approaches for improving restfulness and achieving your sleep goals. Whether you’re brand new to hemp or cannabis or an experienced user, we are here to help
Get started by scheduling a low-cost guidance call with one of our Leaf411 nurses at this link. We understand cost may be a barrier for some. That’s why we’ve collaborated with our business supporting members to offer a special code to offset the cost. Just click on any of our Vetted Members’ logos to go to their website and call their customer service number. Then, their agents will provide a special Leaf411 code for you.
The Leaf411 cannabis nurse hotline, chat and scheduled nurse guidance call services provide 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.
Considering Trying CBG? Here’s What You Need to Know
Learn what CBG is, how to use it, and what makes CBG different from CBD and other cannabinoids
Medically reviewed by Katherine Golden, RN, and Eloise Theisen, NP
Written by Denise Rustning
Many of our Leaf411 business members offer hemp and cannabis products that go far beyond THC and CBD, including rare cannabinoids like CBN, CBG, CBDa, THCv and more. In fact, cannabis and hemp plants contain over 100 different cannabinoids, many with unique benefits and effects.
But it can be hard to know what to look for if you’re just getting into plant-based medicine. For this blog, we talked to KOR Medical, one of our supporting business members, to get their perspective on CBG, as well as fast-acting technology that can give these cannabinoids an extra punch. The company offers the KOR Relief Transdermal Cream, a hemp-based product that features CBG and CBD, and does not contain any THC. They also offer a range of use-driven hemp CBD products designed for Calm, Health and Sleep, combining the power of CBD with other beneficial compounds.
One thing we love about KOR Medical is that their leadership team is made up of medical professionals with extensive backgrounds in pharmaceuticals and biotech, including work on cutting-edge diagnostic technologies. The KOR Medical team understands the importance of science, precision and quantifiable results when it comes to product development and manufacturing.
KOR Medical’s work is inspired in part by their mission to provide alternatives to opioid medications.
“Our mission statement and vision is to help confront the nation’s opioid crisis by offering naturally derived options to patients and consumers who are seeking an alternative,” said Morgan Nichols, Director of Corporate Affairs, KOR Medical.
What is CBG?
CBG, or cannabigerol, is sometimes called the mother of all cannabinoids. Why is that? In short, CBG is a precursor to many other cannabinoids found in cannabis or hemp. CBG is converted to other cannabinoids like THCa and CBDa as the plant matures, or through special processes during extraction and product manufacturing.
Will CBG get you high? How does CBG make you feel?
CBG is non-psychoactive, meaning it will not get you high like THC does. As the KOR Medical website explains: “CBG works by binding to CB1 receptors, strengthening the function of anandamide, an endocannabinoid. Anandamide plays a role in enhancing pleasure and motivation, alleviating pain, regulating our appetite and sleep, and more.”
Many people report that CBG makes them feel energized, calm and mentally focused when they use it. It’s a good cannabinoid to add to your daytime routine, and works well when taken together with CBD.
What is CBG used for?
Based on available research, CBG holds strong potential for a number of wellness goals. CBG has been shown to have anti-inflammatory, antibacterial, antifungal and analgesic properties, as well as calming and uplifting effects for adults of all ages. CBG is being used in many different kinds of topical products such as oils, creams, gels, and skin products due to its strong antibacterial and antifungal properties. Some people use CBG to reduce inflammation or muscle and joint pain. It also has been shown to be a potential benefit for a range of skin conditions and irritations.
This minor cannabinoid has caught the attention of athletes for its potential to help with recovery and boost overall wellness, which are laudable goals whether you’re a serious athlete or just looking for ways to boost your daily workout regimen.
“Part of our work at KOR Medical has been looking at how different cannabinoids work together in beneficial ways,” said David Hayek, Product Development for KOR Medical. “CBD has calming and anti-inflammatory properties which can be helpful for addressing sore joints and muscles following workouts. But when developing KOR Relief we took it a step further, looking at other available cannabinoids that might work well in conjunction with CBD to really address the issue. We found that CBG has a lot of research on its performance recovery effects as well as its antibacterial properties which are a good fit for people working out in gym environments.”
How fast does CBG take effect after ingesting a dose?
Your CBG route of administration (edible that you eat; sublingual that is absorbed under your tongue; transdermal topical applied to skin) as well as product manufacturing will impact how quickly CBG effects take effect. Generally, for a conventionally manufactured CBG product like a tincture or gummy, the effects will start in about 45 minutes to an hour, and will last for up to 6-8 hours.
Some manufacturers, including KOR Medical, have developed proprietary manufacturing practices to shorten onset time and improve bioavailability–meaning you are able to absorb more of the cannabinoids in the product, and that absorption happens more quickly.
Fast-acting hemp CBD, CBG and other cannabinoids: Turbocharging hemp’s benefits
Many leading hemp product makers, including KOR Medical, are researching ways to deliver cannabinoids more quickly and effectively. Nanoemulsion technology is one approach being used to break down large oil-based cannabinoid molecules and encapsulate them inside water molecules, effectively making the cannabinoids water-soluble. This allows for faster onset and absorption via skin or mouth, instead of having to wait for the cannabinoids to work their way through the digestive system.
“The benefit of nanoemulsion is that it increases absorption, making for a more effective product,” said Hayek. “We have our own in-house nanoemulsion equipment that reflects the best in the industry, and we regularly test our products to ensure the nanotization process is meeting our high standards.”
Does your product really contain CBG? Check that COA!
Remember to always check the company’s lab results (also called Certificates of Analysis or COAs) when purchasing hemp products. A third-party COA will help confirm that the hemp edible, tincture, topical or other product contains the promised amount of CBD and any other minor cannabinoids like CBG. Many manufacturers like KOR Medical go above and beyond, also testing for molds, heavy metals or pesticides, and sharing those results as well, assuring consumers that the product is free from contaminants.
Using CBG with other natural supplements
As we mentioned earlier, CBG pairs well with other cannabinoids like CBD. KOR Relief Transdermal Cream contains 50mg CBG together with 150mg CBD and menthol to create fast-acting cooling relief that may speed up post-workout recovery.
When considering whether to buy a particular hemp product, you’ll want to closely check the ingredient label to make sure you know all the ingredients you are taking.
Take for example the KOR Medical’s KOR Sleep Strips which contain both CBD and CBN (another minor cannabinoid we recently discussed at Leaf411). KOR Sleep Strips also contain L-theanine, melatonin and tryptophan–three additional ingredients known to support restfulness. Layering these ingredients can be very effective, but it may mean that you need to adjust your other supplement use. For instance, if you’re already taking melatonin at night, you’ll want to cut back on your normal dose when using KOR Sleep Strips, since they also contain melatonin.
Many of our Leaf411 business members go above and beyond when it comes to product quality and consistency. KOR Medical tests both the cannabinoids going into their products as well as the other ingredients as well.
Setting up a CBD and CBG routine that works for you
Hemp and cannabis are often discussed as personalized plant medicine or as a personalized routine because everyone’s endocannabinoid system is different. Your endocannabinoid system contains CB1 and CB2 receptors that interact with cannabinoids, leading to beneficial effects that support your goals for using hemp or cannabis. (Check out our Cannabis 101: The Endocannabinoid System to learn more about how this process works)
Brands like KOR Medical are crafting unique hemp CBD products with minor cannabinoids and other beneficial compounds designed to optimize consumers’ experiences around specific goals, whether that’s faster physical recovery, improved restfulness or immunity support.
However, to get the best experience, you also have to take into account how your own endocannabinoid system reacts to specific cannabinoids or products. That’s why you’ll often find that a hemp CBD product that works well for your friend may not be as effective for you, or that you need to take a lower or higher dose for optimal effects.
Let Leaf411 help design your optimal hemp regimen
Finding the best hemp product for your unique needs and endocannabinoid system can involve trial and error–which means time and money.
Fortunately, our cannabis-trained Leaf nurses can help! Our Leaf nurses are fully-licensed RNs with real world nursing experience, who can provide guidance on building a hemp regimen around your goals, needs and concerns. For example, our Leaf nurses will ask questions about your other medications to help identify any potential interactions.
Visit our Services page to learn more about our scheduled nurse guidance calls then head to our home page and click on “Let’s Talk” to schedule your call.
The Leaf411 cannabis nurse hotline provides 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.
Curious about CBD consumer trends in 2022?
Recent industry report shows need for consumer education on CBD, hemp and more
Medically reviewed by Katherine Golden, RN, and Eloise Theisen, NP
Written by Denise Rustning
Cannabis analytics firm BDSA released new Consumer Insights data on CBD consumption trends in February 2022. While the data are geared toward a business audience, we thought our Leaf411 followers might appreciate a quick look at some highlights, along with Leaf411’s unique insights on current trends based on the patients and consumers we serve on our guidance line.
Consumers lack education on using CBD
One of BDSA’s top findings was just how little CBD consumers know about the products they’re using. According to the BDSA Consumer Insights report, about 40% of CBD consumers rely on friends and family as their main source of information on CBD. Yet 30% of these consumers haven’t heard of terpenes, and 10% haven’t heard the term “cannabinoids.” Cannabinoids, including CBD, CBG, CBN and others, are core to hemp and marijuana’s beneficial effects, while terpenes play a vital role in the plant’s entourage effect. A basic understanding of these plant compounds can go a long way when it comes to finding the best product for your needs.
The BDSA report doesn’t surprise us at Leaf411. Our own data show that about 40% of our calls are focused on Plant 101. We sometimes even hear inaccurate information from callers who “heard it from a friend.”
At Leaf411, we hope to be part of the solution. The BDSA report mentioned the need for brands and retailers to improve their educational outreach–we can help! If you’re a hemp CBD or cannabis brand looking to level up your consumer education game, reach out to us or consider joining Leaf411 as a business member which brings benefits for both your brand and your consumers. Click here to learn more.
Using CBD for health and wellness? You’re not alone!
According to BDSA’s report, CBD consumers cite health and wellness as their primary reason for purchasing CBD. When it comes to specific uses, pain relief tops the list, with better sleep, stress management and anxiety management rounding out BDSA’s top four list.
While our Leaf411 caller data cuts across both hemp CBD and cannabis, we can also say that pain tops our list of conditions that callers contact us about, followed by mental health issues including anxiety and stress, and sleep issues. While the order is a bit different from BDSA’s findings, the conclusion is clear–many people are seeking alternatives for relief when it comes to these issues!
Smoke it? Not when it comes to CBD for most users
BDSA’s Consumer Insights report found that the majority of CBD consumers (around 75%) are using CBD edibles, with CBD topicals coming in second place. Only one-third of consumers report consuming CBD inhalable products including vapes, concentrates and flower.
There may be various reasons for the dominance of this CBD product format:
- CBD edibles offer a user-friendly format for new consumers who are familiar with other orally-ingested products like vitamin gummies.
- CBD edibles are portable and discreet, providing benefits without noticeable smells or smoke.
- The smokeless format may appeal to consumers’ concerns about respiratory health during the pandemic
- CBD edibles are shelf-stable and fit with other retail products sold by health foods stores, grocery stores and other general goods stores.
- CBD edibles are readily available when compared to hemp CBD flower and concentrates which can be difficult to find.
Whether you prefer edibles, topicals or inhalable products, we have fully-vetted business members who offer a wide range of hemp CBD products–visit our business member directory to learn more.
Our fully-licensed Leaf registered nurses (RNs) can also help guide you to the optimal product format for your needs, reducing the need for trial-and-error which saves you both money and time. Click this link to get started scheduling your call.
Assortment of CBD and THC products including Elixinol Omega Turmeric and CBD; KOR Calm CBD sublingual spray; 1906 Love milk chocolate edibles with 5mg THC and 5mg CBD; Wana Quick Pina Colada Gummies with 5mg THC; Altus Juicy Pear Gummies with 10mg THC; trupura Relief Cream with broad spectrum CBD; Seed & Smith Purple Punch strain flower; and a PAX Era Pro used for vaping cannabis oil extracts.
Many people use both hemp CBD and cannabis
Nearly two-thirds (65%) of CBD consumers also consume cannabis containing higher amounts of THC, according to BDSA’s report.
At Leaf411, a little over one-third (36%) of our callers report previous use of both cannabis and CBD hemp, a noticeable difference from BDSA’s Consumer Insights data. Keep in mind that the BDSA report is looking at a broad cross-section of consumers (purchases made), while Leaf411’s callers represent consumers (both thinking about a first-time purchase or have already made a purchase) seeking clinical information or guidance around specific issues.
Our Leaf nurses are here to help with your questions about CBD!
Click this link for our online scheduling service and find a day and time for your Leaf nurse guidance call. Every day our Leaf RNs help consumers and patients at all levels, from canna-curious people who’ve never used CBD or THC before, to experienced users looking for the best cannabis options to address specific health concerns.
Interested in joining Leaf411 as a business member and supporting our mission to improve access to trustworthy information and guidance on plant-based medicine? Visit our Business Membership page to learn the benefits of supporting Leaf411.
The Leaf411 cannabis nurse hotline provides 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.
Are You at Risk for Cannabinoid Hyperemesis Syndrome?
Get answers to questions about cannabinoid hyperemesis syndrome (CHS), a rare yet concerning issue
Medically reviewed by Katherine Golden, RN, and Eloise Theisen, NP
Written by Denise Rustning
Many people rely on cannabis to help with overall wellness and health, even using cannabis as an alternative to opioids which carry risk of addiction and other unwanted side effects.
So with that in mind, what’s up with the scary-sounding condition called cannabinoid hyperemesis syndrome (CHS) that has been popping up in the news over the past year, where cannabis appears to make people sick?
What is cannabinoid hyperemesis syndrome (CHS)?
CHS was officially recognized by medical professionals in 2004. It is a complex, poorly understood medical condition triggered by cannabis use that causes abdominal pain, extreme nausea and vomiting–basically the opposite of what you would expect when using cannabis!
CHS’s primary symptom is extreme, persistent nausea and vomiting that cannot be traced to a different medical cause, hence the word “hyperemesis.”
The progression of CHS includes three phases:
- In the prodromal phase, the patient experiences early morning nausea but does not find relief in hot showers/bathing.
- During the hyperemesis stage, vomiting becomes cyclic and is relieved with hot showers and bathing, though the only long-term solution appears to be to completely stop all cannabis use.
- Recovery starts when the patient stops using THC.
In general, CHS appears in a small number of people after long-term use of marijuana (weekly use over at least a one-year period). Some doctors have also reported seeing the condition in young people who are using a lot of high-THC concentrates, most often “dabbing” the product, even after short-term use.
One other challenge of diagnosing CHS is that the symptoms are very similar to those of cyclic vomiting syndrome (CVS) which is characterized by episodes of severe vomiting that have no apparent cause. CVS is not connected to cannabis use but can present in a similar way.
Because diagnosing CHS is often a process of elimination, ruling out other medical causes, the costs of diagnosis and care can run into tens of thousands of dollars.
Getting too high can make you nauseous – but it’s not CHS if it’s a one-time event
When it comes to cannabinoids like THC, the dose matters. Dr. Russo has discussed how many cannabinoids, including THC, have a biphastic effect. That means THC will do one thing at a low dose, and have the opposite effect at a higher dose.
For example, THC at a low dose may help with relaxation, but at a higher dose it can cause anxiety. While a low dose of THC often helps reduce feelings of nausea, a higher dose may trigger short-term nausea that goes away as the THC wears off. This short-term nausea from getting too high is different from CHS which is a chronic, long-term condition.
Are you at risk of cannabinoid hyperemesis syndrome?
You may be wondering if you’re at risk of developing CHS, especially if you use cannabis regularly as part of your daily wellness routine.
Thanks to the work of Dr. Ethan Russo and others, we do know some factors that appear to influence CHS:
- There is some evidence that repeatedly using high-dose THC may trigger CHS in some consumers, including newer users. It appears that persistent THC use causes CB1 downregulation and the receptors start to hide within the cells leaving more THC circulating and therefore causing increased side effects.
- Researchers have also looked at whether plant pesticides play a role in triggering CHS, zeroing in on NEEM in particular. However, based on a few unique CHS cases where researchers knew pesticides were not present, this hypothesis doesn’t hold water.
- Dr. Russo and others are looking more closely at genetic differences that may make some people more prone to develop CHS, focusing on specific genes. This promising research is in its early stages.
If you want to learn more, we suggest checking out Project CBD’s interview with Dr. Russo at this link.
Our Leaf nurses can help with your questions about cannabis and CHS
Curious whether your current cannabis use puts you at risk of CHS? We can review your current usage and goals and provide information based on the latest research.
A pattern our Leaf nurses have seen when talking to callers across the country is that most callers know something is very wrong but they’re in denial about the severity of their condition and delayed asking for guidance due to the fear that they would be told they needed to abstain from cannabis use. So what is the solution? When it comes to CHS, we believe that wide-scale education regarding the warning signs may help consumers avoid crossing that threshold into CHS.
At Leaf411, we hear from people every day whose lives have been improved with plant-based medicine. Our fully-licensed, cannabis-trained registered nurses also regularly review the research on cannabis’s therapeutic potential.
Our Leaf nurses are also honest about the fact that cannabis may not be the best option for everyone and that in some instances, it may even be contraindicated, which means that we would advise against using cannabis in those cases.
We are happy to help with your questions about CHS or any other questions about cannabis and hemp. We provide unbiased, nonjudgmental guidance tailored to your specific situation.
Live in a state where marijuana is illegal? We can provide guidance on hemp-based options.
Visit our homepage and click on the “Let’s Talk” button to get started scheduling your Leaf411 guidance call.
The Leaf411 cannabis nurse hotline provides 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.
