Cannabis and Pediatric Patients: A Closer Look at the Medical Marijuana Card Process for Children in Colorado

Medically reviewed by Katherine Golden, RN
Written by Denise Gonzalez-Walker

Back in January, we wrote about the pros and cons of medical marijuana cards. The overall takeaway was that if you live in a state like Colorado that has legal adult-use (rec) cannabis, you very likely don’t need to invest the time and money into a med card (also called a red card, since the cards originally were printed on a red certificate), at least not at first.

However, there were a few notable exceptions, including situations where the patient is under the age of 21. In those cases, med cards are a legal necessity! 

Medical Marijuana Cards for Children Under 18

As of July 2020, the State of Colorado’s Medical Marijuana Registry includes a total of 286 patients under the age of 18, with 138 of those patients between 0-10 years old. While pediatric patients make up only a fraction of the registry, their need for relief is treated just as seriously by the state, with standard processes and safeguards in place to ensure safe access to legal cannabis.

Indeed, patients’ access to safe, legal cannabis is at the front of our minds these days as we fully launch our Leaf411 Affordability Program. One of the program’s priorities is to provide scholarships to patients seeking med cards, with a special emphasis on supporting minor patients who must undergo two independent medical evaluations as part of their med card application process. This doubles the burden on families both in terms of time and finances.

Costs aside, it can also be daunting to navigate the bureaucratic processes required to obtain a med card for your child. That’s why we decided to use today’s blog to walk you through Colorado’s medical marijuana card application process for minors.

A medical professional and patient review a qualifying medical conditions checklist for a medical marijuana card.

Know What Medical Conditions Are Covered

Qualifying debilitating and disabling medical conditions for medical marijuana cards vary from state to state. In Colorado, the qualifying conditions include seizures, persistent muscle spasms, cancer, PTSD and Autism Spectrum Disorder. You can find a full list here.

Beyond knowing what conditions are covered, it’s important to educate yourself on cannabis and cannabis therapeutics before pursuing a med card for your child, according to Leaf411 Advisory Board member Dr. David Gordon, who sees adults and pediatric patients for medical marijuana evaluations at his practice, 4 Pillars Health & Wellness. That education can help you come into the process with realistic expectations and be more prepared for the evaluation process. 

For example, Dr. Dave shared that many people come into the process thinking that CBD is the only compound in cannabis that has value as medicine, while THC is a ‘drug’ to be avoided. That’s not the case at all! 

“In reality, both CBD and THC are highly effective medications, and typically a good cannabis regimen will include both compounds.  Adding THC to someone’s regimen, including children, does not mean the patient is getting high,” says Dr. Dave.

Our Leaf nurses are a great resource at this step. Our nurses can help you understand the compounds of the plant, provide balanced education so you can make an informed decision on when it’s necessary to visit with a cannabis MD, and they’re available at no cost to you! Call 844-LEAF411 (844-532-3411) or chat us from the homepage during our hotline hours. We also have a section in our Leaf Library dedicated to research and news specific to cannabis and minors.

A parent and school age hold hands as they walk away.

Understanding Your Role as a Caregiver

When applying for a medical marijuana card for your minor child, you’re considered the caregiver. As a caregiver, you’ll be responsible for submitting your child’s application and renewal, as well as growing or purchasing cannabis on behalf of your child.

There are four different types of caregivers under Colorado regulations:

  • Cultivating: grows marijuana on behalf of patients.
  • Transporting: transports marijuana for homebound patients. 
  • Parents of a minor patient: Parents of a patient under age 18.
  • Advising: Advises patients on the medicinal use of marijuana.

Only cultivating and transporting caregivers are required to register with the state (see the Caregiver Registration FAQs for more information).

Which Comes First? The Physician Evaluation or the State Med Card Application?

We brought this question to Dr. Dave, who said it’s helpful for the parent or guardian to start the online med card application process before the physician visit, stopping at the point when the application asks for the physician certification. After the visit, you can go back and complete the application.

Round wooden buttons numbered ‘1,’ ‘2,’ and ‘3’ representing steps in the state medical marijuana application process.
Close-up of hands on a laptop keyboard, as the person completes the online med card application.

Completing the Online Marijuana Med Card Application

The online application requires you to provide proof of your child’s identity, parents’ identity and residency in Colorado by supplying the following:

  • Child’s social security number
  • Child’s certified birth certificate
  • Both parents’ Colorado-issued photo IDs. If you recently moved to the state, there are alternate ways to prove residency–ask the physician’s office what documents they require in this case.
  • If the other parent lives in-state but is unable to attend the evaluation, you’ll also need to provide a signed, notarized Minor Patient Consent Form
  • If the other parent lives out of state, you’ll need to submit a copy of their out-of-state ID, unless they are deceased or do not have shared custody. In those cases, you’ll need to provide certified sources reflecting the other parent’s status.

Another part of the med card application process that can be confusing is the “Cultivation Information.” Basically, this is where the state is asking how you’ll get your child’s cannabis medicine. Will you grow it? Buy it in a dispensary? Or both?

Many people prefer to use legal medical marijuana dispensaries which have a wide range of product types and ratios. As a caregiver, you will use your child’s med card to purchase medical marijuana products from dispensaries on their behalf.

Finding a Medical Marijuana Evaluation Physician for Pediatric Patients

It’s highly unlikely that your child’s regular pediatrician or care team will officially recommend medical marijuana, due in part to cannabis’s lack of approval by the FDA. They might risk losing their job if they began recommending cannabis to patients. However, the conversation is slowly changing around cannabis’s potential in pediatric patients, with organizations like Children’s Hospital Colorado developing pediatric medical marijuana policies that address safe use.

How do you find the two providers willing to complete medical marijuana evaluations? While most physicians steer away from conducting medical marijuana evaluations for either adults or children, others are attracted to the field of cannabis medicine after seeing the life-changing difference that cannabis made in their patients’ lives.

In Colorado, a medical marijuana physician must be either an MD or DO who is in good standing and licensed to practice in the state. They also need to be registered with the state to submit medical marijuana certifications online.

At Leaf411, we can help point you toward reputable physicians for your child’s medical marijuana evaluation. We’ve also partnered with select physicians as part of our med card scholarship program. To learn more about this program, check out our Affordability Program page. The link to apply is at the bottom of that page.

Screen with the words ‘Doctor’ and ‘Find’ with doctor in background.
Medical history form which is required as part of the medical marijuana evaluation process.

Preparing for the Medical Marijuana Evaluation Process

Adult medical marijuana evaluations can be very quick and casual, depending on where you go and what level of visit you select. Children’s evaluations, however, tend to be more detailed due to state medical marijuana requirements for this age group.

Plan to bring the same documents that you provide to the state documenting identity and Colorado residency, as well as your child’s medical records and any notes on other treatments or therapies you’ve tried for the child’s condition and the benefits/downsides to those treatments. 

This information helps the physician determine your child’s eligibility for a medical marijuana card. Remember that the physician is bound by law, and can only recommend a med card if your child suffers from one of the state-designated conditions.

Beyond the paperwork, Dr. Dave says it’s important to make sure ahead of time that you’re clear on your specific goals for plant-based therapy as well as any other approaches the physician might suggest. 

Be prepared for the physician to suggest other behavioral or nutritional tools that can complement cannabis medicine. 

Dr. Dave says, “Cannabis is not a one-size-fits-all treatment like most other medications. It can take up to six months to dial in an optimal regimen.  It’s also important for people to know that neither cannabis nor any other medication is ever going to be a magic bullet. To achieve great outcomes, cannabis has to be just one part of a comprehensive treatment plan that typically involves a variety of lifestyle measures.”

At the end of the visit, the physician submits their certification online to the state’s medical marijuana registry. That certification includes your child’s name and identifying information, making it easy for you to link to when you finish setting up your child’s online account with the state.

Close-up of man’s hands as he contemplates pros and cons of a medical marijuana card.

Considerations Before Applying for a Medical Cannabis Card for Your Child

Many parents come to cannabis after exhausting conventional options for managing their child’s seizures, chronic pain or cancer treatment side effects. That was our board member Amy Dawn Bourlon-Hilterbran’s experience, ultimately leading her to form the American Medical Refugees group for other parents in similar situations.

At Leaf411, we’re committed to providing straightforward, balanced information. While we believe in cannabis’s therapeutic potential, we also know that in the current environment, cannabis still suffers from stigma and misunderstandings that could create challenges as you pursue a medical card for your child. 

We don’t mean to discourage you here, but simply prepare you for any potential roadblocks or unanticipated consequences before they arise. These barriers can be very frustrating when all you’re trying to do is find a safe alternative for your child’s health condition:

  • When considering a med card for your child, make sure that you and your parenting partner(s) are on the same page about the plan and your goals for your child’s health. This is especially critical when parents are separated, since even a parent’s legal cannabis use may factor into court decisions around custody.
  • Also, school district policies are evolving in Colorado and other states with legal medical marijuana. Depending on where you live, you’ll likely need to review the laws and provide education to your childcare providers or district personnel who are concerned about liability or loss of federal funding.
  • In higher education, many universities including the University of Colorado and Colorado State University prohibit cannabis possession on campus, with both universities stating that “possession of a Medical Marijuana Registry identification card does not authorize a student to possess, use, or distribute marijuana on campus. This includes university residence halls, dining facilities and public areas.” Students with a documented medical need for cannabis may petition to be released from on-campus housing requirements, though.
  • As long as cannabis remains illegal at the federal level, regular cannabis use will be a likely disqualifier for enlisting in the military, even if the person holds a med card. However, it’s very likely the health condition your child suffers from would be disqualifying in and of itself, so this may not be a concern.
  • If your child is employed or participates in extracurricular activities, they may also be subject to random drug testing—and simply living in a legal state and holding a valid med card isn’t protection against disciplinary action.

So that’s the bad news–for now. Support for full legalization of cannabis is widespread and growing, as the public and medical professionals learn more about the benefits of the plant. As a parent seeking cannabis medicine for your child’s serious health condition, you’ll be one of the pioneers. Other parents have walked the path before, and are willing to share their support via organizations like American Medical Refugees.

Silhouette of young girl and caregiver holding hands with sun shining in background.

A Final Word of Encouragement

When we asked Dr. Dave what he’d say to patients who are contemplating cannabis as an alternative for themselves or their children, he said this: 

“No one needs to be scared of cannabis treatments. When used appropriately, cannabis therapeutics are extremely safe among all age demographics. Most of the fear-mongering is from people who know very little about the plant and its compounds. Many patients who are looking to cannabis have been struggling with issues for years or decades and haven’t been given treatment options beyond pharmaceuticals and surgeries. These patients often have little hope for success. Cannabis can be a powerful medicine but also a gateway into the greater world of integrative health which provides an abundance of options to help these patients achieve success.” –Dr. Dave Gordon

Leaf411 Provides Balanced Cannabis Guidance without Judgment

Remember that we’re happy to help answer your questions on our free anonymous hotline at 844-LEAF411 (844-532-3411). Our Leaf nurses talk to many parents and guardians who are at all stages of their journey helping their children–from those just beginning to seek out alternatives to parents who are seeking guidance on the best CBD: THC ratio for a particular health concern.

Sign up for our newsletter below to be the first to learn about upcoming Leaf Learning: Get the 411 Series events and other news about what we and our Leaf411 supporting members are up to!

Our Top April 2020 Hotline Questions: Cannabis and COVID-19

Cannabis Users’ Questions as the COVID-19 Pandemic Progressed

As the COVID-19 pandemic evolved, so did your questions. Today, our Founder and CEO Katherine Golden, RN, shares some of the most common types of cannabis and hemp CBD questions the hotline received over the past few months. Katherine also talks about why the questions that she and other Leaf nurses are currently receiving gives her hope as we all adapt to changing circumstances brought about by COVID-19.

When COVID-19 first came to Colorado, there were still many, many unknowns with the virus. Guidance at the national, state and local levels seemed to be changing on a daily basis.

At Leaf411, we immediately sprung into action to do all we could to support both our community members and the cannabis industry as a whole.

Old-fashioned red telephone handsets representing busy COVID-19 hotlines.

After hearing that many health hotlines were being overwhelmed with questions about coronavirus, we expanded our hotline’s scope to respond to general questions about coronavirus. We also took cues based on caller questions and developed marijuana dispensary preparedness plans and resources, which are discussed below.

Portable credit card machine held in a gloved hand, showing precautions marijuana dispensaries take to keep customers and employees safe.

The First Round of Cannabis Consumer Questions: Product Safety

On our hotline, we began receiving questions focused on callers’ immediate concerns around access and product safety. Colorado and other states with legal cannabis designated cannabis as essential which ensured access; however, one big question remained: How do I know my product is safe?

CBD hemp consumers and legal marijuana consumers were worried about potential virus exposure via product packaging. They also had many questions about how to ensure product manufacturers, in-person and online retailers, and legal marijuana dispensaries were safely handling products prior to sale.

In response, we provided the latest information based on Centers for Disease Control and Prevention (CDC) and World Health Organization (WHO) guidance, translating those recommendations to the cannabis space.

We also developed preparedness plans and resources for both our supporting members and other non-member dispensaries.

Colorful cannabis edible gummies stacked next to a cannabis leaf.

Changing Cannabis Questions: Concerns about CBD and COVID-19

Legal marijuana dispensaries and CBD hemp sellers did a good job developing safety plans for both their employees and customers, often going above and beyond state mandates for essential businesses. Once customers became familiar with the new protocols, their concerns about product and packaging safety subsided.

However, as everyone’s understanding of COVID-19 continued to grow, research emerged that nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen could worsen COVID-19 symptoms. This issue is still being discussed and debated in the clinical research community. Like many things with COVID-19, we are still very much in the learning phase.

As research on NSAIDS and COVID-19 began circulating in the news, we started fielding calls on the hotline from people who use CBD for its anti-inflammatory properties. Many people have success using CBD to manage symptoms related to osteoarthritis and inflammatory pain. Did they need to change course to reduce their risk of developing serious coronavirus symptoms?

On the Leaf411 hotline, our guidance is always driven by both the research and the unique needs of each caller, so we can’t give a one-size-fits-all answer here. 

However, this resource may help, if you have general questions about cannabis and COVID-19. 

Also, our fully-licensed Leaf nurses are available to answer your specific questions at no cost to you at 844-LEAF411 (844-532-3411).

Clinician wearing PPE holds up a chest x-ray, looking closely for signs of COVID-19 infection.

Cannabis and Lung Health During the Coronavirus Pandemic

COVID-19 is a respiratory virus primarily affecting the lungs. When the virus began to spread, we anticipated that many cannabis users would switch over to non-inhaled products—things like edibles or tinctures.

The reality has been more complicated than that. It’s true that sales figures for edibles (which include tinctures) are strong. However, flower (bud) also remains very popular.

Some industry experts think this is because cannabis flower is the equivalent of a comfort food. Most peoples’ first cannabis experiences were smoking flower, and in times of uncertainty people go back to what they know and trust.

Other people are moving forward with trying new cannabis consumption methods. On the Leaf411 hotline, we’ve heard from people who are navigating the switch from smokable to ingested cannabis products.

It can be difficult to figure out how much to start with, when changing from a flower product containing about 25% THC to an edible with 10 mg THC per piece. Add on to that the fact that inhaled THC enters your bloodstream more quickly while edible products pass through the digestive system and are changed by your metabolic practices. This means using flower versus edible can be very different in how quickly it hits, how long it lasts, and how intensely effects are felt.

Close-up of hand holding joint offering it to another person, with the other person’s hand up declining, choosing other cannabis consumption methods instead.

Cannabis Consumption Methods: Questions About Moving from Flower to Edibles

The switch from smokable to edible cannabis products isn’t as straightforward as you’d think, even for experienced cannabis users. The calls we’ve received on the hotline underscore the importance of understanding product dosing, and starting low and going slow when switching to edibles and tinctures.

In one case, we received a call from someone who assumed that an entire cannabis-infused chocolate bar equaled one dose. In fact, each square of the cannabis chocolate bar was a separate dose!

It’s an easy mistake to make, considering that grocery store candy bars count as a single serving. Unfortunately, in this caller’s case, their mistake meant that they used more cannabis than intended. While this isn’t life-threatening, it can result in a negative experience.

Due to social distancing practices, you may not be able to chat with your budtender about different products like you did in the past.

At Leaf411, we can help! Our cannabis-trained, fully licensed registered nurses know how flower and edibles differ in timing and dosing. Whether you’re planning an online dispensary order, or just returned home with a new product, we can with any questions you have at our free hotline: 844-LEAF411 (844-532-3411). We’re also available via online chat. Look for the chat feature on the bottom of our website home page.

Young African-American man wearing a casual denim shirt and a surgical mask, with hands outstretched in asking gesture.

Our Latest Cannabis Hotline Questions: A Return to Routine Health Concerns

The COVID-19 virus will be a presence in our world for the foreseeable future. The latest calls to our Leaf411 hotline reflect this new reality. The anxiety and fear are still there, but it’s no longer an emergent issue demanding all of our attention. This shift in focus is an encouraging sign, showing that people are finding balance and perspective despite challenging times.

People are shifting their focus back to ongoing health concerns, and medical facilities are opening back up for routine care and elective procedures. (It’s important to note that “elective” includes a wide range of procedures, including joint replacements, biopsies, and even some cancer treatments!) 

As people return to routine care and undergo elective procedures, we’re hearing more questions about cannabis as an alternative for managing health conditions. We’re also getting questions about using cannabis both prior to and after surgery.

Of course, you’ll always want to share your medical history, including cannabis use, with your doctor prior to any surgery or medical treatment. You should also talk with your primary provider ahead of time about your goal to use cannabis as an alternative to opioids following surgery.

If you need help with talking points or research to share with your provider, give us a call at 844-LEAF411 (844-532-3411). Our Leaf nurses understand the clinical research supporting cannabis and can help you find the right resources and research to share with your doctor.

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.

Question of the Month: What Are Transdermal Cannabis Patches and Gels?

Medically reviewed by Katherine Golden, RN
Written by Denise Gonzalez-Walker

We often get questions on the Leaf411 hotline about the different types of cannabis products on the market today.

The product people are most surprised to hear about? Transdermal patches or gels containing cannabis plant compounds—either cannabidiol (CBD), tetrahydrocannabinol (THC), or both CBD and THC. Transdermal products may also feature other cannabinoids like CBN or THCa (tetrahydrocannabinolic acid), which is a raw, non-psychoactive form of THC.

Transdermal products can even contain other cannabinoids, terpenes, and compounds that have therapeutic benefits.

How Transdermal Products Work

What makes transdermal patches or gels different than regular topical products you put on your skin like creams or salves?

Normally, the skin acts as a barrier. While creams and salves are absorbed by the outer layers of skin, they do not make it past all the skin layers and into the bloodstream.

However, transdermal products contain specially formulated carrier agents to help medicines, including cannabinoids, to fully penetrate the skin barrier and be absorbed directly into the bloodstream.This route of administration eliminates the need for medicines to first pass through the digestive system or respiratory system (if inhaled). It also allows for more consistent dosing over longer periods of time.

Transdermal patches and gels are not unique to cannabis. In fact, you’ve probably seen transdermal patches used to deliver other medications.

Transdermal routes of administration are used for certain birth control products, smoking cessation and motion sickness. They’re also used to deliver opioids like fentanyl that are prescribed for persistent chronic pain.

Cannabis transdermal patches use the same technology. The middle of the patch contains different cannabinoids like THC, CBD, or CBN. In some cases, terpenes and other therapeutic compounds like menthol or eucalyptus are also added. Manufacturers also add carrier agents, so that the compounds will be more readily absorbed through the skin and into the bloodstream.

The Advantages of Transdermal Cannabis Products

Transdermal cannabis patches and gels are a good option for people who want cannabis’s therapeutic benefits, but have health conditions or other restrictions that prevent them from either inhaling (smoking/vaping) or ingesting edibles or pill-based forms.

Finding an Effective Transdermal Product

Product quality is a big factor when choosing transdermal cannabis products. As we mentioned earlier, simply putting a cream or salve on your skin and letting it soak in does not make it “transdermal.” Many people—and even some budtenders—don’t understand this difference.

Look for products specifically labeled as “transdermal,” and make sure the manufacturer provides Certificates of Analysis (COAs) on their website with test results confirming the amount of THC, CBD and other cannabinoids.

CBD hemp-based transdermal patches and gels are federally legal (containing less than 0.3% THC). They can be found online or in retail outlets in most states.

Transdermal patches and gels containing higher amounts of THC are only legally sold at recreational or medical dispensaries.

How to Use Transdermal CBD Products

Transdermal CBD patches or gels are typically applied on a part of your body that has veins near the skin’s surface, like the inside of your wrist or on your ankle. The time of onset is rapid, sometimes within 20 minutes, and lasts for up to 12 hours. Remember that CBD is not intoxicating, so you won’t feel “high” from a transdermal CBD patch.

In some cases, transdermal patches can be applied elsewhere on the body for localized relief. For example, our supporting member Arcanum makes Sarco Skin, a CBD-infused kinesiology tape. Kinesiology tape is a favorite of athletes, and may help by supporting muscles and joints, while also having a positive impact on pain signals.

How to Use Transdermal THC Products

Transdermal products containing THC work in much the same way as those containing CBD, with relatively quick onset and an extended, consistent dose. Many people report that the intoxicating effects of THC are more subdued when using transdermal products containing THC or a 1:1 CBD:THC ratio.

When considering your dose, take into account that almost all of the cannabinoids contained in the patch are bioavailable. In other words, you don’t lose part of the dose through first-pass metabolism in your digestive system like you do with edibles.

We always suggest starting with one-fourth of the suggested dose or serving size. 

Transdermal gel can be dosed in smaller amounts. 

For transdermal cannabis patches, products like Mary’s Medicinals transdermal patches can be cut into smaller pieces to provide a lower dose. We suggest you check the manufacturer’s website to make sure the transdermal patch is designed so that it can be cut into smaller portions.

Need Help with Your Cannabis Questions?

The FREE anonymous Leaf411 hotline nurses can help with your questions, whether you’re a recreational cannabis user, patient, or a clinician wanting to learn more about plant-based medicine. Call us 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.

Leaf411 Question of the Month: Does Cannabis Interact with Other Medication?

Medically reviewed by Katherine Golden, RN
Written by Denise Gonzalez-Walker

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.

Smiling senior woman on phone holding prescription bottle, asking about drug interactions with cannabis.

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?

Prescription bottle with warning labels to not eat grapefruit while taking medication, and to take medication as prescribed.

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. 

Leaf411 Question of the Month - December 2019

By Katherine Golden, RN
Leaf411 CEO

Each month, I’ll share insights on questions we receive at the Leaf411 cannabis nurse hotline. While the hotline is anonymous, we keep track of the types of questions we get so that we can continually improve our services.

A Surprising Cannabis Question

One issue I hear all the time, including when we’re out at events like our Veteran’s Day booth, is that people think they have to inhale to get the medicinal benefits from cannabis. It’s surprising to me that this misconception is still prevalent across all age groups.

For those of us in the industry, we know that many different THC and CBD product types are out there—edibles, tinctures, transdermal patches and gels. Sometimes we assume that everyone else knows about these options as well. But when I discuss ways that cannabis can be consumed, people are surprised and have a lot of questions about which route might work best for them.

For example, I recently had a caller who wanted to try cannabis for a specific health concern but was worried how it might impact their liver issues. They had no idea that transdermal patches were an option. When I suggested a transdermal patch, they responded, “Oh, like a pain patch!” It was a medication delivery method the caller knew how to use, and it offered a safe alternative. Transdermal patches deliver THC, CBD and other cannabinoids directly to the bloodstream, bypassing the liver.

I also educated the caller about transdermal gel pens which are used on the venous areas like the inside of the wrist. They were just blown away that these types of advanced products exist in our market. Calls like this really underscore the need for education.

At Leaf411, Our Priority Is Always the Public

Our priority at Leaf411 is always the public, helping people find the best information and resources for safe cannabis use.

When I get a call, my first priority is to listen and understand why the caller wants to go down this road. I’ll ask questions about products they’re already using. If they haven’t tried cannabis yet, I’ll ask why they want to start and what their goals are.

I also spend a lot of time discussing balance. Cannabis by itself is not a magic bullet. I ask questions about callers’ activities of daily living, diet, exercise and sleep as well.

Cannabis is a plant that is shown to have benefits. However, it’s only one part of lifestyle changes that I and the other nurses encourage callers to consider.

I recently talked to someone who thought they would need to move to a different state to access legal cannabis. In fact, their home state has legalized medical cannabis, and hemp CBD products are available to be shipped to most states. They had not considered these options before our conversation.

My goal is to offer solutions that are financially sound and accessible, based on each caller’s unique situation and needs.

When it Comes to Cannabis, More is Not Always Better

We tend to think more is better. Based on my conversations with callers, that attitude has extended into cannabis and hemp CBD as well. But the latest science is showing that sometimes just a small amount  of cannabis can provide symptom relief. We don’t need to flood our systems, when it comes to what most people are trying to treat.

Also, there is a point where you can take too much marijuana, or even too much hemp CBD. I educate callers about precautions they need to take when using cannabis, just like there would be precautions with any other medications.

Launching the Leaf411 Chat Feature

We want to create the best service possible at Leaf411. It was important for us to get the phone hotline up and running, making sure it was a positive experience for people who contacted us, before adding other options to connect.

Last week, we launched the chat function on our website, providing an additional option for people to contact us.

When someone begins a chat with me, I bring the same level of attention to their concerns. I may start off chatting with someone online and then ask them to call the hotline to talk if at all possible.

People have so much to say, and tone of voice is so important to understanding someone’s needs and concerns. My hope is that the human touch that I and the other nurses provide through the phone hotline will reassure callers, even those who initially reached out to us via chat.

Call or chat our free, anonymous hotline today at 844-LEAF411 (844-532-3411) for answers to your cannabis questions!