Recognizing Our Fallen Heroes on Memorial Day

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

While this Memorial Day will be different than most, the true meaning of the holiday remains the same—to honor military service members who died in service to our country.

At Leaf411, we also acknowledge the service members who’ve perished on a different front, as a result of the long-term effects of combat. 

Mental health issues, including post-traumatic stress disorder (PTSD), anxiety and depression haunt many veterans long after they have returned home. In addition, chronic pain from past injuries can wear down even the toughest of warriors over time.

Black and white image of a stressed-out veteran in casual clothes, sitting with his head buried in his hands.

Unfortunately, these realities may drive some veterans to feel there are no alternatives for relief. Many veterans describe their frustration from going down a rabbit hole of conventional pharmaceuticals, where more and more medications are prescribed to counteract side effects from other medications. The end result often leaves them feeling like a zombie, as former Army Specialist Leo Bridgewater describes in this news article

Bridgewater was fortunate to discover cannabis as an effective alternative to the pharmaceuticals that the Veteran’s Administration (VA) “passes out like candy” in his words. He continues to advocate for veterans’ access to cannabis and even collaborated with a New Jersey cannabis cultivator to develop a new chemovar (strain) with a mix of terpenes designed with veterans’ needs in mind.

Sadly, for some of our heroes, cannabis remains out of reach either due to stigma or federal restrictions and suicide begins to appear to be the only option for relief. According to Veterans Administration data, the suicide rate among military veterans is 1.5 times the non-military veteran rate in the United States. Every day, over 15 veterans complete a suicide attempt.

Veterans and Cannabis: Fighting for Effective Plant-Based Alternatives

Veterans like Ron Millward who founded Balanced Veterans, Ryan Foster and Kevin Ogar at The Reville Project , and the leaders of Veterans for Natural Rights embrace a more holistic approach which can include cannabis to treat the veterans’ physical and mental wounds. Many of them have lost fellow soldiers to suicide. They are fierce advocates for veterans’ access to cannabis as an alternative to pharmaceutical treatment.

Are you curious to learn more about how veterans have benefited from cannabis? Check out this 21st Century Cannabis panel hosted by GoFire to hear veterans’ firsthand experiences using cannabis to manage PTSD, depression, insomnia and chronic pain.

Sign saying “Support Medical Marijuana” held above a crowd during a public event.
The U.S. Capitol, where several bills are being considered to improve veterans’ access to medical cannabis.

Current Legislative Action to Expand Research and Veterans’ Access to Cannabis

Research supports the value of cannabis as an effective, safe alternative for veterans who are suffering from PTSD and chronic pain. In March 2020, two bills moved forward in the House of Representatives that would expand research on cannabis’s therapeutic potential to treat PTSD and chronic pain (HR 712), and would allow VA doctors to recommend medical marijuana cards in states with legal marijuana (HR 1647). Currently, VA doctors are restricted from recommending medical marijuana, even in states where it is legal, due to the fact that cannabis is still illegal at the federal level. You can find more details about HR 712 and HR 1647 here.

While the COVID-19 pandemic has created delays in all kinds of important legislation moving forward, including these two bills, veterans like Sensible Colorado’s Kevin Grimsinger and Adam Smith will doubtlessly continue the fight to improve both access and research into cannabis as a safe, effective treatment alternative for veterans.

Holidays Can Be Tough for Survivors

Even in the best of times, holidays can be tough for survivors who’ve lost friends or loved ones.

For veterans, this year’s Memorial Day may be especially difficult due to COVID-19 restrictions. Community events that allow us to get together, reminisce, and celebrate, like the Colorado Veterans Project Memorial Day Run, have been delayed or cancelled.

At Leaf411, it means not being able to meet with our community in person at events like last fall’s Veterans’ Day pop-up at Seed & Smith dispensary. While we have several exciting virtual events in the works, not being able to hear your stories in person and give a hug or a handshake is difficult.

If you’re a veteran who finds yourself struggling this Memorial Day, we encourage you to reach out for help. Find a trusted resource, or call the US Department of Veterans Affairs sponsored Veterans Crisis Line at 1-800-273-8255, or chat them via their website.

The National Suicide Prevention Lifeline is also available 24 hours a day at at 1-800-273-8255 for anyone who is in crisis. The people staffing the lifeline care and are eager to help—you are not burdening them by calling!

Leaf411 is also here for you. While we’re not qualified to provide crisis services (we’ll refer you to the professionals at the Veterans Crisis Line or Lifeline), we do have the background and clinical experience to provide guidance on how to use cannabis for PTSD, anxiety, chronic pain or other conditions. Call our FREE hotline at 844-LEAF411 (844-532-3411) or chat us from our homepage during hotline hours.

Our guidance goes far beyond what you’ll find on anonymous internet forums. Check out last week’s Leaf411 blog post to see an example of how we triage and provide guidance tailored to individual needs.

Katherine stands smiling at the Leaf411 informational table, ready to help veterans with their questions. Katherine a fully-licensed cannabis-trained nurse.
Leaf 411 Co-Founder and CEO/ED Katherine Golden, RN, at the November 2019 Veteran’s Day pop-up event at Seed & Smith dispensary.
Smaller rocks forming an arch between two larger rocks near the ocean, representing finding balance in summertime.

Welcoming Summer and Looking Forward to New Initiatives

At Leaf411, we’re wishing all of you a safe and healthy Memorial Day, which also marks the traditional kickoff for summer. No doubt that it will be more important than ever this summer to find balance. For many of us, cannabis is one of the tools we rely upon to achieve this.

That’s one reason we’re excited about several upcoming initiatives we’re working on to make cannabis more accessible and affordable for patients. We’re not quite ready to share details yet, but encourage you to subscribe to our newsletter so you can be the first to know as these new programs roll out. Sign up for our Leaf411 newsletter below! 

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.


Cannabis and COVID-19: Do You Need to Change Your Cannabis Routine?

A Detailed Look at How Leaf411 Cannabis Nurses Help You Find the Best Cannabis and CBD Hemp Products for Improved Mental Health

Headshot of Leaf411’s Jennifer Axcell smiling in sunny outdoor setting.
Jennifer Axcell, Co-Founder and COO of Leaf411

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

Leaf411 co-founder and COO Jennifer Axcell has a lot of experience in using cannabis to effectively manage chronic pain and PTSD she suffered many years ago as a result of a car crash. She previously shared her story in our very first Leaf411 blog post.

But when coronavirus hit, Jennifer’s PTSD crept back up as stay-at-home restrictions and uncertainty took hold.

“I was struggling, I couldn’t eat or stop crying. I was not feeling like myself. Nothing seemed to help—not even my normal cannabis products. I was afraid that I would have to go back on the same pharmaceuticals that I’d used years ago, along with their terrible side effects,” Jennifer said. 

Instead, Jennifer decided to first check in with her friend and Leaf411 co-founder/CEO Katherine Golden, RN, to get her input. Katherine quickly recognized that a change was needed.

An Inside View of the Leaf411 Cannabis Hotline Triage Process

“When I spoke to Jennifer that day, I triaged her just like I would a caller on the hotline,” Katherine said.

Those triage questions included:

  • What is your daily cannabis consumption? 
  • How many milligrams of CBD and in what form (CBD hemp product, isolate, etc.) do you use?
  • How many milligrams of THC and what type? (Knowing the brand helps us look at the terpene profile if any) 
  • How did this cannabis routine help you prior to this sudden change and what have you done differently since?
  • Describe your feelings when using the products. (This is good to know when trying to figure out someone’s tolerance).

Katherine sits in front of the Leaf411 Hotline banner, wearing a computer headset
Katherine Golden, RN, Co-Founder and CEO of Leaf411, shown during a recent webinar. Katherine is one of several Leaf nurses who staff the hotline.
Durban Poison tincture bottle with product details: 100 mg THC olive oil infusion with 18:1 THC:THCV ratio
Conscious Medz Durban Poison strain-specific tincture

After obtaining all the necessary pieces of the puzzle, Katherine was able to determine that:

  1. Jennifer had continued to increase her CBD hemp from 25mg/day to 50mg or more/day thinking she needed to consume more to reduce her anxiety. She knew that CBD could have biphasic effects (having the opposite effects when used in higher doses), though she thought this occured only with much higher doses than she was taking. CBD can actually worsen conditions or be completely ineffective when used too much, which to Katherine sounded exactly what Jennifer was experiencing. Her CBD was no longer working at the higher level, so Katherine suggested she reduce down to 10-20mg/day BUT also try a tiny amount of THC for its uplifting effects.

    Katherine suggested our business member Conscious Medz product Durban Poison tincture since it has a nice amount of limonene (shows benefits for anxiety and depression) plus a large amount of terpinolene which shows to be very uplifting for daytime use. She suggested that Jennifer only use a micro dose of 2.5mg to start, which should avoid any type of impairment but would be a high enough dose to lift her spirits.

Remedy 1:1 ratio indica tincture bottle with product details: Olive oil infusion with THC and CBD
Conscious Medz Remedy 1:1 Indica Tincture

  1. Jennifer had switched from her THC inhalation (due to COVID precautions) to an edible. The product she was using was made from a distillate with minimal other compounds and no added terpenes. It worked for her prior to the increased stress, but Katherine knew that Jennifer needed something that had a chemovar that included its terpene profile. Katherine suggested Conscious Medz again since their Remedy tincture is a 1:1 Indica with a wonderful amount of sedating terpenes. Katherine again suggested starting with a micro dose and increasing one drop at a time each night until an optimal dose was reached. This meant reaching the point of sedation with a small amount of euphoria and also having the terpenes that benefit anxiety.

This regimen ended up being the perfect combination. 

“After five hours of taking the Conscious Medz Durban Poison tincture, I cracked my first smile in as many days,” Jennifer said.

Jennifer continued, “The biggest ‘aha’ moment for me was looking at the terpene profile. I know I am not the only patient who tends to focus on cannabinoid content (because those are always listed clearly on the packaging) and had forgotten the role that terpenes play. That’s one of the things I like about the Conscious Medz productsthe terpenes are clearly listed on the packaging.”

Jennifer’s new cannabis regimen is a huge shift from where she started and has been for years, which was being an extremely educated inhalation user, to realizing that even small amounts (micro doses) of the right chemovars and cannabinoid ratios may work well for her body’s supplement needs.

Now, Jennifer is feeling better mentally and physically. However, she knows that many others are facing similar challenges as they find their normal cannabis consumption is no longer providing the good sleep, relaxation or pain relief that it has in the past.

An African-American mother sitting on a sofa, stressed with her head down in her hand while her kids run around the living room.

Why Your Usual Stress Relief Routine May No Longer Work

We all have routines that help get us through normal times, but many of those routines have either been interrupted or overwhelmed by the last few months of change.

Anxiety is at an all-time high, according to research. We’re worried about our own health and especially that of our family and friends. We’re worried about how COVID-19 will impact our children’s education. We’re worried about our finances and the economy.

Many of our usual tools for dealing with stress and anxiety are not available—no trips to the gym, weekend brunch outings, or get-togethers with friends to commiserate and provide in-person support. While many resources have moved online, it’s a tough transition.

That means the tools we do have left—including CBD hemp (containing less than 0.3% THC and legal at the federal level) as well as marijuana (containing over 0.3% THC and sold at dispensaries in legal states)—have a lot of heavy lifting to do!

Close-up of colorful CBD hemp gummies and marijuana flower (buds) scattered on the tabletop.

Reassessing Your Cannabis and CBD Hemp Needs

Perhaps in the past, you only consumed marijuana or CBD hemp edibles every once in a while to help with sleep after a stressful workday, but now you’re finding that you’re using edibles every night.

As you can see from Jennifer’s example, everyone is different when it comes to the challenges they are facing and the potential for CBD hemp or marijuana to help. Our Leaf nurses have specialized training to thoroughly assess your needs and provide guidance for safe, effective plant-based medicine that’s tailored to your needs. Call us via our toll-free hotline at 844-LEAF411 (844-532-3411) or chat us from our homepage during hotline hours.

An African-American mother and her daughter doing yoga together, sitting in easy pose with eyes closed, representing other wellness strategies.

Embracing Other Wellness Strategies and Support

We often remind people that cannabis is only one of many tools in your toolbox. The power of cannabis is amplified by other supportive practices, from good nutrition to exercise and mindfulness.

Going back to the sleep example, we suggest not only looking at your cannabis use but also your other nighttime routines. Perhaps you always scanned through social media before going to bed. However, with the current public discourse often leading to online arguments, you might find you need to sign from social media in evenings instead of winding up in a debate with some internet stranger.

In Jennifer’s case, in addition to updating her cannabis regimen, she also committed to taking breaks from daily news and social media, which also helped.

Smiling African-American nurse in blue scrubs making a phone symbol with her hand, reminding readers that the Leaf411 hotline welcomes your calls.

Leaf411 Can Help You Find the Best CBD Hemp or Marijuana Regimen for Your Needs

The current COVID-19 pandemic has interrupted ongoing health routines while also drastically increasing anxiety and stress, which take a toll on both physical and mental health.

Many “canna-curious” folks are deciding that now is the time to give either legal marijuana or CBD hemp a try as an alternative for stress relief or wellness.

And for experienced consumers, many are wondering if a different cannabis chemovar (strain) or product type might provide better results when dealing with our current times.

Our cannabis-trained fully-licensed Leaf nurses can help! Give us a call at 844-LEAF411 (844-532-3411) or chat us from our homepage during hotline hours. 

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 Supporter Spotlight: Mike Lempert, Director of Logistics at Seed & Smith

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

At Leaf411, we love sharing our supporting members’ stories. We really do believe that our members are the best in the industry, and hope that you’ll consider supporting them when shopping. 

As a founding member, Seed & Smith has supported the Leaf411 mission from Day One. Their commitment to education and transparency elevates the industry and provides a counternarrative against outdated stereotypes about cannabis.

Headshot of Mike Lempert, Director of Logistics at Seed & Smith
Mike Lempert, Director of Logistics at Seed & Smith

We recently checked in with Mike Lempert, Director of Logistics at Seed & Smith, to learn more about the Colorado dispensary’s current work. We also got his thoughts on the emerging consensus in legal states that cannabis is an essential need, following up on his recent interview with Denver 7 News.

Recognizing Cannabis as An Essential Need During the COVID-19 Crisis

The legal marijuana market sits in an interesting spot right now. While marijuana remains illegal at the federal level, states with legal medical and/or adult-use (recreational) marijuana have generally classified dispensaries as essential businesses allowed to remain open during the COVID-19 response. Dispensaries are being acknowledged as similar to pharmacies, providing essential medicine to patients.

Many patients, consumers and industry members are thinking about what this will mean for cannabis once the COVID-19 emergency passes. We asked Mike for his thoughts on this topic.

“My stance has always been that there are very serious medical issues that people use cannabis to treat. People come into our dispensary who need cannabis to live a ‘normal life.’ They may be suffering from MS or Parkinson’s disease or cancer or insomnia. Whatever the case may be, there’s a lot of relief (through cannabis),” he said.

“Absolutely, cannabis should be deemed essential,” Mike said. “If people are relying upon something to live a normal life—we’re not talking about a vice but about actual ailments and problems—then 100% cannabis should be deemed essential. It shouldn’t even be questioned whether we need to stay open during times like this.”

Keep reading to learn more about how Seed & Smith is ensuring employee and customer safety while providing access to high-quality legal cannabis amid the COVID-19 business restrictions.

Seed & Smith’s Commitment to Quality and Transparency

Have you ever been curious about how legal cannabis is cultivated, harvested and extracted? Part of the Seed & Smith experience is their free cannabis grow tour featuring their cultivation, production and packaging areas. While the tours have been temporarily cancelled due to COVID-19 restrictions, the spirit of transparency continues in every area of Seed & Smith’s work.

Leaf411 CEO Katherine Golden looks through a window at cannabis plants in Seed & Smith’s cultivation facility.
View from inside Seed & Smith’s cultivation facility. A tour group looks through a window at a big container of cannabis flower.
Checking out Seed & Smith product on the cannabis grow tour. Note: Tours are currently suspended in response to COVID-19.

When we asked Mike what makes Seed & Smith different from the competition, transparency was at the top of his list.

“We consider ourselves to be pioneers in the industry,” he said. “Seed & Smith was formed at the tail end of prohibition for recreational use. We wanted to hit the scene hard with transparency and prove that cannabis isn’t this big, scary drug like a lot of people make it out to be. We wanted people to understand exactly how our cannabis is grown, how it’s packaged, how we extract it to make the concentrates, where it’s sold and who sells it—basically every detail about our product.”

Mike explained how their approach is different, saying, “The cannabis industry is notorious for closing doors and keeping things very close to the vest. We wanted to dismantle that. I think we’ve been extremely successful.”

Seed & Smith’s owners looked to craft breweries as a model for doing things differently.

“Breweries were opening up their doors for the public to come see how their beer was made. You could go and talk to the head brewmaster. You could take a tour. You could see the cleanliness of the facility. You could see the beer getting canned.”

Seed & Smith adapted that model for their own operations, “being fully transparent and allowing people to get the freshest product,” said Mike.

A hand holding the Seed & Smith Dart vaporizer, showing how the vape is small and discreet.
Seed & Smith’s Dart vaporizer
Leaf411 supporting member Seed & Smith’s Dart vaporizer and packaging.
Seed & Smith’s Dart vaporizer

The Seed & Smith Dart: Making a Better Vape

We asked Mike what Seed & Smith products he’s most excited about these days.

 “We’re extremely proud of our Dart vaporizer, which is a pod-based system,” he said.

“We worked with CCell, the hardware manufacturer, for over a year to dial this product in. Now  we’re doing a big push for people to try the Dart vape as part of a move to a cleaner product. If you’re concerned about health risks, you should understand what goes into products that you end up ingesting or inhaling into your body.”

“A lot of companies that make cartridges or vaporizers don’t show you how their oils are made,” said Mike, “At Seed & Smith, you can visit and see our entire process. You can see the product that’s used to make it (the pods). You watch how it’s made through videos. You can see into our extraction rooms. Everything is transparent.”

Mike also talked about the recent vaping crisis that was connected to some manufacturers using Vitamin E acetate or other cutting agents which caused serious health issues.

Seed & Smith was ahead of the curve, however, since they do not use any cutting agents in their vape products. “From day one, it’s been 100% cannabis extracts in our cartridges and that’s it,” Mike said.

Partnering with Leaf411 to Provide Factual Cannabis Information

Mike talked about the challenges of providing factual information to customers, given the federal restrictions on cannabis research. “There’s not enough research done on cannabis, and we fully understand why that is,” he said.

He discussed how the lack of research means that people often fall back on anecdotal reports about how a product worked for a specific person, which may not end up being true for everyone. To navigate this tricky terrain, Seed & Smith sticks with providing education on what they know—their product.

“We give the facts in a clear and concise manner, about what we’re doing and how we grow,” he said.

Seed & Smith also relies on their partnership with Leaf411 to provide education on potential medical benefits of cannabis.

“We partner with Leaf411 to help us deliver reliable, factual information,” Mike said. “Focusing on providing factual information is the biggest key for us because there’s so much misinformation out there right now. We don’t want to add any more.”

At Leaf411, we know misconceptions about both the cannabis plant and the cannabis industry are everywhere. Mike shared a very similar perspective when discussing the education needs that he sees in the cannabis space.

“I’ve only been involved in the industry for three years, and in that three years I’ve learned a lot. I came with a lot of preconceived notions, most of which were wrong. So I’m the perfect poster child for the need for reliable information and education,” he said.

“There’s going to be a huge amount of people in this country and probably around the world shifting to cannabis use at some point. Providing reliable information about what they can expect and what’s in these products is extremely important.”

Seed & Smith dispensary door with a posted notice taped to it listing new COVID-19 rules for customers.
Seed & Smith dispensary door showing updated COVID-19 rules in late March 2020.

Maintaining Safe Dispensary Operations During COVID-19

You’ve likely noticed the impact of COVID-19 on businesses you frequent in person or even online as the government rolls out new rules and restrictions.

Cannabis dispensaries are no different. In Colorado, the Marijuana Enforcement Division (MED) released several rounds of emergency rules for dispensaries that emphasize extreme social distancing and revise retail rules to protect both employees and customers. 

We asked Mike how Seed & Smith’s operations have been impacted by COVID-19.

He answered, “In just about every aspect, our company and the industry itself has been affected.”

“We have 12 cultivation rooms with over 20,000 square feet. We’ve redone the workflow so that growers can work in different rooms at different times. We’re also able to avoid having two employees working together on a specific task,” Mike said.

He went on to describe how the packaging area was expanded and reconfigured to spread out employees and limit interactions. Employees with jobs that can be done from home are required to work remotely.

“It’s extremely tough for me to work remotely. I’m very much in the trenches on a daily basis. But I and my co-directors understand the need to not only reduce our risk of getting sick but to reduce risk to our employees as well. We’re making sacrifices all around but it’s for the greater good—for the company, our employees and our customers,” he said.

Seed & Smith checkout area showing registers spaced far apart and tape on floor to reinforce social distancing rules.
Seed & Smith checkout area with added social distancing measures in late March 2020. These safety measures are regularly updated to comply with state guidance.

How Seed & Smith Is Working to Keep Customers Safe

Mike described precautions that retail employees are taking to regularly disinfect all work areas and practice extreme social distancing while assisting customers. Cash registers have been spaced farther apart and customers have the option to pay by debit card at curbside for online orders. Cash payments must be made inside the store.

As of this writing, customers who order online from Seed & Smith online via Weedmaps will receive a “Thank You” discount code for a future purchase.

As state-issued rules continue to change, you can stay up to date on Seed & Smith’s operations on their blog, Facebook and Instagram.

Red phone on blue table with sticky note that says “Hotline!” as a reminder for the free Leaf411 cannabis nurse hotline.

Answering Your Questions About Cannabis and COVID-19

We know that many of you are worried about the impact of COVID-19 on both your access to cannabis medicine and on other areas of your life, as well. You can trust Leaf411 as a reliable source of information in this challenging time.

We’re here for you, with the clinical knowledge and resources to answer your questions about safely purchasing and using legal marijuana and CBD hemp products. We’re also ready to take your COVID-19 questions at the Leaf411 hotline. 

Call 844-LEAF411 (844-532-3411) at no cost to have your questions answered by one of our fully-licensed RNs.

Don’t like talking on the phone? We can also answer your questions via chat during hotline hours. Look for the chat icon in the lower right corner of the Leaf411 home page. https://leaf411.org/

Also, keep an eye on our Facebook page, where we share updated information, webinars and education resources on COVID-19 and cannabis. 

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.


Standing in Solidarity With Nurses and Other Frontline Workers

How Leaf411 is Helping With the COVID-19 Response

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

Back in early January, we planned the month of March to highlight nurses—especially cannabis nurses—on our blog. The World Health Organization (WHO) designated 2020 as the year of the nurse, and we were eager to highlight the incredible work being done by our Leaf nurses as well as other nurses working in the cannabis space.

Little did we know that an emerging novel virus, COVID-19, was poised to rapidly spread across the world, touching every aspect of life. 

Now, many of us are doing our part to “flatten the curve” by staying at home and limiting close contact with anyone outside of our immediate household. For our Leaf nurses on the hotline, that means working from home.

Not everyone has the option to work remotely, however.

A hospital nurse wearing a face mask puts on gloves to protect herself while caring for COVID-19 patients.

Acknowledging the Work of Nurses and Healthcare Professionals

Today, we’re acknowledging the healthcare professionals, including nurses, who are already on the front lines providing care to COVID-19 patients, often in stressful environments with limited resources. Many other nurses stand ready, waiting in the wings to help as COVID-19 hospitalizations rise.

One of the best ways you can help healthcare workers is by doing your part to flatten the curve. Limit your exposure to other people, even if you feel well. 

You can also check out this link for other ideas on supporting nurses who are working long hours on the front lines.

How Leaf411 Hotline Nurses Are Helping to Increase Capacity

Our Leaf nurses are helping to take pressure off the hospitals and primary care clinics by opening up our free Leaf411 hotline (1-844-LEAF411) to your COVID-19 questions. Our nurses’ backgrounds extend far beyond cannabis nursing, with clinical and hospital experience.

We cannot provide diagnoses or order tests—that falls outside of our scope of practice as RNs. However, we can point you to the best resources based on your specific concerns and needs. We’re also able to answer general questions about COVID-19 and provide context for the emerging research and recommendations.

Check out our Leaf library as well for resources like general guidelines for reducing risk of infection as well as Dr. Dave’s input on cannabis and coronavirus.

Of course, we’re still available to answer your cannabis questions, too. With dispensaries switching to online ordering and curbside pickup, consumers will no longer be able to chat with budtenders about different cannabis products.  

For example, if you’re switching from smokable cannabis to edibles or tinctures, we can provide guidance to help make that transition as successful as possible.

Recognizing All the Frontline Workers Providing Essential Services

We also want to recognize other non-healthcare frontline workers who keep essential services up and running. This includes employees at grocery stores, distribution centers, gas stations and restaurants, as well as delivery drivers and truck drivers.

States and cities are designating marijuana dispensaries as “essential” as well, recognizing that many people rely on cannabis medicine to manage health conditions like pain, nausea and PTSD. While we’re thrilled about this designation, we also know it means that dispensary employees take on increased risk to maintain our access to safe, legally-compliant cannabis. To help out dispensaries, Leaf411 developed Preparedness Plans which we’re sharing with both member and non-member dispensaries through the end of the month.

We’re Ready to Help With Your Questions

Our Leaf nurses are available to answer your questions, whether you’re a clinician, dispensary representative or member of the public. Call us for FREE 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.


The State of Cannabis Nursing

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

We often remind you that Leaf411 hotline is staffed by cannabis-trained nurses.

But what exactly does “cannabis-trained nurse” mean? A lot of people have no idea that cannabis nurses even exist!

As part of our series on nurses this month, we’re sharing the state of cannabis nursing in the U.S. Whether you’re a patient or a registered nurse (RN) interested in pursuing cannabis training, you’re sure to learn something new.

Cannabis nurse explains medication interactions to a woman holding a prescription bottle.

How Cannabis Nurses Help Patients

You’ve likely had a nurse help you with medication-related questions before. Now imagine if a nurse could provide the same type of guidance on using cannabis to manage health conditions.

In fact, cannabis nursing is a thing!

Cannabis nurses complete specialized education on the human endocannabinoid system and cannabis as medicine.

They use this knowledge along with their years of clinical experience to help guide your decisions around using marijuana (cannabis containing >0.3% THC, which is sold legally in dispensaries), or cannabidiol (CBD) hemp products that are federally legal and sold in retail stores and online.

Cannabis nurses can help you save money and time by suggesting general types of products that may work best for your health concern. For example, if you’re dealing with inflammation pain, a cannabis nurse might suggest a specific CBD:THC ratio based on clinical guidelines and evidence.

Red phone on blue table with sticky note that says “Hotline!” as a reminder for the free Leaf411 cannabis nurse hotline.

Where can you find a cannabis-trained nurse? The free Leaf411 hotline is a great place to start!

You can speak to a cannabis-trained RN at no cost via our hotline: 844-LEAF411 (844-532-3411).

The Bigger Picture: Cannabis and The American Nurses Association

The American Nurses Association (ANA) is the largest nursing association in the United States, with over 4 million nurse members. They’ve supported the need for research and evidence-based use of cannabis since 1996!

In their latest position statement (2016), the ANA advocates for reclassification of cannabis so it’s no longer considered a Schedule I controlled substance by the federal government. This change would make clinical research on cannabis’s medicinal benefits much easier.

The ANA also supports development of dosing/recommendation standards, along with legal protections for both patients who use cannabis therapeutically and for the clinicians who discuss or recommend cannabis.

Not all nurses are up-to-date on the potential therapeutic value of cannabis. However, many nurses are hearing more each day from patients who have benefited from using cannabis to manage health conditions. As awareness grows, interest grows as well.

The American Cannabis Nurses Association

The American Cannabis Nurses Association (ACNA) is a national organization dedicated to expanding the knowledge base of endo-cannabinoid therapeutics among nurses. It was formed in 2006 by several nurses who were involved in the Patients Out of Time Fourth National Clinical Conference on Cannabis Therapeutics. These dedicated nurses saw the need for an organization to bring nurses together in a collegial and informational capacity to discuss the growing use of cannabis in medicine.

The ACNA’s ultimate goal is to develop specialty recognition for cannabis nursing, in the same way that other nursing specialties are recognized by the American Nurses Credentialing Center (ANCC), which is a division of the American Nurses Association (ANA).

To date there are over 1,300 nurse members who proudly follow the ACNA’s scope and standards of practice of the emerging role of the cannabis nurse in the United States. The standards of any specialty area of nursing are built upon the foundation of standards of practice expected of all registered nurses (Mariano, 2015) and cannabis nursing is no exception to this rule.

Two three ring binders with words “Regulations” and “Guidelines,” along with a page of regulations in the foreground.

Creating Nursing Guidelines for Medical Marijuana

Professional organizations are also developing guidelines for nurses to use when suggesting CBD hemp or medical marijuana as a treatment option. This work is being undertaken by the National Council of State Boards of Nursing (NCSBN) which developed the National Nursing Guidelines for Medical Marijuana.

The NCSBN guidelines set six principles of essential knowledge for cannabis nurses:

  1. Working knowledge of the current state of legalization of medical and recreational cannabis use.
  2. Working knowledge of the jurisdiction’s (state/local) medical marijuana laws and regulations.
  3. Understanding of the endocannabinoid system and how cannabinoids (THC, CBD and others) interact with the endocannabinoid system receptors.
  4. Understanding of cannabis pharmacology and the research associated with the medical use of cannabis.
  5. Capacity to identify safety considerations for patient use of cannabis.
  6. Ability to approach patients without judgment regarding their choice of treatment or preferences in managing pain or other health symptoms.

We share these guidelines so that you can see how cannabis nursing is actually a serious endeavor, going far beyond the typical budtender or non-clinician’s knowledge!

It makes sense for professional organizations like the NCSBN to develop guidelines for medical marijuana, because several pharmaceutical marijuana products are already on the market, such as cannabidiol-based Epidiolex, as well as several synthetic marijuana drugs designed to reduce nausea, including Marinol and Syndros.

But all cannabis products, synthetic or full-plant, are not created equal, so nurses need to be familiar with the benefits and shortcomings of both. 

In addition, clinicians are aware that many of their patients use cannabis either recreationally or for therapeutic purposes. While cannabis has fewer side effects than many pharmaceuticals, there are precautions that patients should be aware of, especially around potential medication interactions.

So how do nurses and other clinicians gain medically-sound knowledge about cannabis?

Open journal and pen, with open laptop and a cup of tea in background. Laptop screen represents online cannabis education.

The Need for Cannabis Education is Growing

As cannabis legalization expands across states, there’s increasing demand for education designed for growers, manufacturers, dispensary workers and medical professionals.

The Medical Cannabis Institute (TMCI) partnered with the ACNA to create the “Medical Cannabis Curriculum for Nurses” which addresses the National Nursing Guidelines for Medical Marijuana. All our Leaf411 hotline nurses have completed the TMCI program.

In addition to our nurses being members of ACNA and having completed TMCI training, Leaf411 has partnered with Radicle Health for additional education. All Leaf411 nurses have completed Radicle Health’s “Cannabis Therapeutics for Nurses/Medical Professionals” course.

Radicle Health and TMCI are helping to lead the way for clinicians to integrate knowledge of the endocannabinoid system and cannabis into their practice. As more nurses and doctors become aware of the professional resources that exist, we anticipate that demand for cannabis clinician training will continue to grow.

Leaf411’s Perspective on the Future of Cannabis Nursing

The nursing profession holds that health is a universal right, which includes access to health care and education concerning the prevention of health issues. In the words of the American Nurses Association, “It is the shared responsibility of professional nursing organizations to speak for nurses collectively in shaping health care and to promulgate change for the improvement of health and health care” (ANA, 2015).

At Leaf411, we believe cannabis nursing is a viable, emerging specialty. With the ongoing support of national organizations like the ANA and ACNA, we can move forward confidently caring for our public as we do in any other specialty. 

Interested in becoming a cannabis nurse? We offer tips and resources at this link.

Get Help With Your Cannabis Questions

Our Leaf nurses combine nursing expertise with specialized knowledge of the medicinal benefits of cannabis, providing balanced, research-based information and support. Call us for FREE 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.


Recognizing Leaf411 Nurses During the Year of the Nurse

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

Have you ever wondered who answers the calls to the Leaf411 hotline? 

We’re proud to say that all our hotline calls are answered by fully-licensed registered nurses (RNs) who’ve completed specialized cannabis clinician training. Our nurses are also members of American Cannabis Nurses Association (ACNA).

This month, as part of the Year of the Nurse, we’re focusing on the pioneering nurses working in the cannabis space, including the nurses who answer your calls to the hotline! 

Keep reading to hear directly from our nurses and learn more about the ways they can help with your questions.

2020 Is the Year of the Nurse and Midwife

Early in 2019, the World Health Organization (WHO) announced that 2020 would be the Year of the Nurse and Midwife.

In recognition of the Year of the Nurse, we chose the month of March to put a spotlight on the profession that touches the public everyday though our hotline and outreach programs.

Who Do You Trust with Your Health Questions?

For the past 18 years, nurses have topped the list of most trusted professionals in the United States, according to an annual Gallup poll. Nurses’ honesty and high ethical standards are the reasons for those continued high rankings. 

We also think that our ability to listen (bedside manner) and how we work together with patients, their loved ones and their entire clinical care team is another reason nurses are held in high regard.

Nervous About Your Cannabis Questions? Here’s What Our Nurses Wish You Knew

We recently asked two of our Leaf nurses to share their perspectives on Leaf411’s hotline and community education events. Note: We’re using anonymized initials for both nurses.*

“We are non-judgmental. We’re here to help and give you as much accurate information as possible.” explains R.W., one of the hotline nurses. “We interpret for doctors every day. We can interpret (the medical cannabis research) for you, too.”

D.J., another of our hotline nurses, adds, “I would invite anyone to look around our website if they don’t feel comfortable speaking with one of us just yet.”

Leaf411 offers several online resources, including our Leaf Library, Member Directory and our blog. We also offer an online chat function that can translate just about any language during our hotline hours, from Tuesday-Saturday 10:00 am-8:00 pm MST. You can find the chat button on the Leaf411.org homepage.

Sitting man looks at laptop computer screen with puzzled expression and hand on chin. Photo by Bruce Mars/Unsplash

How a Cannabis Nurse’s Advice is Different than a Budtender’s Advice

You may be wondering how a call to the Leaf411 hotline is different from simply researching your question online or asking a budtender for advice on a health issue. 

While budtenders have expertise in the products their dispensary carries, they are not clinical providers. In fact, the law prevents budtenders from providing specific medical recommendations to dispensary customers.

On the other hand, our cannabis nurses have the licensing, clinical background and training to provide individualized medical guidance. However, while our nurses understand the science supporting cannabis, they are not experts in the thousands of different products out there on the market.

In other words, our nurses are not here to sell you a specific product or to convince you to try cannabis. Instead, our mission is to provide the education and resources to guide you in making the best choice, based on your health needs and your budget. We are 100% patient and public advocates.

A cannabis nurse wearing a headset smiles while talking to a patient on the phone. Photo by lilibella/Adobe

Empowering Patients with Education and Resources Through the Leaf411 Hotline

When someone calls the hotline, “We take things one step at a time,” D.J. explains. “We take time to discuss with the caller what their goals are.”

“For example, if they’re having insomnia, we can discuss a higher THC product which is good for nighttime,” she says. “If they’re having issues with pain throughout the day, we can talk about starting off with a non-intoxicating CBD product in the morning that contains little or no THC.”

“By taking it one step at a time, we can make it not so overwhelming. That way, the caller can go into a dispensary with more confidence,” she says.

“It’s really about empowering the consumer to be able to walk in (a store or dispensary) and know, ‘Here’s what I’m looking for. Here’s what I don’t want, and here’s what I do want,’” D.J. says.

By knowing your goals and understanding which types of products might help most, you can be more confident shopping for marijuana and CBD hemp products, quickly finding something that will be successful for your specific needs.

Our Nurses Are Passionate About Providing Medically-Sound Cannabis Information

R.W. already had over a decade’s worth of experience as an RN when she began studying cannabis’s therapeutic benefits. Like many clinicians, she was motivated to look at the research after seeing family members, friends and patients struggle with pain and treatment-related nausea.

Through her help at Leaf411 community-based events, R.W. sees the value of the work she does.

“I get to see how valuable this service is, and how badly it’s needed. People are able to call and get information (about cannabis) for free. That’s phenomenal!” R.W. says. 

She notes that some cannabis clinicians charge upwards of $300 per hour for the same level of service that Leaf411 provides to the public for free.

“Knowing how many people are interested (in cannabis) and experimenting on their own, we can’t leave it to Joe Blow to answer their questions. As wonderful as cannabis is, there are interactions with certain medications and important considerations people need to be aware of. There needs to be someone who can speak to those things,” R.W. says.

As a clinician herself, R.W. knows that many general practitioners are unaware of the research and guidelines supporting medicinal use of cannabis, since it’s not being taught in medical school or traditional nursing programs.

“Unfortunately, you can’t get information from your family doctor because they’re either uneducated (on cannabis) or scared of the ramifications,” she says.

Dictionary book page with smartphone placed on top, showing dictionary definition of cannabis. Photo by Margo Amala/Unsplash

Addressing the Knowledge Gap Around Cannabis

D.J., another of our other Leaf nurses, came to cannabis nursing after first working in cannabis cultivation. As she learned more about the therapeutic benefits of the plant, she gravitated toward the medical field.

“I knew the possibility existed that there was going to be a gap in the public’s knowledge, the medical profession’s knowledge as well as how quickly the industry was moving forward and someone would eventually need to fill in the gaps,” D.J. says. 

This need motivated D.J. to return to school to earn a Bachelor in Nursing (BSN) degree, as well as pursue cannabis nurse education.

“I have put a lot of heart and soul into developing myself as a cannabis nurse,” says D.J. “As a nurse, I can see both the anecdotal evidence (hearing from individual patients), and the empirical evidence. I can help explain what that empirical evidence means to patients.”

Serving the Needs of All the Public: Patients and Clinicians

Four years ago, our co-founder, Katherine Golden, RN, began looking into cannabis as a treatment option when helping a family member who was fighting cancer. 

Once I started looking through all the science I could find, through the most reputable resources, I was angry, angry that more wasn’t done to shout this information from the rooftop for all of us medical professionals to take a deeper look at,” Katherine says. 

In fact, that moment was the beginning of a journey to provide evidence-based, medically sound information to not only her own family, but also to the general public and to other clinicians. 

“We’ve had calls from social workers and other nurses battling medical conditions and seeking plant education themselves, to nutritionists, acupuncturists, physical therapists, and MDs thanking us for providing this type of resource for them to ask us questions that they can then relay the answers back to their patients or clients or send them to us directly,” Katherine says. “When you open your arms and knowledge to allow other colleagues in, you in turn lessen the burden each one of us carries to bed at night.”

When You Call the Leaf411 Hotline, You’ll Get a Cannabis-Trained RN

From the first day, we knew that we wanted the Leaf411 hotline calls to be answered by licensed medical professionals. Registered nurses were the perfect fit. 

By staffing our hotline with RNs who have completed additional cannabis education through Radicle Health and The Medical Cannabis Institute, we make sure that you receive consistent, medically-sound guidance based on research. Our nurses use a medical framework for understanding your health concerns and goals and providing guidance.

Whether you are a patient or clinician, we are here to help! Call us at 844-LEAF411 (844-532-3411) or use the chat function on our home page.

*You may be wondering why we use anonymized initials instead of our nurses’ real names in this post. 

Here’s why: There can be employment or licensing consequences for nurses and doctors who work in the cannabis space, even though their recommendations are in line with the research and comply with state laws. This will only change once federal laws are updated in line with the growing evidence showing the medicinal benefits of cannabis.

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.


Addressing Cannabis Stigma on the Leaf411 Nurse Hotline

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

The cannabis sativa plant has been used as medicine for over 1,500 years, according to historic records.

That can be hard to imagine sometimes, after nearly 100 years of cannabis prohibition in the United States.

Chances are good that you grew up hearing messages about the dangers of marijuana, complete with scary stories of addiction, irresponsible behavior, and negative health impacts.

Where did these messages come from? It’s a long story that we’ll be covering in a future blog, but the takeaway is that many of these negative stories and stereotypes were driven by politics and money, not by research.

Now, research is showing that much of the old propaganda simply isn’t true.

Male clinician in white coat reviewing cannabis research, standing in medical library holding thick book.

With legalization expanding at the state level, many people across all walks of life are going public with their use, showing that cannabis can be used responsibly for therapeutic or recreational purposes.

The cannabis plant contains many different cannabinoids, including tetrahydrocannabinol (THC) and cannabidiol (CBD). When we talk about cannabis, we’re really talking about two categories of products:

  • CBD hemp products are now legal under federal law and almost all state laws (Idaho, Nebraska and South Dakota are the exception). CBD hemp comes from hemp plants—cannabis plants bred and grown to contain very little to no THC. Under federal law, CBD hemp products are limited to less than 0.3% THC.
  • THC is the cannabinoid responsible for the “high” that people feel when using cannabis. Products containing over 0.3% THC are legally sold in dispensaries in states that have voted for legal recreational or medical marijuana.

Despite growing acceptance, many people run headfirst into misconceptions and stigma when considering whether to try cannabis themselves.

Anatomical model of brain in a laboratory. Photo by Robina Weermeijer/Unsplash

Tackling the Stigma: Cannabis Will Not Destroy Your Brain

Our hotline callers are often concerned about whether cannabis will kill brain cells. When we recently talked to Dave Gordon, MD, one of our Leaf411 Advisory Board members, he shared similar stories of patients who worried that cannabis would hurt their brains. Dr. Dave explained that in response, he shares the research showing that in fact, cannabis won’t harm the adult brain, and may even be protective against certain neurological disorders like Alzheimer’s and dementia.

Likewise, our hotline nurses always go to the research when answering specific questions about how cannabis may impact brain health. Peer-reviewed studies can be hard to decipher if you don’t have a medical background and clinical training. One reason we created the FREE Leaf411 cannabis hotline is to help bridge the gap between cannabis research and the public.

Distorted repeated image of woman’s face, representing discomfort from being too high after using cannabis. Photo by Diana Satellite/Unsplash

The Fear of Getting Too High from Cannabis

When people first call the hotline, they often express concerns that using any amount of THC at all, even the very small amount in CBD hemp products, will make them too high.

THC is not like a simple on-off light switch, though.

Instead, you can think of it like a gas pedal in a car, where more gas equals greater speed. The amount of THC you use will impact how much of the “high” you feel—or whether you feel those intoxicating effects at all.

For example, the amount of THC in a full spectrum hemp product is not enough for you to feel it—but it is enough to contribute to the entourage effect when the different plant compounds work together to provide enhanced therapeutic benefits.

Some people are most comfortable starting with CBD hemp products to test the waters and see if it helps their health concern. And CBD hemp is the only legal option for people living in states where recreational and medical marijuana are outlawed.

When you call the hotline, we listen and take your goals and priorities into consideration. We can provide specific guidance to help you minimize the risk of feeling “too high,” while also helping you find a product that is a good match for your needs.

Molecular diagram of THC, with cannabis leaves in background.

THC: Bogeyman or Powerful Plant Ally?

You may still be skeptical about the power of THC, since that cannabinoid is at the root of the propaganda from the past century.

If full-spectrum CBD hemp products contain all the plant compounds, after all, then why is more THC needed?

It’s true that full spectrum CBD hemp alone provides relief for many people, especially when dealing with inflammation pain.

However, when someone is dealing with chronic neuropathic pain, a higher dose of THC may offer more relief, due to the fact that THC works with the same nervous system receptors that opiates do, without the problematic side effects that come with opiates.

The THC cannabinoid can also help with relaxation and mental release, whether you’re dealing with pain, anxiety or other health concerns. However, it can take some trial and error to find the best product, dose and even CBD:THC ratio for your needs.

At Leaf411, our goal is to empower our callers so that your experiences with cannabis are positive. Our hotline nurses have the training and experience to help guide you in the right direction on your journey.

Female nurse in scrubs with a skeptical expression, questioning cannabis’s medical benefits

Addressing Cannabis Stigma Among Clinicians

We know that not all doctors, nurses and other clinicians are on the same page when it comes to the potential therapeutic benefits of cannabis.

Keep in mind, clinicians grew up with the same stereotypes and stigmas as the rest of us. Odds are good that when they went to nursing or medical school, they received little to no education on cannabis, either. For example, a study published in 2017 found that only 9% of medical schools included education on prescribing medical marijuana.

As clinicians ourselves, we always suggest that you discuss your cannabis use with your primary care provider. As providers see more patients who are successfully using cannabis to treat different health conditions, their own minds may be changed about the power of plant-based medicine. In our interview with Dr. Dave, he makes some suggestions for how to broach the topic with your primary care provider.

State legalization, as well as federal legalization of CBD hemp, has put cannabis on the radar for many physicians, nurses and other clinicians. When we talk to our colleagues, we hear them saying that they know their patients are turning to CBD hemp and marijuana as an alternative.

However, as long as cannabis remains illegal at the federal level, many clinicians are reluctant to proactively suggest this option to patients, especially when they don’t have specialized education to guide their recommendations. In addition to a lack of knowledge, they face potential professional repercussions from their own employer or licensing bodies.

Pioneers in the Field: Cannabis Doctors and Nurses

Despite the challenges, many doctors and nurses are actively seeking out the research and training to provide medically-sound guidance to patients on cannabis as a treatment option.

They may be like Dr. Dave, who saw the limits of conventional medicine in bringing relief and balance back to patients’ lives. He began digging deep into the research after realizing he needed better tools.

They may also be like our very own CEO, Katherine Golden, RN, a nurse with over 22 years of experience. She turned to the research when helping a family member who had a cancer diagnosis, and found compelling research on cannabis in well-known medical databases like PubMed and ScienceDirect.

In the coming month, we’ll highlight our Leaf411 hotline nurses, as well as the special training they undergo to prepare them for your calls.

The Leaf411 Hotline: A FREE Public Resource for Your Cannabis Questions

Our hotline nurses are ready to answer your questions on our free anonymous hotline. We combine our nursing expertise with specialized knowledge of the medicinal benefits of cannabis, providing balanced, research-based information and support. 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.


Finding the Best CBD:THC Ratios and Products for Pain

How Different CBD:THC Ratios and Types of Products Can Help with Pain

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

Last week, we overviewed different types of pain and shared how cannabis might help.

When it comes to treating pain with cannabis, both the type of product and the ratio of cannabinoids matter. The two primary cannabinoids are tetrahydrocannabinol (THC) and cannabidiol (CBD), though the cannabis plant contains many other cannabinoids, terpenes, plus other compounds that contribute to its therapeutic effect.

CBD: This cannabinoid is the star player in hemp products which are federally legal. CBD hemp products are required to have below 0.3% THC, which is such a small amount that it’s not intoxicating and won’t get you high. You’ll also find CBD in cannabis products that contain higher levels of THC.

THC: The cannabinoid responsible for the “high,” if used in large enough amounts. Cannabis products containing over 0.3% THC remain illegal at the federal level and can only be legally purchased in states that have legalized recreational or medical marijuana.

Understanding the roles that both CBD and THC play in managing pain can help you find the best product for your needs. If you need a quick refresher on the types of pain that CBD and THC work best on, check out our previous post here.

Timing Your Dose: How Different Cannabis Products Reduce Pain

Whether you’re looking at CBD hemp or cannabis containing higher levels of THC (sold legally in dispensaries), 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 when you’re already taking longer-acting cannabis products). You can also layer inhaled cannabis with a longer-acting method (more on layering below) 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, but 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.

Understanding CBD:THC Ratios

Most marijuana flower sold at legal dispensaries is THC-dominant, with very little CBD. Of course there are exceptions, such as The Wife strain or even some CBD hemp flower strains. However, odds are that if you’re using flower, you won’t find ratios connected to the strain.

Once you start looking at other cannabis products, including vapes, you’ll notice ratios on many—but not all—product labels. Common ratios include 1:1, 5:1, 10:1, and even 20:1. What do these numbers mean? And how do they help with your pain?

The ratio indicates the amount of CBD compared to the amount of THC.

  • A 1:1 ratio is when the amount of CBD and THC are the same in each dose.
  • On the other hand, if a product has a 5:1 ratio, that means there’s five times as much CBD as THC in each dose.

It’s important to note that the ratio is not the same as the amount of CBD and THC. Our supporting member 1906 makes several different products, including their Midnight drops and Genius drops, that are designed to be swallowed. The ratio of each of these recreational products is 1:1—but the amount of CBD and THC in each is different.

  • The 1906 Midnight 1:1 drops have 5 mg of CBD and 5 mg of THC per dose.
  • The 1906 Genius drops are also a 1:1 ratio; however, they have 2.5 mg each of CBD and THC.

What if a product doesn’t list a ratio? In that case, look closely at the product label. The chances are good that the product either contains all CBD, with little or no THC (legal CBD hemp products fall in this category), or the product contains all THC.

What’s the Best CBD:THC Ratio For Your Pain?

The CBD and THC cannabinoids work individually to target different types of pain. By combining them in different ratios, though, you can achieve different effects to fit your specific needs. 

While everyone is different, the following guidelines work for most people:

1:1 – Equal amounts of THC and CBD. A good option to try for all kinds of pain, including neuropathic pain. Products with a 1:1 ratio can be uplifting but this ratio will most likely cause impairment if using the suggested serving size. Always start low, go slow, to avoid intoxicating effects.

2:1, 4:1, 5:1 – A balanced product that can provide optimized levels of both CBD and THC for medicinal use, based on the fact that higher doses of CBD are often needed for relief. Can be intoxicating. 

10:1 – A high CBD alternative for people who find the 5:1 ratio to be too intoxicating.

20:1 – High CBD levels along with very low THC levels provide a good option for managing inflammation pain. Very rarely intoxicating.

Leaf411’s supporting members offer many different CBD:THC ratios to meet different needs.

Be sure to closely look at the product label to make sure you understand the ratio! While it’s not as common, some manufacturers state the ratio reflecting the THC first and the CBD content second, like our member incredibles 10:1 THC:CBD tincture.

Layering Different Cannabis Products

Have you ever woken up in the middle of the night when your pain medication wore off, and suffered as you re-dosed and waited for the medicine to kick in? Fortunately, with CBD and THC products, you can layer different product types to reduce the changes of this happening.

For example, you might use a shorter-acting sublingual pill or vape to bring instant relief, together with an edible or transdermal patch to get you through the night.

If you’re using products containing THC (the cannabinoid that can be intoxicating and make you feel “high”), you’ll want to be careful with your dosing to make sure you don’t get end up with too much THC. The best approach is to start low and slow.

While you cannot overdose on THC, the feeling of being “too high” can be uncomfortable. Our website provides tips for what to do if you feel too high.

Cannabis as an Adjunct Therapy

Depending on how you use cannabis and other medications, there can be possible medication interactions. Our Leaf411 library offers guidance on specific medication interactions here

We recommend consulting with a clinician before combining cannabis (which includes CBD hemp products!) with pharmaceuticals or over-the-counter pain medications.

Our Leaf411 cannabis-trained registered nurses can help with questions specific to medications you’re taking, and our service is FREE! Call us at 844-LEAF411 (844-532-3411).

We’re Here to Help!

We realize that it can feel overwhelming when researching cannabis for pain. There are so many options—different types of products and different ratios. 

Research on cannabis as a safe alternative for treating pain continues to grow. As nurses, we’ve heard and seen firsthand the power of this plant-based medicine, and we stay up-to-date on the latest findings and clinical guidelines for using cannabis for pain. 

Our Leaf411 hotline nurses have both specialized training and experience helping people to find the best option for their particular situation. We’d love to share our expertise with you as well! Reach out to us on our free, anonymous hotline at 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.


Cannabis May Help with Different Types of Pain

How Cannabis May Help with Different Types of Pain

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

We receive many calls on the Leaf411 cannabis nurse hotline from people who are curious to learn how cannabis might help with their pain.

In today’s post, we’ll share some information based on the questions we hear. We also provide suggestions on how to match the right cannabis product to your pain.

Our goal to help callers find a solution allows them to be functional. Of course, you’re always welcome to call our hotline with questions as well!

Much like any other medicine, cannabis is not a magic pill but it’s a tool. From the research and our own experiences working with patients, we believe that the cannabis plant may be an effective alternative to opiates or nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and acetaminophen, which can carry unwanted side effects if overused.

Cannabis for Pain: A Powerful Tool

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. That’s one reason why so many different painkillers are on the market today!

Cannabis is emerging as a different option, proving to be a powerful new tool for controlling pain. The cannabinoids in the cannabis plant, especially cannabidiol (CBD) and tetrahydrocannabinol (THC), have been shown to reduce inflammation and pain. Other cannabinoids and plant compounds like terpenes also play a role in reducing pain. (You can read more about terpenes in one of our past posts ).

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.

xray of broken collarbone, a source of acute pain.

Quick Primer on 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 fits into this category.
  • With chronic pain, “the pain itself becomes the disease,” explains Eduardo Fraifeld, MD, in this article. 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 be a side effect of chemotherapy or other long-term medical treatments. When an injury heals yet the pain remains, that also 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, and 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, post-shingles symptoms, sciatica or pinched nerves, diabetes, and chemotherapy treatment. 

  • Nociplastic pain: A relatively new category for pain that doesn’t fit well into the other two categories. Fibromyalgia, non-specific low back pain, irritable bowel syndrome, and pain associated with and exacerbated by centralized and peripheral sensitization are all examples of nociplastic pain.

THC or CBD? It Depends on the Person and the Type of Pain

Before we jump into the pros and cons of THC versus CBD, we have to mention that to some extent, every human body is different. Cannabis plant compounds (cannabinoids) work on the CB1 and CB2 receptors in your body’s endocannabinoid system (yes, that’s a real thing!). Your body even makes its own cannabinoids.

Everyone’s endocannabinoid system is just a bit different, just like everyone has their own pain tolerance levels. Keep this in mind if your neighbor recommends a specific product that ends up not working for you.

However, we can share some general guidelines for using CBD and THC for pain.

CBD: Many people successfully use CBD products to reduce inflammation-based pain . Full spectrum CBD hemp products containing all the plant compounds, including less than 0.3% THC, tend to be the most effective, since minor cannabinoids, terpenes, flavonoids and essential fatty acids work together synergistically to create the “entourage effect.”

CBD has potent anti-inflammatory properties that can help reduce either acute or chronic inflammation. CBD also works as a muscle relaxant and has been shown to reduce muscle spasms associated with MS and other health conditions.

By reducing inflammation, CBD indirectly helps 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: We’ve heard a lot of people immediately rule out products with THC because they’re concerned that it will make them act silly or that they’ll get too high.

It’s important to know that small amounts of THC may have minimal intoxicating effects. At the same time, THC—even small amounts—can be a gamechanger when it comes to pain.

THC acts on the same receptors in your body that opiates do; however, you don’t get some of the problematic side effects that opiates can bring—nausea, constipation, and risk of physical addiction.

Close-up of clinician’s hands, with one hand holding cannabis flower and the other holding pills, showing different options.

Cannabis Compared to Opiates

Ironically, long-term use of opiates 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 opiates and find a safer alternative for managing pain. Cannabis is showing promise on this front, based on emerging research.

Cannabis does not cause pain sensitization but in fact can help treat it. While THC and other cannabinoids work through the same receptors that opiates do, 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 and 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.” 

If you are going to try cannabis for your neuropathic pain, many different ratios and cannabinoids may need to be explored before finding something that may ease some of the pain so you need to manage your expectations accordingly.

Group of five young adult friends with two dogs walking across field at sunset, healthy and happy.

The Goal: To Restore Function

We wish that we could tell you that CBD or THC products will completely eliminate all pain; however, that’s not the case. If there were a magic one-size-fits-all cure for pain, the pharmaceutical companies would’ve discovered and patented it by now!

Instead, when we talk to people on the hotline, 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.

In our next post, we’ll take a closer look at the best CBD:THC ratios and products for pain. We’ll also talk about how to layer different products to provide optimal short-term and long-term pain relief. Check back next week for more information!

Can’t wait to get started? Our FREE Leaf411 hotline is 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 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.


Talking to Your Partner about Cannabis

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

Cannabis has gone mainstream. Medical marijuana is legal in over half the states. Also, recreational use is legal in 11 states as well as in the District of Columbia and all of Canada.

Cannabidiol (CBD) hemp products containing less than 0.3% tetrahydrocannabinol (THC) are legal at the federal level, and widely available online and in retail outlets in almost all states. Compliant CBD hemp products should not get you high (cause impairment or intoxication), but offer many health benefits.

As legalization has spread, so has acceptance. According to a November 2019 Pew Research poll,  67% of Americans say marijuana should be federally legalized. This support exists across all age groups except for the Silent Generation, made up of people over the age of 75.

The shifting public attitudes might not be reflected in your own home, though.

How do you talk to your significant other if you’re curious to try cannabis but don’t know what they’ll think? This can be especially tricky when your partner has negative experiences, fear or preconceptions about cannabis.

Know Why You Want to Use Cannabis

Before you broach the topic with your partner, take stock of why you want to try cannabis. Are you “canna-curious” and interested in seeing what options exist in the legal marketplace? For example, some people are turning to THC-infused drinks and other products as alternatives to wine or beer.

Many people also seek out cannabis based on growing research about the plant’s health benefits.

Remember that cannabis is not a cure-all or magic pill. However, it can serve as a powerful tool.

Anticipate your Partner’s Concerns

Many of us had less-than-ideal experiences with marijuana in the past, when it was illegal everywhere. Product quality was iffy at best, and you never quite knew what was in the flower (buds) you were smoking. If you got caught, you faced legal charges, fines and even jail time, along with a criminal record.

Keep this recent history in mind when you bring up cannabis to your partner. Even someone with past cannabis experience may respond with skepticism at first, given the nature of their previous experiences.

You can address these concerns by talking about how state regulations provide more oversight and consistency in products sold at legal dispensaries.

While CBD products sold in retail outlets and online are not subject to this same level of oversight, most high-quality manufacturers provide Certificates of Analysis (COAs) with test results for their products to see exactly what makes up that particular product. 

Stigma: The Elephant in the Room… On the Couch Eating Chips

Cannabis still suffers from stereotypes, despite the fact that more athletes, businesspeople, and other high achievers are openly embracing the plant.

When you tell your partner you want to try cannabis, they may immediately picture you glued to the sofa with a bag of Doritos. Those old stereotypes are tough to shake!

Dr. Dave Gordon, founder of 4Pillars Health & Wellness, addressed some of these stereotypes in his recent interview with Leaf411.

“A lot of the cannabis propaganda that people have heard over time is just wrong,” he says. “The perfect example is when someone asks, ‘Is cannabis going to cause me to lose my brain cells?’ … Actually, the science shows that cannabis is probably going to protect your brain.”

You can read more from Dr. Dave on common misconceptions and what the research says about cannabis here.

Putting Cannabis in Context of Lifestyle Changes

When talking with your partner, put your interest in cannabis in context with other areas of your life, explaining how it fits with other goals and priorities. For example, if your goal is to improve your sleep, share other lifestyle changes you’ll be trying along with cannabis, like limiting screen time before bed.

Also, you can point out that while we try many new things in our lives, very few (if any) become all-encompassing. For example, when you took up running, it didn’t mean you were suddenly skipping work to spend all day out on the trails. Your experience with cannabis will likely follow a similar path, becoming a balanced activity, not a problematic one. 

Religion and Cannabis

Cannabis prohibition in the United States has always carried a strong moral undercurrent, using language such as “devil’s lettuce,” and stereotyping cannabis users as lazy stoners.

Most of today’s religions are against recreational use. Medical marijuana, on the other hand, is where many religions (but not all!) have shown more openness.

If your partner’s concerns are based on religion, try to understand their perspective. They may be concerned that you are not treating your body with respect, or that your use will be excessive and sinful.

If you’re only interested in using cannabis for recreational purposes, you’ll have a tough argument to make.

However, if you’re seeking cannabis for health purposes, consider framing your perspective to address your partner’s concerns. For example, talk about how you are seeking alternatives to prescription painkillers that have harmful side effects.

Also, you can point out that your goal is to heal, not to get high, and what that means for you.

For example, you might be starting with CBD hemp products that are federally legal and have no intoxicating effects. If you’re using products with THC, you might talk about how you plan to start low and go slow with dosing, an approach recommended by Leaf411 nurses, Dr. Dave and other cannabis health practitioners. A big misconception is that you need to feel high (intoxicated) to reap the medicinal benefits. This is not the case for most people using THC.

Talking About Substance Abuse Concerns

Substance abuse is a complex issue. You only need to look as far as a set of siblings, where one sibling becomes an alcoholic while the other does not, to see it’s not just a matter of genetics or upbringing. 

Your partner may understandably be concerned if they’ve had friends or family members who abused marijuana. Anything can have an abuse potential, from food to alcohol to cannabis, so explaining your intention is key.

It doesn’t help, either, that the Food and Drug Administration (FDA) lists marijuana as a Schedule 1 drug along with heroin, despite significant evidence that it is not nearly as harmful and has much lower potential for addiction. Part of the Schedule 1 designation is based on the FDA’s position that marijuana has no medical value.

This designation, ironically enough, limits the abilities of academic and medical professionals to conduct research on cannabis’s potential health benefits.

In other words, the FDA requires clinical research to support moving a drug down to a lower level on the schedule; however, due to FDA restrictions, it’s extremely difficult for researchers to conduct the very studies that the FDA requires.

Can someone become dependent on cannabis? According to Dr. Robert Navarra, a psychologist at the Gottman Institute, substance use and addiction fall on a spectrum. About 9% of people who use cannabis will develop cannabis use disorder which means they are dependent on—but not addicted to—cannabis. To put that in perspective, researchers estimate that approximately 30% of Americans have alcohol use disorders.

Respond to your partner’s concerns by talking about what your overall goals are in using cannabis, as well as how this plant-based tool fits in with other strategies you’re trying. If you’re embracing the start low and go slow approach, you can share that knowledge with your partner as well. Your goal is to find the right amount for your purposes.

CBD and Marijuana Health Concerns

In January 2020, new research came out from the American College of Cardiology showing that cannabis may interact with certain cardiac medications.

If your partner saw that study in the news, or other past news about the FDA questioning the safety of CBD, they might have hesitations, especially if you regularly take prescription medications.

We agree that it’s imperative to check with a medical professional before adding any new medicine to your ongoing regimen. You can check out our recent post on the subject here.

Our Leaf411 registered nurses are also available to talk to you or your partner about potential medication interactions with cannabis.

Legal Cannabis and the Workplace

First, we’ll say that if you live in a state without legal recreational or medical marijuana, then we strongly encourage you to limit yourself to CBD hemp products which are federally legal. CBD hemp products may provide many cannabis plant benefits, minus the intoxicating effects of THC.

CBD hemp is also legal at the state level nearly everywhere. (Idaho, Nebraska and South Dakota are the exception.)

Even in a fully-legal state with recreational and medical marijuana, your partner may have legal concerns.

For example, a med card or state legalization doesn’t serve as a defense against positive drug test results in the workplace.

If you work in a job that requires drug testing, then we recommend looking for CBD products that clearly state “No THC” on their label. Verify the product quality and contents, as well, by reviewing the manufacturer’s COA listing the lab test results. Be sure to share this information with your partner as well, so they can understand how you’re taking steps to use safe products.

Is your partner worried that secondhand marijuana smoke could cause them to fail a drug test? This is a common concern. We’ve reviewed the research and haven’t been able to find any published studies that passive or incidental exposure will result in a positive drug test.

Offer Cannabis Resources and Education

Does your partner know the difference between full-spectrum CBD hemp containing under 0.3% THC versus marijuana products with higher THC levels? Do they understand that you don’t need to smoke marijuana for it to be effective?

Check in with your partner to make sure that you’re both talking about the same thing. They might assume that you plan to smoke or vape marijuana flower that will get you high, while you’re actually planning to start with an edible or oil that contains more CBD than THC.

Your first instinct might be to answer your partner’s questions with “Google it.” However, there are thousands of websites offering misinformation on both sides of the cannabis debate.

That’s one reason we formed the Leaf411 nonprofit hotline—to provide a trustworthy resource to the public, providing medically-sound, balanced information.

Our Leaf411 library is a good starting point, offering a list of resources providing a balanced view.

Our registered nurses who staff the FREE Leaf411 hotline are also a great resource. You don’t have to be a cannabis user to call us. We take calls from many non-cannabis users, including spouses, family members, and clinicians who are simply seeking more information to help their patients.

Creating Shared Expectations Around Cannabis Use

It’s important to talk to your partner about how, when and where you plan to use CBD hemp or marijuana, coming up with a plan that both of you can live with.

Some people simply don’t like the smell of marijuana. They may worry that it will cause everyone in the house to smell like they’ve been smoking, or that neighbors will notice the smell. This is a legitimate concern!

Fortunately, there are many alternatives to smoking, including vapes which produce less odor, as well as edibles, tinctures, and even transdermal and topical products.

Other areas you’ll want to discuss are listed below. Your decisions will likely be shaped in part by why you’re using CBD hemp or marijuana. For example, if your goal is to reduce social anxiety, then it won’t be especially helpful if your partner insists that you only use cannabis at home after everyone else is in bed.

Kids: Whether or not to use cannabis around your children is both a highly personal decision, and also a hotly-debated issue. Pediatricians express concerns about secondhand smoke, as well as risks with parents being intoxicated with any substances, including cannabis, while caregiving. On the other hand, more parents like Kaycee Bawdon are speaking out about responsibly using cannabis while parenting. Many parents point out that drinking alcohol around kids is widely accepted, even though it is a more dangerous substance. As a starting point for discussing this issue with your partner, check out this article to read rules different parents have set around using cannabis at home.

Visitors: For many of us, marijuana was a common presence in our younger days. Visit a friend’s dorm room, and they might offer you a hit off their bong. Of course, many dorm room relics no longer fit in our lives.

While many adults enjoy the social aspects of modern cannabis culture, others prefer to keep their use private. Talk to your partner about how to handle this issue in your home, recognizing that different situations may call for different rules.

A Few Final Thoughts on the Importance of Trust

Your partner may not be the biggest fan of cannabis, but hopefully they will respect and support your right to use CBD hemp or marijuana products in a legal, safe, responsible manner. You can help the cause, so to speak, by being truthful about your use. Nothing creates mistrust faster than sneaking around and lying.

Respect is a two-way street. If your partner chooses to not use CBD hemp or marijuana, it’s important for you to respect their decision. Resist the urge to pressure them to try your new vape “just one time” even if you think they’d love it.

Need Help Starting the Conversation?

Our Leaf411 cannabis-trained nurses are available to provide balanced education and guidance on safe, legal cannabis use. We’ve even had couples call and put us on speaker phone, so they could both be part of the conversation!

We encourage you or your partner to call us with your questions at 1-844-LEAF411 (844-532-3411).

The Leaf411 cannabis nurse hotline provides free 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.