A Medical Cannabis consultation isn't a lot different from a traditional medical visit. Providers need to understand the chief complaint or reason you want to explore Medical Cannabis as a therapeutic option. That being said, you still may wonder what this visit will look like. Let's go through it together.
All medical consultations, regardless of the type, begin with you signing a consent form. Medical Cannabis is different only in the fact that it's still considered federally illegal. Therefore, you must sign a liability waiver to discuss and receive a recommendation.
Medical Cannabis providers can only give recommendations for the use of Medical Cannabis within the state that they practice. They cannot give prescriptions for Medical Cannabis because prescriptions require FDA approval and cannabis is still considered illegal federally. This is confusing to many patients and providers, but just know that as a patient, you're accepting liability for your own use of Medical Cannabis according to state law. You can still lose your job or not be hired if your private employer has a zero-tolerance policy.
In many cases, medical clinics provide you with a questionnaire, either online or in person when you arrive, to list your current medical issues in detail as well as some of the history of your condition. Secure, online intake forms can streamline the process because it gives the medical clinic information on your condition prior to you arriving so they can request medical records from you if needed. This is where you can list not only the issue you are requesting a Medical Card for but other health issues you may be suffering from.
Providers need to understand the comorbidities, or other health conditions, that you have. For example, if your main complaint is lower back pain, do you also have obesity? Do you have sleep apnea or another condition that affects your ability to exercise? Often, a comorbidity like insomnia will relate directly to a pain complaint. For example, a patient with lower back pain might have trouble sleeping because of the pain. Or, they may get anxious when they are in pain. All of these issues should be discussed with your medical provider in a Medical Cannabis consultation. Give as much detail as possible, even down to the time of day that certain symptoms occur. This helps us decide how and when to use cannabis as an effective treatment for your condition.
It's also necessary to discuss previous treatment attempts, like physical therapy or different medications that you have tried. It's very important to discuss and list all of your current medications in order to determine whether any of them will interact with Medical Cannabis. While most medications don't interact with Medical Cannabis, there are some that can be dangerous and it's best to keep an open dialogue during your Medical Cannabis consultation.
Because Medical Cannabis is typically recommended only after other medications or treatments have been tried and failed, it's not always necessary for a physical examination. This varies from patient to patient.
Medical Cannabis consultations and recommendations typically take place in an educational setting and feel more like visiting a counselor. You'll review medical records and discuss Medical Cannabis in a comfortable and safe setting.
The first question medical providers need to answer is whether or not you qualify for a Medical Cannabis Card in Utah and if they are willing to issue the recommendation. This decision is likely going to be based on your condition and if your provider thinks it's safe to initiate Medical Cannabis therapy despite your other health issues and current medications. Your provider must also document this decision-making process in your chart in a detailed fashion.
I usually categorize patients into one of four categories, based on the experience they have with cannabis use. This categorization helps me determine the level of education and support you'll need in the initial 30 days. It also helps determine the dosage that I recommend you use daily.
Level 1: A level 1 patient is a newbie or has never used cannabis in their life. I spend the majority of my time explaining the basics of Medical Cannabis. After that, I will work with you to find your "just right" dose. In our clinic, level 1 patients also leave with instructions, helpful tips, and a dosing protocol worksheet.
Level 2: A level 2 patient has used cannabis once or twice. Level 2 patients often need a review of Medical Cannabis basics and a conversation about which products to try. These patients usually find a dosing protocol worksheet helpful, too.
Levels 3 & 4: A level 3 patient uses cannabis occasionally and is already familiar with the effects of cannabis. They'll usually spend most of the time reviewing products they have used. If requested, I'll give additional clinical research data on their condition and delivery methods or dosing suggestions to help these patients find what works best for them. Maybe they've been using vape cartridges for years and a tincture or edible may work best for their condition. With all patients, a "just right" dose and method is crucial to effective treatment. In a level 4 Medical Cannabis consultation, I'll often learn more than I teach.
The concept of ratios in cannabis medicine is becoming much more popular as science reveals its benefits. CBD is widely popular for various conditions, but not strong enough on its own for a lot of Medical Cannabis patients. A provider that is educated on various delivery and dosing methods will be able to assist you in choosing CBD to THC ratios for your specific condition. In my experience, patients should never go under a one-to-one ratio of CBD to THC. Patients with low tolerance to THC require a higher ratio of CBD, acting as a buffer to the psychoactivity of THC. You can find some of this information online or through a pharmacist at the dispensary. However, we feel it's best to have your medical provider help you with these issues in-clinic. They already have an understanding of your condition.
New patients generally start with a sublingual or capsule form of delivery. A dropper or a capsule formulation is easy to understand as medicine. Most people have taken a liquid medicine or a pill before trying Medical Cannabis treatment. A sublingual tincture is probably the easiest dosing method to use for beginners because it can be measured out in the smallest quantity, even drop by drop if needed.
Vaping oil concentrate with a cartridge or cannabis flower with a dry herb vaporizer can also be a very effective method of delivery. You'll feel the effects almost immediately. In the case of raw cannabis flower, you'll also get the benefit of the entourage effect. The entourage effect is the activity of over 100 cannabinoids and terpene's, which make up the cannabis flower, working together to provide you a therapeutic experience.
Most people, in Utah especially, have preconceived notions about using Medical Cannabis. We here at Utahmarijuana.org are doing everything we can to end the stigma surrounding cannabis use. If you do decide to give Medical Cannabis treatment a shot, follow the recommendations of your medical provider and start low and go slow. You can always take more cannabis later, but not less. A mindful approach will help you develop a good relationship with plant-based medicine and all of its complexities. Poke around our website for more about dosing considerations and your Endocannabinoid system.