One of the benefits of state-legal Medical Cannabis is all the anecdotal evidence cited by people who come to the realization that cannabis helps them feel better in ways that were never intended. As a result of this evidence, we hear all sorts of questions about what the drug can and cannot be used to treat. Let’s consider menopause night sweats, for example.
A 2020 survey conducted by the North American Menopause Society (NAMS) seems to suggest that women are using cannabis to self-treat the symptoms of menopause. The study surveyed 232 California women between the ages of 45 and 64 who had enrolled in VA plans in the Golden State.
More on that study in just a minute. First though, it is important to note that we don’t have any comprehensive clinical studies on this particular topic. In fact, we have very little study data on anything relating to menopause symptoms and the endocannabinoid system.
What we do know is that the endocannabinoid system is a multi-functional system. It directly regulates, or indirectly helps to regulate, a long list of biological functions. It is believed that the endocannabinoid system does play a role in regulating a person’s internal thermostat.
If that is truly the case, it would stand to reason that night sweats caused by menopause could be controlled through some sort of endocannabinoid manipulation. But right now, that’s just a theory. Like so many other potential treatment areas, using Medical Cannabis to treat menopause hot flashes needs a lot more study.
Getting back to the previously mentioned study, more than half of the women surveyed reported menopausal symptoms they found bothersome. They mentioned hot flashes and night sweats at a rate of 54%. In addition, 27% complained of insomnia and 69% complained of genitourinary problems.
When asked how they treated their menopause symptoms, 27% reported having used cannabis at one time or another. Survey participants were not asked how frequently they used cannabis or the amount they used.
More interesting was the fact that only 19% reported using traditional menopause therapies. Hormone therapy immediately comes to mind. Yet 10% reported an interest in giving cannabis a try at some point in the future. This tells us something particularly important.
What it tells us is that traditional menopause therapies do not always work. But that’s no different from any other medical therapy. Medical science develops therapies to treat all sorts of diseases, maladies, and conditions. But every medical professional knows that people respond differently to those therapies. A single therapy doesn’t work for every patient. No therapy is foolproof.
It is entirely possible that the majority of the women in the California study who reported treating with cannabis actually found relief in doing so. It’s also possible that some found relief while others didn’t. We just don’t know.
Here in Utah, our list of qualifying conditions for Medical Cannabis is pretty straightforward. Most of the patients who apply for Medical Cannabis cards in our state list chronic pain as their chief complaint. But there are also patients who use Medical Cannabis to treat:
At this time, we do not have enough data to say one way or the other if Medical Cannabis would be an appropriate treatment for menopause night sweats. One day we may have that answer. For now, though, we encourage you to discuss your health with a medical provider if you believe you qualify for a Medical Cannabis card in Utah.
Harvard Health Publishing ran a piece in early December 2022 from Julie Corliss, the executive editor of Harvard Heart Letter. The piece posed a question those of us in the Medical Cannabis community have been asking for quite some time: how does cannabis actually relieve pain? Research cited by Corliss suggests the answer may be in studying what is known as the placebo effect.
The research in question, though small-scale, demonstrated no notable difference in pain relief between Medical Cannabis and placebo. But rather than jumping to the conclusion that Medical Cannabis doesn’t actually work, the research points to our understanding of the placebo effect and its effect on pain perception. The research suggests that cannabis may relieve pain through a similar mechanism.
You may be familiar with the placebo effect in principle. In essence, it is observed when people in clinical trials report positive results after receiving placebos – in contrast to a test group that was provided the real medication. The effect is explained as an effect of the mind. In other words, patients expect to feel better; their expectations become self-fulfilling.
We know the placebo effect is real. It has been demonstrated time and again. But is there anything physiological behind it? According to at least one of the experts interviewed by Corliss for her piece, there is. Ted Kaptchuk, of the Beth Israel Deaconess Medical Center, says the physiological mechanism is related to endocannabinoids.
Kaptchuk says that medical science has known since the 1970s that giving patients a placebo they are thoroughly convinced will work leads to the release of endocannabinoids in the brain. Remember that endocannabinoids are naturally occurring in human biology. They are very similar to the phytocannabinoids, such as CBD and THC, found in Medical Cannabis.
Although science is not clear as to what causes the release of endocannabinoids via the placebo effect, there is little doubt that the human endocannabinoid system helps regulate a variety of physiological functions. It influences appetite, memory, mood, cognition, and more. That’s why cannabis consumption affects many of the same things.
Assuming the placebo effect releases endocannabinoids that are somehow related to pain regulation, patients who sincerely believe a given placebo will relieve their pain are likely to experience some measure of relief. Their sincere expectations contribute to the release of endocannabinoids which bind to pain receptors to provide relief.
Medical Cannabis’ therapeutic benefits lie in the cannabinoids patients consume. Like naturally occurring endocannabinoids, Medical Cannabis cannabinoids bind to those same receptors throughout the body. Therein lies the pain relief. At least that’s the theory. The research cited by Corliss seems to add significant weight to that theory.
If the theory is proved correct, it would ultimately lead to a very important question: if the placebo effect works, what would be the point of recommending Medical Cannabis as a pain treatment? The answer is as simple as understanding human expectations.
The placebo effect relies on a sincere expectation of relief. In other words, patients need to believe a medication will help for the placebo effect to kick in. If it doesn’t kick in, those endocannabinoids don’t get released. Where there is no endocannabinoid release, there is no pain relief.
On the other hand, consuming Medical Cannabis will introduce cannabinoids to the system by default. There is no guessing. There is no sincere expectation required. Medical Cannabis should provide pain relief irrespective of a patient’s expectations. Of course, all of this is dependent on a correct understanding of how the endocannabinoid system regulates pain.
The FDA recently made waves by issuing new opioid guidelines. Although the new guidelines contain some significant changes, the FDA still recommends gradual tapering rather than pulling patients off opioid medications cold turkey. It is hard to argue against such recommendations. But it’s time to go a step further to seriously consider opioid tapering in conjunction with Medical Cannabis use.
Gradual tapering from opioid medications constitutes sound medical science. We know how addictive opioid medications are. We also know the dangers of cold turkey withdrawal. We even have scientific data that indicates chronic pain patients actually feel better when successfully tapered from opioids. So with all that knowledge, it is time to start looking at Medical Cannabis as an alternative to opioids during the tapering process.
Here in Utah, chronic pain is one of the qualifying conditions for Medical Cannabis. Certain types of acute pain also qualify. It is a safe assumption that every other state with legal Medical Cannabis allows doctors to recommend it as a pain treatment. We say all that to say this: those who believe in the efficacy of Medical Cannabis generally agree that it helps patients find an acceptable level of relief from chronic and acute pain.
This should not be discounted in any discussions involving opioid reduction. If we are serious enough about tackling the opioid issue to encourage clinicians to look at alternate treatments, one of those alternate treatments ought to be Medical Cannabis.
As far as opioid tapering is concerned, it is often done in conjunction with substitute medications that still offer patients pain relief. Why not recommend Medical Cannabis as a substitute medication? If it can help relieve pain while patients are slowly weaned from opioids, it seems senseless to not recommend it.
We previously mentioned study data indicating that patients actually feel better after completing a tapering program. Let’s look more closely at that study. It was published in 2019, and it looked at more than 2,100 cases of patients who were prescribed opioid medications for chronic pain.
Each patient was tapered from opioids according to standard guidelines. At the conclusion of tapering, 81.25% reported improvement in their pain. Just 15% reported no change in how they felt. Finally, 3% reported more pain at the completion of tapering.
Looked at another way, 97% of the patients either felt better or noticed no difference in their pain levels following opioid tapering. Just 3% felt worse. The point is that patients can be successfully tapered without worsening their conditions. So there is no good reason to not do it.
Any and all patients who still need some measure of pain relief after opioid tapering should have access to as many choices as possible. For some, the best choice is going to be Medical Cannabis. Others will find pain relief through OTC medications, physical therapy, or other means.
As our knowledge of Medical Cannabis efficacy is expanding, people suffering from all sorts of conditions are beginning to ask whether it is right for them. One condition we hear a lot about is acid reflux. Patients want to know if cannabis can address the disease and, if not, at least relieve the pain. The simple answer is this: we don’t know.
Cannabis has not been the subject of nearly as much study as so many other potential therapies. You know the reasons why. The good news is that research is starting to pick up. It is probably only a matter of time before scientists take a good look at Medical Cannabis as an acid reflux treatment for the disease, the pain it causes, or both.
There is reason to hope that Medical Cannabis may someday lead to a more effective treatment for acid reflux. Why? Because we do know that the endocannabinoid system regulates a whole host of biological functions ranging from appetite to metabolism and feelings of nausea. This is due to the presence of CB1 and CB2 receptors scattered throughout the body.
If you’d like more detailed information on this, check out a Cannigma article found here. In a nutshell, CB1 and CB2 cannabinoid receptors are found in every organ in the body. They are found throughout the digestive tract as well as the esophagus and stomach. The chances of them being there coincidentally are pretty slim. The fact that the receptors are found in these areas is compelling evidence that the endocannabinoid system regulates them at some level.
As the thinking goes, stimulating the endocannabinoid system with certain cannabinoids may lead to a reduction in acid production. Perhaps reduced inflammation and a more relaxed esophagus, both as the result of endocannabinoid manipulation, are also possible via Medical Cannabis.
The Cannigma cites three separate studies in support of Medical Cannabis as an acid reflux treatment. Two of the three were animal studies done in 2002 and 2009, respectively. A 2010 study conducted using human participants show promising results despite only 87 subjects being enrolled.
If you live in Utah and suffer from acid reflux, you need to know that the condition is not on the state’s list of qualifying conditions for Medical Cannabis. In theory, you could probably still apply for a card based on your experience with chronic pain. But that would be up to you and your medical provider to discuss. We couldn’t say one way or the other if Medical Cannabis would be the most appropriate treatment for you.
We do know that there are other acid reflux treatments out there. If they aren’t working, you can always sit down with your medical provider and discuss other options. In the meantime, remember that any possibility of your doctor recommending Medical Cannabis would be rooted in a chronic pain diagnosis.
In closing this post, we want to remind readers that state law requires possession of a valid Medical Cannabis Card to consume cannabis products in Utah. Whether you want to use cannabis for chronic pain or some other condition, you first need to meet with a Qualified Medical Provider (QMP) or Limited Medical Provider (LMP) who can recommend cannabis to you.
If your own doctor will not act as your LMP, feel free to contact us to make an appointment with one of our QMPs. We are more than happy to sit down and discuss Medical Cannabis as an option for you.
Medicine can be delivered to the human body in any number of ways. More often than not, oral consumption is the preferred delivery method for Medical Cannabis. You simply swallow some pills or capsules and that’s that. There are also aerosols to be inhaled and medications delivered through injections. Then there is the transdermal patch. It doesn’t get a lot of play because it’s not utilized as much as most of the other delivery methods.
The transdermal patch is a means of delivering medication through the skin. Here in Utah, transdermal delivery is legal within the Medical Cannabis realm. So it’s theoretically possible that a manufacturer could produce a Medical Cannabis transdermal patch for pain, or some other qualifying condition.
A transdermal Medical Cannabis patch works the same as any other transdermal application. The explanation is found in the name. ‘Transdermal’ refers to the idea of transferring medication into the body through the skin. In terms of the transdermal patch, the patch is saturated with the medication in question. As it makes contact with the skin, the medication is transferred and then absorbed. It travels through the skin and into the underlying tissue.
Delivering medication through a transdermal patch is very similar to delivering it through a topical ointment. The big difference is that a patch maintains contact with the skin, thereby delivering more medication for a longer period of time. A transdermal patch gives you a lot more bang for your buck than a topical ointment or cream.
Transdermal applications are possible due to the skin’s nature as an organ. In fact, the skin is the largest organ in the body. It is waterproof yet breathable. It is flexible but still strong. Finally, it has an uncanny ability to absorb all sorts of substances.
Medical science has known of the effectiveness of transdermal applications for quite some time. So much so that doctors have been recommending them for decades. Three of the most common uses are:
As effective as transdermal patches are, patients really shouldn’t be careless with them. Preparation is key before applying a patch. Preparation starts with removing any other patches that contain the same medication. This is to prevent overdose. The second step is to clean the area where the patch will be applied and then wash the hands with soap and water.
Only after all the prep is completed is it appropriate to open the package and remove the transdermal patch. It is then applied directly to the skin. Adhesive on the patch keeps it in place.
It’s a good idea with any type of transdermal patch to keep your doctor up to date on how it’s working. The doctor should also be kept informed of any negative side effects you may experience. Of course, this applies to all transdermal patches.
If you are using a transdermal Medical Cannabis product, you’ll be delivering THC to your body through your skin. Keep a record of how this works for you. Write down when you apply a patch, how it makes you feel, and any unpleasant side effects you experience. Give that information to your pharmacist next time you purchase Medical Cannabis. Every bit of information you can provide will help them offer you the best possible advice.
The transdermal patch has been an effective medicine delivery tool for years. Undoubtedly, some Medical Cannabis patients prefer it as their main delivery option.
Utah regulations require all patients wishing to use Medical Cannabis to have a valid Medical Cannabis card. Patients are not allowed to purchase cannabis products and give them to others, especially friends and family members who do not have valid cards themselves. Patients cannot even give cannabis to out-of-state visitors. But out-of-state visitors can apply for a non-Utah resident card.
Are you aware of the non-Utah resident Medical Cannabis Card? The card didn’t exist back when our state first implemented its Medical Cannabis program. It was added after the fact, to make it easier for Medical Cannabis patients from other states to continue using their medications when they visit Utah.
A non-Utah resident card essentially gives out-of-state visitors temporary access to Medical Cannabis here. The process for obtaining a card is very similar to the process Utah residents complete. Requirements are virtually the same as well. The only significant difference is the duration of a non-resident card.
Let’s say your family visits from Oklahoma. One of your family members has a valid card from Oklahoma. That card is not recognized in Utah, but your family member can apply for a non-Utah resident card. If granted, the card would give your family member the opportunity to use Medical Cannabis for up to 21 days of a single stay.
Non-residents can apply for cards twice per year. However, expiration dates are not extendable or negotiable. A non-Utah resident card is good for 21 days and that’s it. Those 21 days are consecutive as well. A visitor could not use it for a week in July, then another in August, and a third in September.
In order to apply for a non-Utah resident Medical Cannabis Card, an out-of-state visitor must have a qualifying condition recognized by state regulations. The most commonly cited conditions in the Beehive State are chronic pain, PTSD, seizure disorders, and cancer. The out-of-state visitor must also possess a valid card from their home state.
The process for applying begins with a visit to the UtahID website where the visitor will create an account and furnish ID information. Once an ID account has been established, the visitor can log on to Utah’s Electronic Verification System (EVS) to complete the non-Utah resident Medical Cannabis Card application.
Visitors are required to provide information about their medical conditions and existing cards. Once completed and submitted (along with the application fee), a visitor’s application is reviewed by the DHHS before approval or denial. It can take up to three weeks for the DHHS to respond. Therefore, we suggest visitors apply at least a month before their arrival. They are required to pick a date on which the card becomes valid. It will expire 21 days later.
One final thing you should know is that the non-Utah resident Medical Cannabis Card does not give out of town visitors permission to bring cannabis into the state from elsewhere. Transporting Medical Cannabis across state lines is not allowed.
That means an out-of-state visitor with a valid non-resident card must purchase their medications from a state-licensed Medical Cannabis pharmacy. Visitors cannot take cannabis out of the state, either. So everything purchased here must be consumed here.
State lawmakers approved the non-Utah resident card to make it easier for out-of-town guests to continue treating their qualifying medical conditions while visiting the state. Thanks to the non-resident card program, your friends and family members can visit you in Utah without having to worry about their medications. Schedule an appointment with Utah Marijuana to get your non-resident card!
It is a pretty safe bet that you’re familiar with Medical Cannabis delivery methods, such as vaping, using tinctures, and ingesting gummies, tablets, etc. But have you ever considered transdermal patches? Transdermal preparations are among the approved products in Utah. They are also a different way to use Medical Cannabis that don’t get a lot of attention.
Transdermal preparations would fall under the topical category. As topicals, you apply them to the skin. The idea is that the medication travels through the skin on the way to the bloodstream. By contrast, vaping delivers medicine to the bloodstream through the lungs while tinctures deliver it through the skin underneath the tongue.
A good way to think of a transdermal Medical Cannabis product is to compare it to a nicotine patch for smoking cessation. Perhaps you know someone who has used nicotine patches. Maybe you have used them yourself. You stick the nicotine patch to your skin (usually on an arm) and then mostly forget about it. It slowly releases nicotine into your skin and on to the bloodstream.
The beauty of the nicotine patch is that it delivers a continuous stream of nicotine at a very slow rate. Its effects are consistent and more easily controlled. By applying the same concept to Medical Cannabis, manufacturers of transdermal products give patients another option for slow, steady cannabinoid delivery.
By now you are probably wondering what types of patients would use transdermal patches. There is no particular group per se, but transdermal products are ideal for people who need all-day relief from their symptoms. They can just apply the patch early in the day and not have to worry about it any further.
Transdermal products are also good choice for people who don’t want to vape or dry heat raw plant material. The same goes for folks who aren’t all that plussed by tinctures. Again, the number one benefit of the transdermal product is that it consistently delivers medication throughout the day.
Like we say all the time, transdermal patches may or may not work for you. Results vary among patients. For starters, your particular qualifying medical condition might be best treated with another form of Medical Cannabis. That’s for you, your medical provider, and your pharmacist to determine.
There is also the reality that patients respond differently. A friend of yours might consider transdermal patches the greatest thing since sliced bread. You might decide that tinctures still work best for you. The only way to know for sure is to try.
If you would like to give transdermal patches a try, ask about them on your next visit to the Medical Cannabis pharmacy. You can always buy one and see how it goes. We would recommend tracking your usage so as to give your Pharmacy Medical Provider (PMP) the data they need to advise you.
Come to think of it, we think it’s a good idea to track all your Medical Cannabis consumption. Regardless of your preferred delivery method and strains, tracking is a fantastic way to help both you and your PMP better understand how Medical Cannabis is working for you.
As for the transdermal patch, it is one of many options we have available in Utah. Go ahead and research the transdermal principle and see what you think. Then talk it over with your medical provider. A transdermal patch could turn out to be the best product for you. And if not, you still have other choices.
Medical Cannabis Cards can be recommended in Utah by two types of medical providers. The first is the Qualified Medical Provider (QMP), the second is the Limited Medical Provider (LMP). The latter group is the topic of this post. How much do you know about them?
Utah’s LMP program was not initially part of the Medical Cannabis package that resulted from passage of Proposition 2 in 2018. In fact, the state didn’t finally approve LMPs until just over a year ago. Adding them to the equation has arguably had a positive impact on Medical Cannabis patients.
Things have been going so well for the Limited Medical Provider program that Utah Physician magazine just ran a detailed piece about it in their October-November 2022 issue. It is a great article that offers some information that was previously hard to come by just by looking at the state’s Medical Cannabis website.
You might already know that QMPs are medical providers who have taken the necessary steps to be certified with the state to recommend Medical Cannabis. They have prescribing authority, they have met the continuing education requirements, and they have registered with the state. The reward for going through that process is the ability to recommend Medical Cannabis to hundreds of patients.
The LMP hasn’t gone through the certification process. Still, they are a licensed medical provider with existing authority to prescribe narcotics. Your family doctor or nurse practitioner is the perfect example.
LMPs with prescribing authority can recommend Medical Cannabis to up to 15 patients at a time. They do not have to undergo continuing education or pay the annual licensing fee.
We think it is important to point out that a Limited Medical Provider is every bit as qualified as QMPs to recommend Medical Cannabis. Even without state certification and continuing education, they are still licensed medical professionals with the same overall training education as the rest of their peers.
Giving them the ability to recommend Medical Cannabis was designed to help patients who may not have easy access to QMPs. Think rural patients who live an hour or more away from one of Utah’s urban centers. Allowing their local doctors to help them out makes life much easier on them.
For us, one of the big take-aways from the Utah Physician article was the knowledge that the process is slightly different for LMPs. When a QMP recommends Medical Cannabis to a patient, they actually interact with the state’s electronic verification system (EVS). That is not the case for LMPs.
An LMP downloads and completes a form on behalf of the patient. The form can then be sent to a local Medical Cannabis pharmacy via electronic means or delivered in person by the patient him or herself. Pharmacy staff enter information from the form into the EVS. A temporary card is issued via email and the patient can immediately make that first purchase.
It is not quite clear why the process was set up differently. If we had to hazard a guess, we would say that the state is trying to make things as easy as possible on LMPs in order to encourage more medical providers to get on board.
At any rate, potential Medical Cannabis patients who don’t have easy access to a QMP can now enlist the help of a willing medical doctor, nurse practitioner, etc. with prescribing authority in Utah. We invite you to learn more about the Utah Limited Medical Provider program whether you are a patient or provider. It is a great program that provides a valuable service.
It is a good thing that the state decided to implement administration of the Medical Cannabis program online. We all live online these days. So establishing the electronic verification system (EVS) was a no-brainer. That said, the EVS can be confusing. Consider a patient’s EVS status. There are four options that could show up in a patient’s account.
Imagine you just completed your Medical Cannabis Card application and paid your fee. Now you are waiting for your card to arrive via email. You can check your status any time by logging in to your account. Likewise, current patients looking to renew their cards can also check their status.
Here are the four options and what each one means:
The first option is ‘Awaiting State Review’. By law, the state has up to 15 days to review your application and render a decision. Reviews are typically completed in considerably less time, but there aren’t any guarantees. Seeing this status on your account page lets you know that your application is being processed.
If you are concerned that it’s taking too long, you can always check with your QMP’s office to see if they have submitted the required information on their end. If you used an LMP, this particular issue doesn’t apply.
Assuming your application has been processed and approved, your status should say ‘Active’. You should have already received your Medical Cannabis Card via email. If not, check your spam folder. Maybe it got diverted there by mistake.
You can also print a paper copy of your card directly from the EVS. Visit the EVS website with a smartphone and you should be able to view your card as well. If so, you can save a copy to your phone’s internal storage.
A quick word here about the ‘Active’ status and renewals is in order. Let’s say you renew your card a few days before it expires. You check your status and see that it’s still ‘Active’. Great. The state will not issue your new card until the day after your existing card expires.
Make a point of checking in that day after. If you haven’t received your new card via email, check your spam folder. You should be able to see the new card on the EVS page. You can print a paper copy if you like.
Seeing the ‘Incomplete’ status on your account tells you that the DHHS needs more information before they can render a decision. They have either sent you an email or will be doing so shortly. So again, check your spam folder.
What more information would the state need? It’s hard to say. Maybe you made a mistake entering your contact information. Perhaps the information you provided doesn’t exactly match what your QMP provided. Hopefully it’s a minor issue you can correct with little effort.
Unfortunately, some Medical Cannabis Card applications do get denied. There can be a number of reasons for such denials. If that’s the case for you, your status on the EVS will state ‘Denied’. Changing your application to that status should trigger an email explaining what happened. Check your spam folder if you don’t get one.
Card status on the EVS site is designed to help Medical Cannabis patients know where they are with their cards at any given time. It is not a perfect system (no system is) but it does the job. As a Medical Cannabis patient, you can check your own status any time simply by logging in to your EVS account.