Chronic pain and cancer are among the top five reasons people apply for Medical Cannabis cards in Utah. Interestingly, cancer patients often choose Medical Cannabis to help deal with the pain of the disease and its treatments. In such cases, a cancer patient’s Pharmacy Medical Provider (PMP) becomes an important member of the care team.
Cancer is a bit unusual in the sense that treating it often causes more discomfort than the disease itself. Chemotherapy and radiation treatments are not easy on the body. So it’s not unusual for cancer patients to experience significant pain along with other symptoms, including nausea.
Medical Cannabis can help alleviate both symptoms. However, a patient’s oncologist may not know the best way to utilize Medical Cannabis for each individual patient. That is where the PMP comes in.
The PMP is the most qualified medical provider to advise on Medical Cannabis use. As a licensed pharmacist, the PMP is trained in all things pharmacology. They are intimately familiar with the human endocannabinoid system. They understand how Medical Cannabis interacts with that system.
Oncologists, general practitioners, etc. are not trained in pharmacology. Their medical school training focused primarily on biology and physiology, along with some anatomy. So while an oncologist may discuss Medical Cannabis with a cancer patient, they may not fully understand how the drug should be used to help that particular patient.
The lack of knowledge among oncologists can leave cancer patients wondering where to turn for answers to their questions. According to a recently published study from Boston’s Dana-Farber Cancer Institute, patients often rely on the advice of dispensary and pharmacy staff.
Their study interviewed twenty-six dispensary/pharmacy employees in thirteen states to try to understand their knowledge of Medical Cannabis as a therapeutic response to cancer pain and nausea. Unfortunately, the interviews revealed a lack of knowledge among these cannabis professionals.
In a previous study, the same Boston research team found that some 80% of oncologists were willing to discuss Medical Cannabis with patients. Yet only 30% felt they had the qualifications to actually recommend its use.
This takes us back to the PMP at the Medical Cannabis pharmacy. In Utah, every pharmacy is required to have a PMP on staff whenever the doors are open. PMPs are there to answer questions, offer advice, and even consult with patients to help them come up with a strategic care plan.
We consider the PMP one of the more critical members of the care team when it comes to Medical Cannabis therapeutics. The reason is simple: there are so many choices. It is easy for patients to walk into a pharmacy and immediately feel overwhelmed by the different products and delivery methods.
Things are made more complicated by the fact that people experience cancer pain and nausea in different ways. For some people, the pain is moderately annoying but tolerable. Other people find cancer pain nearly debilitating. It takes an experienced professional to help patients find the right therapeutic formula.
The oncologist is not adequately trained in pharmacology. That’s fine. No one expects it. On the other hand, the PMP is trained. That makes the PMP an important member of any cancer patient’s care team.
If you use Medical Cannabis, do you take advantage of your local pharmacy’s PMP? If not, you really should. Your PMP is a fountain of helpful knowledge and advice that could really make a difference in your treatment. Why not take advantage of everything your PMP knows?
Imagine you are sitting in a job interview listening to the HR manager talk about workplace policies. She mentions random workplace drug testing and your mind begins to race. You use Medical Cannabis from time to time to help with migraine headaches. Meanwhile, CBD supplements are part of your daily routine.
Will either Medical Cannabis or CBD show up on workplace drug tests? And if so, could the results of a drug test prevent you from being hired? You just don’t know. You are terrified when the HR manager directly asks you about drug use.
First of all, relax. We have come a long way here in Utah regarding Medical Cannabis and cultural acceptance. You may have nothing to worry about. Just explain to the HR manager why you use Medical Cannabis. A simple explanation can go a lot further than not saying anything until you test positive.
You probably have nothing to worry about where most of your CBD products are concerned. CBD doesn’t show up on drug tests simply because the tests are designed to detect it. Employers generally don’t have issues with CBD because it’s not intoxicating.
As you may know, CBD products sold in the United States must contain less than 0.3% THC by volume to be considered CBD by law. So in most cases, you’ll be all right. However, there are some exceptions to pay attention to:
If you prefer CBD isolate, you should have no worries at all. An isolate is a concentrated form of the cannabinoid. There should be no THC in it whatsoever.
THC does show up on workplace drug tests because the tests are designed to detect it. You are using Medical Cannabis to treat chronic pain, so there is a good chance that at least trace amounts of THC will be in your system when a random drug test is called for.
Here’s what you need to know regarding the law in Utah: private sector employers retain the legal right to establish their own workplace drug policies. The law allows them to say no to Medical Cannabis if they choose. This is primarily because private-sector employment is at-will employment, giving both employer and employee the legal right to terminate the relationship at any time and for any reason.
This is not to say that a prospective employer would refuse to hire you because you use Medical Cannabis. A simple explanation may be enough to satisfy an HR manager that you are not a risk. As for public-sector employees, the law is much different.
Thanks to a pivotal court case and action taken by the state legislature, public-sector employers are required to treat Medical Cannabis like any other prescription medication. As long as cannabis consumption does not affect an employee’s work or present a safety issue, employees cannot be discriminated against for Medical Cannabis use.
Things are getting better with Medical Cannabis in Utah. The current legal framework certainly isn’t perfect, but it is a lot better than it was three years ago. That being said, your best bet regarding CBD, THC, and random workplace drug tests is to know and understand what the law says. Knowing your legal rights is the best way to make sure they are not infringed upon.
You are in good company as a Medical Cannabis patient who uses the medicine to treat chronic pain. Among all the conditions on Utah’s qualifying conditions list, chronic pain ranks number one. Hopefully, you are finding the relief you need. If not, are you keeping a patient journal of your chronic pain and experiences with cannabis?
Journaling for chronic pain patients is a practice recommended by both state regulators and experienced medical providers. It is the practice of recording how you use Medical Cannabis, when you use it, and how it makes you feel. Journal data can be helpful for several reasons, such as helping you to truly understand how your medicines are working. That same data can give your medical provider valuable information that makes their advice better.
As important as Medical Cannabis journaling is, it cannot be something you consider drudgery. Otherwise, you are not going to do it. So pick some sort of system that works for you. You may prefer a spreadsheet on your computer. You might be the type of person who prefers mobile apps on your phone. If you like old-fashioned paper and pen, the state produces a free PDF journal form you can download and print.
The thing about journaling is that consistency is the key. When you’re treating chronic pain, your experiences are bound to change from time to time. You need a consistent journal to account for those changes. If you are inconsistent, you and your medical provider may not be able to figure out the best path for you.
Chronic pain can be a very complex condition. So to make journaling as effective as possible, it helps to keep track of some very specific things. Taking all the information you recorded with you on every pharmacy visit helps your Pharmacy Medical Provider (PMP) fully understand what is going on with you.
Here’s what you should be tracking:
First and foremost are your goals. Why are you using Medical Cannabis? Is it only to deal with chronic pain, or are there other symptoms you are trying to address? For example, cancer patients use Medical Cannabis for both pain and nausea.
Your Medical Cannabis pharmacy is undoubtedly stocked with a variety of products. You have gummies, tinctures, and vaping products. Each one may have a different terpene profile. You also have different strains to work with. Tracking all these details can help you pinpoint which products work best for you.
You have probably discovered that different dosages and delivery methods address your pain with differing levels of success. So tracking both gives you a better idea of what does and doesn’t work. Dosage and delivery method information is especially helpful to your PMP.
Believe it or not, the setting in which you consume Medical Cannabis can make a difference. Track where you are when you take your medicine. Record the date and time. If there is anything unusual about the setting, write that down as well.
Wrapping it all up is how Medical Cannabis makes you feel. You may find great relief in one case but very little relief in another. Keeping track of this will help your PMP draw correlations between all the other information and each unique experience it pertains to.
Journaling for chronic pain patients is a fantastic way to get the most out of Medical Cannabis. It is especially helpful for chronic pain sufferers whose circumstances and experiences change from time to time. If you are not journaling yet, why not start today?
It has been a long time since we have discussed cannabis reciprocity here in Utah. Therefore, we thought a refresher was in order. With tens of thousands of Medical Cannabis patients in Utah now, new patients are being added to the roles daily. Reciprocity is a topic that needs to be discussed more often.
What is cannabis reciprocity? How does it affect you? Keep reading to find out. As you read, bear in mind that Utah Therapeutic Health Center assists patients looking to obtain or renew their Utah Medical Cannabis Cards. We have a number of clinics located throughout the state.
The concept of reciprocity, from the perspective of state law, is pretty easy to understand. States involved in a reciprocity agreement recognize and honor the laws of the other states involved in the agreement. Your driver’s license is the perfect example.
All fifty states and the District of Columbia practice reciprocity when it comes to driver’s licenses. So even though you earned your driver’s license in Utah, it is valid anywhere in the country. That’s reciprocity. All the other states agree to honor Utah’s driver’s license. In exchange, Utah honors licenses from all the other states as well.
Reciprocity is a necessity in the U.S. due to how our federal and state laws are implemented. First of all, anything not explicitly mentioned in the Constitution is regulated at the state level. That is why we do not have a federal driver’s license. Our state-heavy system keeps Washington at arm’s length. At the same time, it also means different laws from one state to the next.
The reality is that reciprocity is never guaranteed. We know this all too well where Medical Cannabis is concerned. To date, there are only thirty-eight states that legally recognize Medical Cannabis. Patients cannot use Medical Cannabis in the remaining twelve states. So right off the bat, there is a reciprocity issue with those states.
Even among states with legalized Medical Cannabis, reciprocity isn’t universal. There are a few states that have reached reciprocity agreements. Utah is not one of them, so there is no guarantee that your Utah Medical Cannabis card will be recognized anywhere else.
Utah doesn’t recognize Medical Cannabis Cards from other states, either. But not all is lost. The state does offer another option: the non-resident Medical Cannabis card. People from other states can apply for these temporary cards in advance of a planned visit.
A non-resident card gives out-of-state visitors the same legal rights and access as residents with permanent cards. The only real difference is how long the cards are valid for. Resident Medical Cannabis Cards are issued for six months at a time. Non-resident cards are only good for 21 days.
Patients should also note that they must have a valid Medical Cannabis Card from their own state and be diagnosed with a qualifying condition according to Utah regulations. As long as those two conditions are met, non-residents can get temporary cards.
One last thing you should be aware of is that reciprocity doesn’t necessarily mean you can transport Medical Cannabis across state lines. Under federal law, you cannot. The same goes for Utah. Visitors are not allowed to carry Medical Cannabis into the state; residents cannot carry it out of the state. Reciprocity has no bearing on that particular aspect.
Here’s hoping that Medical Cannabis Cards will one day be just like driver’s licenses. Perhaps a decade from now, a card from any state will be recognized by every other state and the District of Columbia.
Utah lawmakers passed a bill earlier in 2022 which requires the Legislative Management Committee to form a working group tasked with studying the possibility of consolidating all Medical Cannabis regulation under a single regulating authority. The idea has a lot of merit. We just need to wait to find out what the working group determines.
As things currently stand, there are multiple agencies involved with regulating Medical Cannabis in Utah. The arrangement has both negative and positive aspects. Among the negative are the competing goals of multiple agencies that some say are causing a variety of problems, including inhibiting the supply chain.
A single regulating authority would streamline things. At least that is the theory. And if regulation can be streamlined, supply could be boosted, and access made easier. But there is also a big negative to consider: centralized, top-down control.
One of the proposals being looked at by the working group involves forming a single regulating agency comprised of representatives from government, healthcare, and the cannabis industry. A multi-representational agency would be able to regulate in a more collaborative way compared to a top-down, centralized governing body.
Whenever government operates outside a multi-representational scenario, viewpoints are limited. Ideas, opinions, and suggestions are less likely to make their way to the top because there are fewer of them. You end up with a bureaucratic model that tends to become more bureaucratic over time.
Should state lawmakers eventually decide to consolidate cannabis regulation under a single agency, here’s hoping they do so based on a multi-representational model. We need input from as many different viewpoints as possible. That is the only way to make the state’s Medical Cannabis program the best in the nation.
A number of organizations that help pushed Senate Bill 153 through the 2022 session say that the state should also make some moves to increase competition and give patients more options. Again, both ideas have a lot of merit.
We know from experience that free markets do best when there is healthy competition among multiple players. Competition provides the incentive to do better. On the other hand, when industries consolidate, the incentive to keep customers happy wanes. Quality and customer service suffer as a result.
We do know that the supply chain in Utah is limited. We know that access is a problem for a lot of Medical Cannabis patients. If the state can address supply chain issues by encouraging greater competition, then let’s do it. One of the results would be more options for patients.
For now, we are encouraged by the fact that there is a working group actively seeking at least one way to make the state’s Medical Cannabis program better. There is always room for improvement. In the meantime, we already have a pretty good program here in Utah.
Though our state is on the more conservative side, we have a fairly long qualifying conditions list that covers all the most commonly cited reasons for using Medical Cannabis. It includes things like chronic pain, cancer, PTSD, and seizure disorders.
In addition, it is not really too difficult to get a Medical Cannabis Card in Utah. Patients need only fill out electronic applications and then see a Qualified Medical Provider (QMP) or Limited Medical Provider (LMP).
Here at Utah Marijuana, we help patients obtain their Medical Cannabis Cards. We invite you to stop by any of the clinics we operate in the state. If you qualify, we can help you obtain a card that could ultimately change your life.
Being a scientist, I always have questions about where CBD products come from, how they’re made, how pure they are, all of these types of things. Because federal oversight is so low, anyone can jump into the CBD market and make products, and that can be extremely sketchy! I’ve said it before, but I don’t think I’d buy breakfast cereal from my next-door neighbor making it in his bathtub… so what would the criteria be if I wasn’t producing my own CBD? If I wanted to purchase another product, what would I look for first?
Whoever I’m purchasing CBD from should know what farm was growing the CBD. They should also have water analysis, soil analysis, know what strain it is, and they should basically have a profile of everything associated with the plant. After that I would want to know who extracted it, as well as their method of extraction: are they using CO2? Are they using ethanol? Are they collecting terpenes? Do they winterize? I would want to make sure that all of the things that they are doing could be accounted for because if somebody who’s selling CBD doesn’t know how the producers are producing, that’s a problem.
After that, I would want a certificate of analysis (COA) from a laboratory. The laboratory needs to be ISO certified and needs to follow GLP (good laboratory practices). The reason for that is because it’s not that hard for a shady company to buy a high-performance liquid chromatography machine and get somebody who could theoretically run it after being trained by the company. That doesn’t mean that’s necessarily good science, doesn’t mean it’s being done right, and doesn’t mean it’s being done to the proper standards. So really, I would want products that are analyzed by people who spend their whole lives being trained, people who know not only how to analyze cannabinoids, but also know how to analyze anything under the sun, using the instruments of the trade. A company that is ISO certified and follows GLP is not going to be willing to risk its licensure to manipulate data, whereas a company that just starts a lab is more likely to manipulate its tests to show the kind of results they want. That seems to be one of the ways that some laboratories get more and more business. Not all laboratories are created equal, just like not all CBD is created equal.
Once I’ve established that the COA is coming from a reputable laboratory, I would want to dig into the COA to make sure they included several important items. The COA should include pesticide analysis, solvent residual analysis, and mycotoxins. It should have an analysis of the potency, hopefully, a terpene analysis, and a heavy metals analysis. A COA should have all of the things that you would want to know to make sure that the product is safe!
After all of that, I would look specifically at the label. Is it claiming to be hemp seed oil? If so, the company is not telling you the truth. There are no cannabinoids found in hemp seed oil; hemp seed oil is a light oil, and cannabis oils are medium-chain triglycerides. If a company is selling a hemp seed oil product and marketing it as a CBD product, that means the company is willing to withhold the truth in order to sell more products. Even if perhaps a product has passed all tests and is deemed to be safe, it doesn’t sit well with me that a company would openly say something that is known to not be true just so they could get more product out there.
Also important when reviewing the label: what are they claiming? What are they saying the product does? If anyone peddling CBD products claims that their product will absolutely fix an ailment or condition, without an actual scientific study that’s been conducted, that’s a huge concern. We have anecdotal evidence and a degree of knowledge that allows us to make assumptions about how we know cannabinoids will work, but that’s different from me saying “this will cure your diabetes,” or “this marijuana is going to fix your cancer!” That’s a whole different level of a claim that the industry as a whole cannot make, as there must be substance and data to back up any claims made.
Finally, I’d probably look at the nutritional information, like what oils they are using and how many calories the product contains. For flavoring, are they using natural flavors such as terpenes, are they using botanical terpenes, or are they just using literally the natural flavor of extracted oil? I don’t know whether any one of those things is wrong or not wrong, and often this can be a personal choice, but I would like to know what a product truly is before I ingest it. I encourage anyone reading this to do the same.
Zion Medicinal CEO Blake Smith is giving you an insider’s perspective about Medical Cannabis in this limited feature series, “Between Two Herbs.” Keep an eye out for Blake’s next piece.
Medical Cannabis users are as susceptible to trends as anyone else. One of the hottest trends right now is that of microwaving your cannabis. It is a big enough trend that even celebrities are endorsing it. Doing so isn’t going to harm you, but we want you to know that microwaving Medical Cannabis isn’t a smart idea.
To understand why we recommend against microwaving Medical Cannabis, we should probably explain how microwaves work. A microwave oven doesn’t actually cook food. It heats food by exciting water molecules. Those molecules vibrate when exposed to microwaves, and the vibrations produce heat.
Every piece of food you place in your microwave has at least some water content. As soon as you hit the ‘start’ button, microwaves begin hitting the surface of the food. Water molecules start vibrating, generating heat, and passing that heat through the food. In less than two minutes, your leftovers are hot and ready to eat.
There appears to be a misunderstanding among people who think they can decarboxylate their cannabis by putting it in the microwave. Technically, that may be true when you are dealing with straight plant material. But practically speaking, it doesn’t really work.
When you burn cannabis, the heat produced by combustion decarboxylates the material. But combustion is a more tightly controlled process compared to microwaving.
Microwaving is inconsistent. It is also difficult to control the temperature of the plant material while it’s in the oven. As a result, certain portions of the plant material getting too hot would mean lowering the potency due to heating up cannabinoids past their evaporation point.
If you consume medical cannabis by purchasing raw flower and using it to make edibles at home, stick to the old ways of doing things. Cooking your cannabis over the stove or utilizing a commercial infuser are your best bets. Both processes can be tightly controlled so that the plant material doesn’t get too hot.
Going with a microwave could ultimately reduce the potency of your medicine by either under-heating or over-heating it. It would probably take a lot of trial and error to figure out how to best microwave plant material without harming potency, but why waste valuable medicine on trial and error?
It goes without saying that there isn’t any point in microwaving anything other than plant material. So even if you do decide to throw raw flower in the microwave, don’t bother trying to microwave Medical Cannabis products like gummies and tinctures.
Medical Cannabis products derived from plant material already contain decarboxylated cannabinoid acids. You cannot decarboxylate a second time. So heating such products not only does not increase their potency, but it could also actually decrease the potency by causing cannabinoids to evaporate.
As a Medical Cannabis user, you want your medications to be as potent as they can be. You are better off using them as-is rather than trying to improve them by way of a fad that has no scientific evidence behind it.
In closing, we want to encourage you to educate yourself about Medical Cannabis as much as possible. There is a ton to learn. We get it. But knowledge is the key to getting the most out of your medications.
A little research reveals why putting Medical Cannabis in a microwave is not a smart idea. Again, doing so will not harm you. But it could reduce the effectiveness of your medication. As expensive as Medical Cannabis is, reducing its effectiveness doesn’t make a lot of sense.
WNBA star Brittney Griner will spend the next nine years of her life in a Russian jail unless some sort of intervention frees her. Griner pleaded guilty to drug charges after she was found carrying a Medical Cannabis product in her luggage. Her tragic story is a reminder of the need for legal awareness within the Medical Cannabis community.
Griner’s use of a Medical Cannabis vape to help manage chronic pain is not considered unusual here in the U.S. In fact, it is pretty common in many parts of the world. But Medical Cannabis is not approved in Russia. There, possession still constitutes a crime.
America wishes Griner the best and hopes that some sort of deal can be worked out to bring her home. That would be the best resolution to what is otherwise an unpleasant situation. In the meantime, Medical Cannabis patients in the States should be constantly educating themselves on federal and state laws.
Medical Cannabis consumption has only increased as more states have gotten on board. Care to guess what the number one reason for using it is? Treating chronic pain. Whether pain is the result of a sports injury, a car accident, or even an underlying medical condition, the majority of Medical Cannabis users cite pain as their qualifying condition.
The thing about chronic pain is that it doesn’t take a vacation when you leave home. If you leave Utah to enjoy a week-long vacation in California, your pain goes along for the ride. Whether or not you take your Medical Cannabis medicines with you is another matter.
By the letter of the law, you cannot transport the medications across state lines. That is a matter of both federal and Utah regulations. Are you likely to have a problem if you’re pulled over in California and found to have a vape pen in your luggage? Probably not. Traveling overseas could be a different thing, though.
Traveling is not always easy for a chronic pain patient. The travel itself can be uncomfortable, and then you need to worry about how you are going to manage until you return home. The best advice we can offer to Medical Cannabis patients is to plan before you travel. Legal awareness can help you to plan well in advance.
We don’t know about other states, but we do know that Utah makes provision for out-of-state visitors. Let’s say one of your out-of-state family members, who uses Medical Cannabis to treat chronic pain, is planning to visit you for Christmas. No worries. They could apply for a temporary Utah Medical Cannabis Card.
Utah law does not allow your family member to bring cannabis into the state. But with a valid temporary card, your family member could visit any Medical Cannabis pharmacy in the state to obtain medication.
Your pain travels with you whenever you leave home. There is no avoiding it. Still, don’t take any chances with Medical Cannabis. Do your research and plan before you travel. Be especially diligent if you are planning to travel overseas.
There are a lot of overseas destinations fully open to Medical Cannabis. Likewise, there are others that do not allow it. You need to know which are which before you hop on a plane. Otherwise, you could find yourself in quite a bit of trouble.
Medical Cannabis use continues to grow across the country. As it does, so should legal awareness. Patients should take the time to learn as much as they can about the law. Doing so is their best protection.
During your time as a Medical Cannabis patient, you may have noticed that your medicine gradually loses its effectiveness. As a result, your Pharmacy Medical Provider (PMP) has suggested that you take brief and regular breaks. You do and discover that things go back to normal. Your medicine starts working again. Do you understand why this is?
Those of us in the Medical Cannabis field recommend that patients take regular breaks. The breaks are sometimes referred to as tolerance breaks – or T-breaks if you prefer. The reason for our recommendation is found in the name itself: tolerance.
Tolerance is a physical reaction to a drug, a reaction that occurs when a person’s body gets used to that drug. Tolerance can be experienced with any kind of drug whatsoever; it is not limited to Medical Cannabis. But in the cannabis realm, tolerance is the result of how cannabinoid receptors in the brain interact with the drug.
A good way to illustrate tolerance is to discuss THC. As you know, THC is the cannabinoid that produces the high feeling in cannabis users. That feeling is the result of how THC interacts with CB1 receptors in the brain. If you only used Medical Cannabis once every few weeks, it is likely that the CB1 receptors would continue functioning normally. If you used every day though, it would be a different matter.
Cannabinoid receptors can gradually get used to the amount of THC they are exposed to. When that happens, you have the condition known as tolerance. Your brain gets used to a certain amount of THC in your system and adapts accordingly. Now, you do not experience the same effects from the same dosage. You need to increase your dosage to achieve the effects that you are looking for.
At this point, it must be made clear that tolerance is not dependence. Tolerance is simply a physical reaction to using Medical Cannabis – or any other drug, for that matter. This is not to say that marijuana dependence is impossible. It’s not. But the likelihood of it being a problem for Medical Canada’s patients under the supervision of a Qualified Medical Provider (QMP) are pretty low.
The reason for taking breaks is not to prevent dependence. Rather, it is to allow the cannabinoid receptors to reset themselves. The interesting thing is that there is no black-and-white formula we can apply to every Medical Cannabis patient.
A long-term patient using mostly Type I (THC dominant) products on a daily basis may need a break of several weeks if they have gone 10-12 months without a break. Such a long break might be too difficult for some patients, especially those who rely on Medical Cannabis to treat chronic pain. Perhaps a better plan would be to set aside three days per month as break days. The days need to be consecutive if they are at be of any value.
The bottom line is that Medical Cannabis patients should consider taking regular breaks so that tolerance doesn’t become an issue. Otherwise, obtaining medicines can get awfully expensive. Managing tolerance makes it possible to consistently use the least amount of medicine to feel better.
If you are a Medical Cannabis patient and have any questions about tolerance or taking breaks, consult with your medical provider. That could be your QMP, LMP, or PMP. Regardless, your medical provider should be able to explain tolerance to you and recommend an adequate schedule for taking breaks. Please heed their advice. It is offered for your benefit.
