Everybody likes to save money, right? Given the current state of the economy, every dollar saved is valuable. We get it. We also know that Medical Marijuana is not cheap. We want to help in whatever way we can, so we have come up with a coupon code program to help you save at the pharmacy. One of the best ways to save money at Utah’s cannabis pharmacies is to take advantage of any coupon codes that might be available.
Here are a few ways to save money on Medical Cannabis:
The first step toward utilizing cannabis as a medicine is obtaining a state Medical Cannabis Card. To do that, patients are required to visit with a Qualified Medical Provider whose job is to verify the existence of a qualifying condition and recommend Medical Marijuana as an appropriate treatment. With a QMP’s recommendation, the patient submits an application and pays a small registration fee. The state then approves the application and issues the card electronically.
The relationship between QMP and patient is an important link in the chain. Patients need to be able to visit with QMPs they can trust. The QMPs at Utah Therapeutic Health Center work hard to earn the trust of each and every patient we see. We give patients access to QMPs at clinics located around the state.
When you visit one of our clinics, we want you to feel right at home. We strive to maintain an open and transparent environment where you can receive sound advice and assistance navigating the Medical Marijuana Card program without feeling like you are being judged.
We are also here to answer your questions, so don’t be afraid to ask. We know a lot about the effectiveness of marijuana as a medicine, but there is still plenty we do not know. All of us are learning together – medical science, medical providers, and patients.
Your relationship with us does not have to end after your Medical Cannabis evaluation. In fact, we don’t want it to end. We want you to stay informed of all things related to Medical Cannabis so that you can make sound decisions about your health. You can do that by signing up for our newsletter in the section below.
Our newsletter is packed with useful information to expand your knowledge and answer your questions about Medical Cannabis.
One way or the other, we are confident that our newsletter will help you better understand the entire Medical Marijuana concept.
Remember, ways to save money at Utah’s cannabis pharmacies are not always easy to find. And with prices as high as they are, a little financial help can go a long way.
Episode 94 of Utah in the Weeds features Michelle Spear, Tim’s youngest sister. Michelle suffers from colon cancer and is new to using Medical Cannabis. In this episode, Tim teaches Michelle to use Medical Cannabis to relieve the side effects of chemotherapy.
We began the episode with an overview of Michelle’s battle with cancer, which began in 2016, when she was 32. [03:33]
Next, they talked about cannabis tinctures, which are liquids containing concentrated cannabis extracts. [11:43]
Then, Tim taught Michelle about cannabis gummies. [18:12]
Cannabis vape cartridges are useful for fast-acting relief, and there are some that contain no THC. [26:58]
Tim Pickett:
Welcome everybody out to Utah in the Weeds. This is Tim pickett, and this is episode 94. 94 with my youngest sister Michelle. So, Michelle is 38 years old. She is going through chemotherapy for the third time for colon cancer. She has colon cancer that came back not once but twice. And she’s got four children. She is a spitfire. Okay? And I don’t get the chance to see her very often.
Tim Pickett:
And with her chemotherapy being very … Causing a lot of nausea and her pain getting a little worse, I was able to go up to see her and visit her. And we recorded the interview, and just me teaching her how to use cannabis. Because I thought that would be interesting for people, if you’re interested in that. And give me a chance to interview my sister without causing a lot of emotional stress on both of us. Frankly, I’m a crybaby.
Tim Pickett:
So, I didn’t think interviewing my sister was going to work out really well for me. And my sister also is a go-getter. She does not like to slow down. When we were there, for example, she picked me up from the airport. We went to Costco, bought a bunch of strawberries and candy. Yes, she loves candy. And went to lunch, went home, unloaded everything. She started making strawberry jam, because she was out, needed to make some.
Tim Pickett:
Proceeded to make 15 bottles of strawberry jam, do this interview, and learn about cannabis. Then we were going to dinner. It’s just busy, busy, busy. She nonstop taking care of her kids, building Nerf gun battle setups in the backyard, traveling with her husband. That interview I’d like to do it, but it would be very difficult for this situation I think. So, here is an interview with my sister, Michelle. A little housekeeping before we get into that interview.
Tim Pickett:
If you’re not subscribed, subscribe Utah in the Weeds. We appreciate the subscriptions and the downloads and it makes a difference. We have a subsidy program, utahmarijuana.org/uplift. You can donate money, we match it. We have it matched now eight times. And that gets people through the process of getting cards, and getting education, and getting discounts on products in Utah. So, utahmarijuana.org/uplift.
Tim Pickett:
And without further delay, here’s me teaching my sister Michelle, how to use cannabis for nausea and pain. So, I’m up here, little insight into what we’re doing today, one day maybe we’ll post this for the Utah in the Weeds podcast, maybe not. Depends, but I’ve come up here to my sister Michelle’s house. A little insight into the why you get into cannabis medicine. My sister, Missy. Okay. So, here we have … So, you’re doing chemo. Right?
Michelle Spear:
Yes.
Tim Pickett:
For the third time [crosstalk 00:04:09].
Michelle Spear:
Second time.
Tim Pickett:
I mean, it’s really the third time. Right? Because you had the HIPEC.
Michelle Spear:
That’s true. That was internal chemo. So yes, this is the third time. About fourth time I’ve had cancer, because radiation-
Tim Pickett:
What was the first time?
Michelle Spear:
First time was my colon.
Tim Pickett:
Well, that was when you were 32?
Michelle Spear:
Yep.
Tim Pickett:
Right? Six years ago.
Michelle Spear:
Yep. And then-
Tim Pickett:
About right now, right? Six years ago you got diagnosed in December?
Michelle Spear:
Nope. After I had Scarlet in March.
Tim Pickett:
So six years ago, right now?
Michelle Spear:
Yep. Six years ago right now I got diagnosed and had chemotherapy for six months, and then 18 months later it came back on my ovaries and my uterus. So, I had that removed, but it erupted so that’s when I did the HIPEC.
Tim Pickett:
That’s when I was working in surgery with Akin.
Michelle Spear:
Yep.
Tim Pickett:
And I remember thinking, “Oh my God, the HIPEC. That’s a major deal.”
Michelle Spear:
Yeah.
Tim Pickett:
So, everybody was researching it. That’s a big surgery where they open you up all the way, top to bottom. They fill you with chemotherapy fluid and try to kill it all.
Michelle Spear:
Yep. It’s heated chemo.
Tim Pickett:
What do you think about that now? Do you think that was a good thing?
Michelle Spear:
I think that saved a lot of my life. Yeah.
Tim Pickett:
Yeah. I mean, I think so too. This time though, you had a bowel obstruct last what, October?
Michelle Spear:
October.
Tim Pickett:
No, it was before that-
Michelle Spear:
But before that I did radiation.
Tim Pickett:
Because November we went to Disneyland. So, it was like August.
Michelle Spear:
That’s true. I did have it bowel obstruction, and I went into the hospital twice in one month. They just did IV fluid and did bowel rest because they didn’t want to open me up. But then the third time I went into the emergency room, they were like, “Well, this obviously isn’t healing itself.”
Michelle Spear:
My doctor that actually did the HIPEC also, he was like, “We got to open you up and see what’s going on.” And so he opened me up and took out two, four inches of my colon or not my colon. I don’t have colon.
Tim Pickett:
No. And how do you figure out … What do they call it now? They can’t call it colon cancer, you don’t have a colon.
Michelle Spear:
It’s true. But they still do. Yes.
Tim Pickett:
Because that’s where it originated.
Michelle Spear:
That is where it originated. So then they did-
Tim Pickett:
So, then he took that piece out, which was obstructed.
Michelle Spear:
Yeah.
Tim Pickett:
And that was like a ball of scar tissue?
Michelle Spear:
Yep. Two balls of scar tissue they took out, and then they put my … The rest of my intestines in a hammock.
Tim Pickett:
So, now you have a-
Michelle Spear:
Now there’s-
Tim Pickett:
Intestine hammock
Michelle Spear:
I have an intestine hammock.
Tim Pickett:
Does that feel different? Did it feel different at the beginning?
Michelle Spear:
No. I never-
Tim Pickett:
For those of you who are listening, our mom is in the kitchen over here on the other side doing the dishes. Don’t be sorry. It’s fine. But that’s the water you hear. We’re in the kitchen in Spokane and we just got back.
Tim Pickett:
So, I came up here to see you really, but also I’m using cannabis as an excuse to come up here and see you. To give you a little bit of a lesson on some tools in cannabis stuff. Because this time the chemo seems like it’s been worse.
Michelle Spear:
Yes. Which they say after your body has already experienced it, it just reacts more potently, I guess. Because your body’s like, “Oh, I remember this.”
Tim Pickett:
And then, “Oh, I remember that this is like poison.”
Michelle Spear:
Yeah.
Tim Pickett:
So, when we talked last week, you were not feeling very good?
Michelle Spear:
No, I have a lot of nausea and pretty much I sleep a lot during the chemo. Because I’m on for three days, well for 48 hours. I take home chemo, and that is when I’m the most sick.
Tim Pickett:
So, you don’t have to go to an infusion center, they just bring it to you?
Michelle Spear:
No I do. I go in and I’m there for about four hours and I do two kinds of chemo there.
Tim Pickett:
Do you remember the names?
Michelle Spear:
One of them is 5FU and FOLFOX.
Tim Pickett:
FOLFOX. Yep. The 5FU and the FOLFOX, that’s the chemo that has been in around for really a generation, I think. Maybe probably more. I worked in GI surgery and we didn’t do the orders for the chemo, but we were very … We had a lot of people with colon cancer that would do that. And then you have a different one that you do also.
Michelle Spear:
You take home. Yep. After the four hours, they give you a chemo that you just … It’s a fanny pack and it slowly puts 0.1 milligrams into your body every minute.
Tim Pickett:
Through your pick? Not your pick, but your port, which you’ve kept all six years.
Michelle Spear:
Yep. Actually this is my second port.
Tim Pickett:
Really?
Michelle Spear:
I got my first port taken out.
Tim Pickett:
Because you were cured.
Michelle Spear:
Because I was cured. And then when I went into the HIPEC, they were like, “Well, since you’re already under, we’re going to put in another port.” And it never got used until now. So, I’m just washing it for the four years.
Tim Pickett:
For the past four years.
Michelle Spear:
Yeah.
Tim Pickett:
Okay. So six years ago you got diagnosed with colon cancer, you had the entire colon removed after having your baby. I mean, that was really a mess. Right?
Michelle Spear:
Yes.
Tim Pickett:
You were on TPN for nutrition because you needed to continue the pregnancy for another couple of months. Then you had the baby. You’re already obstructed with cancer. Then you heal from the baby. Then you have your colon removed completely. And by the way, for people who … So, you have a ileostomy bag. Right?
Michelle Spear:
Yes.
Tim Pickett:
Because you had a total colectomy with a proctectomy, so you have an ileostomy bag. For those of you who’re out there who think that living with a bag is death, I mean, you are really listening to a person who swims with her kids, goes water skiing.
Michelle Spear:
Skis. I would recommend it actually to people that are-
Tim Pickett:
Well, it’s not like-
Michelle Spear:
It changes your life. Because then all of a sudden you’re not a target going, “Oh, I know where the bathroom is.” Every place you go when you have Crohn’s disease, you know exactly where every bathroom is. I mean, if you’ve ever pooped on the side of the road, I have. But now with the bag you can just…
Tim Pickett:
So it’s not the end of the world, right?
Michelle Spear:
No, it is not the end of the world.
Tim Pickett:
It’s interesting. Your perspective on things has always been pretty interesting, and you’ve always been extremely active. I mean, literally you have a bowel obstruction, you have part of your colon taken outlast fall even. You barely let yourself recover before you went to California.
Michelle Spear:
Yes.
Tim Pickett:
Hiked up and down all those stairs. I remember your husband John, he’s worried because we had all these stairs going down to the beach.
Michelle Spear:
Yes. And he was like, “You better be careful, hold onto the side.” And I’m like, “I’m fine. Whatever.” Yeah. Well and after the HIPEC-
Tim Pickett:
Having Nerf gun parties in the backyard.
Michelle Spear:
After the HIPEC, I went to Hawaii with my kids a month and a half later. I told him, I said, “I got to get out of the hospital because I have Hawaii tickets.”
Tim Pickett:
Wow.
Michelle Spear:
And he’s like, “Oh well, okay.” And he let me swim and…
Tim Pickett:
Interesting.
Michelle Spear:
I don’t let it slow me down.
Tim Pickett:
Well, that’s for damn sure. Okay. So, we’re going to talk about … And this is going to be a lot of stuff that people can’t see. But in front of me laid out, we have just been to the dispensary in Spokane, we’ve been to Cinder. Great people there, different products than in Utah.
Tim Pickett:
Some products that I’ve tried before that I really, really like, and I wish were in Utah. And some products that … Most products that are definitely not in Utah. So, you’ve been using some little mints.
Michelle Spear:
Moxey mints.
Tim Pickett:
Moxey mints, which are one milligram of THC and a little bit of CBD. But you were saying they’re not strong enough. But then when you take too much, you’re-
Michelle Spear:
I feel like I’m on a rollercoaster and I’m like, “I can’t close my eyes. I’m going to go down the hill and it’s going to make me dizzy.”
Tim Pickett:
Really? So when you stand up, is that a problem?
Michelle Spear:
No, it’s more when I close my eyes actually.
Tim Pickett:
When you close your eyes you feel like you’re on a roller coaster?
Michelle Spear:
Yes.
Tim Pickett:
But you’ve never smoked weed ever. I mean, I’ve known you my whole life, I know you never smoked weed.
Michelle Spear:
No, I watered it when you guys were kids.
Tim Pickett:
That was not mine that was Katie’s. That was Katie’s on the porch or on the deck.
Michelle Spear:
[inaudible 00:12:56].
Tim Pickett:
You were little though. I mean, we’re talking … Katie was in high school. Right?
Michelle Spear:
Yeah.
Tim Pickett:
So you were in junior high. You’re six years younger than me.
Michelle Spear:
Yep.
Tim Pickett:
I’m 43, you’re 38.
Michelle Spear:
Yep.
Tim Pickett:
Well, I mean five and a half. You’re exactly five and a half years younger than me. Okay. So, here we have a tincture. Okay? So the first thing we talk about is, with this type of stuff, is you’ve got to build up some tolerance. Okay? You can barely take five milligrams of THC, and you got to build up some tolerance.
Michelle Spear:
Yeah.
Tim Pickett:
Okay.
Michelle Spear:
Probably, yes.
Tim Pickett:
Because then you can take two and a half milligrams as a micro dose most of the day, and not feel like you’re in a roller coaster when you close your eyes. So we’re not going to try to … For those of you at home, we’re not trying to cure cancer with this cannabis, we’re just trying to feel better.
Tim Pickett:
But it’s relatively safe, so we might as well … I mean, if you can get a lot of cannabinoids in your body and it slows the tumor growth, then why the heck not? So there are cannabinoids we want to think about, CBD. We want to get a bunch of CBD in your system. Okay? CBG, we want to get a bunch of CBG in your system. Then THC, we want to work up to where you can tolerate 10, 15 milligrams of THC per dose. Okay?
Tim Pickett:
So that’s a whole gummy. So we have a tincture here, it’s made by green revolution. It’s a water base tincture, which is cool because that means it’s emulsified in water so it will absorb fast. For one dropper full, it’s going to have 12 and a half milligrams of CBD, and 2.5 milligrams of THC. This is actually going to be pretty dang good for … And it has a teeny bit of CBG.
Tim Pickett:
So this is good for all the time. Half a dropper full at a time, is the same as your Moxey Mint. Okay? Half a dropper full … That’s not true. One dropper full is the same as your Moxey Mint.
Michelle Spear:
The red ones?
Tim Pickett:
Yep. One dropper full. I don’t know what flavor or what … Let’s taste it.
Michelle Spear:
Does it taste like dirt?
Tim Pickett:
It probably tastes like skunks and dirt. Take just a drop. we’re not going to get high, just to taste it. Just a drop.
Michelle Spear:
Under my tongue or on top?
Tim Pickett:
It doesn’t matter because we’re just tasting it. That’s one drop, thank you. Put the lid back on.
Michelle Spear:
That’s not too bad. It’s lemony.
Tim Pickett:
Yeah, it feels lemony. Now a full dropper you’re going to, “That’s in the back of my throat, it’s like oh.”
Michelle Spear:
Yeah. I can tell.
Tim Pickett:
It’s a little planty. You can mix this with stuff.
Michelle Spear:
With a big Mac?
Tim Pickett:
You can mix this with a big Mac. I know you love big Macs.
Michelle Spear:
Wait, no my peanut butter.
Tim Pickett:
Peanut butter and jelly. Nana over there, so for those of you who are now listening, if you want a Christmas card with a cannabis flower on it or marijuana norm that’s Nana, sock monkey, everything. She’s making strawberry jam over here.
Michelle Spear:
We are not going to put any cannabis.
Tim Pickett:
No cannabis, because the kids are coming home. So the marijuana norms and the cards are pretty popular. So not runny jam, just regular good strawberry jam. Because at Michelle’s house, they go through a bottle of jam, how often?
Michelle Spear:
Every two weeks.
Tim Pickett:
A bottle of strawberry jam every two weeks. And we just got home from Costco where you literally bought six bags of those ding, what are they?
Michelle Spear:
The Reese’s chocolate eggs.
Tim Pickett:
Because why?
Michelle Spear:
The eggs are fresh? The peanut butter is fresh. You know when you go and get a Reese’s bar and you’re like, “Oh this is pretty still, it’s been here for six months.” But those ones are the hearts at Valentine’s, and the Easter ones are fresh and they’re yummy. And I eat them.
Tim Pickett:
Place we went when I show up in the … On the airplane, we go from the important to Costco. She goes in there, she shows her ID card. The eggs are at the front. She just starts loading the bags into the cart.
Michelle Spear:
I think I got six or seven support.
Tim Pickett:
Okay. Tincture is a five to one. You can take one dropper full at a time and not get roller coaster. Okay?
Michelle Spear:
Okay. That wasn’t too bad. I haven’t tasted any [crosstalk 00:17:42].
Tim Pickett:
It’s not terrible. Okay. That’s going to last you six hours. Okay? So you can do that three, four times a day, that’s fine. But you need to do something like that every single day to build up some tolerance. Okay?
Michelle Spear:
Okay.
Tim Pickett:
Like a half a dropper in the morning, every single morning only to build up tolerance, and to get some CBD in your system. Because the CBD will help overall. Okay? Now, we’re going to move on to this Wyld some gummies. In Utah these are called [inaudible 00:18:15].
Tim Pickett:
So Wyld, W-Y-L-D this is one of my favorite brands. They’re totally natural. They’re peach, this one’s a peach gummy. Why are they in a bag? This is dumb. Hey, do you have any-?
Michelle Spear:
It has a zipper?
Tim Pickett:
So child-proof ziploc bags, you push your … You put your hands and then you twist it. When you open a gummy or a flower package-
Michelle Spear:
Or a Moxey Mint even they do natural.
Tim Pickett:
They have these little childproof bags, and you can’t open the bag just by pulling the bag open. You have to push your fingers on the opposite sides of the zip lock, and then you twist it.
Michelle Spear:
You’re snapping your fingers.
Tim Pickett:
Like you’re snapping your fingers, and it will slide the Ziploc open and it will open your bag.
Michelle Spear:
I cut mine sometimes too.
Tim Pickett:
Everybody cuts them open. So inside here, all of these are individually wrapped. What a waste of plastic. They are two to one CBD to THC, but these are 10 milligrams per gummy. That is the same as-
Michelle Spear:
Full dropper.
Tim Pickett:
Four droppers full. Four droppers full is the same as this. So now we’re cutting these into quarters. Right? Now, this will last you eight hours. This will last you eight hours. And it takes a little longer to take effect. So you want to plan ahead.
Tim Pickett:
So cut these into quarters, and you take one of these, is the same as a Moxey Mint. But they taste better and they have two times the CBD again, because CBD is the sandpaper to THC. It’s smooth is out the rough edges. Okay? These are going to be super good. And I already-
Michelle Spear:
I’m getting a marker.
Tim Pickett:
Yeah. Can you write all this stuff down?
Michelle Spear:
Yeah. Maybe just-
Tim Pickett:
So you can make a list.
Michelle Spear:
Because I can’t remember my own name sometimes.
Suzi St. Jeor:
[inaudible 00:20:30].
Tim Pickett:
Tincture is going to act in … I would say this one where it’s water-based, is probably going to act within 20 … It’s going to start acting within 20 to 45 minutes. Where a gummy would take 45 minutes to an hour and a half to take full effect for most people. Some people with a gummy it’ll take two plus hours.
Tim Pickett:
But the Tinctures, the water-based Tinctures tend to work a little faster. Oil-based Tinctures tend to work a little slower. So the Tinctures again, half a dropper, three times a day, totally fine. One drop is 2.5 milligrams THC and-
Michelle Spear:
So it build up that one?
Tim Pickett:
So build up. That’s the one that you are using to build up the tolerance. Then you have the peach gummy, which is pretty similar, but you only want to take a quarter of the gummy at a time.
Michelle Spear:
And it lasts eight hours?
Tim Pickett:
It’ll last eight hours. And it takes a long time to take effect. I’m going to put the gummies inside the medicine bag. Okay? I’ve got a medicine bag here. It’s a skunk pilot bag, it has a little lock, little luggage lock, kids don’t get in. It keeps all the medicine away from the kids. Do you want these in the cute box?
Michelle Spear:
No, it doesn’t matter.
Tim Pickett:
Or do you just want them here?
Michelle Spear:
Yeah, just in there. Right now I keep them with my dog treats.
Tim Pickett:
Yes.
Michelle Spear:
Because I’m hoping my kids don’t eat dog treats. [crosstalk 00:21:54].
Tim Pickett:
As a side note, if you want to protect your children from the gummies, just keep them with the dog treats.
Michelle Spear:
Exactly. That’s what I do.
Tim Pickett:
Okay.
Suzi St. Jeor:
[inaudible 00:22:07].
Tim Pickett:
Right? Well I guess, unless you want to give the gummies to the dogs. Okay. Second one is the Wyld pair. This is cool. This one I really like, it’s got CBG and THC. Okay? So one to one. So this is going to be different. This will feel different.
Tim Pickett:
People call this a bubble bath for your brain. With the CBG same thing, you’re going to cut this in quarters. You’re going to cut this in quarters. And I think you’re going to like these a lot for the daytime.
Michelle Spear:
And do they last eight hours?
Tim Pickett:
Yes. I would consider this one to be my pain gummy.
Michelle Spear:
Okay.
Tim Pickett:
My pain gummy during the day.
Suzi St. Jeor:
Your what?
Tim Pickett:
The pain. Because CBG tends to be a little bit better for pain. Right?
Michelle Spear:
You’re trying to get rid of my oxycodone?
Tim Pickett:
Yeah. I mean, you don’t have a colon so you … So poop moves through faster.
Michelle Spear:
Yes.
Tim Pickett:
So the oxycodone does have a benefit, because it slows you down.
Michelle Spear:
Yeah.
Tim Pickett:
And we’re not really worried about you getting addicted at this point. Right? But you don’t take that very often.
Michelle Spear:
No, I only … I don’t.
Tim Pickett:
Because your right hip, your left knee … And what else was it?
Michelle Spear:
My back.
Tim Pickett:
Your back hurts. Is that new starting chemo?
Michelle Spear:
Yeah. My hip has always hurt. I think we dance. But it’s weird because it’s not my knee that I tore my meniscus on, it’s my other knee.
Tim Pickett:
What about your back?
Michelle Spear:
I think my back is because I sleep with my dogs.
Tim Pickett:
And then you just don’t sleep very well, your dogs are all over the place?
Michelle Spear:
Yes. Always sleep on my back or my face.
Tim Pickett:
Okay. So green is the CBG. That’s the pain, we do that one for pain. Right?
Michelle Spear:
Yes.
Tim Pickett:
The peach one is a balance. Okay? That’s good. This is fun, this is like Christmas. Okay. Now, we’re going to move on. We’re going to add this CBD Tincture. Okay? CBD Tincture. This is the one I brought from home. It’s a Zion medicinal CBD Tincture. This one is a little bit pepperminty from the taste, and it’s an oil based Tincture.
Tim Pickett:
And this one has, let me see, for a full … A full dropper full is going to be 30 milligram CBD. You really need to take one of these at least one full dropper a day. This will not get you high at all. Okay? So I’m going to put a whole milliliter in the dropper full, put it in my mouth and then it is … I don’t I just eat it.
Suzi St. Jeor:
You say that [inaudible 00:25:13].
Tim Pickett:
Yeah, the under your tongue will absorb a little bit better, but honestly I don’t get too crazy about that. I’m much more practical, I feel like that’s … I don’t know.
Michelle Spear:
My zone friend that’s what … They’re always like, “Underneath.” I’m like, “Yeah, I’m just sticking it on my tongue.”
Tim Pickett:
Just chew it. It absorbs pretty quick.
Michelle Spear:
Well, on the roof of your mouth too. So I just stick it to my roof.
Tim Pickett:
Instead of up your nose, you put the cocaine under your tongue. Yeah. Well, okay. Thanks. Thank you. I never really tried it, so I don’t know. Most people haven’t tried that out, but yes, it will absorb faster.
Tim Pickett:
So try that. I feel like that’s like a Starburst, it’s oily. I mean, take a half a dropper, I promise it’s not going to get you high.
Michelle Spear:
Yeah. It’s like oil.
Tim Pickett:
Yeah, it’s MCT oil it’s … Which is a coconut oil thing. So see how it coach your mouth a little bit?
Michelle Spear:
No, it’d be good for my mouth sores. You never know.
Tim Pickett:
So you want to build up to where you’re taking a dropper in the morning and a dropper in the afternoon. Doesn’t have to be full, it just has to be … I tell patients, “Just take a slug of it in the morning and a slug of it in the afternoon.” We’re building up cannabinoids in the system. Okay? We’re building up cannabinoids in the system. No high. Okay? Could help your pain long term.
Tim Pickett:
It’s a little bit anti-inflammatory, it could help your … I mean, it can help your anxiety, reduce the use of a lorazepam if you took that. Okay. Now, we’re getting into the real deal and I know this is out of the wheelhouse for you, but I brought up vape pen. Okay? A vape pen, I brought some flower too. We’ll talk about that in a minute. So this is called a battery.
Tim Pickett:
This is a Yocan pro battery, and this is what you put the vaporizers in. Now, I brought up two clean leaf vape carts. These little cartridges will not get you high. Okay? They won’t get you high, but they’re pretty strong. Okay. Have you ever tried one of these mom?
Suzi St. Jeor:
Well, I vape.
Tim Pickett:
Yeah. But this is CBD only. So this one is called Balance. Okay? You have one that’s called Balance and one that’s called Uplift.
Michelle Spear:
What I would say is, why would I?
Tim Pickett:
Why would I use a non … A cartridge that would not get me high? Well, I’ll tell you why.
Michelle Spear:
Okay.
Tim Pickett:
If you have a super low tolerance to THC, or you’re trying to get off of a medication and you’re just trying to chill out, or you get way too high from the gummy. And you’re like, “Oh my God, I’m I like … I think I need to go to the ER, I’m pretty anxious about this.”
Tim Pickett:
Then you take a nice inhalation off of this vape pen and it just will … Smooths out the rough edges of what’s going on. Okay? You’re fighting with everybody, go in the garage and you take a little head off those things. And you’re like, “Oh, I’m not high. I just feel a little bit better.” What are you doing?
Suzi St. Jeor:
What’s that called?
Tim Pickett:
This one’s Balance. So I sell these in the clinic.
Suzi St. Jeor:
Okay.
Tim Pickett:
Because Kyle Eggbert is the guy who makes these and he’s just … He’s a good guy. He knows what he is doing. He makes strong vape carts like this, they’re non THC. This one has CBN, CBG, CB … It’s like CBDV.
Michelle Spear:
Yeah.
Suzi St. Jeor:
So what is the-
Tim Pickett:
CBD, CBG, CBC, CBN, CBDV and THCV, this is all good … These are all the best cannabinoid.
Suzi St. Jeor:
I have a vape pen, but what’s [crosstalk 00:29:17]?
Tim Pickett:
This one is a little bigger and the battery will last a little longer. So I use this one because it’s foolproof.
Suzi St. Jeor:
It’s cute.
Tim Pickett:
It’s simple, it’s gold, it’s … Is that mov? What do you call it?
Suzi St. Jeor:
Yeah. Natural rose gold.
Tim Pickett:
Rose gold. At the bottom of the vape cart there’s a … What’s called a five 10 thread. See that little thing? I think your neuropathic fingers can put this on there. Did you lose the ability to knit?
Michelle Spear:
You know what, actually, I can knit, but holding my hands closed for too long hurts. So I actually don’t knit anymore.
Tim Pickett:
Can you feel the ends of your fingers?
Michelle Spear:
Yeah. If they get too cold or too hot, they hurt like pain.
Tim Pickett:
Your feet too?
Michelle Spear:
Yes. My feet are more sensitive than my hands.
Tim Pickett:
When did that happen?
Michelle Spear:
After the first round of chemo I did, the Oxaliplatin and they … That gives you neuropathy.
Tim Pickett:
Forever?
Michelle Spear:
Forever. It got better after six months, but it … I don’t like to get pedicures because I don’t like people to touch my feet because it … You can feel them touching your feet, but it’s a weird sensation.
Tim Pickett:
Is it like pins and needles?
Michelle Spear:
Sometimes yeah. I always have to wear shoes.
Tim Pickett:
Even in your house?
Michelle Spear:
Even in my house.
Tim Pickett:
Just because of the-
Michelle Spear:
The feeling of it being-
Tim Pickett:
Is there like a burning?
Michelle Spear:
Yeah.
Tim Pickett:
Mostly a burning?
Michelle Spear:
Mm-hmm (affirmative).
Tim Pickett:
And that’s the hands too?
Michelle Spear:
My hands aren’t as bad, but I have to be careful because I can touch hot things and not know that I’m touching hot things.
Tim Pickett:
And then you get burned?
Michelle Spear:
Yes.
Suzi St. Jeor:
One time she stuck something in her leg and did not know it was bleeding.
Michelle Spear:
Yeah. I did stuck a X-acto knife in my leg one time and I was like, “Oh dang.”
Tim Pickett:
Wow. Okay.
Michelle Spear:
And then it was bleeding at a baseball game and they’re like-
Tim Pickett:
Hey Michelle.
Michelle Spear:
“Michelle you’re bleeding.” And it was bleeding into my shoe.
Tim Pickett:
Wow. Okay. Well-
Michelle Spear:
Good thing I had a first aid kid in my car.
Tim Pickett:
This has been sitting for a little while. So you see how it’s crystallized, so we may have to use a blow dryer or something warm to … Go ahead. Yes, you’re raising your hand.
Suzi St. Jeor:
I know it won’t work for you, but put it in your bra-
Tim Pickett:
It will not work for me.
Suzi St. Jeor:
I put my [inaudible 00:31:49] if there was sticky.
Tim Pickett:
Yeah. So the crystallization just is something that sometimes happens. And so you can heat it up and you can reactivate the oil in there. So you turn the five, 10 thread onto there and then you just drop it in like that. And then it just magnetizes to the bottom. You can turn that if you want to lock it in, and then literally you just push this button and it’s on and you let go and it’s off.
Tim Pickett:
But five clicks turns it on, and five clicks turns it off. Okay? Five clicks turns it on, five clicks turns it off. I never turn it off. So I never really have to worry about this, because it just shuts off on its own. And the battery will last three weeks.
Tim Pickett:
And then you see the number on the screen there, it’s 2.7, it will go up. So the higher the number, the harsher the inhalation. So you want it at about 3.0 is my low. Okay? And then you push the button.
Suzi St. Jeor:
Hey, do you have to hold it a long time?
Tim Pickett:
No. Total myth. There is so much surface area in your lungs, you do not need to hold your breath. You just-
Suzi St. Jeor:
Even the THC?
Tim Pickett:
Yeah, you do not do that. Okay. So all you’re going to do is-
Suzi St. Jeor:
My whole [inaudible 00:33:24].
Tim Pickett:
You’re just going to push this button, you’re going to … I don’t know who’s calling you, but I’m sure it’s not important. Maybe it is important. Okay. You’re welcome to try this.
Tim Pickett:
This is not the one that gets you high, so you don’t need to worry about that. Yeah, that’s the CBD oil. It’s good. Well, yeah, it looks the same than [crosstalk 00:33:49].
Michelle Spear:
Okay, one more time. You hold the button down.
Tim Pickett:
Yep. You hold the button down and it’s activated-
Suzi St. Jeor:
And just suck it in.
Tim Pickett:
And then you just … Not big, just [crosstalk 00:33:58].
Michelle Spear:
No [crosstalk 00:33:58].
Tim Pickett:
So you sip.
Michelle Spear:
But you don’t swallow?
Tim Pickett:
That’s right. But you’re but you’re thinking about it like sipping it. You’re not going to suck it in. Okay? Just a little bit.
Michelle Spear:
I’m so going to cough.
Tim Pickett:
It’s just a little. Okay just push the button just a little. I know, it’s weird. Yep. Now it’s on, now you in … That’s too much now. Yeah blow it out, oh my gosh so you got it in your mouth. So that’s good.
Suzi St. Jeor:
Did you get it in your lungs?
Tim Pickett:
No, she didn’t get it in her lungs, but that’s okay.
Suzi St. Jeor:
So just make sure that you’re breathing all in.
Tim Pickett:
That’s twice as much as you need.
Michelle Spear:
So wait, you hold it less?
Tim Pickett:
Yes.
Michelle Spear:
Let me do it again.
Tim Pickett:
So look, I’m inhaling, then I’m exhaling.
Michelle Spear:
Because I can feel it in the back of my throat now.
Tim Pickett:
Yeah. Because you took it into your mouth, but you didn’t let it get into your lungs. So you sucked on it, but you didn’t inhale it. Okay, just not as big.
Michelle Spear:
Okay.
Tim Pickett:
So breathe in your belly, just a little.
Michelle Spear:
This is like voiceless.
Tim Pickett:
This is like voice lessons. I know this [crosstalk 00:35:14].
Michelle Spear:
Wait, push your belly out?
Tim Pickett:
See you just did it, you breathe. Just put that to your mouth while you do that.
Michelle Spear:
Like that?
Tim Pickett:
Yeah. Just do that. Just normal breathing, just hold the button down. Pretty much. Okay. You’re doing it pretty much. There you go. This is how you teach your sister how to smoke weed.
Suzi St. Jeor:
You need to get a little bit more than that.
Tim Pickett:
Yeah, but that’s okay. We started-
Suzi St. Jeor:
But it’s normal breathing.
Tim Pickett:
But it’s normal breathing. Okay? Two second inhalation. Okay?
Michelle Spear:
Okay.
Tim Pickett:
I mean, I tried smoking before, we’re smokers so in the past. So I take it into my mouth and then I inhale it, that’s a smoker thing. That’s what mom does.
Suzi St. Jeor:
That’s what I do. [crosstalk 00:36:02].
Tim Pickett:
Because that’s a smoker thing I think.
Michelle Spear:
Wait, let me see it again.
Tim Pickett:
So just suck inhale it.
Michelle Spear:
I can see that.
Tim Pickett:
Yeah. Okay. Try it one more time. This is like the [inaudible 00:36:18] thing.
Suzi St. Jeor:
I do that, I didn’t know that time.
Tim Pickett:
I can totally feel that calming the situation. Yeah. Perfect. You did it. Okay. No more. You’re going to get too much CBD. Don’t want you to get crazy on the CBD. Okay. I mean, people say that CBD is not psychoactive, but it does calm people down, which by definition is psychoactive.
Tim Pickett:
So you have one that’s called uplift. Okay? That’s going to be energy day time. So not high, just energy nausea during the daytime that’s uplift. Okay? And then you have the other one called balance.
Michelle Spear:
Like red bull. That’s what it should called.
Tim Pickett:
This black one is called red bull.
Suzi St. Jeor:
So if you take it out of the package and you don’t keep it in the package, you’re not going to know which just which so [crosstalk 00:37:16].
Tim Pickett:
So just write down black daytime, white I don’t know.
Suzi St. Jeor:
Relaxation.
Tim Pickett:
Chill. Yeah. White is chill.
Suzi St. Jeor:
In the couch.
Tim Pickett:
In the couch. Now, I have two more of these that are a little different. Okay? But we only have one, five, 10 thread. That’s the one drawback with these batteries, just don’t lose that because these things go together. So now I have powered by … It’s a Zenergy balance THC and CBG. So remember the pair ones that we talked about with CBG?
Michelle Spear:
Yes.
Tim Pickett:
This is exactly the same thing just a vaporized cartridge. This is pretty cool. I was really impressed with these, the way they describe it. So this one says balance Zenergy pain. Okay? Pain. Because that one’s the CBG one. And they come with these little … They come with these little caps on them, which is fine if you want to put those back on and you put them in here.
Tim Pickett:
See there’s a little … In the skunk bag there’s a little thing, and you can just put them all in here. So pain. Now, you inhale this one, you’re getting high. Okay? But could be better for if you’re doing chemo day. If you’re not doing chemo day, these might be great. And these might be great with this. All right? I don’t know. These are just, you just have to experiment with this.
Michelle Spear:
Okay. So always put this on the bottom?
Tim Pickett:
Yes. So screw that on. We’ll give this one a shot.
Suzi St. Jeor:
[crosstalk 00:39:03] keep one in the thing and that way you’ll never lose the battery.
Tim Pickett:
Of course. Yeah. You always want to keep one cartridge loaded in the battery.
Michelle Spear:
Okay. And then you just drop it in?
Tim Pickett:
Yep, drop it in. Then you push the button, suck inhale and you’re there. And see how the top of that one’s round, so you can tell. Round, going to get me a little high.
Michelle Spear:
But the ones that are flat-
Tim Pickett:
Well, this one’s flat too and it’s going to get you high if you try this one too. So all different.
Michelle Spear:
It’s not necessarily.
Tim Pickett:
No, it’s not universal. I’m going to open this one. So that one is CBG. That one’s going to be good for daytime and pain. This one is sativa, so daytime. So both of these vape cartridges are both daytime. This one is very similar to the other one. Where did we put the other one? So see the black one it looks the same.
Michelle Spear:
I have labeled it. I’ll Just label those.
Tim Pickett:
Yeah. Label this one as daytime. This one’s daytime, but this one has THC in it. Okay?
Michelle Spear:
So the balance Zenergy is for pain? That one is for-
Tim Pickett:
Balance Zenergy, pain. This one is going to be … I mean, this was basically like … This is a THC vaporized cart, a sativa dominant vape cart.
Suzi St. Jeor:
So it’s not a downer though?
Tim Pickett:
It’s not a downer, this is an upper. Because you were saying you get really tired on that. And I know you, you tend not to want to be tired. Right? I know. I didn’t really buy … We didn’t buy a lot of downers.
Michelle Spear:
As soon as I hit the pillow man-
Tim Pickett:
You’re out.
Michelle Spear:
I’m out, snoring. [crosstalk 00:40:57]. Two seconds?
Tim Pickett:
You may have to turn it up, a couple of notches. Cotton candy, that tastes like cotton freaking candy.
Michelle Spear:
Yummy. I like cotton candy.
Tim Pickett:
It does huh? So that cloud right there you saw from her, that’s way too much for you. Okay? Way too much. Her tolerance has been built up over months and years. Okay? So you can taste this. So taste this, but don’t really inhale a lot. A little more than that. Oh my gosh.
Michelle Spear:
You said little.
Tim Pickett:
I know. And to your credit.
Michelle Spear:
I can taste the cotton candy. Yeah.
Tim Pickett:
So the one that tastes like cotton candy is the pain one. I’m glad you’re taking notes.
Suzi St. Jeor:
THC too?
Tim Pickett:
But it’s THC. And then this one, let me just see what this one tastes like. These vape carts they’re just so convenient, because they’re not going to smell up your house. And if you get too much, these are one to two hours of effect. These are not going to knock you out, so you can’t go pick up the kids.
Tim Pickett:
If you need to eat lunch and you’re doing chemo and you just need to get rid of the nausea so you can have a little energy, and get a little stuff done around here, and eat lunch, and then be sober to go pick up the kids, the vape cart is the answer. Right? The gummy is going to last you a long time. So the gummies are good for microdosing throughout the day and the night.
Tim Pickett:
And then you can use these on top of the gummies. And put your coat on it’s cold. You keep your house cold anyway. I mean, this one tastes like weeds. It doesn’t taste like cannabis, but it just tastes like grass. Okay. I’m going to leave the cotton candy one in. Okay?
Michelle Spear:
Yeah. Hello, cotton candy is way better.
Tim Pickett:
I know because we were talking about the eggs, the sugar. This is going to be interesting.
Suzi St. Jeor:
So the cotton candy is THC though?
Tim Pickett:
Yeah. Cotton candy is THC. So that’s your battery.
Michelle Spear:
Well, this is why I haven’t lost weight, see because I eat my Moxey Mints and I eat all my candy eggs.
Tim Pickett:
So that one I’m going to put in here. See, it’s a silver bottom with black top THC, black bottom black top only CBD. I’ll put that in there. You’ll be fine, you can call me.
Michelle Spear:
I’ll label those later.
Tim Pickett:
Okay. Charger. Okay? There’s a charger for your battery that just plugs into right there. Okay? Normal USB. Okay. And mostly you can just put that in your purse and then you’re good. So final thing, you don’t have to use this, but you should have access to it, flower. So I have an eighth of flower that’s 3.5 grams of cannabis flower.
Tim Pickett:
And I have a DaVinci IQ2, this is the top of the line, medical grade, dry herb vaporizer. This is an oven for weed that will bake it so that you can inhale the vapor, get all the magic, but you won’t have the burning in your lungs. This is not smoking. Okay? Okay. I’m going to-
Michelle Spear:
This is more vaping?
Tim Pickett:
This is called vaping, but it is dry herb vaping. It is not oil. Okay? It’s the real flowevr. So inside the box is what’s called a little straw. So I’ll pull this out. Okay? So see then this just flips over, and now it looks like it looks like a joint or a vape cartridge.
Tim Pickett:
Right? It looks like that’s the place you put your mouth. Same thing you push this button five times, I don’t know who came up with five.
Suzi St. Jeor:
I don’t know but they’re all the same.
Tim Pickett:
It’s totally random they’re all the same five times. And on the front, on the IQ2, it will show you how much the battery is and what mode it is. So this is on the mode where that’s three, that’s four, so this is the temperature. So for you, I would say probably a temperature of two is going to be fine.
Tim Pickett:
Two or three. Okay? That’s going to be between 350 degrees and 430 all the way to the top. And then this will heat up and it will vibrate when it’s ready. And then it will stay on for about eight minute. Okay?
Suzi St. Jeor:
Vibrate when it’s [crosstalk 00:46:19].
Tim Pickett:
When it’s ready, so it’s hot.
Suzi St. Jeor:
So you haven’t put the-
Tim Pickett:
No, I have not put the pot in the base. There’s a bottom little dial that I think you don’t really need to worry about. It affects how much air flow is coming through the chamber.
Michelle Spear:
Okay. So you to turn it five times on, click it on, and then you push the button to cook it?
Tim Pickett:
Nope. With this once it’s on it’s cooking.
Michelle Spear:
It’s going to cooking.
Tim Pickett:
It’s cooking the weed in the oven.
Michelle Spear:
You don’t have to push the button until you-
Tim Pickett:
You don’t have to push the button until you want to turn it off, five times. Okay? You’re only turning the temperature up and down on this one, because you want … So now let’s show you where to put the flower.
Tim Pickett:
So all you do is you just push it open like that, and then there’s a little chamber in the bottom. You see that little chamber?
Michelle Spear:
Yes.
Tim Pickett:
You put your weed in there. Okay? Now, the there’s a couple of options to put the flower in there. This is a little stir stick. It’s an extra stir stick because inside the top of the DaVinci, they have a stir stick already. Because when you use these-
Michelle Spear:
You’re going to have to take it out.
Tim Pickett:
Well, you have to clean it out. So you have to dump it on the lawn. You know what I mean? On the lawn. You can save it, but don’t worry about that right now. You can save the old vape grindings and make them into oil. But it’s not worth it right now. We just want to keep things simple. Okay? Keep it simple because this is already as complicated. I’m sure when you’re looking at this as it possibly can be.
Tim Pickett:
So let me put this back together. Okay. So that’s an extra stir stick, and it comes also with these little ceramic … The ceramic container. So if you want to, I think your fingers would have a hard time with this. So I don’t don’t know that this is going to be perfect for you, but you can try it. You can grind the flower and you can put it in there, and then you can put this on like that.
Tim Pickett:
And it’s a little container. It’s a teeny, tiny little container of weed, and then you drop that inside. So some people really don’t want to put weed in there because it gets it dirty, and so they really want to keep it clean. I don’t care. You can clean this out with alcohol and it’s fine.
Tim Pickett:
But you can use that. And if you are concerned about dosing and how much weed you’re putting in there, then you can use this little thing. Shit that thing is hotter than mother. Careful. Yeah. That oven is-
Michelle Spear:
I’ll touch it my hand is-
Tim Pickett:
That’s so stupid. That’s so funny.
Suzi St. Jeor:
That’s not funny. Are you okay?
Tim Pickett:
So that’s ceramic, so it won’t give off any taste. So the taste of the weed still stays. Your home teachers?
Michelle Spear:
No, it’s my delivery.
Tim Pickett:
It’s Amazon. Yes. Okay. So open that and smell it.
Michelle Spear:
It’s going to smell gross.
Tim Pickett:
Okay. That smells exactly like weed right there.
Michelle Spear:
That’s very strong.
Tim Pickett:
It is. So this is pretty strong. This is totally organic, totally pesticide-free, including natural pesticides that they use essential oils and stuff. Because I think for you where you’re immunocompromised, you really want to reduce the number of things that you put in your lungs that are contaminants. Right?
Tim Pickett:
So clean things really important for somebody like you. For everybody, but somebody like you. That’s a bud, that’s a nug, okay, and you’re just going to press that into the grinder so it sticks.
Michelle Spear:
Okay.
Tim Pickett:
Now, you can watch YouTube to figure out how to do this. Then you’re going to take the top of the grinder, and I’ve got you a baby grinder. And you put that down and then you just twist this like this back and forth. There’s the sound of it. And then you tap it for good luck.
Michelle Spear:
Tap.
Tim Pickett:
You got to tap it for good luck. I always tap it. I always tap the grinder for good luck, it’s the thing. Yeah it’s the grinder you put the nug of weed in there. Whoopsy, we’re making a mess. You put the nug and then you grind it. And then you open up the second chamber and that’s where the grindings are.
Michelle Spear:
So easy.
Tim Pickett:
Ain’t that weird. So this is essentially an herb grinder. Right? That you’ve used for Weed, but it’s an aluminum herb grinder.
Suzi St. Jeor:
That [inaudible 00:51:32] was hella fresh.
Tim Pickett:
When you get your time and you’re doing it. So at the bottom, there’s a little container.
Michelle Spear:
Spoon.
Tim Pickett:
Yeah. A little spatula and people put … This is where the … What falls in there is called kief. You don’t need to write this down. It’s called kief. It’s just the trichomes fall down in there, and it’s really potent down in there. And some people smoke enough weed that they actually accumulate a lot of kief. And then they’ll use it in their joints or in their flower as a boost, it’s like an octane booster.
Tim Pickett:
You will never need to worry about kief. Okay? And I think most people need to just forget about it as a thing, they just need to get over it. But that’s my personal opinion, thank you very much. Okay. So you’re going to open this up. Okay. Now everybody learns how to do this in a certain way, but you see I put my thumb right there, and then I hold this so between my thumb and my third finger, and then I tip it and I use my finger to fill that.
Tim Pickett:
To fill that DaVinci on the bottom. And then I tap the DaVinci with my finger, because the DaVinci is shaped like a funnel. So everything falls in there, and you just fill it up to the white line. See that white line inside? I just fill it up to about the white line loose.
Tim Pickett:
Now this there’s a round nubbin on the end of the DaVinci that heats up as well. So you’re getting heat from both ends. And then you’ll just close that like a magnet, and now it’s loaded up ready to go.
Michelle Spear:
And then you click five times to-
Tim Pickett:
And it will heat up and then when it vibrates, we’re going to do the same thing with this as we did with the vaporizer pen, the battery. Right? We’re going to just inhale it, and we’re going to exhale it. Okay, that is how to use flower. I’m going to put this in the little thing, and I’m going to tell you the reasons why is people choose flower over the oil. The flower is the natural plant.
Tim Pickett:
So a lot of people really like the natural thing. Flower the sensation’s different, it’s called the entourage effect. It’s going to be more like … To me, it’s the difference between eating canned tomato sauce and an heirloom fresh ripe tomato from the vine. Flower tends to be a little bit more rich experience, whereas the vaporized oil tends to be a little more grocery store, convenience store experience for when you build up tolerance and send you start enjoying this.
Tim Pickett:
Okay. And the smell becomes not so gross. Flower will last longer too, it will last three to four hours. The effects will last three to four hours and it is much more mild. The flower is 20% THC in here, but the vaporized cartridge is 77% THC. So the same inhalation is much more powerful with the oil. It’s three times more powerful than the inhalation with the flower.
Suzi St. Jeor:
So if you-
Tim Pickett:
For the same amount of product.
Suzi St. Jeor:
If you heat that up and smoke it, then it … That is just done?
Tim Pickett:
It looks like coffee grounds.
Suzi St. Jeor:
But can you heat it back up and [crosstalk 00:55:20]?
Tim Pickett:
You can use this, for somebody like you could get at least two to three sessions out of one loaded DaVinci, two to three sessions. For somebody like me with a small amount there, I would use it up all in one. You might use it up all in one. Right?
Tim Pickett:
Because you’re going to use … You’re going to inhale … Michelle, you’re going to inhale three or four times with this and be totally fine. Maybe even two times and be totally good. I’m going to burn it down. Right? I’m going to use up the whole thing. Because when I hurt my back, I wanted 50 milligrams of THC inhaled and you want five. Right?
Michelle Spear:
Yeah.
Tim Pickett:
There is an app you can connect the DaVinci to your phone, but I don’t really think that’s important right now. That will tell you exactly how many milligrams you’re inhaling.
Michelle Spear:
Oh really?
Tim Pickett:
It’s really cool. So that when you want to dial it in, then you can say, “That’s how I know I had a product that was 27% THC.” You put that in your phone, then as you inhale it tells you, “Okay, you’re at eight milligrams. Okay, you’re at 16. Okay, you’re at about 20. Okay, you’re you’re jacking it up. Okay, you’re 48. Okay, watch out you’re getting … Mayday, mayday you’re going to get too high.”
Suzi St. Jeor:
So that’s really good because then if you’re thinking one time this is perfect.
Tim Pickett:
Well, then you could look at your phone and you could say, “Oh yeah, that session I was 30 milligrams or I was 10 milligrams.”
Suzi St. Jeor:
[inaudible 00:56:53].
Michelle Spear:
Or nine.
Tim Pickett:
So that is flower. Okay? This is really why this bag is so nice because this bag will take all of that smell and keep it inside. Okay?
Suzi St. Jeor:
There’s also the toilet paper roll with that. So if you inhale [crosstalk 00:57:17].
Tim Pickett:
This grinder is so little that there’s still always going to be a little bit of grindings in there. And it’s not that big of a deal, you can just dump them out somewhere, but you can store it in there. You want to grind about as much as you want to use or within a few days, because it’ll dry out in here and then it’ll become a little bit more harsh.
Tim Pickett:
Okay. So that can all just stay right there. Okay? I think the important things seem to be gummies, the Tinctures, and then this vape cartridge, because it … You can layer the microdosing of the gummies with the inhaled method on top. And you can just try it.
Michelle Spear:
And notes in here.
Tim Pickett:
And you can put your notes in there. Now, I don’t know when you want to put all these. I’ll put this DaVinci thing here. What do you think about all this?
Michelle Spear:
No, I think it’s going to help. Yeah.
Have you heard that Utah’s much-anticipated Limited Medical Provider (LMP) program has finally launched? The LMP program is a fantastic upgrade that should prove beneficial to patients who may not have access to a QMP near them. That being said, your regular doctor or advanced practice nurse may not be willing to act as an LMP.
Cannigma contributor, medical doctor, and Medical Cannabis proponent Dr. Daniela Garelick, M.D. discussed provider reluctance in a post published a couple of years ago. Even though some time has passed, her comments are still relevant today. They certainly apply to the situation here in Utah.
Garelick suggests three reasons medical providers may still be reluctant to recommend Medical Cannabis. Before we get to them, a quick word about the LMP program: thanks to changes in the law, any physician, nurse practitioner, physician assistant, or podiatrist with prescribing authority in the state can now recommend Medical Cannabis for up to fifteen patients at a time. That is it in a nutshell.
Moving on to the reasons doctors may be reluctant to get on board, the first cited by Dr. Garelick relates to ongoing legal questions. Medical Cannabis may be completely legal under state law, but cannabis is still an illicit substance under federal law. This puts medical providers in a position of not understanding their own legal status.
It is completely understandable that legal questions would deter a provider from getting involved. No one wants to be on the wrong side of the law. But for medical providers, legal problems are more serious because they affect everything from licensing to insurance and admitting privileges.
Medical providers base their decisions on a combination of experience, general medical knowledge, and clinical data. A lack of clinical data makes it more difficult for doctors to advise. And unfortunately, while multiple studies investigating the benefits of Medical Cannabis have been done over the years, much of the data is inconclusive about specific medical conditions.
To put it in simple terms, medical providers already lacking sufficient knowledge of the endocannabinoid system may not see enough clinical data to convince them that recommending Medical Cannabis is the right way to go. Though it can be frustrating, do not fault them for this. Medical Cannabis is still relatively new compared to most of the other therapies doctors rely on. It is going to take time for doctors to fully embrace cannabis.
Last but not least are worries about potential patient abuse. Some such worries are the result of hearing anecdotal evidence from other providers. Yet we cannot discount the stigma effect, either. For the better part of fifty years, cannabis has been considered an illicit substance. Doctors have a tendency to equate illicit substances with abuse.
The potential for abuse exists with virtually every prescription drug on the market. Medical Cannabis should not be singled out simply because of its federal status. But again, do not fault doctors for their concerns. They are a product of their times.
It remains to be seen just how many professionals take advantage of Utah’s new LMP program. Here’s hoping that most providers with prescribing authority will get on board. That would be extremely helpful for patients who otherwise have to travel great distances to see a QMP.
Meanwhile, if you are a patient looking to get your Medical Cannabis card and you live anywhere near one of our locations, make an appointment to see one of our QMPs. We will do what we can to help you.
You have completed all the steps to obtain a Medical Cannabis Card. Now you are getting ready to head to your local pharmacy for the first time. That’s great. You are embarking on a journey that could literally change how you view your health and the condition that makes you eligible for Medical Cannabis. But here is a quick word of caution: start slowly.
The slow approach to Medical Cannabis is the wise approach. Jumping right in and going full bore isn’t likely to cause serious harm. But it could make it more difficult for you and your Pharmacy Medical Provider (PMP) to treat your condition appropriately. If you want to get the most out of cannabis, we strongly recommend taking a slow and thoughtful approach.
To our knowledge, there has never been a reported death attributed to overdosing on cannabis. There are a number of reasons explaining why, but it’s mostly due to cannabinoid receptors, where in the body they are located, and how the body reacts when those receptors are activated.
With all that said, not being able to overdose on cannabis doesn’t negate the possibility of using too much in too short a time. That is entirely possible. Using too much is always a concern among new patients. It can result in something known as “greening out.”
Greening out is the cannabis equivalent of blacking out, although actually losing consciousness is rare. People experience this phenomenon in different ways. Some of the more common symptoms include
As a new patient, greening out may produce any number of symptoms that may or may not be similar to someone else’s experience. Regardless, chances are you would find the experience at least somewhat unpleasant. Some people find it a bit frightening, too. So doing your best to avoid greening out is smart.
Greening out is really the extreme of using too much cannabis in too short a time. Even if you never experience it, there are still valid reasons for taking the slow approach. For instance, there is no way to know how your body will react to certain types of Medical Cannabis products and delivery methods without actually trying them.
A Qualified Medical Provider or Pharmacy Medical Provider may have specific recommendations for you as a new Medical Cannabis patient. For example, the QMP or PMP may suggest trying an inhaled form or an edible form of cannabis.
One form may have a much better therapeutic benefit for you than another. But the only way to know for sure is to try both. So you start out slowly, taking stock of how the drug affects you. If the effect is positive, you may decide to gradually increase your doses. The goal is to find a comfortable and effective dosage.
If the initial suggestions don’t seem to be effective, your PMP might recommend something different, like a tincture or a capsule. Once again, the standard recommendation is to “start low and go slow.”
If you want to get the most out of your Medical Cannabis treatments, we strongly encourage you to keep a journal. Write down the strains, delivery methods, and doses you’ve used, along with their effects. By keeping track of what works, and what doesn’t work, you can maximize the therapeutic potential of your cannabis use.
If need be, you might even try combining doses and delivery methods in order to layer the effects of the drug.
What it all boils down to is the reality that your body is going to react to Medical Cannabis in its own way. Since you do not know what that will look like right from the start, the idea is to go slowly until you figure it out. The slow approach will help you zero-in on the best delivery method and dosage while avoiding the possibility of accidentally greening out.
Episode 93 of Utah in the Weeds features Donna Froncillo, who uses Medical Cannabis to treat her cystic fibrosis.
We started this episode with a discussion of Donna’s diagnosis of cystic fibrosis at age 42. Before her diagnosis, she suffered from several other health conditions that left her feeling confused about their cause. [02:10]
After she was diagnosed with cystic fibrosis, Donna started taking a large variety of medications. Within three years, she says, her doctors prescribed as many as 19 new medications for her. She says the meds interfered with her thoughts and moods, and she didn’t feel like herself. [06:27]
Donna’s life began to change when a friend from California encouraged her to try a cookie made with canna-butter. The cookie relieved her pain and helped her sleep, so she decided to make cannabis part of her medical routine. Because she was on so many medications at the time, Donna checked herself into a mental hospital for help with weaning herself off most of her medications. She says she was able to stop using 13 of those 19 medications. [08:11]
Donna says she prefers indica varieties of cannabis in tincture form, which she makes herself using cannabis flower and olive oil. Donna also uses a vaporizer when she needs fast-acting relief from headaches. [16:08]
Donna also uses cannabis to reduce symptoms of stress, joint pain, colitis cramps, insomnia, and bone pain. [24:00]
Donna talked about her initial experimentation with cannabis medicine, and the products and delivery methods that work best for her. [29:42]
Tim asked Donna about the perception that cannabis can change a person’s self-identity. Donna says the real “her” disappeared when she was taking large amounts of prescription meds, and cannabis helped her feel like herself again. [34:41]
We wrapped up this episode with a quick discussion of Donna’s favorite products for treating cystic fibrosis. [40:54]
Tim Pickett:
Welcome everybody out to Utah in the Weeds. This is episode 93. We are coming up on 100. Seven more episodes after this, stay tuned. Stay subscribed to Utah in the Weeds on any podcast player that you have access to. And you can listen to the podcast on Discover Marijuana, YouTube channel, which we are doing a YouTube giveaway this month, coming up on the final week of the giveaway. You need to be subscribed and comment on the most recent video to be entered into the contest. We’re giving away free visits to Utah Therapeutic Health center for cannabis related healthcare. Also a DaVinci IQ2. That is a $300 dry herb vaporizer, extremely well put together. Ceramic bowl, glass tube, the taste is better than any other vaporizer that I have tried, and some other swag items too giving away. Discover Marijuana on YouTube. Slam that subscribe button.
Tim Pickett:
Today’s interview and discussion is with Donna Froncillo. She is a Utahan now, she moved here and is a cystic fibrosis patient. She found cannabis, well, I’ll let her tell this story and how many medications she was on and how cannabis has affected her. What she has found works for her. Another really great conversation with somebody who is legitimately using cannabis as medicine in a way that makes sense, in my opinion. Otherwise, I really appreciate all of you. Appreciate you subscribing to the podcast, Utah in the Weeds. Again, my name is Tim Pickett. Enjoy this episode.
Tim Pickett:
So how did all of this process of cystic fibrosis kind of come about?
Donna Froncillo:
Okay, so 15 years ago I had a bout of pancreatitis and I ended up in the hospital for a month. Well, the doctors were kind of baffled about it because they didn’t know why. There was no reason for it. It just came about, I didn’t have a long history of drinking or doing any drugs or doing anything that would… My diet was pretty healthy, too. Not as healthy as it is today, but anyways, so I was in the hospital for a month. Well then the following year I got pneumonia and I couldn’t get rid of the pneumonia. It went on for 16 weeks and they kept giving me antibiotics and sending me home and giving me antibiotics. And then finally after 16 weeks the same hospital that I kept going to the ER, they said, well, why don’t we just keep you? And why don’t we do some testing because you’re not getting rid of this pneumonia that’s in the base of your lungs. So that’s what they did. They brought a lung doc. What is the lung doctor called? I don’t even know. Lung doctor?
Tim Pickett:
Lung. Yeah, lung doctor’s fine.
Donna Froncillo:
Okay.
Tim Pickett:
Pulmonologist is the word, pulmonologist is the word you’re looking for.
Donna Froncillo:
Pulmonologist. That’s the word. Yes, right. So they brought him and he said he was going to do a bronchoscopy. Well, when he went in there to discover what he did, he had to send that, which he said was the worst thing he’d ever seen, but he had to send that to the CDC to be tested, to see what was in there. And that’s when he came back and said, you have microbacterium abscessus and it came back.
Donna Froncillo:
And at the same time, I had asked him to diagnose me, to see if I had cystic fibrosis, because I did have a third cousin who had died from it. And he wasn’t going to because I was 42. And he said, we’ll do it based on family history. And sure enough, I had it and it was positive. And that was it. And then I was on three years of different medications to get rid of the microbacterium abscessus and an IV. I had the pick lines for a few months, along with some other oral antibiotics and yep. So I think there was a straight two plus years of oral antibiotics after the IV pick line. And they told me they did not think I was going to make it. They said, this is really bad. This is the worst thing you could have got. Worse. And I was like, “Whoa, I’m thinking I’m going to die.”
Tim Pickett:
Yeah, no kidding. And really cystic fibrosis is a lung, it has a lot of effect on the lungs. The pancreas is involved. So this kind of fit the whole picture all of a sudden.
Donna Froncillo:
It did every thing, everything. Everything from my sinus problems in my early twenties, to my infertility of not being able to have a child. IBS, getting diagnosed with IBS when I was in my upper twenties, my thyroid went nutso when I was in my early thirties. I was premenopausal at 35. I mean, there was some weird things going on in my life that I had. I was like, I didn’t know. I just was confused for years.
Tim Pickett:
Yeah, I bet. So how long ago were you diagnosed?
Donna Froncillo:
I believe this is 15th year. That would bring us back to what year? 2008?
Tim Pickett:
Yeah. 2008 would be 15 years from now or 2007.
Donna Froncillo:
I think it was 2008, because in ’07 is when I had pancreatitis. And I think in ’08 is when I had the pneumonia. And then that’s when I found out. And then I finally got Medicare approved in 2010.
Tim Pickett:
So what changed in your life once you were diagnosed and you kind of knew this was the case and you started to realize these symptoms came from a place of this chronic illness that you had.
Donna Froncillo:
Wow. What happened? A lot of strange happened. When I was put on these medications, I hadn’t been on many medications. I had just been introduced to Synthroid a couple years prior. And so I wasn’t really on medications. Well, what happened was I started getting side effects and I was on a new medication. Then I was on another medication. Then I was on another one. Before a three-year period, I ended up on 19 different new medications, 19. And I just started feeling like I just wasn’t me anymore. There was something wrong with me. I was thinking different thoughts. I was having these different moods. I was crying a lot. There were things that it just wasn’t my normal. And I was on something for going to sleep. I was something on for stress. I was something for fibromyalgia. Then they gave me something for stomach cramping. And then I was on a muscle relaxer. And then I was on, oh pain pills. And then I was on pain pills. They were giving me like seven of those a day.
Donna Froncillo:
And I was just like, it just seemed like I was getting worse and worse and worse. So that went on for about three years. And finally, and this is in Florida. I had this friend who had come from California and she said she wanted me to try a marijuana, she called it cannabis butter.
Tim Pickett:
Yes.
Donna Froncillo:
So she called it cannabis butter. And she said she wanted me to try a cookie. Well, I did. And I slept well that night. I ate, I wasn’t in any pain. I felt like I was normal me again. And I was like, whoa. And it was made of Girl Scout cookies. I’ll never, ever forget it was Girl Scout cookies. Because I remember asking her “What was the name of that thing you gave me?”
Donna Froncillo:
And so what I had realized was something was up with that medication. So then now I had a dilemma on my hands because now I had this new drug and with all these other drugs. So what I did is I did something that’s kind of not normal. I took myself to Tampa General Hospital and I asked them to admit me to the psych ward.
Donna Froncillo:
And I came with a laptop. I thought I was going to be in there for a week. Just a vacation. They’re going to help me out here. No, no, no. It was a different shock altogether when I got there. So anyway, laptop was not going with me. I couldn’t bring anything upstairs with me and they wanted to know why I was there. And I said, “Well,” I said, “I have to get off of all these drugs. And I know I need to do it, but I don’t want to do it by myself because what if I do this and something happens to me?”
Tim Pickett:
Right? I mean, you’re on 19.
Donna Froncillo:
I mean this is a lot of drugs.
Tim Pickett:
Yeah. You’re on more than 10 drugs. There’s all kinds of side effects from taking all the drugs. There’s bound to be side effects from coming off of them.
Donna Froncillo:
Right. Right. And I didn’t know what to expect. And so I thought the safest thing would be, is be under medical care. So I went, they admitted me. I saw the doctor the next day and he asked me what exactly I wanted to do. And I told him, I said, “I don’t need all these drugs.” I said, “I need my nebulizers. I need my Synthroid. I need the basics. But the rest of these, I don’t think I need these.” And he says, “Well, we’re going to have to stabilize you with something.” He said, just because this is a lot we’re going to wean you off of. And I said, “Okay”, so we agreed on Prozac. But then I did ask him about marijuana. I said, “I would really like to try marijuana.” And he gave me Marinol. Which didn’t work. It didn’t work. And that next morning I told him, I said, “That didn’t work. That wasn’t the same as the butter my friend gave me.”
Donna Froncillo:
So anyway, so I just went through my five days. It was a five-day thing. He did put me on Prozac. He wanted me to stay on that until further noticed, because keep the chemistry normal. So I got out of there. I was relieved. And that was so basically 12 years ago was when I started using it, which I know a lot of people find that hard to believe. They’re like, “Didn’t you use it? Weren’t you smoking it when you were a teenager, weren’t you out there?” And I was like, “No.” I grew up in a house where it was bad. And when you grow up learning that this is a terrible, terrible drug, don’t ever try it. It’ll turn your brains to mush. You’re going to kill your brain cells. So I had all this fear about it and yeah, so 12 years ago, so I wiped out of the 19, I would say, because of what I still have to do today, I would say 13 are gone.
Tim Pickett:
Wow.
Donna Froncillo:
So that was good. It was good.
Tim Pickett:
Do you feel like you got a little bit of your life back, a little bit of normalcy back?
Donna Froncillo:
Yes. And I tell people that and I’m like, I know that there’s a lot of people who don’t understand cannabis and there’s a stigmatism to it. There’s still people that I’ll approach and they’ll say, “Oh yeah, you just want to get high. It’s a good excuse to get high”. No matter what, you’re a stoner that’s it and I’m like you just don’t get it. You don’t understand that it’s more to it than just somebody who just wants to sit around getting high all day long.
Donna Froncillo:
Anyway so it seems like I’ve had to, really in order for people to understand it and they don’t. They don’t want to hear it or they don’t get it. But yeah, telling people that over and over and over is that cannabis gave me my life back. And in a sense, I owe that to God, because I believe that God put this here as a healing plant for us. And I’m not a person who can take a lot of medications because my pancreas now hates pill. It hates anything manmade. It hates processed. It’s the weirdest thing. It’s like my pancreas is dictating my whole life. And if my pancreas, if I take a regular pain pill, I get pain.
Tim Pickett:
Do you?
Donna Froncillo:
And I’m like so what good is that? I can’t do that. If I eat say, let’s say I decided to eat a donut, it wouldn’t be good. I’d be like. So I’ve had to change my diet. I’ve had to completely change my diet. I’ve had to completely change my lifestyle. I’ve had to add things into my life and I’ll tell you what, they’ve told me anything that ends with the word -itis I’ve been diagnosed with. Yeah. Arthritis, bursitis, tendonitis, colitis, gingivitis at one time. Sinusitis. It goes on and on and on.
Tim Pickett:
You’re a bag of inflammation.
Donna Froncillo:
Right. And that’s what CF is. And see and that’s the big thing that I wanted to touch base with is that there’s something, and I don’t know the mechanism of the drug. I don’t know that end of science. All I do know is that it does conquer inflammation. And what causes inflammation? I mean, you got your joints, your stress, you’ve got foods that you eat, medications you take, sugar. There’s a lot of things that inflame the body. So it’s not just about, oh, I’m going to just take this cannabis here and I’m going to be fine. There’s more that comes along with that. Not only do you do the cannabis, but you may have to also cut back on the sugar or you might have to stop drinking the alcohol. So anyway, so I just want to hit some bases on this inflammation because inflammation is what triggers cystic fibrosis. And then we end up sick. So if you can control the inflammation, you can control the sickness.
Tim Pickett:
Yes.
Donna Froncillo:
And I don’t like to be sick. So I have a fight against. My fight is What’s the term I use? My fight is against inflammation or the itis. Yes, my fight against itis. Itis fight
Tim Pickett:
It’s like a foe, it’s like you’re going into the ring and you see this in a pretty complete picture too, because I think a lot of people don’t, or wouldn’t, see this as cannabis is one part of the solution. It’s not the whole thing. It gives you some options. What do you feel like cannabis does for you, for your day-to-day life?
Donna Froncillo:
Well, I’m an indica person. So basically, it keeps me balanced. So what I do is I think we discussed, this is what I do is I do tinctures and I do them about every four hours I’ll do one ML. And now I bought this one time because I told you I would try it. This was $80. But what I do is I tend to buy this. It is going to sound like not much, I buy this it’s 3.5 and then I take my own olive oil and I actually just cook it on the stove for like five hours. And then I make my own little oil.
Tim Pickett:
Yeah. You were showing me an eighth of flower, right, of trike flower here.
Donna Froncillo:
So this is 3.5 grams.
Tim Pickett:
Right. 3.5 grams of flower. And then you take that amount, you put it in some oil and you decarboxylate it, you make your own.
Donna Froncillo:
Yes. Yes.
Tim Pickett:
You make your own oil.
Donna Froncillo:
Right. And then I take this and I use this and-
Tim Pickett:
Little dropper.
Donna Froncillo:
And then it, yep. And it’s a 1.0. And I do that every four hours. And that keeps me balanced.
Tim Pickett:
Do you feel like that’s better medicine or do you feel like that’s cheaper for you? What makes you want to do it by yourself? Make your own oil?
Donna Froncillo:
Well, because honestly I can’t afford $80 a bottle. I cannot afford.
Tim Pickett:
So you feel like it’s a little bit cheaper to take your own flower, make your own oil, and then that’s going to give it a nice…
Donna Froncillo:
Well, it’s not going to be as strong. It’s going to be weaker. And I already know that it’s weaker and it is what it is. It works for me, but it works, but it also takes a long time. It could take up to two hours. So doing it every four hours keeps it going.
Tim Pickett:
Keeps you level.
Donna Froncillo:
That’s what I noticed. Right.
Tim Pickett:
And if it’s weaker and you’re doing it more, I really like this idea. I really like this idea, especially for you. This is good.
Donna Froncillo:
And it’s olive oil. So olive oil’s one of those things that I can actually digest because I’m limited with what I can digest anymore. So then I have the other one. Now this deal was a buy one, get one free.
Tim Pickett:
Okay.
Donna Froncillo:
So when it’s a buy one, get one free. I can do this. And it’s more economical for me. And it’ll last me a couple months. Now I also buy another indica, which is a stronger indica than this one. This one is during the day, the other one is going to knock me right out. That one is one ML. I take it and within an hour I’m out and it’s a 70/30 indica.
Tim Pickett:
Okay.
Donna Froncillo:
It’s pretty strong and it’s the same thing. So, but it was a buy one, get one free. And when you get that kind of a deal and you do it cost dollar for dollar, it works out pretty well. It keeps that-
Tim Pickett:
For sure.
Donna Froncillo:
Keeps it in the budget so I can afford it.
Tim Pickett:
Yeah. Well, okay. Side question. How bad does it smell up your house when you make the oil,
Donna Froncillo:
It’s a good smell up for about six hours.
Tim Pickett:
Then it kind of goes away?
Donna Froncillo:
Yeah.
Tim Pickett:
Your house smells like it.
Donna Froncillo:
Yeah. It’s about six hours. We’ve timed it.
Tim Pickett:
Have you? That’s funny.
Donna Froncillo:
We had to because there’s somebody in the house that really doesn’t want the smell in the house. They don’t really care for it. And so we have to make sure that person’s gone for at least six hours so that she doesn’t have to smell it.
Tim Pickett:
I see.
Donna Froncillo:
So anyway, but yeah. And then now, sometimes I still have to use my vaporizer, which yeah. I like the Davincis. I did go and look at them because I hear you talk. Yeah. I was hearing you talk about them. They look great. They’re great. But I bought something that was just a little bit, it’s cheaper and it’s faster. And last night I had the worst headache and it came on and I ignore it. I can’t take Tylenol. I can’t take ibuprofen and aspirin doesn’t even touch it. So I said, fine, I’ll vaporize. And I only need to vaporize it for like 10 minutes and then my headache’s gone and then I can go upstairs and I can go to sleep.
Tim Pickett:
That’s cool. Same strains you’re using in your oil, your indica strains. Which are nice. They can be really good for headaches for people. And I like that a lot. I think that’s a smart way to do it.
Donna Froncillo:
Well, I think that’s the medical way to do it, but then, okay. Let me see. So here’s I was going to tell you too, is that, so I had to get through a time period of actually believing that I wasn’t doing something that was wrong. And I had a hard time with my family. I come from a family of law enforcement, so they’re not into marijuana. I’m like that black sheep.
Tim Pickett:
So when you started to use this medically, were they still not into it?
Donna Froncillo:
No. That was the funny thing is they all mentioned how well they thought I was doing and you’re [crosstalk 00:22:06] Keep it up.
Tim Pickett:
Yeah. You’re doing great. What are you doing? And you say, “Well, I’m using marijuana.” And they’re like, “Ah!”
Donna Froncillo:
Right.
Tim Pickett:
“How could you?”
Donna Froncillo:
Yeah. They’re all in New York state.
Tim Pickett:
Oh yeah. You know in New York they just adjusted their law. They have an open consumption law. Now they’re one of the only places in the country that you can smoke cannabis. You can smoke cannabis anywhere you can smoke cigarettes, out in the open. Yeah.
Donna Froncillo:
In New York, huh?
Tim Pickett:
One of the only places. They actually use more. I mean, trivia with Tim. Is they use more cannabis in New York City than any other city in the US. 77 metric tons of weed a year goes through that city. Yeah. Bigger than LA, San Francisco. All the California cities. Yeah. They use a ton of it there and now you can smoke it in public in New York. I got to go on vacation there just to see this, just to see it.
Donna Froncillo:
Well, I would too. See, because I’m from Buffalo. Buffalo, a whole nother place.
Tim Pickett:
Oh, I’m sure.
Donna Froncillo:
It’s not even anything like New York City. In fact, New York City would be weird to them. “Ugh. New York City’s weird!” Yeah. No and here’s the thing, this is what I’ve noticed now okay, even medications, here’s the thing is even medications that I was on that caused me severe joint pain and edema. I’m talking about the Levofloxacin family. The floxacins. Yeah. So what did I have to, when I called up my doctors during that time, I said, “What can I possibly take?” I didn’t even know what to take anymore. And they said, “Just get some edibles.”
Tim Pickett:
Oh, wow.
Donna Froncillo:
That was the CF center. So that was cool.
Tim Pickett:
Yeah. That is cool.
Donna Froncillo:
So, but here’s the thing what I noticed that it helps me with. First off, it helps me with any stress situations, brings me right back down. My body stays calm. It’s all about keeping the body calm for CF. If you can keep your body calm, you won’t inflame your lungs. And if you can eat the right foods and get the right nutrition through the pancreas, without upsetting the pancreas, the pancreas will stay nice and calm too. But so what I’ve noticed is I’ve noticed appetite, because I have an issue with malnutrition. So I’ve lost a lot of weight and now the endocrinologist is actually doing some testing to see what exactly is happening. So sometimes I’ll have like no appetite, none. I’ll just be walking through the day. Like what do I want to eat? What do I want to eat? Anyway so I get an appetite, major appetite, especially with this one, this Who Dat Cush Orange or something it’s called. I’m like, “Who Dat orange? That stuff is making me eat all the time!”
Tim Pickett:
That’s great.
Donna Froncillo:
It is, if you want an appetite, get some Who Dat Orange. Anyway, whatever it’s Who Dat Orange Crush. All right. So appetite, joint pain, colitis, cramping. My headaches, when I get them. The insomnia, the stressful situations. Lung exasperations, when my bones start to hurt. When I get pancreatitis, when I get pancreatitis, the only thing I can do is vaporize. That’s it. There is nothing else in this world. I don’t even care. Morphine, oh, except for when I’m in the hospital and I get on an IV, they have to give me morphine because it’s an equivalent. That’s the level of pain. Yeah. It’s horrific. So anyway it helps with that.
Tim Pickett:
Pancreatitis can be really, really bad. My background’s in GI surgery and we would admit you, and that would be the general surgery service or something that would potentially admit you. And yeah, that was me. And we would just fill people up with IV fluids and anti-nausea pills and Dilaudid or morphine, or just the heavy-duty stuff, because we didn’t have access to cannabis. It’s horrible. But you make a really interesting, I believe cannabis to be one of the best medications for pancreatitis, you get the pain control, you get the nausea control, you get a little appetite. You don’t get the slow down in the GI system. I mean, it’s as if it was grown for pancreatitics like yourself.
Donna Froncillo:
I am in awe. There’s so many times that I’m in awe because it was something I avoided for so long in my life. And I met with a, I think it was a psychologist at one point, and we were touching base on the marijuana and where were we going with that? Well, first off he made a comment that he doesn’t believe that it would’ve affected me in this way if I had been a partaker of it in my youth. That it wouldn’t have worked as well, because I didn’t have a history with it.
Tim Pickett:
Do you believe that?
Donna Froncillo:
I don’t even know what to think, because I’m just saying to myself, I can’t believe that I was made to feel like this was such a criminal thing.
Tim Pickett:
I know I don’t-
Donna Froncillo:
And it’s not, it’s a good medical thing.
Tim Pickett:
Yes. It is. I agree.
Donna Froncillo:
So I don’t know.
Tim Pickett:
I don’t know if I buy that. I mean, I there’s something too that I guess if you were to use a ton of it when you were really young, screw up your endo cannabinoid system. Yeah, maybe. I think that’s a stretch a little bit. I guess I would say we don’t don’t really know, is the bottom line.
Donna Froncillo:
Well, the other thing too is they questioned me heavily about what it does to me. How it helps me escape. And I’m just like “Escape. Escape from what? I mean, I didn’t know. He said, “Well, people do it because they have some emotional pains they don’t want to deal with.” And I’m like, “No, no, no. See I’m in pain and I need something for pain and this is what I take. And there’s nothing to escape because reality’s going to be there. Reality’s always there. How can I escape it?” I can’t escape reality.
Tim Pickett:
Yeah cannabis does not make you escape reality. Does it?
Donna Froncillo:
That’s what they want to know. That’s what they asked me-
Tim Pickett:
Yeah. What do you want to escape? What do you, what do you?
Donna Froncillo:
Yeah.
Tim Pickett:
Yeah. No, I want to be in the present
Donna Froncillo:
Pain. I don’t want any pain.
Tim Pickett:
Yeah I don’t want to have pain, but I want to be here. I want to do stuff I want to do today. And I don’t want to feel like crap while I’m doing it.
Donna Froncillo:
Right. Right. And so when I’ve told people, then they’ll say, “Oh, well, well you’re you just want to get high?” Hmm. Okay. Well, first off I wake up high. I mean, I wake up and I’m happy to wake up. I’m like, if I take my little blinders off, because I wear a mask. I’ll take my mask off and I’ll see that it’s light out. And I’m like, “Yes!” So I get up and I’m all excited. I’m already like that. So I have to do indica. Now I have experimented because I had to start trying all these different strains and doing these different things because I was so new to it I didn’t know what I was doing. So I was trying some sativa and Ooh, that wasn’t for me. Because I was already excitable. I was already high. I already had so much serotonin. And I always said, I have an abundance of serotonin in me and serotonin and dopamine.
Donna Froncillo:
So it was too much. It was so much that it actually gave me the shakes and I was like, and that’s how I had to get to know what worked for me. So I go through this whole three year trial where I was trying this, trying that, vaping this, eating that, rubbing this on, doing this patch. I mean I did everything and sometimes I wanted to see if I could do what other people said they could do, which was, they said they would get a head high and they called it headband.
Tim Pickett:
Yeah.
Donna Froncillo:
And I’ve tried and I can’t get there for some reason. I can’t get high in my head like people describe. And it’s always baffled me.
Tim Pickett:
That’s very interesting. You’re not the first person
Donna Froncillo:
Is it not get-
Tim Pickett:
No, you’re not the first person I’ve ever met that has said that. Most people build up a lot of tolerance in order to do that. But there is something about the blood brain barrier that’s not getting crossed maybe by the THC and who knows. And maybe it’s just like when somebody describes this to me, I compare it to Adderall or Ritalin. So for an ADHD person, you have all of this neuromodulation that’s going up and down and up and down and up and down. And so Adderall will raise all of the signaling up and it levels it out for people. And for people with severe ADD or ADHD that actually makes them feel more calm. And it actually kind of lowers their sensation of things and for you, but for somebody else who doesn’t have ADD, or that they can take Adderall and it’s very stimulating to them, their wide awake, they think. They describe the contrast as more.
Tim Pickett:
And so I wondered if it would be the same type of thing. You are using THC and it’s actually just becoming a modulator, right? So you’re not feeling that head high sensation because almost like you need it, you need it to modulate you, it finds your balance. It makes you balanced. You describe that in the beginning. You take an indica and now you feel like, “Oh, I’m me.”
Donna Froncillo:
Yeah. But even if I take more and more and more, even if I took? It doesn’t matter. It doesn’t even matter. It just doesn’t, it never mattered. It’s never mattered. The only thing that I noticed was if it’s more of a sativa strain and say I get a 50/50, the only thing that’s going to happen is I’m going to laugh a lot. I’m just going to be laughing and laughing and laughing. And that’s only if it’s more of a sativa. And so that’s the side effect. And one time I remember my father telling me, he said, because he knew about the marijuana because at that time I was making cookies. And he said, “If this is the only side effect that you are getting is you’re getting the laughs and you’re laughing like this and you’re happy”, he said, “Then it’s okay. It’s okay.” And it took a lot for my father to say that because of him being in law enforcement. Because I know he’s still anti-marijuana but he did tell me that. And that made me feel like at that time that was his blessing. You know what I’m saying? I’m giving you my blessing. Just don’t ever drive under the influence.
Donna Froncillo:
And he’s made that clear because he was a recovering alcoholic. He hasn’t drank in like 55 years. No like 52 years. And so he’s always told me that. Whatever you do, do not eat your cookies and put anything on social media and do not eat your cookies and do not drive when you eat your cookies.
Tim Pickett:
This is good fatherly advice. This is very good fatherly advice.
Donna Froncillo:
So every time I do have something to say and I did medicate. I’m like, Hm, I better not get on Facebook. I’ll just stay off.
Tim Pickett:
I’ll just wait on this one. We’ll wait on this one just a little bit. That’s good.
Donna Froncillo:
Just in case, because I don’t know. It doesn’t feel like I’m saying anything wrong or anything, but I have that little voice in me telling me be careful.
Tim Pickett:
So you don’t ever feel like you’re really, people are very scared when they start cannabis or when they’re exploring cannabis that it’s going to change who they are when they use it. Do you feel like it, I don’t feel like that, but to you, Donna, do you feel like this changes who you are at all in a negative way?
Donna Froncillo:
No. No. I never even thought about it changing me. No, when I went into it and I decided to do it, I just wanted to have myself back because myself was gone after all those pills and all those drugs being pumped through me and all that was going on. I was gone. Me, the real me, and I just wanted me back. And so even through prayer. I’ve prayed. I pray a lot for every answer I want. And I always get led to holistic approaches. Like right now I’m studying iridology and foot reflexology. And I also have a lot of data that I’ve been collecting on foods and healings of foods and herbs. I’ve got a collection of herbs now that I’m going to make my own tinctures. And I keep being led into the direction of holistic approaches.
Tim Pickett:
That’s really cool.
Donna Froncillo:
But I’ve never, I’ve always just wanted to maintain who I was and this is who I am and I didn’t want to lose that. And that’s what I felt I was losing through pharma.
Tim Pickett:
Yeah.
Donna Froncillo:
I was losing me and I wasn’t me. And yeah, it was really weird. It was a very strange time in my life. And if it wasn’t for, there was a doctor in Tampa Bay and my doctor sat me down after this three-year period of me being on all these different medications and he sat me down and he said, “I don’t know what to think. What’s going on right now.” And he said, “I’m concerned about you.” And he said, “I’m concerned about how many pills you’re on now.” He said, “I’ve been your doctor all these years. And you were only on two medications.” He said, “And I want you to really think about what’s going on right now because you’re on a lot of medications”, and if it wasn’t for him, bless his heart because he’s a normal PCP, for him to do that, he really made me stop and think, what’s wrong? What’s going on with me? And so he ultimately led me to get my life saved. So yeah. Yep.
Tim Pickett:
Thanks for sharing that.
Donna Froncillo:
Yeah. And he wasn’t in the cystic fibrosis community and see, that was the other thing too, is with the CF doctors, they’re normally lung doctors.
Tim Pickett:
Yeah.
Donna Froncillo:
So what happens when you go, they start treating your lung issues, but they can’t help you with your pancreas, with your kidneys, with your bladder, with your GI. So they send you to all these other doctors, they send you here and they send you there and then they send you to pain management and then they send you this. So I had about nine doctors that I was seeing on a monthly basis for years. And I would bring my sheet of paper in. I kept an Excel spreadsheet of all these drugs I was on and I would bring it in to each and every doctor down there in Florida. And I would say, okay, I say, “These are all the drugs I’m on. This is what I’m experiencing.” “Oh, okay. Well we’re going to go ahead and give you some Lyrica because this is all, sounds like this is a lot of fibromyalgia related, so Lyrica should do it.” Then they would just put another pill on me and then I would specifically ask them, “Well, are these pills okay with that one?” “Oh yeah, those are all fine.”
Tim Pickett:
Yeah.
Donna Froncillo:
But they really, really weren’t. And none of them said anything bad. They all said moderate indicator moderate, mild. But I knew in my brain that something was happening.
Tim Pickett:
Yeah. Well, I’m so glad that you found yourself again, through this whole experience.
Donna Froncillo:
Yeah.
Tim Pickett:
And now you’re able to really be an advocate for cannabis as a real medicine with your own experience. I really appreciate you coming on and talking about it. It’s been really great.
Donna Froncillo:
Yeah. And especially for the CF people, because the cystic fibrosis community, they think smoking, that’s what they’re always thinking. Smoking, smoking, smoking. I was very fortunate to be under UCSF and Stanford and UCSF and Stanford and California both do recommend edibles or tinctures or patches. They never, ever recommended smoking but at least they were open-minded enough to say, we can put this on, some of our patients can be on this. But there is a lot of people that don’t understand in the cystic fibrosis community that have children or have teenagers or have 20 something year olds that it’s not about them trying to seek a high.
Donna Froncillo:
I’m a mother. I have a 30 year old and I understand where they’re coming from, but they’re also hearing from a mother that’s telling them that this is a medication that can help with their inflammation and they don’t have to be in the hospital every other month or three or four times a year. It doesn’t have to be like that. And they don’t have to get down to 85 pounds. There’s something that might help. Cannabis.
Tim Pickett:
Yeah. Yeah. I appreciate you saying that. And do you have, so your favorite strain in Utah, is it the Who Dat Orange Crush?
Donna Froncillo:
That one’s really good for daytime indica use, but the other one I have is it’s just a normal cush, something. Sorbet. That’s a good one for sleep. That’s the one that knocks me right out. So, so far I’d say that those are probably my favorites so far. And then of course this tincture, this it’s called myrcene Terpineol.
Tim Pickett:
Myrcene Terpineol is a Boojum tincture. Mm-hmm (affirmative).
Donna Froncillo:
Yeah. And this really knocked me out.
Tim Pickett:
Yeah. It’s strong.
Donna Froncillo:
Yeah.
Tim Pickett:
That stuff, it is really strong.
Donna Froncillo:
You’ll need a half a drop of that and you’re out. And so I don’t know if I could ever make mine that strong, I doubt it. And that was what I’m doing.
Tim Pickett:
Yeah. Yeah. Well, I’m glad that you came on and told your story. Donna, this has been really fun. It’s very fun to listen to you and your experience in getting off these medications.
Donna Froncillo:
Well, thank you for having me.
Tim Pickett:
You bet, for any of you who are listening Utah in the Weeds podcast, subscribe on any podcast player that you have access to Donna Froncillo, thanks for being with us today. And everybody stay safe out there.
Regular listeners of the Utah in the Weeds podcast have heard our very own Tim Pickett discuss the concept of taking regular breaks from Medical Cannabis. The idea behind doing so is to address cannabis tolerance, which occurs naturally and develops with regular cannabis use.
Tolerance is not a bad thing. It is one of the body’s many defense mechanisms designed to keep things in balance. Yet tolerance isn’t ideal for Medical Cannabis patients because it reduces the effectiveness of their medicines. Taking regular breaks reduces tolerance so the patients don’t continually have to increase dosage and frequency.
Cannabis isn’t the only drug that can produce tolerance. Tolerance is reality with a variety of pain medications, sleep aids, antidepressants, etc. Where cannabis is concerned, tolerance is the result of how THC affects the brain.
THC’s psychoactive effects occur when the cannabinoid binds to cannabinoid receptors in the human body. A receptor is a cellular structure that binds to certain molecules. So cannabinoid receptors bind to cannabinoids, like THC and CBD.
Here is the problem: the body can get used to having a certain amount of THC in the system. As that happens, the body produces fewer receptors in an attempt to balance things out. The result is that the same Medical Cannabis dosage doesn’t produce the same effect.
Tolerance in Medical Cannabis patients isn’t ideal because it ultimately means they need more medicine. When you consider just how expensive Medical Cannabis is, having to continually update your dosage is not a good thing. Your tolerance could be such that you simply cannot afford to medicate any longer. That’s what we’re trying to avoid when we recommend taking regular breaks.
Above and beyond being quite expensive, another possible outcome of unchecked tolerance is that Medical Cannabis eventually becomes less effective as a medicine. Then what? Going back to less effective prescription medications doesn’t seem like a particularly good option.
By now you have figured out that taking regular breaks from cannabis is a way to address tolerance. But what is actually happening physiologically? For that answer, we go back to cannabinoid receptors.
Just as the body produces fewer receptors in order to accommodate an expected level of THC in the system, it will begin producing more receptors as THC levels drop. By taking a break for 3 to 7 days, you are giving your body a chance to readjust. You’re giving your body the opportunity to start producing receptors again.
There are no hard and fast rules dictating how often you should take a break and for how long. A general rule of thumb among Medical Cannabis patients is to tolerance breaks at least once every three months. See our “Reset Your Tolerance” guide for details on getting the most out of your next tolerance break.
If you are a long-term cannabis user and you find that your consumption has increased to the point where you believe the drug is no longer helping you as it should, you might want to consider a longer break. It is not unheard of for long-term patients to take a break of up to a week or longer. Just be prepared to approach cannabis more slowly after your break is over. You’re going to feel the effects of the drug like you used to, so you don’t want to jump back in too fast.
Tolerance is a reality of Medical Cannabis use. It is also a natural biological function. However, it is nothing to worry about, and it can be managed just by taking regular breaks.
Episode 92 of Utah in the Weeds features Rich Oborn, the director of Utah’s Center for Medical Cannabis.
We started the episode with Rich’s thoughts on Utah’s 2022 legislative session, which resulted in a few changes to Utah’s Medical Cannabis Program. [02:28]
Senate Bill 190, sponsored by Sen. Evan Vickers, will prohibit over-the-counter sales of hemp products with a combined total of THC or THC analogs of 10 percent or more of the product’s total cannabinoid content. However, those types of products will continue to be available for sale at Utah’s cannabis pharmacies. [05:28]
SB 190 further clarifies packaging requirements for products containing synthetic THC, and it removes the prohibition of cannabis pharmacies employing convicted felons. [09:00]
SB 190 also adds “aerosol” as an approved Medical Cannabis dosage form in Utah. Rich says such products exist in other markets, but they’re expensive to manufacture. He doesn’t expect local companies to start making cannabis aerosol products right away. [15:22]
Another change in SB 190 will make it easier for cannabis pharmacy agents to work in Utah’s Electronic Verification System (EVS). [17:07]
Senate Bill 195, sponsored by Sen. Luz Escamilla, expands access to Utah’s Medical Cannabis program by requiring hospice programs to have at least one Qualified Medical Provider. It also adds acute pain as a qualifying condition, making cannabis available as a post-surgery pain relief treatment. [24:09]
Next, Tim and Rich talked about the current state of cannabis research, including an upcoming study to be funded by Utah. House Bill 2, an appropriation bill, sets aside $538,000 for a study on cannabis and chronic pain. [34:24]
Lawmakers did not approve “opioid use disorder” as a qualifying condition for Medical Cannabis in Utah. Instead, medical providers will need to consider a patient’s past drug use when writing a Medical Cannabis recommendation. As Tim points out, this is already a best practice for medical providers. [39:53]
Next, Tim and Rich talked about THC-infused drinks. Senate Bill 190 excludes “liquid suspensions” of cannabis branded as beverages. Tim estimates such drinks will continue to be sold in Utah until some time around November. Liquid suspensions of 30 mL or less will continue to be available. [44:37]
Senate Bill 195 also modifies the state’s advertising standards for Medical Cannabis, allowing cannabis companies to place more types of ads than previously allowed. [46:51]
Rich says Utah’s Medical Cannabis community is growing by about 1,000-2,000 new cardholders per month. At the end of February, there were 44,800 active cardholders registered in the program. About 30% of cardholders do not renew their cards. [52:15]
Next, Rich told us about some of Utah’s educational and informational resources on Medical Cannabis. The state has educational material for both patients and providers. There is also a website to monitor the cost of Medical Cannabis evaluations at clinics throughout the state. [54:55]
This year, the Utah Department of Health is developing an analysis of Medical Cannabis inventory across the state. UDOH will share the results of that analysis with industry professionals in an effort to identify and address any shortages for in-demand products. The Utah Legislature is also working on a governance study to analyze the administration of the Medical Cannabis program. [57:50]
Tim Pickett:
Welcome everybody out to episode 92 of Utah in the Weeds. I am your host, Tim Pickett. And today we have what is becoming our annual legislative update with the Department of Health Director of Medical Cannabis, Rich Oborn. Rich is here to discuss the updates to the legislation in the Medical Cannabis Program. And we will discuss in this conversation the hemp changes and the changes to the CBD and the over-the-counter hemp sales. What has happened with that? How we’ve been able to decrease the amount of THC or delta-8 in those products available to really be purchased by children, which increased patient safety. There was some controversy. And we talk about that as well. Talk about the advertising changes to the program and the added condition that has been added to the Medical Cannabis Program for patients. Is a great conversation, feel free to reach out and comment as this will be posted on YouTube with any questions that you have about the legislation, and we’ll answer them all.
Tim Pickett:
Other than that, subscribe to Utah in the Weeds on any podcast player that you have access to. We’re on all of the platforms. We release these, we try to release these every Friday at 4:20 AM. Last week, we took a little bit of a break and we’re back in the swing of things now. We’ve got a lot of updates coming up for you. The CEO of High Times and partner in Beehive Farmacy coming up in April. We’ve got a special episode coming up with my sister, who I’ve been teaching a little bit about medical cannabis with her condition. Just a lot of good content coming out. Season four of Discover Marijuana is also getting ready to launch in the next month. Of course, April and 420 celebrations are coming. Stay tuned and subscribe to Utah in the Weeds and enjoy this conversation with Rich Oborn. How was the legislative session? I mean, from a workload standpoint?
Rich Oborn:
Yeah, it was heavy I’d say. We had three bills that had direct impact on us. And in the past some time… I guess if I compare it to last year, I don’t think there was as many amendments that we were tracking within the bills. There were two bills last year that had some direct impact on us. And this year there were two main ones, but then there was the third one with SB 153, the medical cannabis governance structured bill. That was one that we tracked and were providing input on throughout the session.
Tim Pickett:
It seemed like this session, there was more work up front. There wasn’t as much work on changes at the back end.
Rich Oborn:
Right, right.
Tim Pickett:
Was that your experience?
Rich Oborn:
Yeah, yeah, yeah. That’s how it should be. We don’t like to see a lot of flurry of things going on at the end, because that’s when you don’t have time to think through things logically, right? You don’t want to see stuff put together in a rush as much as possible.
Tim Pickett:
Sure.
Rich Oborn:
Sometimes that happens no matter what, but… Yeah. Yeah. So, yeah, I’d say that’s a good way to say it. There was some work that went on at the beginning and there are a few tweaks we had to make throughout. And on most of those, we were able to get them in the bills. So that was good.
Tim Pickett:
Yeah. Now, as of this recording, Governor Cox has not signed the bills that we’re going to talk about today, but is there any chance he doesn’t really? I mean, there’s always a chance.
Rich Oborn:
I feel like if there was a possibility, I would’ve probably heard about it. Last year, you’re probably familiar with the bill that was vetoed that related to the hemp program, Department of Agriculture and Food and the Hemp Industry. And that was a big deal that it was vetoed. And so this year they’ve had some time to work on some things, and I don’t expect there to be a veto on any of the bills, including the HP 365, which was the one that related to the hemp issue primarily. But then there’s also SB 190 that does have some hemp components to it.
Tim Pickett:
Let’s jump into that one because it seems like, and I did a little update a couple episodes back of 190 and 195. But 190 was Vickers’ bill and that was the one that was primarily hemp. And it seemed like that was more to do with things that involved the Department of Agriculture. And then there was a lot of controversy over this delta-8 and even the naming of things, right? You can’t even name it. Let’s talk about this because it seems like there’s a lot in this bill that people were a little upset about.
Rich Oborn:
It’s a little more controversial.
Tim Pickett:
It is a little more controversial.
Rich Oborn:
Sure.
Tim Pickett:
So talk about this, what’s the change from what’s before with this delta-8 or over-the-counter psychoactive substances derived from cannabis, I guess? Is that a good way to put it?
Rich Oborn:
Yeah. Yeah. And I want to emphasize the Department of Health, while we are indirectly involved because we oversee the medical cannabis pharmacies that sell these products, the Department of Agriculture is more directly involved in the oversight of these hemp industry. And the Department of Health doesn’t have any jurisdiction over the hemp retailers and growers, but [inaudible 00:06:58] does. And so after December 1, 2022, hemp products in Utah cannot have a combined total THC and any THC analog that exceeds 10% of the total cannabinoid content. So if you’re comparing the different cannabinoids that are in a specific product’s profile, THC or an analog of THC cannot exceed 10% when compared to the other cannabinoids in that product.
Tim Pickett:
Okay.
Rich Oborn:
So that was a critical change. If you’re a hemp retailer, you would not be able to sell those products legally under state law. Medical cannabis pharmacies continue to be able to sell these products to medical cannabis cardholders within the medical cannabis industry pipeline. So it’s not like patients won’t be able to access these products, they will. But it’s only through-
Tim Pickett:
It’s just that the 16-year-old can’t go down the CBD store and buy it over the counter. But this is also added to the already 0.3% total weight.
Rich Oborn:
Right.
Tim Pickett:
Right. This particular piece, you could buy a 1:10 THC tincture, and this would fit that, right? It would have 10 times the amount of CBD than THC, and it would fit this thing. But you add to that 0.3% by weight, and now you have to have a Gatorade bottle full of liquid in order to have, I think it’s 6 or 10 milligrams of THC. So it really, really dilutes the ability to sell. Really they’re called PUCK gummies and they were being sold kind of all over the place.
Rich Oborn:
Yeah. Yep. And the basis of this was to help with product safety and patient awareness so patients are aware of the contents of the medication they’re purchasing. And in the medical cannabis pipeline, those type of products that the processors under SB 190, they’re required to ensure that the label identifies each derivative or synthetic cannabinoid as a derivative or synthetic cannabinoid. So the processor is required to be transparent about which of those cannabinoids are synthetic and which are natural.
Tim Pickett:
This is going to be good, I think, for that garage chemistry. And I’ve talked about this before that a lot of the delta-8 is made by some organic garage chemistry that leaves some byproducts. And I think this helps with the labeling, keeping bad actors out of the market essentially.
Rich Oborn:
Right. And there are some additional restrictions that the Department of Agriculture and Food places on processors in the medical cannabis industry when compared to the hemp industry. And so I think that’s critical to keep in mind that these are medications, and there’s a rigorous scientific approach to these products. We don’t want to have people compromise their medical condition or their safety by consuming products. And so as a regulator, I know the Department of Agriculture does what they can to ensure that those patient protections are kept in mind as there’s different tests for contaminants and different tests are run to ensure that the ingredients of the products are actually what they claim to be on the labels. And also that there’s no misrepresentation or misunderstanding about whether a cannabinoid is synthetic or not. So that’s something that’ll be new that we’ll be rolling out with SB 190.
Tim Pickett:
So that includes the… Does that include the Medical Cannabis Program too that they’re now going to be required to label synthetic versus derived cannabinoids? In most of the packaging that I see, they’re already labeling it as such.
Rich Oborn:
Right. Right. I think that’s important to emphasize is that they’re already labeling it as such, but this just clarifies the law in relation to medical cannabis processors and pharmacies that there’s this more clear requirement that that label must identify whether that cannabinoid is a synthetic, when it is a synthetic. So you can still purchase THC products that are synthetic THC, but when you do that, you’ll be informed on the label that that’s the type of product you’re purchasing. And there were processors that were, I think, already doing a good job of that, but this just clarifies the law, makes it so-
Tim Pickett:
It standardizes it.
Rich Oborn:
… Right.
Tim Pickett:
So this was passed really as a patient safety and a consumer safety issue, the delta-8 controversy and having young people being able to buy psychoactive products that were potentially dangerous to their health. So personally as a provider, I like this. I can see there was some arguments about low income folks not being able to access their medicine. And this helps people go into the… It kind of forces some of those people into the medical market, but that’s… And I mean, it increases patient safety overall. And so I tended to support this piece despite the controversy of it.
Rich Oborn:
Yeah. And I think there’s some things that the legislators are doing and also private entities are doing to make medical cannabis more affordable in Utah. I think the ideal is still not in place, which would be that insurance would be able to help someone purchase this type of medication. But while we wait for the Federal Government to take action on that, I think there’s some good options out there. Although we know everybody maybe is not aware of those options. And so I feel like private identities, they can take it upon themselves to share information about the options that are out there to get help for making the medication more affordable to them. And it’s great to see that entities are stepping up to play that role and people are willing to donate money to assist others in affording medication that’s not as affordable as other medications.
Tim Pickett:
Right. So still staying on this SB 190, there was another thing with felony convictions. If somebody had a felony over 10 years ago, they weren’t able to work in a medical cannabis pharmacy before, but now that’s not prohibited. That seems like a really good idea.
Rich Oborn:
Yeah. And that was actually something we had contacted lawmakers about. We had a case or two come up where we did have to deny an individual from being able to obtain a pharmacy agent card because of the fact that they did have a felony. And there was this prohibition of any employee of a medical cannabis pharmacy having a felony of any type and it didn’t place a timeframe on it. So the law’s been amended to allow for that. And I think that’s a step in the right direction. Although if you do have a felony within the 10 years, it can still stop somebody from getting a pharmacy agent card. Having a felony within 10 years doesn’t prohibit you from getting a pharmacy agent card. It’s a factor that the Department of Health considers.
Tim Pickett:
Yeah. And then we added some dosing forms, inhaler, nasal spray, nebulizer. I mean, I can see the nasal spray for sure. That actually is a product that I’ve heard that a few people are developing. But the nebulizer and the inhaler, I don’t know of any products out there even in other states that are that type of delivery system, like an albuterol inhaler, right? Or a meter dose inhaler.
Rich Oborn:
Right. They exist, but they’re not that common because they are expensive to manufacture. That’s my understanding. And so we don’t expect any companies to be chomping at the bed to do this immediately. But as I think the program matures, it’ll be a possibility and a processor could decide, “Hey, we feel like there’s a market for this. There’s enough patients that are asking for it.” And it would begin to be a legal dosage form [crosstalk 00:16:28].
Tim Pickett:
It’s extremely useful from a meter dosage in an inhaler form is one of the big problems with moving inhaled cannabis products into the traditional medical market because it’s just hard to dose, right? There’s only very few products that will measure the amount you inhale and they’re $300. And so meter inhaled product, while you’re right, I’m sure it’s really expensive to manufacture. From a medical standpoint, it’s going to be nice. I could think of a lot of patients who could really use it. And then there was this technicality change in 190 where they had EVS… The pharmacy agents couldn’t access the EVS, only the pharmacist could. And I remember thinking, “Oh, that’s interesting because our MAs can access EVS as a proxy.” So this codifies that with 190 and allows them access. Are they going to act as a proxy or do they just have visual access or is that something that the department is kind of yet to determine?
Rich Oborn:
They will have their own role within the electronic verification system. And for those of you who don’t know what that is, it’s the system that… Is the patient registration system that pharmacies rely on in order to verify if someone has a medical cannabis card or not. It’s also the software that a medical clinic and a QMP, qualified medical provider, uses to make a recommendation for a specific patient to receive a medical cannabis card. So pharmacy agents that work every day in the medical cannabis pharmacy, who make up the majority of the employees at a medical cannabis pharmacy, they’ll begin to have access to the EVS. And the way that’s being set up is that a pharmacist in charge for the specific medical cannabis pharmacy location will be able to authorize agents. There will be some agents that the pharmacist in charge may decide should have that access to edit and to view that information.
Rich Oborn:
But there could be some pharmacy agents that really have no role in the EVS they do. They maybe just have a niche in the pharmacy of a certain type that doesn’t require that they get access to the EVS. So that’ll be something that a pharmacist in charge, the PIC, would would determine for a specific location. And so it’ll take some time to work without [ vendor 00:00:19:13] and execute this change in the EVS, but we’ll be engaging with medical cannabis pharmacies and the pharmacists who work there and pharmacy agents on how this is set up and we’ll get their input and ensure that we inform them of when it’s an [ in production 00:19:31] and actually able to be used by pharmacy agents. And one thing that’s coinciding with this requirement is that pharmacy agents will begin to have to complete continuing education course on confidentiality and the protection of patient information.
Rich Oborn:
And I’m sure that there are some pharmacy agents that are already generally familiar with HIPAA and protection of confidential medical information, but there could be some that have no clue about it. So it’s important that anybody that works in a medical facility like a medical cannabis pharmacy has at least an intermediate level training on protection of that information and how patient information must be safeguarded. And how, for example, in the EVS, it would never be appropriate to search for a neighbor’s name in the EVS if they’re not a patient. You have no business doing searches like that in a medical type software like this. And other medical facilities have these same standards. And so these standards also apply to medical cannabis pharmacies, although they’re still selling a federally illegal product.
Tim Pickett:
Right. Yeah. But in the normal pharmacy down the street from me, I mean, all of the techs are all going to have some HIPAA training. They’re all going to understand the privacy, the confidentiality. That’s just standard. And I knew that that was one of the reasons why the pharmacy agents didn’t have access before. And so it’s nice to see because there’s an issue frankly with… There was a little bit of a weird thing where the pharmacy agent couldn’t transfer the dosage recommendation from a provider into MJ Freeway because they couldn’t access EVS. And it was kind of a big logistical kind of thing where it brought this up, or it was one of the things that brought this up as something to kind of solve.
Rich Oborn:
Right. And one of the plans we already had in place, regardless of what happened during the legislative session, was to have an integration of information from the EVS regarding the dosing recommendation be sent to the MJ Freeway software. So a pharmacy agent wouldn’t have to go to the EVS to get information about the recommendation. They’d be able to view that within the MJ Freeway software that they use for their patient profile and purchases and point of sale system. So that was already in the works. But this, I think, is just another way that a pharmacy will be able to be efficient in helping customers and supporting them and having a good experience there at the medical cannabis pharmacy as they come in.
Rich Oborn:
One thing that I want to point out though that’s critical is that there will be information regarding a QMP’s notes that they have. Potentially a QMP may want a pharmacy to be aware of a specific patient’s treatment history or medication history. And that type of information, it’s the option of the QMP to pace that into the software. And they would need to advise the patient of this choice they’re making to share this information with an outside party at the pharmacy. So there’s patient consent needed in that type of a case, but there are many QMPs that do choose to keep the pharmacist informed of the other medications that the patient is taking and some details that they feel are relevant about the condition. That helps the pharmacist make the decision about what specific product may be the best for treating that specific condition.
Rich Oborn:
So the pharmacy agents will have access to that information. It’s sensitive information, and we need to treat it as such. And so it’s important that the pharmacy agents go through the training and learn more about how to ensure that they provide the best service to patients as they protect the confidentiality of their medical information.
Tim Pickett:
Let’s switch over now to… That’s a lot of the big items kind of in SB 190, the bill that was kind of on Senator Vickers’ side. Senator Escamilla, she was the one who put out SB 195. That has to do with the Medical Cannabis Program a little bit more on… There was some additions to making the program a little more inclusive. We’re making the general medical community more inclusive of the program. One was the addition of the… If you run a hospice program, you have to have at least one medical provider that’s registered in the system as a QMP.
Rich Oborn:
Right.
Tim Pickett:
I thought that was kind of an interesting addition.
Rich Oborn:
Yeah. The requirement does not begin until January 1 of 2022, or excuse me, 2023. But, yeah, every hospice program has to have at least one medical provider registered with the Department of Health to recommend medical cannabis to patients. Now, one thing that’s critical though is that if the facility accepts federal or insurance money, they would want to consult with their legal counsel and third party reimbursement to determine if the facility may allow for delivery and possession of a federally illegal drug while they’re in that type of a facility. So although they have to have at least one medical provider that is registered as a QMP, there are some things that they should be aware of as it relates to reimbursement of funds from a federal source or insurance money. This doesn’t mean that they are obligated to recommend medical cannabis at that facility. It just requires that they have a qualified medical provider registered with the Department of Health that would be able to do it if they chose to.
Tim Pickett:
And this is every hospital, hospice facility, nursing home, or not in the state?
Rich Oborn:
Well, it’s hospice program. So there’s only so many of those, it’s a specific type of facility. It’s a hospice program that must have at least one medical provider registered with the Department of Health as a QMP. Okay? But then a separate requirement is that an assisted living facility, a nursing care facility or a general acute hospital, the law was modified to allow them to receive deliveries of medical cannabis products from a medical cannabis courier for a patient who is a medical cannabis cardholder. But if that facility accepts federal insurance money or insurance money, I would think that they should consult legal counsel about third party reimbursement because there could be some specific guidance from the federal agency regarding acceptance of those types of products, because they are still federally illegal.
Tim Pickett:
Yeah. Because the idea is that you might have a employee of the facility receive these products in order to hand them to somebody else. And that action of receiving the product is essentially an action of receiving a Schedule I drug. So we need to make sure that that’s on the… You need to talk to your lawyer for sure.
Rich Oborn:
Right.
Tim Pickett:
This kind of goes along with the, and I don’t know if we have this, this kind of goes along with this same idea that we are going to allow schools. There was some clarification on the school system being able to store medical cannabis for a patient that was in the school system. Not that the employee of the school would then handle that if they needed to, but it’s allowed from state statute.
Rich Oborn:
I’m glad you brought that up because that was taken out of the bill.
Tim Pickett:
Ah, because I heard the committee meeting and I heard Senator Escamilla kind of defend that. And there was some very interesting questions, right? One of them was, so basically, are we going to just let this child show up with it in their backpack? And I know of cases where the school district is questioning this because they have a child with a condition and a card. This is a real sticky situation because you want the child to have access and you want the schools to be protected. And by the way, I would mention that schools are like pharmacies. They have a ton of medications that they deliver in store for other conditions, right? This is not something that’s not done, right? We have controlled substances there for children who need them.
Rich Oborn:
Right. But they’re also federally funded.
Tim Pickett:
Yep. So they pulled that out.
Rich Oborn:
They did.
Tim Pickett:
So as of now, the child would essentially need to be removed from the school property to dose their cannabis with their caregiver and then be brought back to school.
Rich Oborn:
Well, I think a general approach would be ensure that you vet this with legal counsel and the school authorities, the school district. There could be some school districts that handle it differently than other school districts. I can’t speak for them, but yeah.
Tim Pickett:
Yeah. I’m glad we talked about that because I thought that had stayed in, but it hasn’t. So that’s good to know. The other thing that was interesting to me is we added acute pain as a qualifying condition. So this means that a person who is about to get a knee surgery, if the provider, the orthopedic surgeon says, “You know what? This is going to cause a lot of pain. I don’t want you on as many opioids and I’m going to offer to recommend a short term card.” Am I thinking of that correctly?
Rich Oborn:
Yes. So any cards issued with acute pain as a qualifying condition, they will always expire after 30 days. Just as when a medical provider prescribes opiates for a limited duration because of a surgery, it’s acute pain. So they’re not going to prescribe opiates for a long period. It’s for a specific condition of some acute pain that’s coming up because of that surgery. So, yeah, a medical provider would generally prescribe opiates for limited duration, but now they’d be able to recommend medical cannabis as an alternative to opiates. And we expect that medical providers will exercise this with great discretion and in cases where they feel like it would be a better alternative medically for a certain type of patient. They’re now able to have that as an option.
Tim Pickett:
So these two things we’ve just talked about, the hospice and this acute pain thing, this doesn’t sound like something that the Department of Health they were… It sounds like this was something that you were told was going to be proposed in the bill and not something that the Department of Health would’ve had a horse in the race, so to speak.
Rich Oborn:
Right. I mean, there’s certain things where we contact the legislature and we see if they might be able to tweak something that we feel would help promote public health, very rarely do we come out in opposition to specific provisions publicly. And so we’re just typically neutral on some of those provisions that maybe don’t have as much evidence as others for being an effective type of treatment. And then we’re responsible to execute the laws that are passed by the legislature. So we want to ensure that they’re implemented in a way that’s fair and easy for patients to take advantage of if their provider chooses to recommend them.
Tim Pickett:
You’ve done a very good job of… I’ll shoot an opinion here about this particular qualifying condition. I personally think this is kind of silly. I can see why an advocate would propose this condition. As a provider who recommends cannabis, I think that 99.9% of the time, if you’re getting your knee replaced and you need a 30 day card, you certainly qualify for a medical cannabis card in the original system. And evidence with acute pain is different than evidence with chronic pain, but there you have it from Tim and I’m not a employee or a regulator. So I get to voice my opinion a little bit more freely about this one. I like expansion of the program; that I’m certainly for. I think this was kind of a funny one myself.
Rich Oborn:
Yeah. We just hope it’s exercised with wisdom and that providers are careful with how they exercise it, just as we hope with every other type of recommendation they do what we hope that they-
Tim Pickett:
And it will be good to study… This will be a unique thing to kind of study how many of these are issued? What’s the progress? How many of these cards get converted to a regular longer term card? What’s the success of reducing opioids after surgery? We could design some really interesting studies around that. And in fact, not to skip through and go right to the bill that funds a study, there was a bill that funds a study.
Rich Oborn:
… Right. Yeah. So Senate Bill 2, that was a big appropriation bill. And in that bill, the legislature appropriated $538,000 to fund a study of medical cannabis and chronic pain. And that was proposed by representative Ray Ward. And the Department of Health was able to provide some general thoughts about how that should be done, and we’re working out details of that. But it’ll be done through an RFP process where academic researchers at universities have an opportunity to bid on receiving these funds. But we’re very serious about funding research, and we’re excited about the legislature having an interest in doing it. And so we want to ensure that it’s done in a way Utah can be proud of, that can be shared with other states and help them learn as well as we move forward with trying to understand more about medical cannabis and its impact on chronic pain, without federal funding. It’s not easy without getting federal grants to do research.
Tim Pickett:
Is $538,000 a large amount for a study, a small amount? Do we have perspective on that?
Rich Oborn:
That’s a good question. It depends on what type of study, because there’s double blind studies that really cost thousands more than that of dollars beyond the $538,000. So this won’t be something like that. It’ll be something on a lower scale, but it will still be, I think, something that researchers and providers in Utah and outside of Utah will find helpful. We want it to be not just something that’s tucked away, but is something that providers can learn from and patients can learn from and pharmacists at the medical cannabis pharmacies can apply to work they’re doing. Although, we defer to those studies that have a lot more funding that are published as studies that just have more resources to do something that’s even more extensive. Those are exciting to see, and we hope to see those happen even more outside of Utah. We see some of those in other countries, Israel and Canada, or to the countries that we see them more in than within the United States.
Tim Pickett:
Yeah. And I’m interested in why, I know Ray Ward was very interested in getting a little allocation for some research to be done. There was talk about whether to research a condition like this, or to research the program itself and how it was working. So it’ll be interesting to get this process started. I think there’s a ton of research on cannabis. I find it interesting that the medical community still says, “Oh, there’s no evidence” when there’s thousands of studies being done. Like you say, Israel and Canada has some fairly decent, if not excellent, research on some of these things already. But Utah is unique. We like our own programs, right? We like to see things done our way, and this is the beginning of doing that. It’s kind of a culture thing, I think. We like to see ourselves.
Rich Oborn:
Yeah. I think most people agree though is that when you compare the studies done on other drugs to those on cannabis, there is more of a volume of studies of scientific rigor on other types of medications that we don’t see on cannabis yet. There’s just a bigger volume. So it’s just the nature of dealing with a federally illegal drug that there’s not as much research on it, even if you add the research in other countries. So that’s one of the sources of some of the reluctance of some providers to join in and make recommendations regarding medical cannabis. There’s been some good literature that has taken a look at studies not just in United States, but these other countries.
Rich Oborn:
And even combining all of that, there’s still some weakness when compared to other drugs. So I think that that’s important to keep in mind. I don’t want that to take away from some of the, I think, positive experiences people are having with medical cannabis as they treat their medical conditions and finding more success in treating their conditions with medical cannabis compared to other drugs. We don’t want to take away from those experiences and Utah law allows for those experiences to happen legally, which is great. But we still want to be able to continue to add to the evidence out there regarding treatment of A, B and C condition with medical cannabis.
Tim Pickett:
In a really rigorous way, I agree. There’s not comparison studies and the double blind studies, and there’s a huge amount of inclusion bias in cannabis studies, which is always kind of an issue in medicine. So when we added a little bit of history, they weren’t able to get opioid use disorder as a condition. So it seems like we compromised or the advocates kind of compromised here and added this language that we’ve got to now consider the patient’s qualifying condition history of substance use or opioid use disorder when we’re doing this. This seems like something we’re already doing, but-
Rich Oborn:
It should be. Right. Yeah.
Tim Pickett:
… This should be something. If they have opioid use disorder, this would be a reasonable alternative to opioids.
Rich Oborn:
Well, I think the purpose of this amendment to the law is to have a medical provider be more careful in their consideration of a recommendation when they learn about a patient’s history of substance use or opiate use disorder. Because there are some studies that find that individuals that have those conditions, that they have the propensity to overuse medical cannabis in some cases beyond it’s medical purpose.
Tim Pickett:
Yeah.
Rich Oborn:
So [crosstalk 00:41:20] interacts with those disorders. And there’s some studies done that show that it actually exacerbates or makes them worse when used in the wrong way. So it’s important that there be a screening done. I think this is the best practice and people ask, “Well, what’s screening?” Well, there’s a few types of screenings that are out there. People that work at these type of facilities are very familiar with the types of screenings and different types you do. But as a medical provider, it’s just important that there be an awareness of the patient’s substance use or opiate use disorder history if there is one. And if there is one take, take a step back, consider whether recommending medical cannabis should still be done in light of that patient’s condition.
Tim Pickett:
Yeah. I’ve had patients who we have removed their ability to access all forms, right? Reduced it to… Been asked by a patient frankly to reduce their forms to only topicals because they were having trouble, they were spending too much money, consuming too much, had a history of addiction to other substances. And it’s… Yeah. I do think it’s real. I think there’s about a 9%, I think the statistics are between 8- and 9% of cannabis users can become addicted, which interestingly is just barely below the number for opioids. But I think that just goes to show that people get addicted to things. They like… Humans, we like the dopamine.
Rich Oborn:
Right. And I think researchers out there have said there’s little evidence that it works as an effective treatment of substance use or opiate use disorder. There’s mixed results in the studies that show that. And in fact, there’s some studies that show that it makes them worse. So we want to see providers take a step back, consider that recommendation in light of the patient’s qualifying condition if they have a history of substance use or opiate use disorder. This is what a provider does when they recommend controlled substances outside of the Medical Cannabis Program for other drugs that are federally illegal, they consider, “Okay, how does this drug impact these other conditions that this person may have, right?”
Tim Pickett:
Yeah, we’d even call other providers and say, “Hey, I’m about to prescribe your patient or our patient now. When you’re a specialist, we’re going to add this to their drug list. And what do you think? The neurologist, the psychiatrist.
Rich Oborn:
Right.
Tim Pickett:
Create more of a team approach. I like the idea. I think it does create a little bit of increased liability on the provider to make sure that they’re doing their due diligence. And so providers shape up, right? Let’s see. Oh, the drinks. I keep getting emails about the drinks. When are the drinks going away? When are the drinks going away? So currently you can buy a drink, you can buy a Seltzer, you can buy something in a can, there’s a few of these around, and we’re going to take that back down to 30 MLs. So basically a tincture bottle or a little oil bottle. There was some controversy on this too.
Rich Oborn:
There was. And I think I can’t speak for policy makers, but naturally they weigh benefit and harm. And they decided there was more risk to liquid suspensions being above 30 milliliter than there was benefit. And I think it’s easier to abuse the use of a medical cannabis liquid suspension when it’s above 30 milliliter-
Tim Pickett:
Yeah. And I’ll say it, I mean, a can of spiked Seltzer with THC in it just looks wreck. It just looks more recreational as a product than a tincture oil, or even a Select Squeeze where Curaleaf makes that drink additive. Even that looks less recreational or [ adult 00:00:46:05] use than a four pack or a six pack.
Rich Oborn:
… Sure. And you don’t typically see from a Walgreens, you don’t go to the pharmacy and purchase a liquid suspension to treat the types of conditions that are [crosstalk 00:46:23] conditions in the state of Utah.
Tim Pickett:
NyQuil doesn’t come with a can that you crack open.
Rich Oborn:
Right. Right. Yeah. There’s a reason why it is the way it is. It’s for patient safety.
Tim Pickett:
Sure.
Rich Oborn:
So same goes in this respect.
Tim Pickett:
Patients have until the end of November. Basically Thanksgiving, folks. They’ll maybe be on the shelves till then, but I doubt they’ll make any more of them. I bet they just clear out their inventory and then that’s kind of it.
Rich Oborn:
Right. Yep.
Tim Pickett:
Let’s talk about advertising because this was something that got changed a little bit, not a ton. I see you’re getting out your cheat sheet here because this is wholesome co-delivery, doesn’t the delivery third party… Explain the advertising changes.
Rich Oborn:
Yeah. So I think there was a lack of clarity in the current law and with these bills that goes it into place with SB 195, there’s more clarity as it relates to advertising and the limits that are placed on medical clinics and medical cannabis pharmacies. And so the law states that a medical cannabis pharmacy, they’re able to advertise in any medium. So there’s no longer restriction on the type of medium they can use for advertising. In the past there was, but with SB 195, there will not be. But they’re able to include information in their advertising such as a service available at the pharmacy, the best practices that the medical cannabis pharmacy upholds, education materials, they can advertise those obviously. That’s important.
Rich Oborn:
And their inventories, they can advertise their inventories obviously. And a medical cannabis pharmacy may provide information regarding subsidies for the cost of medical cannabis treatment to patients who affirmatively accept receipt of the subsidy information. So all those things are really important. Pharmacies will be able to do those things, some of which they could not do in the past because they were restricted in the type of mediums that they could engage with patients in. So that, I think, will have an impact on patients for the good. There’ll be information that’ll be more accessible about education materials and best practices that the medical cannabis pharmacy upholds. So I think it clarifies some of that.
Tim Pickett:
You’re not passing out coupons at the county fair, right? You’re having to essentially be a patient and opt in to those communications to receive a coupon, a subsidy program.
Rich Oborn:
Right. Right. So a pharmacy would not be able to advertise promotional discounts or incentives. They would not be able to advertise a specific medical cannabis product in their advertising. And they would not be able to advertise an assurance regarding an outcome related to medical cannabis treatment, for example. Those are some things that they would be prohibited from doing. So those are some of the advertising limits that will be in place under SB 195.
Tim Pickett:
Yeah. I think that clarity is somewhat helpful. We’ve already run into it with utahmarijuana.org with billboards and [ reagan 00:00:49:56] and everybody’s kind of trying to shift and adjust and making sure that everybody’s in compliance. And so I’m sure you’ll have a lot of questions coming up. In fact, I was talking to Cole today who was like, “Oh, you’re talking to Rich, ask him about the advertising.”
Rich Oborn:
One thing that I think is great is that a nonprofit that offers financial assistance for medical cannabis treatment to low income patients, they may advertise the organization’s assistance if the advertisement doesn’t relate to a specific medical cannabis pharmacy, or a specific cannabis product. So there is this emphasis on allowing the nonprofits to do that.
Tim Pickett:
Yeah. I don’t know that you can register a 501(c)(3) related to cannabis yet, but certainly our uplift program that subsidizes low income Medicaid and terminally ill patients was one of the things that I know the lobbyists and the activists kind of made sure to mention to the legislators that said, “Hey, we’re bringing people through the program who can’t afford it because it is costly for a lot of people.” And the program essentially was designed for these low income folks and terminally ill and really chronically ill patients. And yet there’s a bunch of them who can’t afford to even get into the program as it is. So helping those patients, it’s been surprising how interested the growers, retailers, processors are in giving back to those programs and subsidizing that, which kind of, I don’t know whether some people think it’s ironic, right? That they’re using their profits to help subsidize the poor. But on the other hand, you kind of have to have fire… The cashflow is fuel to the fire. This thing has to run.
Rich Oborn:
Yeah. And so we’ll be working with the industry on putting together some additional standards and rule that relate to some of these advertising standards that are in the statute. We’ve got some authority to do that. And so we’ll be reaching out to get some of that input.
Tim Pickett:
Cool. So let’s talk about the growth before I let you go. What are we up to cardholder wise?
Rich Oborn:
Yeah. So as of the end of February, we were at 44,800 active medical cannabis cardholders. And that represents a growth of, I’d say, between 1000 and 2000 cards per month new active medical cannabis cardholders. And so we’ve seen a steady rate of growth happen, which is good to see, although we know that medical cannabis isn’t for everybody. And so when we did an analysis, we found that there was about a 70% card renewal rate. And there’s lots of reasons why people would choose to renew their card. And a lot of reasons why they may not choose to renew their card. They may find that, “Hey, medical cannabis isn’t working for me, but these other medications do or these other treatments do. So I’m not going to renew my card. I’m going to work with my provider on these other medications or treatments that are looking better for my chronic pain.” Because, like anybody, people just don’t want to buy something. To buy it, it’s expensive. So also-
Tim Pickett:
Yeah, and I know cost is a significant answer we get when people let their card lapse. Cost of the QMP visits, cost of the product, whether or not all of that’s justified or not, that’s just a big reason people leave the program.
Rich Oborn:
… Right. One of the most critical things that the Department of Health has been implementing just recently is the limited medical provider recommendation program. And there have been approximately 50 limited medical provider recommendations since January 19th, 2022, when it was launched. And these are providers who are not registered with the Department of Health, but who choose under the state law to recommend medical cannabis to up to 15 other patients.
Tim Pickett:
There’s something like 16,000 controlled substance license holders in Utah, right?
Rich Oborn:
Right.
Tim Pickett:
Available for the limited medical provider program.
Rich Oborn:
Right. Any MD, DO, APRN, PA or podiatrist falls under that. And so we’ve seen just a steady growth, but it’s been a slow growth just because naturally it takes time for providers to feel comfortable, I think, with a new program. And so we’ve done some webinars just recently. We’ve done four webinars since January to help providers who are interested in learning more about limited medical providers and how they can recommend cannabis in an easy way. There’s information on our website that a patient could direct their regular physician to if they wanted their physician to explore that possibility of recommending to them and making them one of their 15. And so that’s one thing that I think is helping patients make a medical cannabis visit more affordable because in some cases, in the past, there have been some clinics that I think have been charging a lot more than other clinics for a similar service.
Tim Pickett:
I did a podcast and the guy’s in the $5,000 range over the two years because of a clinic that was having him come up every 90 days for 400 bucks. It was the worst I’d heard about, but there still are. And now there’s a website people can go to where they can see a little bit of this. They only see the cost, but there is a website where people can look at the initial visit cost, right?
Rich Oborn:
Right. So policy make were listening and they thought this is not right. We need to do something. So they created this limited medical provider program as just one strategy to address this concern. A second strategy was to require that the Department of Health work with the state auditor’s office on gathering data from all the medical clinics that have QMPs who advertise publicly that they offer medical cannabis evaluations, that they report those fees to us that they charge. And that those fees be posted on the state auditor’s website. And so we’re getting about 200 to 400 visits a week to that website, which is a good sign. We like to see that people are using it. And this is not just for people that are wanting to get a medical cannabis evaluation for the very first time. But it’s for those that have been in the program for a long time.
Rich Oborn:
Maybe they joined in March, 2020, and they, at this point, are ready to just learn more about what some other clinics are charging and they want to compare some of those costs. And as you know, Tim, there’s different reasons why clinics charge different fees. Some clinics take more time with their patients and maybe have more training than other providers do on a particular subject related to medical cannabis.
Tim Pickett:
Yeah. Not a bad place to start your search. Definitely not a place I would say to end your search in who to go see.
Rich Oborn:
Right.
Tim Pickett:
But more information is always better.
Rich Oborn:
Right.
Tim Pickett:
What’s some of the plans for 2022 in the program that the Department of Health has?
Rich Oborn:
Yeah. So one thing that we’re excited about is putting together an analysis of medical cannabis product inventory across the state. And I think there’s from some concern about not finding a certain type of product in Utah, and we want to be able to do an analysis that actually relies on some of the actual inventory available across the state to really see if some of those concerns are valid. And then we want to share that analysis with clinics, with pharmacies, with the industry in hopes that they would find creative ways to address some of those gaps that may exist throughout the state.
Tim Pickett:
Yeah. We’ve heard of those where we’ll send a patient for a certain product and then it’s not there. But, yeah, it’d be very interesting to know and be able to kind of look at whether or not that’s really true.
Rich Oborn:
And we understand there are some unique conditions that people suffer from that require unique types of products. And so there may not be a market right now in our program, but as the maturity of the program increases and there’s more patients, there may be a market in a year or two for certain types of products to be worth it for a processor to manufacture such as a breathalyzer or something like that.
Tim Pickett:
Yeah.
Rich Oborn:
We also want to do additional outreach to medical providers, medical clinics and stakeholders to ensure that they’re receiving accurate information about the laws in Utah and also best practices. And there’s some great information in a publication that the Cannabinoid Product Board has put together that we feel is underutilized and could be, I think, shared more universally and distributed with providers. And we want to share it in a way that’s easy for them to digest and it’s not complicated. So I think we’ll do some additional outreach. And we’re excited about those plans. We’ll be helping lawmakers with a medical cannabis governance study during the next year. There was Senate Bill 153 in the past that required that lawmakers put together a committee that will study the feasibility and the benefits, potential benefits, of having the responsibilities of the Department of Health under a single agency with the responsibilities of the Department of Agriculture and Food.
Rich Oborn:
And other states have that type of a governance model where it’s all under one single agency. And there’s reasons why that could work, there’s reasons why it may not work, but legislature wants to do this study and we’re happy to help them conduct that. And they plan to include not just us in it, but I think even more importantly, patients and providers in the industry and getting input on how things are put together long term. And the legislature plans on putting together this study and conducting it. I think the deadline is October 2022. And then potentially taking action, legislative action, during the legislative session of 2023 that the study has recommendations that lawmakers want to take action on.
Tim Pickett:
Sounds like you got a busy year, and you got to upgrade the EVS system.
Rich Oborn:
Yes.
Tim Pickett:
Right?
Rich Oborn:
Yeah. I know that’s something that’ll impact pharmacies quite a bit and also providers in clinics as they are the primary users of that system. And we want to make things just easier for people to get access to information so they can spend more time with patients and help them get through some of the things they’re dealing with with medical conditions. And we want patients to be able to just have better access to the counseling that’s available at the pharmacies. And sometimes it starts with improving the softwares that they use to allow for more time that they can spend one on one with the patient. So that’s one goal we have.
Tim Pickett:
Well, there’s a lot that’s updated. This has been a great conversation. I think we’ve gone through a lot of this stuff that people will be interested in hearing about. If you’re not subscribed to Utah in the Weeds, you can subscribe on any podcast player that you have access to. Anything else we’re missing?
Rich Oborn:
No, that was quite a bit. We’re excited that [crosstalk 01:02:59].
Tim Pickett:
Last year we ended up taking a long time as well. So this is turning into our annual legislative update with Rich Oborn, the Department of Health Medical Cannabis Program Director. And appreciate your time today.
Rich Oborn:
Yep. Good to chat with you, Tim.
Tim Pickett:
All right, everybody. Stay safe out there.
Like just about any other drug, Medical Cannabis does have its side effects. They are numerous, and patients react to them differently. Some experience only a few while others many more. The one thing to remember is this: it is important to speak with your Qualified Medical Provider (QMP) or Pharmacy Medical Provider (PMP) about any side effects that you experience.
Your provider is the most qualified person to help you understand why you are experiencing particular side effects. Likewise, working with your provider to find solutions is the best way to minimize any side effects that you find uncomfortable.
For the record, here are some of the more common issues associated with using Medical Cannabis:
None of the side effects are considered medical emergencies. If you experience them, it is not the end of the world, but seriously consider discussing them with your provider. Here are five reasons that might encourage you to do so:
If you have been using Medical Cannabis for any length of time, you know that the variety of products only continues to grow. There are never-ending strains along with different delivery methods to choose from. As it turns out, certain side effects may be an indication that you are using the wrong product.
For example, you may notice that THC makes you nauseous while not providing as much relief as you had hoped. Your provider might recommend you use CBD instead. Or perhaps THC is really what you need, but vaping is not the best delivery method. Your provider might recommend an edible instead.
In addition to potentially using the wrong product, certain side effects could indicate that you are using the wrong dosage. Your provider can help you figure that out. To make things easier, track your usage on a regular basis. Your provider can use tracking data to help adjust your dosage accordingly.
We have all talked to people who have stopped using prescription medications because they did not like the side effects. The same thing can happen with Medical Cannabis. But discontinuing use of your medicines is like throwing the baby out with the bathwater. It may not be necessary. Your PMP or QMP might be able to help you adjust delivery method and dosage to alleviate side effects. You don’t necessarily have to stop using the drug.
Some Medical Cannabis patients do not experience maximum relief because the side effects they are experiencing are much stronger than they should be. It’s a shame when it happens. Why? Because Medical Cannabis is supposed to bring relief. If a patient is not experiencing maximum relief, the whole point of using the drug is negated.
Finally, some side effects might suggest that you’re using too much cannabis. Maybe you are not sure of the best dosage for your circumstances. Perhaps you are a long-term user starting to develop significant tolerance. Whatever the case might be, it is important to reduce your cannabis consumption to a level more appropriate to your situation.
Side effects are normal with any drug, including Medical Cannabis. If you are experiencing side effects yourself, make a point of discussing them with your provider. There may be ways to alleviate them and increase the effectiveness of your medications at the same time.
There are a lot of cannabis-related phenomena that, up until recently, were things people just talked about behind closed doors. But with cannabis legalization spreading across the country, some of these phenomena are starting to come out of the closet. One such phenomenon is known as the “cannabis shakes.”
Anecdotal evidence suggests that the cannabis shakes are legit; people really do experience them from time to time. Perhaps you have. At any rate, the cannabis shakes are not dangerous. Yes, they can be uncomfortable and a little disconcerting, but shaking after consuming cannabis is not likely to harm you.
We know from the testimonies of Medical Cannabis users that the shakes are legit. Unfortunately, we don’t know what causes them. There hasn’t been a whole lot of scientific research into this particular phenomenon. That is going to change at some point but until then, we can only offer some educated guesses as to why some cannabis users experience the shakes.
The Cannigma website recently published a great post talking about the cannabis shakes. They offered a number of possible causes:
Animal studies have demonstrated that THC can cause a drop in body temperature. The same thing has been observed in human beings as well. So if that’s the case, even a slight drop in body temperature would make a person feel cold. That could be enough to induce shaking.
As a cannabis user, you might be so preoccupied with the shakes that you don’t realize you feel cold. Figuring it out would prompt you to grab a blanket or throw on a jacket. As you warmed up, the shakes would go away.
Some people experience mild anxiety when using cannabis. For others, the anxiety could be significant enough to cause shaking. It is really not all that different from being so angry that you’re shaking, or even being so scared by something that you get the shakes. It’s just your emotions getting the better of you.
It is possible that some people get the cannabis shakes because they combine their Medical Cannabis with other stimulants. For example, have you ever heard people say they avoid coffee because it makes them jittery? The caffeine in coffee is a stimulant. If you were to experience the shakes first thing in the morning, after drinking a cup of coffee and then using Medical Cannabis, chances are that you’re experiencing the result of combining multiple stimulants.
Using too much cannabis in too short a time can result in a phenomenon known as “greening out.” We recently published another post discussing this phenomenon, if you’re interested. That said, one of the symptoms of greening out is feeling anxious or uneasy. Combine those feelings with another symptom, increased heart rate, and you could experience the shakes.
Experiencing the shakes can be a bit unpleasant. Is there anything you can do about it? Yes, but only after you figure out the exact trigger. If you are shaking because you are cold, put on some warmer clothing. If the shakes are a result of greening out, slow down. Do not use so much cannabis in so short a time.
As a Medical Cannabis patient, don’t be alarmed if you experience the shakes from time to time. The shakes are a normal reaction to the drug that some patients experience. It is not a dangerous condition, and it generally goes away on its own. If you persistently experience the shakes, talk with your QMP or PMP about using CBD instead.
