Episode 86 of Utah in the Weeds features Kylee Shumway, Pharmacist In Charge at WholesomeCo Cannabis in West Bountiful.
Shumway is also the Medical Director for the Utah Patients Coalition, a cannabis advocacy group. UPC led the signature-gathering initiative that brought Medical Cannabis to Utah’s midterm election in 2018.
Like many people, Shumway’s first experiences with cannabis happened when she was a teenager. Growing up in Lindon, Utah, she noticed cannabis seemed to be more popular among her religious classmates than it was for people outside of the dominant religion. [3:33]
Kylee told us about her education and early career as a pharmacist. Her first job out of college was at a Smith’s pharmacy. [05:54]
Shumway says she was interested in becoming a cannabis pharmacist as early as 2012. When Utah passed Medical Cannabis legislation in 2018, she knew it was time to take her career on a new path. [12:24]
Kylee’s passion for Medical Cannabis began while she was in pharmacy school. Her father, a cancer patient, had lost 80-90 pounds during the course of his treatment. But cannabis helped to restore his appetite and his ability to swallow. [13:44]
In January 2020, the Utah Dept. of Health announced the recipients of the state’s first 14 Medical Cannabis pharmacy licenses. Kylee immediately started to apply for work as a cannabis pharmacist. [17:21]
Kylee is very interested in cannabinoids and how they interact with the body. She and Tim agree there is a vast amount of research about cannabis yet to be done. [24:09]
The conversation turned to Utah’s Medical Cannabis program. Kylee says it’s “astonishing” that Utah has Medical Cannabis. She’s glad to see healthcare providers working to educate each other, and their patients, about Medical Cannabis. [27:38]
Kylee is heavily involved in educating patients and her fellow healthcare professionals about Medical Cannabis. She says WholesomeCo enables her to research cannabis and put together educational material as she sees fit. [33:25]
She told us about her involvement with Utah Patients Coalition and her duties as their medical director. She spends a lot of time with UPC at the Utah State Capitol, where they continue to advocate for patients’ access to Medical Cannabis. [36:47]
Shumway is also interested in the therapeutic uses of psilocybin, the active ingredient in hallucinogenic mushrooms. She’s involved in a political push to form a task force for Utah to investigate psilocybin’s medical potential. [37:42]
Tim and Kylee are keeping a close eye on the Utah Legislature’s 2022 session, and any Medical Cannabis legislation that could be passed in the session. We expect to see better protections for patients, including some who are public servants. [43:58]
Kylee talked about her favorite cannabis delivery methods: tinctures and edibles. She likes them because they’re discreet, effective, and are available in a variety of cannabinoid ratios. [47:34]
If you’d like to get in touch with Kylee, she recommends reaching out to her via the Utah Patients Coalition’s social media channels. [53:13]
Kylee Shumway:
That is actually why I’m up there, is I’m helping the Utah Patients Coalition with whatever they need. Essentially I am their expert on cannabis and patients, and we are doing some stuff with a psilocybin task force still, and so I’m also their expert there.
Tim Pickett:
Okay, just stop right now. Let’s talk about psilocybin. Welcome everybody out to Utah in the Weeds. My name is Tim Pickett and I am your host. Today is episode 86, an interview with Kylee Shumway, a friend of mine in the cannabis industry and medical cannabis space. Somebody with whom I share a lot of familiar opinions with, frankly, as you listen to this episode. Kylee Shumway is the pharmacist in charge at WholesomeCo Medical Cannabis Pharmacy, here in Bountiful, Utah. WholesomeCo is one of the growing medical cannabis pharmacies in the state of Utah and they currently offer delivery services to every corner of Utah for free. I want to mention that, because they’re the only pharmacy to do that. And Kylee runs their medical program as a pharmacist. Here in this interview, we talk about her background, how she got into cannabis and what things are really important to her with regard to the patients here in Utah in her patient care.
Tim Pickett:
Kylee is also the medical director for the Utah Patients Coalition and activist group here in the state of Utah, and along with Desiree Hennessy, the executive director of that Utah Patients Coalition, is very, very involved on the Hill during the legislative session now, that’s in session here in Utah, working for patients, working for us, right? Patients and providers, trying to increase safety, increase access, decrease costs, make those tweaks and changes that we’re all hoping, hoping that the state will move forward on. Additionally, she is working with the Utah Patients Coalition on a psilocybin bill, which we talk about here in the interview, so make sure you listen to that as well.
Tim Pickett:
We talk all about her background and how she got into pharmacy, what she loves about THC and compounding cannabinoids. Very, very fun conversation to listen to. From a housekeeping perspective, stay tuned. One of our next episodes will be with a veteran who has experience with Truu Med. Now you may be familiar with them, because their owner and operator was recently arrested for kidnapping and torturing a woman. We are going to talk to a veteran who was a patient of theirs and had that experience, and listen to what he has to say about that whole thing, how he feels like they were very unfair to him in that didn’t really take care of him. If you’re not subscribed to Utah in the Weeds, go ahead, download it on any podcast player that you have access to. Again, my name’s Tim Pickett. Enjoy this episode with Kylie Shumway. Okay. Kylie, what started this all, your journey into cannabis? When was the first time you were exposed to cannabis? Tell me about that.
Kylee Shumway:
I think-
Tim Pickett:
And don’t lie. Your mom’s not going to listen to this.
Kylee Shumway:
Yeah, my mom’s never going to hear this. I had friends that used cannabis when I was in high school. I wasn’t as into it. I definitely did use cannabis in high school, but-
Tim Pickett:
Did you grow up in Utah?
Kylee Shumway:
I did. I grew up in Lindon, Utah.
Tim Pickett:
Wow. We’ve met a lot of people on the podcast who have actually used cannabis in high school, and frankly I’m surprised, because I didn’t think it was that prevalent, but evidently it was a bigger deal than I thought.
Kylee Shumway:
It was really prevalent with more of the religious kids. They actually seemed to use more cannabis than maybe the kids that were outside of the dominant religion.
Tim Pickett:
Cool. Used it a little bit in high school, but didn’t really love it?
Kylee Shumway:
I tried it, but I didn’t love it for a whole lot of reasons. One being that I had a lot of anxiety when I was younger, so it just made me more anxious. And so I was like, I don’t love this-
Tim Pickett:
Classic. This, to me, is like… My experience was pretty similar. I did it a little bit, but honestly, the funnest part about smoking weed in high school is the moment right before you actually get high. Right before that, because then you’re like, I’m doing thing that I’m not supposed to. It’s really exciting, you’ve got all that adrenaline and then you get high and you’re just paranoid. Right? This is not fun.
Kylee Shumway:
Yeah, and then paranoia kicks in and then this is awful. I’m not having fun, but yeah, you’re right. The time leading up to that, the camaraderie and with your friends and you’re having so much fun and then you’re not having fun.
Tim Pickett:
Yeah, then all of a sudden you’re really not having fun. Kids, don’t smoke weed. It’s really not really worth it.
Kylee Shumway:
I did not have fun.
Tim Pickett:
Because it’s just not fun.
Kylee Shumway:
I did not have fun. I didn’t actually find any medicinal benefit from cannabis until I was an adult and I could make more well-informed decisions with my pharmacy knowledge, with the background that I then had.
Tim Pickett:
Ah, really? When did you go into pharmacy?
Kylee Shumway:
I started my… In 2011 was my first year of college.
Tim Pickett:
2011?
Kylee Shumway:
Yeah, so 2011. And I knew, I was pretty sure that I wanted to be a pharmacist. I tried some other things. I took some programming classes and just some other stuff to make sure that that’s what I really wanted, but after my first biology and my first chemistry class, it was like, that’s it.
Tim Pickett:
You’re like, “Wow, this is really cool.”
Kylee Shumway:
This is exactly what I want.
Tim Pickett:
Why pharmacy?
Kylee Shumway:
I thought about going to medical school, but when I started college, I was actually 25 and I was concerned about how long medical school takes. I felt a little rushed, which wasn’t true. I should not have felt rushed. But at 25 in Utah, I was like, I’m too old. I didn’t start soon enough, which was all a fallacy. That was all not true, but that’s how I felt. I was like, “I’m going to be a pharmacist, I can do that in between five and nine years, instead of 15 years. I can get done with it.” Because I wouldn’t need to do… It’s not required to do a residency or anything like that, but you can do a residency if you want.
Tim Pickett:
You can do a one-year intensive-
Kylee Shumway:
I think they do two-year residencies.
Tim Pickett:
Oh, they do?
Kylee Shumway:
Yeah, uh-huh (affirmative).
Tim Pickett:
With PA school, there’s only a couple of what they would consider residencies in the nation, right? And they don’t make you more money. There’s a few. There’s one trauma program at IHC for PAs.
Kylee Shumway:
Oh, interesting. There’s quite a few residencies now for pharmacy school, but again, I just had this idea that I was in a hurry and that I needed to hurry up and pick a job and hurry up and do something with myself.
Tim Pickett:
Yeah, hurry up and do all the… Yeah, right.
Kylee Shumway:
Hurry up and be an adult.
Tim Pickett:
Yeah, hurry up. Geez, Kylee, 25.
Kylee Shumway:
I was 25 and I was-
Tim Pickett:
Come on.
Kylee Shumway:
… in such a rush.
Tim Pickett:
2011, you go back to school?
Kylee Shumway:
Yeah, that is when I go back to school. I had graduated years earlier, but I just knew I wasn’t ready for college when I graduated from high school. I still had all that anxiety that I was working on and I still had this idea that maybe I wasn’t smart enough, which was also a lie, but anxiety makes it hard to see what’s true.
Tim Pickett:
Yeah, I could totally see that. Then did you work in retail pharmacy?
Kylee Shumway:
Yes, that was my very first job out of college, when I graduated in 2016. I rushed through college. I actually, at the end, I think I was taking 37-and-a-half credit hours a semester or something, in two-week blocks.
Tim Pickett:
Oh wow, yeah, uh-huh (affirmative). You were really in a hurry.
Kylee Shumway:
I was really in a hurry.
Tim Pickett:
You were really in a hurry. Do you feel like you’re in that big of a hurry now?
Kylee Shumway:
No.
Tim Pickett:
Not quite? You’re busy though.
Kylee Shumway:
I’m busy.
Tim Pickett:
You’re really busy now. We’ll talk about that in a second. But so 2016, what was your first job as a pharmacist?
Kylee Shumway:
I was a retail pharmacist at Smith’s and I actually enjoyed it. I got a lot of patient interaction and it was really a way for me to become comfortable with myself as a healthcare provider. I had a lot of really good pharmacists around me to help me out and I was really glad that that’s where I started. Though pretty soon after that, I think I was a retail pharmacist for about a year, and then I got into compounding pharmacy. I loved retail pharmacy. It was great, but there are some problems at the corporate level that have come to light actually, recently. There’s a big movement all over social media right now. I think it’s called. She Waited, and then Pizza Is Not Working.
Tim Pickett:
Oh, okay. Describe that. What’s happening?
Kylee Shumway:
There was a pharmacist in a retail pharmacy chain that got sick, called corporate and said, “Hey, I need somebody to cover me. I’m really sick.” And they’re like, “Well, we don’t have anybody.” And they had all these excuses. “You can’t shut the pharmacy down. You have to wait until somebody else gets there,” because she was the only pharmacist and the pharmacist can’t leave the pharmacy or the pharmacy has to shut down. She waited, and while she waited, she had a heart attack and died.
Tim Pickett:
Oh man!
Kylee Shumway:
It was so bad. And I’m pretty sure it was CVS.
Tim Pickett:
Interesting.
Kylee Shumway:
Yeah, there’s some stuff in retail pharmacy that I think needs fixing and it needed fixing while I was a retail pharmacist.
Tim Pickett:
Did you like compounding better?
Kylee Shumway:
Much better.
Tim Pickett:
Compounding, the difference is with compounding pharmacies, you get a lot more providers calling in and then saying, “Hey, I need you to mix up this.”
Kylee Shumway:
Yeah, or-
Tim Pickett:
That’s like mortar and pestle, the whole… Did you do that?
Kylee Shumway:
I actually used mortar and pestles all the time, and capsule machines. It’s so fun. It’s so fun and I love to bake as well, so it’s right up my alley. I was just like, “This is great.”
Tim Pickett:
You’re like a drug baker.
Kylee Shumway:
This is everything that I could have ever wanted and I loved it, so I specialized in bioidentical hormone replacement, and that’s a lot of what we were compounding. I loved it. I loved it so much. I worked there for years. I did compounding pharmacy for years in a couple different compounding pharmacies, and it was so fun. And then I got to the point that I was really confident, I was doing really great and I really knew what I was doing, and then the law passed in Utah for cannabis, in, what was that? 2018?
Tim Pickett:
Yep.
Kylee Shumway:
And I started telling everybody around me, I was like, “That’s what I want to do.” And that had started. Me talking about being a cannabis pharmacist started in probably 2012.
Tim Pickett:
Interesting. That is… Because in Utah, there wasn’t any discussion about really even the law at all, passing before that big push in 2018, when it passed.
Kylee Shumway:
Yeah. I would tell people that I was going to move out of state to become-
Tim Pickett:
To become a pharmacist?
Kylee Shumway:
A cannabis pharmacist.
Tim Pickett:
There’s a couple of other states that require pharmacists in their programs. It’s Connecticut, I think?
Kylee Shumway:
Yeah, Connecticut does, because we had looked at Connecticut’s program for this program. We were looking at some of the similarities, and then I think Columbia Care keeps pharmacists on staff, no matter what state it’s in.
Tim Pickett:
Uh-huh (affirmative), and I think Curealeaf does a very similar thing. They like pharmacists there in their programs, even in states where they don’t require one.
Kylee Shumway:
Yeah, yeah. There was there was that going on, and then I would tell people that that’s what I was going to do. And then in pharmacy school, my dad got sick. While I was in pharmacy school, my dad got cancer and he got really sick and the chemotherapy was so hard on him. He was on cisplatin, which is the one that makes you the most nauseous, and then he was on doxorubicin and vincristine, and those are really hard on your body, especially the doxorubicin, so he was really sick all the time. We had to leave the state to get cannabis for him, because he had lost so much weight.
Kylee Shumway:
He had lost 80 pounds or 90 pounds, or something crazy like that. We finally took him out of state and he started eating again and the sores in his mouth weren’t so bad and he could swallow, because he’d lost the ability to swallow, and when he started using cannabis again, he could swallow. We couldn’t tell anybody, because he’s at the VA. We can’t tell anybody that we’re using this, but the nurses were like, “Oh, I can’t believe how great you’re doing. You’ve totally turned around. This is wonderful.”
Tim Pickett:
Wow. And it was all because the cannabis he was using, and all of a sudden he’s got a little appetite.
Kylee Shumway:
So he could eat. Mm-hmm (affirmative), some pain relief.
Tim Pickett:
Is that where you learned all your real cannabis medicine, really?
Kylee Shumway:
I think that’s where my passion came from for it. I saw my dad do a 180 and I was like, “I could do that for people.” I had joked about it in 2012 and be like, “I’m going to be a cannabis pharmacist. Ha ha. So funny.” And then that happened and I was like, “I know really I could do this.”
Tim Pickett:
Yeah, now all of a sudden it’s real. I feel like sometimes, with my experience, in the textbook you assume it is real and you believe it and you know how it makes you feel and you know it stimulates your appetite or it makes you relaxed or it helps your back pain, but you don’t really see the benefits for other people until you actually see them have benefit. There’s a difference in reading it in a book and having-
Kylee Shumway:
An experience.
Tim Pickett:
… and experienced… Yeah, or by your patients even too, right?
Kylee Shumway:
Uh-huh (affirmative), oh yeah.
Tim Pickett:
Having your dad… Wow, no, this isn’t just… This is actually real.
Kylee Shumway:
This is real and I knew, once my dad had finished his chemo and he was doing great, and he’s still alive and he’s still doing so good-
Tim Pickett:
That’s so amazing.
Kylee Shumway:
I was like, I could do this for somebody. I could be that person that helps somebody like that and then helps their family too. Because to have my dad get better didn’t just have him get better. It was better for my mom, because she was his main caretaker. It was better for me, because I was helping. It was better for everybody involved, because he had a better attitude. He didn’t hurt so bad, he could get up and move himself around better, because he wasn’t just in so much pain and so sick.
Tim Pickett:
Yeah, he was able to disassociate with what was physically happening.
Kylee Shumway:
Yeah.
Tim Pickett:
That’s really great.
Kylee Shumway:
It was amazing. All of that, and then becoming… Yeah, so all of that, I was a retail pharmacist, a compounding pharmacist and then the bill passed and I was like, “I don’t have to move. I’m going to stay here.”
Tim Pickett:
When did you get your job with Wholesome?
Kylee Shumway:
I started emailing as soon as they announced who had got the licenses in January of 2020.
Tim Pickett:
Yeah, I remember that. I remember I was lifting weights at the time, with Sean Hammond, who had applied for a license and we were waiting, waiting, waiting, waiting, waiting for those to come around. Yep, yeah, that was fun. That’s a fun time. Then you become a pharmacist at Wholesome and now you’re in charge. You’re in charge of the place.
Kylee Shumway:
I am in charge of a lot of things. Some of the stuff I’m in charge in, I’m actually going to split it up with Kelly now, because my job has gotten to where it’s three or four people’s job. I am going to get some help. Kelly has been really fabulous, so she’s going to help me out and I’m going to take over much more of a… I’m going to do less of the day-to-day, writing the schedule and checking on people’s consults and stuff like that. I’m going to be working-
Tim Pickett:
And now you have to check every transaction number.
Kylee Shumway:
Yeah.
Tim Pickett:
I haven’t really talked to a pharmacist since that’s happened. I think we talked about, like with Rich last year, that it happened. And what I’m describing is the, for those of you who are listening, is there was an update to the legislation last year in Utah, where a pharmacist has to now verify that a patient’s dosing and purchasing ability is matching with what they’re purchasing, meaning they can’t go over their limit. And that has to be verified at every transaction.
Kylee Shumway:
Yes. And then along with that, what the pharmacists are also verifying is that what is in the bag is what’s on their receipt. It’s a lot like doing the final check in an actual retail pharmacy, where we’re making sure-
Tim Pickett:
And that was why it was passed. That was… Right.
Kylee Shumway:
Now we’re making sure that, just like we do at a retail pharmacy, where I’m looking, I’m physically looking in the bottle and making sure that those pills are what they say on the screen, because sometimes they’re not.
Tim Pickett:
Interesting.
Kylee Shumway:
And I don’t know how many times I’ve either caught the wrong pills in the bottle, the wrong strength is in the bottle or the wrong medication has been typed in from the prescription, or that the prescription actually has the wrong drug name on it. The prescription from the… There’s a lot of things to catch. But the big thing is, is that I’m actually checking and seeing what’s in the bag is what’s supposed to be in the bag, and it’s just another way… It’s that final check to make sure that everything is in there is in there, but I think it’s also a way to… Everybody’s really worried about diversion, and it’s just one more way of not having-
Tim Pickett:
Yeah, looking the patient in the eye and saying, “This is for you. This is not for somebody else.”
Kylee Shumway:
Yeah, yes.
Tim Pickett:
And I think diversion… What do you think? I think diversion’s a bigger issue than… Nobody really wants to talk about it, but-
Kylee Shumway:
No one wants to talk about it. I was even nervous saying the words. I was like, oh-
Tim Pickett:
I know, because let’s be honest, your sister, your brother, your mom, your son, they need to try something. You’re like, “I’m a patient. I’ll just run down there and you can try some of my tincture.”
Kylee Shumway:
Right?
Tim Pickett:
That is against, not just state law, that’s against federal law and state law. That’s really dangerous. But I don’t know, it’s like it’s no big deal almost.
Kylee Shumway:
Yeah, and nobody wants to talk about it.
Tim Pickett:
Yeah, nobody wants to talk about it, but people, it’s a real thing. People divert. It’s called diversion.
Kylee Shumway:
It’s called diversion.
Tim Pickett:
It’s essentially like… In fact, it’s probably worse, from a legal perspective, to divert cannabis than it is to divert opioids. I don’t know. It may be-
Kylee Shumway:
Because they’re more illegal.
Tim Pickett:
It’s less dangerous to your health, but they’re more-
Kylee Shumway:
It’s a schedule one drug, which-
Tim Pickett:
Weed’s more illegal.
Kylee Shumway:
… I think is going to change.
Tim Pickett:
I think that’s ridiculous.
Kylee Shumway:
Yeah.
Tim Pickett:
Right, yeah, okay. Let’s not go down that rabbit hole yet, but-
Kylee Shumway:
Yeah, that’s a dangerous road for us to go.
Tim Pickett:
Okay, now you see patients at Wholesome, you come all this way from Lindon, and every time I see you, you’re really happy. You seem like you really like your life right now.
Kylee Shumway:
Well, honestly, I cannot believe that this is what I get to do. I can’t believe it. I’ve been talking about it since I started college, “I want to be a cannabis pharmacist. That’s what I want.” And here I am. Who gets that? Who gets to have that in their life?
Tim Pickett:
There’s only 10 of you. Actually, maybe there’s 30 of you now in Utah.
Kylee Shumway:
Yeah, I get to have my dream job.
Tim Pickett:
Right. You get to literally… What I tell people is I literally teach people how to use cannabis. I literally teach people how to smoke weed for a living. It’s pretty awesome. Pretty fun.
Kylee Shumway:
It’s incredible. And I have the chance to do all the research that I want and look at anything that has anything to do with patient care and have a real impact on how patients are taken care of in the cannabis space. And it has been incredible. I love it. I love it and I feel like sometimes outside of medical programs, my patients are forgotten. My true medical patients… Not true, all of them. Everybody’s a medical patient, really, in my opinion, but sometimes they’re forgotten when the medical programs go away, and I get to make sure that they’re taken care of here.
Tim Pickett:
Yep. In Oregon, there’s been a 70% reduction in the medical patients. And there’s certainly going to be a reduction in any adult use program, but I do like that it’s medical here first. I think legitimizing it first, it was the right move.
Kylee Shumway:
Yeah, and making sure that people have good information and that the QMP and the PMPs, we’re doing all we can to educate patients on what’s true, because there’s so much misinformation on the internet. You can just go on the internet and find whatever you want, and there’s a lot of it that’s wrong.
Tim Pickett:
You can really find whatever you want.
Kylee Shumway:
Yeah, yeah.
Tim Pickett:
You really like terpenes. This is your thing.
Kylee Shumway:
I like terpenes. What I-
Tim Pickett:
Or is it cannabinoids?
Kylee Shumway:
Cannabinoids, that’s really… There’s studies on terpenes, and we think that they do the things that we think they do. There’s more science on the cannabinoids, so I’m actually more focused on them. And recently, I don’t know how recently, we have found a whole bunch of the receptors that they interact with outside of the endo cannabinoid system, which has been fascinating for me.
Tim Pickett:
Oh, describe what you’re talking about.
Kylee Shumway:
They interact with GABA receptors. They interact with the TRP receptors, serotonin receptors, so receptors that we would think of classically as outside of the endo cannabinoid system. They are involved in a bunch of pathways in our body, which is so incredible, and it’s why we get the effects that we do. But terpenes, we don’t know if they interact. Well, we know they don’t interact directly, most of them, with the endo cannabinoid system, but we don’t know how they interact with these other systems now, that we’re finding that cannabis interacts with.
Tim Pickett:
Yeah. I love the science of cannabis, but I also… A lot of times we say, “Yes, there’s plenty of evidence. There’s plenty of evidence.” And there is for certain things. Does it work for pain?
Kylee Shumway:
Yes.
Tim Pickett:
Yes. Does it work for this? Yes. But there’s so much that it’s kind of daunting how much we don’t know.
Kylee Shumway:
And the more I learn, the more I know, the more I know how much we don’t know, which makes me more careful now, speaking about cannabis, than when I first started, because there’s so much minutia that we don’t know. There’s a ton of mechanisms of action that we don’t even understand yet. We don’t know how it works. We just know that it does work. Which is true for a lot of medications, so it’s not something that’s overly concerning, but it just shows me how much we don’t know and how much more research we should be doing. We need more, better science.
Tim Pickett:
We need better science in a lot of fronts too, but cannabis is… There’s just a glaring hole in side-by-side studies. The double blind, randomly controlled stuff, then the side-by-side, does cannabis work, does THC work against Ativan? Does THC work against Prozac? Does THC work against… Where there’s-
Kylee Shumway:
I don’t know if we even have anything like that.
Tim Pickett:
Where there’s side-by-side stuff-
Kylee Shumway:
Yeah.
Tim Pickett:
No, I’ve never heard of anything like that. And there needs to be stuff like that so we can say, “Look, in these types of patients, comparing these two medication modalities, this tends to work better or this doesn’t.” Yeah, that type of thing we’re really missing. I don’t even know if we’ll ever get there.
Kylee Shumway:
I believe that we will. I just wish it was faster. It’s hard for me to have to wait on something that I know is important and we need the information, and just because it’s a schedule one drug, I can’t get the information that I need.
Tim Pickett:
Are there things about the program? Could you say what’s your favorite thing about program, or what might be working well with the program? I see you kind of smirking. Don’t smirk. And then, or, alternatively, we can talk about what is not working in the program, what we think we want to change.
Kylee Shumway:
I think there’s a long list of both of those questions. I’m glad that we have a program. The fact that we have a program here in Utah is astonishing. That is good. I think the program being so focused on education and having medical providers and healthcare providers working together the way we are is so important. I love that about the program. There are fiddly bits in the program though, that are so hard to work with. MJ Freeway is so hard to work with.
Tim Pickett:
This is the software program that does seed to sale tracking, and it also is, there’s a sister of it that’s called the electronic verification system, where we house all these patient deadlines and certifications, and then MJ Freeway’s also tied into the retail.
Kylee Shumway:
Yeah. It’s access to point of sale. And I don’t know if it’s robust enough for a medical program.
Tim Pickett:
How about the limited medical provider program? Have you interacted with that program yet, since they launched it last week?
Kylee Shumway:
All of my pharmacists are signed up to do and work in the EVS with the limited medical providers, but I have not had a single patient come to me with a limited medical provider-
Tim Pickett:
With a letter?
Kylee Shumway:
Yeah.
Tim Pickett:
You’re the second pharmacist… Here, it’s been launched for a little less than a week. At the time of this recording, we’ve been a little less than a week for the limited medical provider program. There are 16,000 controlled substance licensed providers in Utah, who basically received the ability at this to authorize 15 patients with medical cannabis. That’s a lot of providers, it’s a lot of patients. There are 14 pharmacies and I have not talked to a single pharmacist who’s interacted with that program one time yet. I’m not saying it’s a-
Kylee Shumway:
I’m not surprised.
Tim Pickett:
I’m not saying it’s a bad program, but it is, and I am saying that, I guess, but I don’t know. I don’t think it’s going to do what they think it’s going to do.
Kylee Shumway:
I am not surprised you haven’t seen anything, because how… I know, I’m sure they sent an email to all the providers, saying this is available, but how many of those provider are actually going to sit down, truly read that email, understand the implications of the email and then act upon it. They don’t have any resources. They don’t know where to go to start. They don’t what pharmacies to call. They probably-
Tim Pickett:
I think there’s still people that come into my clinics who don’t know weed is legal in Utah.
Kylee Shumway:
Exactly.
Tim Pickett:
Let alone a provider who is knee deep in COVID and medical practice and all this stuff now-
Kylee Shumway:
And a million of-
Tim Pickett:
Thinking, okay, I’ve got to learn all this stuff so I can write a letter, when I didn’t yesterday and I was just fine.
Kylee Shumway:
Yeah, and then-
Tim Pickett:
Yesterday, I was fine without it. Today, I’m probably fine without it. I just-
Kylee Shumway:
Exactly. And some of them aren’t going to want to write the letter and hand it to the patient. They’re going to have to track down a pharmacy that they can then fax it to. I think there are just some logistics of the program that make it difficult and very… Maybe not as accessible as they had hoped it was going to be.
Tim Pickett:
Well, to me-
Kylee Shumway:
That’s the diplomatic way-
Tim Pickett:
Last Monday… Yes, thank you. And on Monday, I talked to a patient who was having a bad trip, a very bad experience. We care for a lot of people in once in a while, somebody has a problem. And as the program grows, the number of phone calls we get about this actually grow too. Surprise, surprise. And I thought after this phone call, she was headed to the ER-
Kylee Shumway:
Oh my goodness!
Tim Pickett:
This patient was headed to the ER, “I am freaked out of my mind. I took an edible. I know I took too much, but I’m headed to the ER.”
Kylee Shumway:
Oh my gosh.
Tim Pickett:
I was thinking to myself, as an LMP, what would I do? Where would I-
Kylee Shumway:
You would send them to the ER.
Tim Pickett:
What would I even do? Yeah, I’d just send them to the ER. I wouldn’t even know the questions to ask. That part of it, to me, worries me for patients, because I want my patients to have a good experience and so I want the providers to be educated. I know we’re spending a little time on this and I’m on my soapbox now, so I’ll stop and we’ll get back to the real thing, but you and I… Kylee and I, for those of you who are listening, Kylee and I talk every couple of weeks. We’re involved in a medical cannabis advisory group that’s semi-related to the Utah Cannabis Association and this is important stuff to us, right?
Kylee Shumway:
Yeah. To me, this is important.
Tim Pickett:
Together, we see a lot of people.
Kylee Shumway:
Holy cow, yeah.
Tim Pickett:
Okay, so that’s Wholesome, and Wholesome, I love… The whole outreach side of Wholesome is good, and I can see that they’re really encouraging you to do research and videos and talk about this stuff, right?
Kylee Shumway:
Yes. They give me almost total free reign to do the research that I think is important, to put together educational material that I feel like is important. They really have allowed me, they have deferred to me on all of these things, that I’m like, “Patients need this. QMPs need this. Other PMPs need this. And then patients’ caregivers need this information.” And I have been allowed to do whatever I feel like is important for the… Because I see so many patients that I was starting to get a really good idea of what people know and what they don’t know, or what more information they would like to have, or information for their spouse or someone like that, that maybe isn’t going to take cannabis, but is going to be with them on this journey.
Tim Pickett:
Yes, and you’re repeating yourself over and over, and then finally saying, “You know what? We should have a handout.”
Kylee Shumway:
I should have handout for this. And I’m happy to repeat it over and over, but maybe if I have this handout, they can come to me with other questions, more in depth questions for themselves, that are more relevant for them If they have some information up front. Now we have a booklet that we hand out, we have tons of educational material. We do cannabis night school, we try to do other educational videos. I go out into the community and do education. And not just for patients. I’ve done it for QMP’s offices, I’ve done it for healthcare providers that just have questions, that aren’t QMPs.
Tim Pickett:
Yeah, and here’s a plug. A plug for your education is twofold; one, Cannabis Night School, if you missed Kylee and I talking about terpenes at Wholesome’s Cannabis Night School, check that out.
Kylee Shumway:
That’s fun.
Tim Pickett:
And two, Kylee is on a ton of videos on Discover Marijuana on YouTube, and if you are not subscribed, as everybody loves to say, slam that subscribe button on Discover Marijuana on YouTube and you can watch Kylee and I talk about all kinds of things on those videos, that were just wrapping up that season, season three of that channel. That was really fun.
Kylee Shumway:
I enjoyed that so much. And I still get text messages from people that are like, “I saw you on TV. I saw you on YouTube.” But, “Oh my gosh, I saw you. I loved that.” And I get text messages all the time from people that I used to know from school and stuff.
Tim Pickett:
Oh really? That’s great. Yeah, it’s just a fun project. It kind of puts you on the spot to be videoed and then have a question asked, now all of a sudden you’ve got be like, whoa, I got to know what I’m talking about here.
Kylee Shumway:
I’m glad we did it. It got me ready for some other things that I got myself involved with. It was-
Tim Pickett:
Talk about those, because you’re involved at the legislature now. We were talking before we started recording, every Wednesday, it seems like you’re up there during the session, all day.
Kylee Shumway:
Yeah, last Wednesday I was up there a ton, and I was trying to balance being at the Capitol building and doing all the things that I need to do up there, with some meetings and some stuff that I needed to do at Wholesome. It was-
Tim Pickett:
Yeah, what’s your role at the Capitol?
Kylee Shumway:
Actually, while I’m at the Capitol, I am now the medical director for the Utah Patients Coalition, and that is a volunteer position. I don’t get paid for that, but-
Tim Pickett:
Got it.
Kylee Shumway:
That is actually why I’m up there, is I’m helping the Utah Patients Coalition with whatever they need, essentially. I am their expert on cannabis and patients and we are doing some stuff with a psilocybin taskforce bill, and so I’m also their expert there.
Tim Pickett:
Okay, just stop right now. Let’s talk about psilocybin. I have never experienced psilocybin.
Kylee Shumway:
Psilocybin?
Tim Pickett:
Psilocybin, but there’s some really cool research. There’s some really cool research about it.
Kylee Shumway:
It’s some amazing research coming out. They actually were able to do a blind… A double blind or just blind, head-to-head study with escitalopram and psilocybin. Escitalopram is an SSRI. It is an antidepressant, for those of you who don’t know. They did a head-to-head with it and psilocybin was outperforming it on a whole bunch of different scales that they were using to look at it. I don’t want to get too into the study, because I haven’t memorized the study, but I did read it and understand it. It was amazing. And they had done one last… Johns Hopkins is doing a bunch of research on psychedelics right now.
Tim Pickett:
Yeah, PTSD, smoking and addiction research.
Kylee Shumway:
Depression, anxiety.
Tim Pickett:
The depression, the death, dealing with death, I think, is another big issue-
Kylee Shumway:
Cancer patients, that was the big one.
Tim Pickett:
Cancer patients, mm-hmm (affirmative).
Kylee Shumway:
Death, yeah acceptance. Accepting that you’re going to die. The results that they’re having are incredible. Sometimes I’m reading it and I’m like, how did we miss out on this for so long?
Tim Pickett:
This is different than cannabis, because this is specific and extremely accurate, seemingly extremely accurate, data-driven science on something that [crosstalk 00:39:42]-
Kylee Shumway:
On hard science, the real-
Tim Pickett:
It’s not wishy-washy. This is legit stuff.
Kylee Shumway:
No, and this is the kind of science I want to see done with cannabis.
Tim Pickett:
Yes, but they’re not doing it, but for some reason… Okay, what’s the bill that is proposed? There’s a psilocybin bill at the Utah-
Kylee Shumway:
What we’re trying to propose is we’re going to put together a taskforce. A bunch of healthcare professionals, people at the Huntsman Mental Health… Oh my goodness. A bunch of people, a bunch of professionals-
Tim Pickett:
Yeah, the Neuropsychiatric Institute.
Kylee Shumway:
Thank you. We’re going to bring together this taskforce where they will meet almost all this year, look at the research on psilocybin, see who, what, when, where and how, and hopefully, in October, we would have them presenting what their findings were, what we envision… I guess not we, I guess the taskforce, what they would envision that that would look like in Utah. What the clinics would look like, who would need to be involved, what kind of laws would need to be written, and then hopefully a bill would be in the works after that to pass it medically, possibly.
Tim Pickett:
Basically, we’re looking at a taskforce that would study it, get the experts, do a big report for maybe the Department of Health, where they say, “Okay, here’s the research, here are different programs that exist, here’s what it might look like in Utah, based on current law-
Kylee Shumway:
Here’s our opinion on what it should look like.
Tim Pickett:
Here’s our opinion on what providers should be licensed to do this, what the visits might look like, what the patient qualifications would look like, and so we’re essentially maybe two years away from a bill. If you get a taskforce passed and some money to do the studies, you’re looking at a couple of years to get something done.
Kylee Shumway:
Yes, it’s a few years out.
Tim Pickett:
It’s fascinating though.
Kylee Shumway:
It’s fascinating. I don’t even know where to start. There’s so much good information, there’s so many things to be excited for about it. It’s almost overwhelming, but the taskforce bill hasn’t passed yet, as far as I know, not as of today, but I’d love to see it pass, so at least we could look at it, the possibility of it. This is just looking at the possibility. This isn’t a bill to legalize anything. We should just look at it.
Tim Pickett:
Yeah, this is just a little bit of money to look at it, and so what… Have you seen any language on a bill or proposal to update the medical cannabis program up there?
Kylee Shumway:
There is some language on… There’s a lot of language going on. There’s a lot going on, and I’ll know a little bit more tomorrow. This is just the first week, and there was not a lot of people at the actual Capitol building. It wasn’t as crowded as it usually is. But there’s some stuff-
Tim Pickett:
There is a pandemic.
Kylee Shumway:
Yeah.
Tim Pickett:
COVID’s not real up there.
Kylee Shumway:
It felt that way.
Tim Pickett:
Apparently.
Kylee Shumway:
I was accosted by one man that asked me why I was wearing a mask.
Tim Pickett:
Well, I don’t even know if I want to get into this.
Kylee Shumway:
I just did, because it felt like the right thing to do. It doesn’t matter what my opinion is on it.
Tim Pickett:
Yeah. It just felt like the right thing to do.
Kylee Shumway:
So I did.
Tim Pickett:
I don’t know, when I work in the ER, I wear a mask.
Kylee Shumway:
I wear a mask all day when I work in-
Tim Pickett:
Surprise, surprise.
Kylee Shumway:
… the compounding lab.
Tim Pickett:
Yep.
Kylee Shumway:
I wear a mask all day.
Tim Pickett:
And if you were working around somebody with the flu-
Kylee Shumway:
Wear a mask.
Tim Pickett:
… it’s a good idea to wear a mask. I would recommend it. As a medical provider, if you’re working around somebody with the flu, it is my medical opinion, professionally, that you should be wearing a mask.
Kylee Shumway:
I love this for us.
Tim Pickett:
That’s all I have to say. That’s all. That’s all I have to say about that. Okay, you’ve got the psilocybin bill and we haven’t seen language on what’s coming up for the cannabis bill, but between you and I, I think we’ve got patient protection?
Kylee Shumway:
Yes.
Tim Pickett:
Right?
Kylee Shumway:
Mm-hmm (affirmative).
Tim Pickett:
We’re going to-
Kylee Shumway:
We’re working on-
Tim Pickett:
Pretty much a lot of patient protection stuff.
Kylee Shumway:
A lot of patient protection stuff. A lot-
Tim Pickett:
because there was the firefighter up North.
Kylee Shumway:
Yes.
Tim Pickett:
Hey, by the way, we had a firefighter come in and get his card, specifically because he was like, “This is bullshit that guy’s getting fired-
Kylee Shumway:
Good for him.
Tim Pickett:
… and I’m getting my card, because-
Kylee Shumway:
Because you should be able to.
Tim Pickett:
… if they’re going to fire more… Because we all should get our cards as in support. Then fire us all, and they can’t fire us all.” I thought it was pretty cool.
Kylee Shumway:
I love that. Good for him. Good for him. Yeah, we’re going to change some language around firefighters and police. There’s some stuff about caregivers cards in there. The LMP was a big one. There’s a lot of stuff. A lot of it hasn’t been decided, so I hate to say it and then have it just disappear into the ether.
Tim Pickett:
I know. I know. The patient cap thing, we always talk about that-
Kylee Shumway:
Oh, the patient cap thing. Have we heard anything about that?
Tim Pickett:
Not that I am aware. I’m I’m working hard. If anybody knows how to get this done-
Kylee Shumway:
I swear I saw someone post something on social media that was like, “We got it taken away.” I’m like, did we?
Tim Pickett:
Yeah, no. Yeah, we’re definitely having patient caps and we’re definitely going to have a problem this year, because all of the QMPs are going to expire. All of the first year QMPs like me, we’re going to expire and there’s going to be a lot of QMPs, this just happens, that have moved out of state and they’re leaving us with 200 patients and where the hell do those patients go? They’re going to be lost. I think, my proposal is that we allow a QMP to authorize another QMP in their group to take over their patients. I’m the QMP, I saw 200 people. I’m going to move to Oklahoma to take this hepatobiliary job and I’m going to leave, so I don’t want to leave my patients in the lurch, so I’m going to authorize Tim or Adam or whoever in my practice group to take over my patients. They’ll just add them to their… Doesn’t change their patient cap, per se, but it just allows me to see those 200, those specific 200 people-
Kylee Shumway:
Then you don’t have orphan patients.
Tim Pickett:
Exactly. Just take care of the orphan patients, because this year, the orphan patients issue is going to be big.
Kylee Shumway:
It’s going to be a big deal. And there are some… A lot of my patients, I get phone calls and they are like, “How do I renew my card?” If they’re not sure how to renew their card, because it is a little convoluted, how are they going to find a brand new QMP when they’ve been abandoned? And abandoned isn’t even the right word.
Tim Pickett:
Yeah, that’s a bad… But it kind of is. We don’t want them to be abandoned.
Kylee Shumway:
But I feel like they’re being abandoned-
Tim Pickett:
We want to support them.
Kylee Shumway:
… so I use that word.
Tim Pickett:
Yeah, we’re leaving them. We’re leaving them in the lurch and saying, “Hey, well, whoever you went to-
Kylee Shumway:
They’re gone.
Tim Pickett:
… they’re gone, so good luck.”
Kylee Shumway:
Okay, bye. I feel sad for them, because some of them are… Maybe they’re not as good with technology. Maybe they’re a little bit older. Maybe they need a little more hand holding, and a lot of them are going to get left behind.
Tim Pickett:
Okay, back to back to cannabis, back to weed, what’s your favorite delivery form?
Kylee Shumway:
I prefer a tincture or a gummy, because generally I need longer term relief. I also find them to be more discreet and that can be really important when… It’s pretty much just important for my whole life. I’m not going to carry a cannabis vape to the Capitol building.
Tim Pickett:
No, I don’t think that’s a…
Kylee Shumway:
Well, I’m not going to.
Tim Pickett:
I guess you just do what you got to do.
Kylee Shumway:
Well, other people could do whatever their heart desires. I’m not going to.
Tim Pickett:
Yeah. It seems like an odd thing, an uncomfortable thing to put that thing through the metal detector.
Kylee Shumway:
I don’t want to.
Tim Pickett:
Empty your pockets and your vape pens.
Kylee Shumway:
I’m not having that conversation with the guy with the gun.
Tim Pickett:
Nor, we already have to have conversations about the masks, so might as well not add to that problem.
Kylee Shumway:
I had just finished-
Tim Pickett:
That’s a rough-
Kylee Shumway:
It was such a strange interaction. I had just finished the interview that I was doing with Fox 13, and this guy just comes up to me and he’s like, “Who are you? Why are you wearing a mask?” What?
Tim Pickett:
Well, sir, I am a weed pharmacist.
Kylee Shumway:
Oh. Yeah, it was… I’m obviously still shocked by it, because I’m talking about it, but yeah, there’s just… I like a little more discreet usage form and I generally need longer acting, and then I prefer lower quantities of THC and higher quantities of CBG or CBD. That, I can really pick and choose that when I use a tincture, or even a gummy. We have so many good gummies right now that have great ratios.
Tim Pickett:
Name a few.
Kylee Shumway:
Boojum makes some great one to ones. [Q-ga 00:49:41] makes good one to ones. True North, I think they do some, and Standard does.
Tim Pickett:
Yeah, True North is-
Kylee Shumway:
I can think of a bunch of ones that I can use ratio products that way, which is what I prefer.
Tim Pickett:
Yep. Well, as a compounder, you can also, I think pretty soon, you’ll be able to get higher CBG tinctures, meaning you could just buy a CBG, CBD tincture over the counter-
Kylee Shumway:
I can put them together the way I like.
Tim Pickett:
Right, then you could put them together in your body the way you like. And I think that’ll be fun, especially with tinctures going forward, when we have more minor cannabinoids as their own products, because you can’t compound in the THC world-
Kylee Shumway:
Not yet.
Tim Pickett:
At least that’s not in the bill.
Kylee Shumway:
Someday.
Tim Pickett:
Right, we’re not… Maybe someday, but people could. You could design a product for somebody, say, “Hey, go home, take three drops of this, two drops of that, half a slug of that and call me in the morning.”
Kylee Shumway:
And that’s something that I do with the gummy and the tinctures. There’s a lot of great tinctures. There’s one to one to ones, there’s one to one to tens, there’s one to ones, there’s one to fours, there’s one to 25s. You can get a whole bunch of ratios. And I like to put them together with the relief I need, and generally lower THC, because I do have… It makes me anxious. I don’t want anxiety. I’m using this and I don’t want to get anxiety from it.
Tim Pickett:
Yeah, we want anti.
Kylee Shumway:
Yeah, a lot of the times I am using it for evening pain. For some reason, it seems to be this thing where everybody’s pain is worse at night. That’s why I love the tinctures. It’s why I love gummies. They’re just so easy for me to put together the way that I want them to be. There’s not a lot of guesswork for me when I’m using that kind. I think inhaled forms are great. I just can’t seem to get the cannabinoids that I want in them right now. But I think that will change.
Tim Pickett:
Yeah. I hope so.
Kylee Shumway:
I hope so.
Tim Pickett:
I’ve been doing a lot of recommending on layering. Layering a cannabinoid product, like CBG, THC or one to one to one, like CBD, THC, CBN in the oral form, and then adding an inhaled form on top of that.
Kylee Shumway:
I love that.
Tim Pickett:
Plus, you’re getting the cannabinoids. Where you’re not getting the CBN and the flower, you’re getting it in the tincture, so you’re mixing forms, and I think think what I’ve been recommending a lot.
Kylee Shumway:
It’s such a great way for patients to use their cannabis. They can get immediate relief and then long term relief and it’s so… I think it’s almost comforting in a way, that they can have that and use it that way. Because they know that they’ll have something for breakthrough pain, but they’re not going to have to use their inhaled form every two hours or something, maybe the way they don’t want to. I love that.
Tim Pickett:
They can dose it to a way they’re not high all day either, and then if they need to be high-
Kylee Shumway:
They can be.
Tim Pickett:
They can get there, they can be, and that’s not going to last as long. I think this has been really fun. It’s fun to watch people reduce their medication use and it seems fun to be involved.
Kylee Shumway:
I love it.
Tim Pickett:
You and I, we have a lot of that. We’re a lot alike.
Kylee Shumway:
I love when people come back and they’re like, “Oh my gosh, I’m off 15 of the medications that I was taking for my back pain.” And I’m like, “That’s great!”
Tim Pickett:
What’s the best way for people to get involved right now, do you think? Or get maybe even in touch with you, about the legislative effort-
Kylee Shumway:
Oh man, through UPC would be a great way. I am super involved on the UPC’s, the Utah Patient Coalition’s social media, I can see messages that come through there, but you can also send us emails and I’ll do everything I can to get back to you. But I would love to hear from people.
Tim Pickett:
Yeah, but if you go to the Utah Patients Coalition site, you can go to the contact us page and you could reach out there. But social media seems like a great way to go too.
Kylee Shumway:
Yeah, social media is easy. We do have a Facebook page and then we have a public Facebook group that we allow public discourse on. You can get on there, you can put a comment on there, you can ask a question. The page is private, but the group is a public group that you can post to.
Tim Pickett:
Oh, that’s cool. And then you’ll update how the bills are going there, hopefully.
Kylee Shumway:
Yeah, we have quite a few updates on there about cannabis stuff, and I think we posted three times in the last couple days, because there’s been enough information coming forward that we’ve been able to post a little bit more, and I’ve had some really good help with that, from Des and a new girl we’ve been working with. Her name is Haley. It’s been amazing. They’ve been really helpful, because I can’t do it by myself.
Tim Pickett:
I’m sure you can’t, no. It’s too big of a job to do. And especially with you being involved so heavily, full-time at Wholesome, and the program is really just growing so fast. Is there anything that you feel like you want to say, you want to talk about?
Kylee Shumway:
Man, we covered so much. I just want people to reach out, ask me questions, even if you think they’re stupid. I bet they’re not. Let’s talk about stuff.
Tim Pickett:
Yeah, I bet they’re not. And whether you’re a patient or not-
Kylee Shumway:
Yeah, I don’t care.
Tim Pickett:
You’re cannabis curious, that doesn’t matter. If you have a question for Kylee and or you have a question for me, for that matter, reach out on WholesomeCo, their website from the pharmacy standpoint, Utah Marijuana.org. If you have a question for… Even if you have a question for Kylee and the only place you can find is to go to YouTube, the Discover Marijuana channel and make the comment there, we’ll get you the comment. We’ll answer the comment and the question. If you have a legislative priority or something that you think is very, very important, we’re-
Kylee Shumway:
I want to know.
Tim Pickett:
Kylee, she’s right here.
Kylee Shumway:
I want to know about it.
Tim Pickett:
The medical director of the Utah Patients Coalition. This is the person to reach out to and talk about it, so that know. We’re interacting with the program more than anyone else.
Kylee Shumway:
I’ve had a lot of people reach out to me with opinions and I want to hear them all, because I’m just one person and there’s only so many things I’m going to think of on my own. If we don’t have this public discourse, if we don’t have people asking questions, if we don’t have people making suggestions, I won’t be able to think of every single thing.
Tim Pickett:
Right. You’ll only be thinking about the stuff that you see.
Kylee Shumway:
Mm-hmm (affirmative).
Tim Pickett:
Yeah, yeah. Well Kylee, thanks for coming on. Kylee Shumway, pharmacist in charge at WholesomeCo, and medical director of the Utah Patients Coalition. Congratulations.
Kylee Shumway:
Thank you.
Tim Pickett:
On both. You’re living your best life.
Kylee Shumway:
I’m living my best life. My dream.
Tim Pickett:
Yes. And for those of you who aren’t subscribed to the podcast, Utah in the Weeds, download it on any podcast player that you have access to. Thanks so much Kylee, for coming on and talking to me.
Kylee Shumway:
This was so fun.
Tim Pickett:
Yeah, it was. All right, everybody. Stay safe out there.
Episode 85 of Utah in the Weeds is for anyone interested in using cannabis to treat PTSD. Utah Therapeutic Health Center clinicians Tim Pickett, PA-C and Clif Uckerman, LCSW, hosted an online webinar and Q&A session on the subject.
We started with some details about Clif’s background as a licensed clinical social worker and therapist. [4:18]
He and Tim talked about some of the ways post-traumatic stress order can be defined. [8:35]
They went over some of the most common symptoms associated with PTSD. Clif says anxiety tops the list of the most common PTSD symptoms. “Hyperarousal” or, as Clif puts it, a state of “hypervigilance,” is another common experience among PTSD patients. [10:10]
Clif went over the clinical processes for diagnosing PTSD, and some of the other mental health issues that can accompany PTSD. [13:35]
Tim talked about some of the existing research regarding PTSD and cannabis, and some of the related biochemistry. [17:45]
Clif discussed the use of cannabis in conjunction with a therapy session. According to Clif, some patients find their therapy sessions are more meaningful when they’ve used cannabis beforehand. Clif says a good therapy session can be cathartic, but it often leaves the patient feeling anxious and insecure afterward. This, he says, is another time when cannabis can be very useful. [23:05]
Tim talked about the “mechanism of action” by which cannabinoids like THC and CBD interact with the body’s endocannabinoid system. Then, he talked about some of the most common cannabis delivery methods and their effects. [29:45]
Next, Tim went over the importance of keeping a journal when using cannabis to treat a medical condition. [36:38]
Cannabis has several chemical compounds (cannabinoids and terpenes) useful in treating PTSD. Tim talked about some of the most important compounds and their effects. [37:50]
Tim recommends hybrid and indica strains for PTSD patients. He says the Ice Cream Cake and Do-Si-Dos cannabis strains are easy to find at most of Utah’s pharmacies, and they work well for treating PTSD. For PTSD patients who prefer edibles, Tim recommends Zion Medicinals’ Plush Wild Cherry gummies. Tinctures also work well for treating PTSD. Tim recommends tinctures with THC/CBD ratios ranging from 1:4 to 1:10. [40:24]
Clif says low-THC, high-CBD cannabis products work well for his patients. Most of his patients who use cannabis prefer edibles. [41:51]
Next, Tim talked about finding the right cannabis doses for treating PTSD. He said scientific evidence shows a “sweet spot” for THC dosing between 7.5 mg and 12 mg. Too much THC can worsen anxiety associated with PTSD. [42:44]
Tim answered a question about Utah’s Compassionate Use Board, which can approve cannabis recommendations for people under 21. [44:48]
If you’re interested in talking with Clif about using Medical Cannabis to treat PTSD, call 801-851-5554 to schedule an appointment.
Tim Pickett:
Tonight’s webinar is by utahmarijuana.org. I’m Tim Pickett, a medical cannabis provider here in Utah. We’re going to do just a conversation really around PTSD and I am so happy that we have an expert essentially on PTSD and behavioral health, Cliff Uckerman. Will you introduce yourself, Cliff and talk a little bit about your background and you?
Clifton Uckerman:
Yeah. Well, thanks for inviting me to this webinar, if that’s what we’re going to call it, the metanar. So I’m a licensed clinical social worker. Graduated from the University of Utah, 2010. So since then have been providing substance use addiction, mental health services, clinical services for the last, what now, 12 years.
Clifton Uckerman:
And a lot of different settings, cradle to the grave, all different ages. Where I’m at right now, in my career, I think I’ve gravitated towards treating PTSD, trauma, understanding really what that is, what that can look like for so many different people. I’ve worked with thousands of different people, one on one, in groups, with families, and also gravitating more towards the use of medical cannabis in conjunction with trauma treatment or trauma therapies.
Clifton Uckerman:
So I also teach up at the U of U as an associate instructor and I am currently the senior clinical director and founder of Altium Health which is an addiction and wellness center out in Jordan Landing. But I’m just in the process of really trying to be a behavioral health provider in the medical cannabis industry. Unlike, I think, anybody is doing right now, I think a lot of us are trying to figure out with insurances and philosophies of therapy and trying to break down all the stigmas and stereotypes around marijuana and cannabis, trying to figure out where a lot of us behavioral health providers are trying to figure out how does this work and how can we make this work and be a good thing for a lot of people with PTSD. So I’m really interested in continuing to find the model that works for this in the medical cannabis industry.
Tim Pickett:
It’s cool to have you as part of this, and I think we’ll get into some discussions that I haven’t been able to have with anybody in the clinical setting regarding PTSD specifically and medical cannabis. So topics, we’ll try to go over tonight. What is PTSD? Some symptoms of PTSD. What the effects of THC and CBD are in general, but also specifically four symptoms of PTSD.
Tim Pickett:
We’ll discuss a little bit of the mechanism of action, what we think is happening. There’s some of this we know and some of this that’s assumed, right? You think, “Well, maybe we should know more before we use it, but frankly we don’t know the mechanism of action of a lot of drugs we use in “normal medicine” Right? So then we’ll talk about suggestions and uses of medical cannabis. And at the end, I’m going to make a couple of product recommendations that I think are similar to products that you might want to try or really products you might want to go out and try yourself.
Tim Pickett:
This webinar and more videos can be found at Discover Marijuana. This is a QR code. You can just take a picture of it right now. If you are not subscribed, and you’re somebody who is interested in medical cannabis, there are a lot of videos there. There’s a lot of videos with me and Blake Smith who’s a bio analytical chemist for Zion Medicinal, lot of mechanism of action for other conditions. A lot of discussion around different forms and delivery.
Tim Pickett:
I like this YouTube channel. There you go. Subscribe to that. So let’s talk to about PTSD in general. So Cliff, this is really your wheelhouse, right? What is PTSD?
Clifton Uckerman:
Well, the way that you’ve got it listed up here referencing the APA, American Psychiatric Association. So the DSM, the Holy Bible of Psychiatry where we get all of our mental health diagnoses disorders would say anybody who’s experienced or witnessed a traumatic event or been threatened with death, sexual violence or serious injury.
Clifton Uckerman:
So that’s one way to define it. But when I work with patients and the way that I define it is it’s that negative life event that a lot of us may experience in our lives at one point in time in our life, that kind of leaves a sense of shock, internalized shame, grief, and makes us feel really bad about ourselves in a lot of different ways. A lot of times the trauma is something that leads to detrimental development, and we look at it and we can’t see any good from it. We can’t see any positive coming away from it.
Clifton Uckerman:
So it just leaves the mind, the body, the spirit in a lot of distress. So we later on, if we don’t talk about it and we’re not processing the trauma in order to reverse the trauma or heal the trauma, then we end up having nightmares flashbacks, lots of anxiety. Anxiety is probably number one when it comes to PTSD in terms of symptoms. So that’s how I would probably define PTSD. You got a list of symptoms right here, again, nightmare effects.
Tim Pickett:
Do you find that there are symptoms that are more common in this list or is everybody really different?
Clifton Uckerman:
Well, everybody’s symptoms express and manifest differently in different kinds of ways, but generally across the board, the common things that I see is lots and lots of anxiety. And that would include social anxiety, sleep problems, insomnia, of course the flashback and nightmares. But essentially, one thing that is common between everybody with a PTSD diagnosis is this kind of state of hypervigilance, being very hyper aroused.
Clifton Uckerman:
So getting triggered from something or someone in some kind of setting or context, and having a really bad, negative, distressing reaction to that. So that could lead to some kind of flare up of blowing up, acting out, getting angry and explosive. Running away, avoiding, shutting down hiding out and isolating from people is typically what I would see between a lot of different people diagnosed with PTSD.
Tim Pickett:
Is this something like with chronic pain, when we look at it clinically, we would say, “Okay, is this pain something that is affecting your ability to do the things that you want to do?” Right?
Clifton Uckerman:
Yes.
Tim Pickett:
So that’s the physical part of you use a physical symptom and then you say, “Well, is this actually harming or keeping you from doing other things like your leg pain? Then I would say, “Oh yeah, you have chronic pain. We need to deal with that because it’s affecting your ability to do things.” Is that one of the criteria when you’re diagnosing somebody with PTSD? It’s not just I’m anxious all the time, or I have these triggers, it’s that I’m actually doing things differently because of the trauma.
Clifton Uckerman:
Yeah. And with PTSD and all disorders in the DSM, you really can’t make a formal diagnosis unless there’s some life domain impairment. So between all of the people that I work with that have an actual precise accurate diagnosis of PTSD, employment is disrupted. A lot of people have a hard time going to work or being at work. Relationships with family, spouses, children, friends, parents, siblings are pretty impacted and there’s a lot of relational distress that can occur and happen.
Clifton Uckerman:
Then so many other life domains can be affected too. Sometimes in an attempt to escape or even avoid a person can start to maybe self-sooth or use different types or forms of medication, whether it be legal and prescribed or elicit and off the street. So sometimes with that kind of use can come health problems, emergency room visits, sometimes criminal charges and incarceration. So anytime there’s a life impairment, that would be one criteria of meeting a diagnosis.
Tim Pickett:
Is typically the diagnosis done with like a paper evaluation. You have of like a questionnaire people fill out and then you score it and then you take that with a behavioral health like evaluation?
Clifton Uckerman:
Yep. There’s so many different instruments, but we use the instruments that were developed and certified by the VA, which diagnosing PTSD originally when it came along to be a formal diagnosis was with military coming from post deployment and combat. So the VA has a lot of specialty in diagnosing and screening for PTSD. So we use what’s called the LEC-5 and then the PCL-5 which screens for the life events and the symptoms. It’s like a symptom checklist.
Clifton Uckerman:
If that has a positive suggestion for PTSD, then we do a full on behavioral health assessment which takes about an hour. And we look at self-reporting, we look at presentation in the symptom. We’re making observations around the information that’s being provided. And then we do a collateral kind of clinical collection of documentation from other providers or history of providers.
Clifton Uckerman:
Now, what we notice is most people that I work with, chances are have some kind of trauma that’s still affecting or impacting them and causing some disruption in life domain. A lot of times we look at a diagnostic matrix, how many symptoms or sets of symptoms come into the picture or with that patient that might indicate a particular mental health diagnosis like anxiety and depression and bipolar and those kinds of things.
Clifton Uckerman:
What we notice is a person that comes in with a history of three or more diagnoses in their diagnostic matrix, chances are that is all falling under the umbrella of a PTSD diagnosis.
Tim Pickett:
Okay. I think in medicine that I have experienced in, it is much more… It’s 15 minutes. I get 15 minutes, 20 minutes with the patient. We’re going to talk about it real quick. And then I’m going to pick a medication to put them on. What you’re essentially saying is that that doesn’t really help people in some ways, right?
Clifton Uckerman:
It’s part of it. It can help and it’s part of it, but it’s not the end of the road for a lot of patients for sure.
Tim Pickett:
Right. Okay. So in Utah, PTSD is the only condition that is in the mental health world, in the behavioral health world. PTSD has to be diagnosed by one of these psychiatrist, psychologist, LCSW, psychiatric APRN. And you also have to be in ongoing treatment, in ongoing treatment. So it’s the only condition in Utah that requires not only the diagnosis, but you must be an ongoing treatment which I think is a good thing. Would you agree with that?
Clifton Uckerman:
Yeah. I mean, I think people have a hard time when they feel like they’re forced to do something. So if a person has choice and control and they’re getting good quality therapy to treat trauma takes a lot of expertise. I think most people probably would want good therapy over the long-term. We screen patients and we say how long do you think you want to be in therapy? And most people with a true precise, accurate diagnosis of PTSD are wanting to be in therapy for a year or more because there’s so much that they need to work through and be able to process.
Tim Pickett:
So let’s talk a little bit about… We’re not going to go through these very much, but there are some studies and I find these are particular ones that I picked out. So some Israeli research is very interesting. They have given a hundred grams of cannabis flower per month to some of their soldiers, right? A hundred grams. That’s a lot of flower. Okay. In Utah, four ounces, 113 grams. So we’re talking more than three ounces, three and a half ounces of flower.
Tim Pickett:
You’re smoking more than not quite an ounce a week. I don’t know how much in this study, the patients we’re actually using, but they’re measuring symptoms before. They’re measuring symptoms after. And they’re showing really good results with access to cannabis flower in this study.
Clifton Uckerman:
Right.
Tim Pickett:
In 2017, there was a really good review too about CBD specifically that it produces an enduring reduction in learned fear expression. So one of the things that we’ll go into, and maybe we have a slide on it, I don’t really know. But what’s happening from a brain chemistry standpoint is you’re building callouses between the amygdala, the emotional part of brain and the frontal lobe, which is your reasoning. You’re building these pathways that it’s hard for the brain to get out of. And that is what we would consider learned fear. Right? If we can reduce that learned fear, then in theory, we can reduce the impact of the trauma to the patient’s life experience.
Clifton Uckerman:
Right. Yeah. Lessening the anxiety, reducing the symptoms so that we can slow things down and lessen the reactivity that a person often exhibits to be able then to do more work below the symptoms of it all.
Tim Pickett:
Yeah. So that makes sense. You’re basically utilizing it to soften the clay so you can mold it a little better.
Clifton Uckerman:
Yep.
Tim Pickett:
Right?
Clifton Uckerman:
That’s a great analogy.
Tim Pickett:
Okay. So the effects of Delta-9, this is kind of a fun little video where Blake talks about it.
Tim Pickett:
What’s happening in the body chemically with depression? Why is cannabis good or bad? Tell us about that.
Blake Smith:
If someone is having depression, this is not going to really inspire you not to be depressed, right?
Tim Pickett:
Right.
Blake Smith:
This is just a chemical explanation about this and really work with your doctor. Everyone deserves to be happy and have joy. It’s not just the interplay of dopamine by itself. It’s melatonin, it’s serotonin, and you have a whole slew of other neurotransmitters that are all oscillating. So what you’re trying to do is get to homeostasis or this natural typical curve.
Tim Pickett:
I show that partly because if you want more information about this, you can go to Discover Marijuana and you can listen to Blake talk a lot about stuff like that. All these different pathways that THC and CBD are affecting, and really not necessarily what we’re talking about here in depth, but that’s the chemical explanation of how these things are helping because CBD and cannabis in general is really trying to get the body back to homeostasis.
Blake Smith:
Yes.
Tim Pickett:
It’s a very, very interesting substance that will stimulate certain pathways in the neurons and inhibit other pathways in order to maintain that balance. It’s what you and I really like about the cannabis treatment in general. We find that the things that cannabis can be really good for is improving sleep, decreasing anxiety to a certain extent if you’re using it correctly in the correct dosing and delivery forms for the patient, having the right kind of intention around the cannabis use tends to help lower anxiety, anger outbursts, and avoidance behavior.
Tim Pickett:
Have you found, Cliff that the avoidance behavior goes down? This is somebody who doesn’t want to interact with that individual because in the past they had a traumatic event with somebody who looked like that.
Clifton Uckerman:
Yeah. Or sounded like them.
Tim Pickett:
Or sounded like that.
Clifton Uckerman:
I said the same things that they said. I think that with the use of cannabis… And lot of times I think the CBD, that’s part of the ratio. A lot of these symptoms are lessened. I think when they’re in session and doing therapy then… Because trauma is really memory. So you have a traumatic memory with a lot of feeling embedded into that memory. So anything that triggers the memory is going to trigger a feeling.
Clifton Uckerman:
So if I have somebody that’s coming in to do trauma therapy and it’s in conjunction with medical cannabis, then they have a whole hour that they can sit without running away and really confront and face the memories and then process the emotions. The trick in the trauma therapy, which is why I love the use of medical cannabis, because it allows the person to be able to release and relinquish themselves from those feelings being calm enough and slowed down enough, and less anxious enough to be able to have a really good cry.
Clifton Uckerman:
A cathartic moment like that releases those emotional molecules, which are just really built up toxins stored in all of those old memories that’s creating disturbance internally. So that’s what I love about the medicinal cannabis. [crosstalk 00:20:27]
Tim Pickett:
Are you specifically having certain patients or are certain patients choosing to use cannabis during their sessions?
Clifton Uckerman:
Yeah. Whether it’s cannabis or an anti-anxiety pill or an antidepressant, typically people who are on some form of medication are taking their daily dose in the morning before they get up for the day and get ready and do something with their life including therapy. So if it’s medical cannabis that they’re using when they get up and before therapy, that’s what they use. And oftentimes if that’s what they do, the therapy session is just a much more meaningful for them and much more quality with the time that we have to be able to work through and process things that they normally would be hyperaroused by, hyperreactive to avoiding, not wanting to talk about being afraid or too anxious to talk about.
Clifton Uckerman:
Sometimes the medical cannabis actually helps restore the memory because a lot of times people don’t remember what there is to talk about and they can’t recall what to talk about in the first place. And that’s just because of that hyperaroused kind of state of mind that they might be in or that hyperactive emotional state that they might be in.
Clifton Uckerman:
So if they take their medicinal cannabis in the daytime and the morning when they get up, they come to therapy, they’re much more able to remember and recall, have an emotional release and then be able to confront and face those fears without all of the anxiety.
Tim Pickett:
I love this, and I don’t think there’s enough of this going on in… Certainly we’re not talking about it enough, and I think people really need to hear that this is an option. When you talk about like the mechanism of action, which is the next slide, which we don’t really… This isn’t something that I want to spend much time on in detail, but we’re… Cannabis enhances the present by disconnecting us from our short term memory a little bit. But you are bringing up that you can access these long-term memories, and it seems like that would be more clear because there’s not so much distortion or noise. There’s not so much noise in the mind. Right? You’re able to really focus like you say and slow down and talk it out. Right?
Clifton Uckerman:
Right.
Tim Pickett:
And like you say, have a good cry. I think there are a lot of us and probably even in the participants, in the audience here that have experienced that. It’s not all just euphoria and giggles with cannabis. There are times when you can have an incredibly meaningful conversation with somebody and learn a lot about yourself and about your perception of reality and very, very meaningful experiences.
Clifton Uckerman:
Right. Getting real with some stuff. The other thing too, that I don’t think most people realize is that in trauma work, even being able to talk about these kinds of things in session, and a lot of times people are sharing things in ways of themselves that they’ve never shared before with anybody else at all, because it’s been so buried and it’s been kind of trapped and contained in shame and secrecy because a person feels like it was their fault. They’re to blame. They did something wrong. They weren’t good enough. There’s something wrong with them.
Clifton Uckerman:
Now, the thing that most people don’t realize is that after that session, because that person has been able to disclose so much in such a vulnerable way, it likely will leave them feeling insecure when they walk away and after they go home questioning, “Should I have brought that up? I shouldn’t have said that. I shouldn’t have told him that. I wonder what he’s thinking about me now.”
Clifton Uckerman:
So there’s a really can be in trauma work after a really good, meaningful, positive session, a whole lot of increased anxiety and securities in the aftermath of it. So that’s one thing that I also think that medical cannabis can help with. Oftentimes, I tell my patients, “Go home and take a good nap and try to sleep really well tonight.” And the one thing that helps them sleep and take a really good nap so that their brain can do pruning after all those oxytocins are released because of that good cathartic cry is use cannabis to help them get there to lessen the anxiety and to help them get to sleep so that their brain can do some repair work.
Tim Pickett:
I think the other thing I would add to that is allowing your… The nice thing about having a therapy session and having a professional that you work with, or a really, really good friend, somebody that you have as a trusted confidant giving you permission to be vulnerable so that you don’t have that. There is this anxiety associated with THC use as well. And a lot of times people have to give themselves permission to talk, and to be open.
Tim Pickett:
And to use and to be a little stony, I guess, for lack of a better word. Nathan has a question, but we’re going to get to that in just a second. And I think we can help with that question. So this slide talks about the mechanism of action of the endo cannabinoid system, which really the keyword there is modulation.
Tim Pickett:
So we’re creating things. We’re consolidating things. We’re trying to get back to a balance. We’re trying to get back to this homeostasis and we’re using the CB1. The CB1 receptor system is in the brain and the nervous system and the CB2 receptor system is in tissues. And we’re using both in trauma therapy and PTSD therapy.
Tim Pickett:
There’s this hypothalamic pituitary… This is emotional brain talking to the frontal lobe. That’s the simple version of that. And then the 5-HT1A, that’s that serotonin kind of pathway. That’s that depression pathway. It’s modulated a little bit, not so much activity with depression specifically with THC and CBD use more help with anxiety and that part.
Tim Pickett:
So let’s move on to some interesting stuff. So the tinctures and edibles, I want to teach everybody, remind everybody that tinctures and edibles are going to be a slower onset to peak effect. You’re looking at, I would say an hour to two hours to peak effect. You’re going to have a slow decrease over the course of four to six hours typically with oral methods of cannabis.
Tim Pickett:
Really good for consistent dosing. And if you’re taking it morning, noon, and night. If you’re taking it at night, tinctures and edibles tend to be really, really good because they last a long time and you can sleep. Then you have flower and vaporizers, inhaled methods, which are quick to action, but they decrease over a shorter amount of time, much more rapid.
Tim Pickett:
So this tends to be good for triggering events, things that you either know something is going to be triggering. So you can dose, or you have a triggering event and then you dose where an edible or a tincture is going to take a little too long to take effect. And this goes to the question, and I’ll read this question out.
Tim Pickett:
So the question is really around, “So there’s edibles before bed, but found myself super groggy in the morning.” And over the last few months, he switched to a dryer vaporizer, usually a one-to-one type strain. So that means a one part CBD, one part THC. We’ll talk about that in a couple of slides coming up, does not have the same effect, meaning not groggy. I’m hoping that I’m getting that right. “Any suggestions on methods might be better that will lead me functional in the morning?”
Tim Pickett:
So using these two slides as your guide, if you’re using a dryer vaporizer, you’re only going to get effect between two and four hours, but if you’re using an edible, you’re going to get effect for a long period of time. So usually it’s depending on the dosing and how long before bed, or how early you wake up.
Tim Pickett:
We can get a little more nuanced than that with absorption. Absorption can happen depending on what you eat, either slower or faster. So if you weigh a high fat meal, you might have more effect because it’s a absorbed with the fat, and that may actually last longer as your gut slows down with these big meals. So you can tend to get an eight to 12 hour sometimes almost high from an edible and leave people groggy in the morning.
Tim Pickett:
So I think if the question is trying not to feel groggy in the morning, then the answer is using shorter methods like flowers. That’s the answer. If the question is you want to sleep as good as you did with the edible, and you’re not getting that effect with the flower, that’s probably strain related or level of dose related more so than the duration of effect. And there’s a couple of suggestions in my last slide about products.
Clifton Uckerman:
Is it also possible too that with the edible before bed that all has to digest and then it has a longer span of time to take effect and stay in effect?
Tim Pickett:
Yes. Because you might only be absorbing one or two milligrams at a time and you might be absorbing clear through the night.
Clifton Uckerman:
Right. Go ahead, Tim.
Tim Pickett:
No, go ahead.
Clifton Uckerman:
I was going to say, so just my part as a therapist, as a medical cannabis therapist because we really want to try to have the greatest and most positive effect of what’s being consumed, be on the most effective of the least amount of things, right?
Tim Pickett:
Yes.
Clifton Uckerman:
So something that I’m seeing here, if Nathan came to me to therapy, I would probably really want to explore, also, what is the antidepressant? What is the anti-anxiety? And what kind of edible is it? What strain and ratio is it? Because I want to understand the interaction risks between all of these things, but I would want to also understand is sometimes if I wake up groggy and still tired, something has been flooded, chances are, and you got antidepressant and an anti-anxiety depending on what types of medications those are and the dosage that he might be on in combination with the edible, whatever that is, could actually be not the best concoction or mixture of medications.
Clifton Uckerman:
So I’d want him to explore that and really then talk to somebody like you, and see if there’s a way to get on the least amount of the most effective. As a medical cannabis therapist, I typically would tell my patients, “Gosh, you know what think about one or the other.” I mean, medical cannabis is very natural, organic. It’s a plant based medicine and the antidepressants and anti-anxieties come from the lab and are based… It’s pharmaceutical based.
Tim Pickett:
Completely synthetic, yep.
Clifton Uckerman:
Synthetic. So you never know, and there’s no recurrent research that tells us, “Hey, this is what happens when you put these things together in your unique body.” So that’s the kind of conversation that I would also probably want to be having as well.
Tim Pickett:
And that brings up Colin’s point, which is here, that it’s best to start low and go slow and then keep a journal. So keeping a journal, not only of your cannabis use, but of your other medications that you take, and maybe even what you’re eating for dinner. I know that these journals… We don’t want these journals to be so detailed that you’re not going to do it, but if you have a set of things that you’re tracking and then a couple hours later, how you feel, especially with cannabis, if you’re tracking how much you take and when you take it, and then how you feel a couple of hours later, then you’re going to… Over time, you’re going to get a sense.
Tim Pickett:
You’re going to be able to go back and get a sense of what’s working and what might not be. But the whole old point of a journal is to keep the record. And like Nathan said, I mean, if you’re tracking too much data, you’re not going to do it. So only track enough data that you’re going to do it every day or do it every session. And over time you find like I definitely have things that I will not take at certain doses. I promise you.
Tim Pickett:
I am very specific at about a couple of things. Let’s talk about that specifically, what to take and what to look for, for PTSD and mental health really. And maybe what to avoid a little bit. So terpenes are found in everything, right? When you go through the forest and you smell, you’re smelling pine. When you eat a lemon or smell an orange, or there’s a lot of limonene in that. Myrcene is the most dominant terpene found in cannabis.
Tim Pickett:
It’s up to, I think, 4% in some strains, but definitely the most common. Linalool is very much like lavender. That’s the smell that we have. And caryophyllene, beta-caryophyllene is a common anti-inflammatory terpene. It’s very common in strains that tend to help with chronic pain, but these three are my favorite terpenes when it comes to PTSD symptoms. If you have the ability to look for terpene, product with these terpenes, either added or these terpenes are dominant in the flower, then these would be pretty good.
Tim Pickett:
The cannabinoids, there’s about 120 cannabinoids we know of. THC is a cannabinoid, CBG, CBC, CBD, and CBN. CBN is known for its relaxing properties. It’s known to be very calming. It is very good for sleep and calming anxiety during the day.
Tim Pickett:
So if you’re looking for products with cannabinoids or terpenes that may help a PTSD type of condition, these would be where I would start. And you can find this particular graphic on utahmarijuana.org. And you can find information on terpenes. It’s readily available online. Terpenes are essential oils, right, which a really common thing in Utah to treat things.
Tim Pickett:
One warning about terpenes, you do not want to inhale terpenes on their own, right? You’re not vaping terpenes. Don’t vape your essential oils. That is very, very dangerous. It’s not recommended. You’ll notice in these products, there’s very small percentage of terpenes added because they can be very strong in low doses.
Tim Pickett:
And then product recommendations, for me, I’m going to tend to recommend indica or hybrid type products. A couple of things in Utah that are fairly common and easy to find are ice cream cake and Dosie Dough. Dosie Dough is a vape cart and a flower. There’s a bunch of different companies that make these products with the Dosie Dough kind of breakdown.
Tim Pickett:
The only edible that I could find with a breakdown of what’s actually in it was a Zion Medicinal, the Plush Wild Cherry gummies. The reason why I like this one is because of the ratio. I think you want that ratio of THC to CBD, which brings me really to my favorite products for PTSD and for new patients, which are tinctures. I recommend ratios of one to four, up to one to 10 THC to CBD.
Tim Pickett:
If you go back in our slides, you’ll find that that CBD research is really good and CBD tends to smooth out the rough edges of the THC effect. So patients who use them together tend to have better sessions when they’re in that one to four ratio or at least one to one ratios. Cliff, do you have any favorite products?
Clifton Uckerman:
Yeah, I think anything that is higher CBD, lower THC. For me and my patients, the one to one sometimes can be a little too much. The one to four, what do they got, one to 10, one to 30. And then some people really do like flower and there are flower products out there that are mostly, if not all CBD with a little bit of THC, which can be really helpful. But they’ve got vapes and tinctures and edibles. But I think for me and my patients, the tinctures are great, but edibles tend to kind of be what I hear a lot of my patients using a lot more is the edible.
Tim Pickett:
This is good slide for reference for dosing. Just like Cliff was saying, the one to 10 THC to CBD, that seems to be a really good sweet spot for people who are new to cannabis, to people who want to decrease anxiety, help their sleep, decrease their dreams. That 2.5 to 12.5 milligrams per dose also seems to be, when you look at the evidence, we tend to come to this 7.5 to 12.5 has the sweet spot for THC dosing.
Tim Pickett:
A lot of that is around, if you get too much THC, the brain starts to spin and you’re watching the waterfall. You’re behind the waterfall and this is just going and going and going. And that can ruin your sleep.
Clifton Uckerman:
Especially the sativa. I you already come with a lot of anxiety and anxiety is a big part of PTSD, but if you already have a lot of anxiety and then you’re using really high dosages of THC and sativa chances are, you’re probably going to get a little bit more paranoid. Anxiety can turn into paranoia if your brain is overactivated.
Tim Pickett:
The last thing I’ll say before we get to questions is if you are concerned about the high start with CBD one milligram per kilograms, take your body weighting pounds, divide it by 2.2, that’s your kilograms. One milligram per kilogram per day. Start with that, right? So I’m 170 pounds. That’s 80, 75 kilos. So I’m going to take 75 milligrams of CBD every single day divided. So I take a slug, I call it. Just take a good slug in the morning, good slug in the middle of the day. And that will help on its own without any psycho activity, and can be used during the day, because it’s not psychoactive and you don’t get that high feeling.
Tim Pickett:
So let’s go to some questions. We’ve got a question about a teenage child who’s been diagnosed with PTSD at a loss for how to handle the compassionate service board. Yes. I have some comments about that, if I have any advice. She has a diagnosis from her therapist who’s an LCSW. Her therapist is supportive, but not a QMP. So this is a great question and there’s a couple of things about this. Cliff is an LCSW, right?
Clifton Uckerman:
Yes.
Tim Pickett:
So Cliff cannot be a QMP under state law because he doesn’t have a controlled substance license or a license to prescribe controlled substances in Utah. That requires somebody like me, a PA with a controlled substance license. So in this case, no matter what, if the patient is diagnosed with PTSD from a LCSW and you then go to see a QMP, you can take that diagnosis and that letter of treatment, and you can then get a recommendation from the QMP for medical cannabis.
Tim Pickett:
So these two things go together, right? You’re going to get the cannabis recommendation from the QMP. You’re going to get the help and the therapy from the clinical social worker. And I hope that makes sense. That’s just in general, the process. Then you add on to that the Compassionate Use Board for somebody under 21.
Tim Pickett:
So that application has to be done through the QMP with help from the social worker. So there’s an entire application process that has to be done. They have to take that application to the Compassionate Use Board, which is seven physicians in Utah. And that board will make a recommendation for medical cannabis and allow them access.
Tim Pickett:
Then you, as the parent have to have a guardian card or a caregiver card to help them access that medication, if they’re under 18. The process takes one to two months. And really if the patient is between… If they’re 16 and over, you can go to utahmarijuana.org, and you can see us. We will help. The Compassionate Use Board has been a little hesitant to use specialist providers as QMPs. It’s a tricky scenario, but we can help guide you through it.
Tim Pickett:
So give us a call. We have somebody who’s actually an expert on the Compassionate Use Board and, and does all of that for us. So hopefully that helps, and we can get you more resources as well.
Tim Pickett:
Okay, perfect. I’m going to answer that one. There we go. And then we had a nice comment. Very thankful to us for… We’re exploring the cannabis family. Yeah. Thank you. I don’t know if it’s Jeanie or Jean, but thanks for those kind words.
Tim Pickett:
Yes. Cliff and I actually really like this stuff. I don’t know if you noticed, but we’re all jazzed up about this, about this topic, right? I’m fascinated with the idea that you can manipulate the mind and you can change like you can change behavior and you can change your perception of your own life and your experience. I think that’s so important and I think that’s missing with modern medicine. I just feel like a lot of the times we just prescribe, and prescribe, and prescribe and dull everything.
Clifton Uckerman:
Yeah. Yes.
Tim Pickett:
And cannabis is like a turning point. It’s not about the cannabis. The cannabis is just unlocking something that is allowing us to take a step forward in our life and in our growth.
Clifton Uckerman:
And there also may be some healing properties too. I mean, I think for me, I grew up as a delinquent youth. So I was in the system a lot. As a way to prevent youth from getting into trouble, they made us feel like all drugs and alcohol were bad and to never use it. Well, when my brother had diabetes and it went blind because of glaucoma, he started using cannabis and brought his vision back. And with all the people that I’ve worked with, especially when I worked in the jail and I ran a program there, we could not talk about it, yet most of the people in there were in there because of drug charges and a lot of it marijuana and were also using cannabis when they were in jail. Sometimes they would use it in jail too.
Tim Pickett:
Oh my gosh.
Clifton Uckerman:
But we couldn’t talk about it. So in the last couple years, as I’ve been working more with patients with trauma and seeing how much this can help and have healing properties, I think it’s something that I want to be a part of and be involved in the conversation about, for sure.
Tim Pickett:
Okay. We have a last question and it is perfectly timed, so thank you Nathan for asking it, and that is this, “Any recommendations to find a therapist willing to work with a cannabis patient like him?” Well, yes, there you go. Call Cliff. And you can get a hold of Cliff by reaching out to us because that’s not part of this presentation as far as our… And I think probably just an oversight on my part, frankly, Cliff, so sorry. So go to utahmarijuana.org, reach out to us, mention the webinar. We will set you up, right?
Tim Pickett:
We’ll give you all the information you need and you can just call our office. We have locations and Cliff is going to be involved with us clinically in our locations, specifically in Bountiful, if that’s somewhere that you want to go. To be honest, I want to do it because I’m just interested in utilizing cannabis like going to the next level and getting really serious about my mental health and use some cannabis.
Tim Pickett:
You can also follow us on Twitter, Facebook, Instagram. We’re on all the things. And at the end of this, hopefully if you’ve signed up for this, then there’ll be a feedback poll. So we really appreciate the feedback. One way to get ahold of me or Cliff is when this is posted on YouTube. If you make a comment on any of the videos that I have, we answer all those questions. It’s better than email because when we answer the question, we get to answer it for everybody and not just keep it a secret for only you.
Tim Pickett:
I think that’s the best way to get the information out is just go to YouTube, comment away and we’ll get it. Anything else that we missed, Cliff?
Clifton Uckerman:
Nope. I think that was great. I appreciate it. It sounds like everybody had a good time. The one thing I wanted to mention is if you can’t journal, some people have a hard time writing and tracking stuff, come to therapy. Let me be your journal. I’ll keep a documented record of it. Every time you come in, we’ll measure it every time. We’ll send it to Tim and we’ll all work together to make something work for you in the best kind of way.
Tim Pickett:
That is a great idea. All right. Thanks, everybody. Stay safe out there, will you?
Clifton Uckerman:
See you later.
Nearly every plant species in the world has its landrace varieties. Many animal species do as well. If you are guessing that cannabis has its own landrace strains, you’re right on the ball. Unfortunately, such strains are rare. They are exceedingly difficult to find these days, which is why they are so expensive.
The landrace principal is based on the concept of adaptation. No matter where you go in the world, local flora and fauna adapt to the natural environment. It is why you find different varieties of pine trees in upstate New York as opposed to central Florida. Cannabis is no exception to the adaptation rule. Different strains have grown in different parts of the world for millennia.
What you will find with landrace varieties is that they possess unique environmental properties. We cannot speak specifically to cannabis because true landrace strains are so hard to find. But a good comparison would be coffee. Here are some common types of coffee with properties specific to the regions in which they are grown:
This post is not about coffee, so we will leave the examples here. The point is that coffee takes on unique characteristics based on where it is produced. The same holds true for landrace cannabis. The big difference between the two is availability. Landrace coffees are widely available; landrace cannabis strains are not.
So why are landrace strains so difficult to find? According to The Cannigma, the main culprit is hybridization. Back in the 1960s and 70s, cannabis was a lot more local than it is today. Somewhere during that time, growers began searching for new and exciting strains they could bring back to the U.S. to crossbreed. They went far and wide looking for strains that offered exactly the right mixture of cannabinoids and terpenes.
Years of crossbreeding taught them how to produce plants with the most desirable properties. They learned how to increase THC levels and manipulate growth cycles. They learned how to create more robust plants capable of surviving harsh weather conditions.
Because hybridization now dominates cannabis production around the world, it is getting harder and harder to find genuine landrace strains unless you are willing to go out and hunt the wilderness. Most of what is produced today is the result of hybridization and cloning.
Older cannabis users may long for the ‘good old days’ before hybridization, but the truth is that hybridization is not necessarily a bad thing. Over the years we have learned a lot about cannabinoids and terpenes. We are just beginning to understand how isolating and combining specific cannabinoids with select terpenes can lead to better medicines.
Even now, skilled processors here in Utah are investigating hybridization techniques that could lead to better products. Imagine a day when medical cannabis products are as specific as other prescription drugs. That day is coming, thanks to research and hybridization.
Meanwhile, consider yourself lucky if you ever manage to find a landrace strain. Such strains are hard to come by. They are as unique as the environments in which they are grown, just like landrace varieties of any other plant or animal species.
CBD oils, vapes, and other products can be legally bought and sold without any special license or permit. In Utah, the same cannot be said about Medical Cannabis. If you don’t think this matters, think again. The results of a research study published in early 2021 suggests that CBD can reduce the effects of a THC high. That puts a whole new spin on the differences between the two cannabinoids.
Cannabis products are generally divided into two categories under Utah law. CBD products contain less than 0.3% THC by volume. Medical Cannabis products contain more than 0.3%. Both types of products are derived from cannabis plants. Just the fact that we think of them separately tells us everything we need to know about how policymakers view CBD and THC.
Perhaps that’s why so little work has been done on combining the two cannabinoids for medical purposes. But now that scientific research demonstrates that CBD affects THC uptake, there may be room to develop an entirely new line of medicines for Medical Cannabis users.
The study in question was published in September 2021 in the Journal of Clinical Psychopharmacology. Conducted by Spanish researchers, the study looked at combining CBD with THC and measuring its impact on the human brain. Researchers discovered something phenomenal: combining THC and CBD at a 2-to-1 ratio led to a less intoxicating THC high.
The thing about CBD is that it is psychoactive in the sense that it can affect mental and emotional responses. We tend to consider it non-psychoactive because it does not have an intoxicating effect. But psychoactivity is psychoactivity, whether it happens to be intoxicating or not.
A patient might take CBD because it helps relieve anxiety. It might help another user who struggles with mood swings. Either way, people use CBD because it helps them feel better. If we can combine it with THC to make a better medicine, why not do so? Why continue to keep them separate?
Right now, the implications of combining CBD with THC are still being understood. Still, think about what the results of the Spanish study might mean for medical users. Combining CBD and THC could give a Medical Cannabis patient the best of both worlds. It could mean the benefits of THC without a seriously intoxicating high.
This has pretty serious implications for people who need to medicate around the clock – even at times when being high is not acceptable. We can imagine the day when a CBD-THC combination makes it possible for Medical Cannabis patients to hold jobs they currently cannot hold.
Then there are those patients who need THC but just do not want to experience the high. If CBD can minimize the intoxicating effects without seriously reducing the therapeutic benefits of Medical Cannabis, such patients would be in a much better place.
One thing we definitely know is that there is still a lot to learn about cannabinoids and how they affect human biology. Here at Utah Marijuana, we are just happy to see that serious research is finally getting underway. Trying to understand how CBD influences THC uptake is just the tip of the iceberg.
If you are a Medical Cannabis patient in Utah, keep an eye open and an ear to the ground. We will be seeing more research as the months and years go on. Undoubtedly, a lot of that research is going to mean good things for Medical Cannabis here in Utah and around the world. That is definitely a good thing.
Chances are you have heard your fellow Medical Cannabis users talk about cannabis strains. Perhaps you’ve also heard about varieties and cultivars. So what’s the difference? Actually, there is none. All the terms are used to describe the same thing. Unfortunately, none of them are technically correct.
All the aforementioned terms are used to categorize different types of cannabis products. What we normally call strains or varieties are actually chemovars – or chemical varieties, if you prefer. They are known by their cannabinoid and terpene profiles.
All the science aside, we talk about different strains and varieties because we do not know any other words to use. That’s okay. Just know that the name of a given strain does not necessarily tell you anything about its makeup. It doesn’t really tell you about cannabinoid and terpene profiles.
It may seem important to study the many strains, varieties, and cultivars everyone talks about. But ask yourself this question: what is in a name? We are guessing you have one or two favorites in terms of your medicines. But what do the names of those medicines tell you? Not much.
Maybe you are a big fan of Blue Dream Vape or Wautomelon. Maybe Purple Urkle is your thing. Regardless, all those names are chosen for marketing purposes. That’s fine. You get to know the names of your preferred products and you stick with them. But what if you want to try something new?
The key is getting to know the cannabinoid and terpene profiles of the products you are currently using. You can then use that information to research new products.
Some people have tried to explain the differences in varieties as being similar to differences in wines. In the wine-making world, you have three main categories: white, red, and champagne. Knowing that you prefer red wine doesn’t do much for you in terms of the many varieties in that category.
You might like sweet red wine while your spouse prefers a nice cabernet sauvignon. Both types of red wine taste drastically different because they have different chemical makeups. It is the same thing with Medical Cannabis strains. Each product makeup means different results for patients.
The wine comparison breaks down due to the fact that there are very strict standards for classifying wines. Those standards have been in place for hundreds of years. No such standards exist in the cannabis arena. Until they do, a lot of what goes into finding the right medicine is a matter of trial and error.
The best advice we can offer for making sense of the many strains and varieties is to work closely with your Pharmacy Medical Provider (PMP) at your cannabis pharmacy. It is your PMP’s job to be familiar with the many different cannabinoid and terpene profiles in the products on pharmacy shelves. Do not be afraid to tap into their expertise.
Your PMP can help you figure out which products are best for your condition. You can contribute by tracking how often you use your medicines, the effects that you experience, and any other relevant information your PMP asks for. Together, you can come up with a solid therapeutic plan to ensure that you feel better.
One final thought is this: do not stress over having to choose between so many strains, varieties, and cultivars. All those different names you find on Medical Cannabis shelves are really just for marketing. Once you and your PMP figure out which cannabinoids and terpenes work best, finding the right medicines will be a lot easier.
Have you heard of a runner’s high? It’s probably safe to say that every one of us has either experienced one firsthand or skeptically rolled our eyes at someone who has. Apparently, after you run enough, you reach a point of euphoria where running becomes awesome and fun. I’ve never gotten there myself, but, boy, do I have some serious FOMO about it. Rather than literally chasing that high that may never come, I opt to get high and then run.
Chances are by this point, I’ve already lost some of you. Frankly, there was a point in my life when I’d never considered using cannabis before exercise. What a waste of a good thing, I’d say! And while it might not be for everybody, there are a few of us out there who have tried to exercise while medicated and found that it helped. Does it really, though? There are some experts who have gathered information about the subject (though it’s important to note that no official scientific studies have been run to test the effects of cannabis on exercise). If you’ve ever been curious about mixing the two, here are a few tips contrived of a healthy mix of my own personal experience and anecdotal evidence from said experts.
Note: I’m a Medical Cannabis patient, not a doctor or a scientist. The following should not be considered medical advice of any kind.
It’s important to understand your personal relationship with cannabis before attempting vigorous physical activity.* You’re not going to want to get your Medical Cannabis Card, get blitzed, and head to the gym. Patients of UTTHC are educated on the importance of finding your just-right dose and given a tailor-made treatment plan to follow to help them find optimal relief at the lowest possible dose (known as microdosing). You can download our Find Your Just-Right Dose guide and many other helpful Medical Cannabis guides here.
Once you’re comfortable with your body’s reaction to canna-treatment, take a moment to be mindful of how you feel. If you feel a little couchlocked, maybe take a bit less than your just-right dose prior to your workout. Remember, we’re going for medicated here, not stoned.
It’s no secret that Medical Cannabis can help treat chronic pain. The concept here is the same: when you’re exercising with cannabis in your system, your body can tolerate aches and pains much better. You may be able to run that extra mile, lunge a little deeper, or knock out a few more squats — and who knows? That extra boost could be just what you’ve needed all this time to see those gains you’ve been working so hard for. Check out this episode of Utah in the Weeds where we interview local athlete, Toby Larson, about how cannabis before exercise has helped him lose near 50 pounds.
Sometimes, a good workout is all about the experience you create for yourself. A good playlist and a little energy can carry us through most workouts, but when you need that extra oomph, cannabis can get you there. Microdosing before repetitive or tedious gym sessions — like weightlifting, running on the treadmill, or yoga — can get you in the zone faster and help you to stay focused on your form.
After a heavy workout (or a string of them), when your joints ache and your muscles feel like they’re on fire, you’re not going to want to throw on your gym shorts and head out to hit it hard again. Cannabinoids like CBD, THC, CBG, etc. can help to decrease that inflammation so your muscles can recover. Then you can get back to it sooner, ultimately helping you to build more muscle and get stronger.
Shout out to cannabidiol. Better known as CBD — the infamous ultra-therapeutic, non-psychoactive compound in the cannabis plant. CBD can help to treat many things, but we’ve gotta give it up for its anti-inflammatory and analgesic properties. These two properties in particular make CBD a gift when it comes to recovery. And while Medical Cannabis is legal in Utah, it’s not as quite easily accessible as CBD is. Not to mention the fact that not all of us can just go off and use cannabis. Maybe you’re regularly drug-tested or don’t like feeling “high”. I’m here to tell you that CBD oil will get the job done and you’ll likely notice a positive difference.
That being said, medicating with whole plant (THC and other cannabinoids included) is far more likely to provide more well-rounded relief, as many cannabinoids play off of one another in your endocannabinoid system. For example, while you’ll get one anti-inflammatory effect from CBD, you’ll get a totally different one from THC or CBG. Not to mention the effect you’ll feel when they all work together (called the Entourage Effect). There are roughly 100 other cannabinoids in the cannabis plant. You never know which might be your saving grace until you try. It’s worth a shot, no?
This goes without saying. I mean, obviously, right? But for those of us who don’t like exercising and have a hard time staying active because of it, microdosing a little cannabis beforehand could spice it up for you. (This same advice goes for other mundane tasks, like laundry and shoveling snow.)
So, if like so many of us, your 2022 resolution is to exercise more, be healthier, or feel better, I implore you to see what cannabis can do for you. You could go from couch potato to gym rat and flex on all of your loved ones by this time next year. If you still need your Medical Card in Utah, reserve an appointment in any of UTTHC’s six clinics across the state. What are you waiting for? Make 2022 the year you put your health first.
Now, considering the above — and because it’s fresh on everyone’s minds after the Sha’Carri Richardson scandal last July — do you think cannabis could be a performance-enhancing drug? And if so, should it be put in the same category as steroids for Olympic athletes? Here’s what our founder, Tim Pickett, had to say on the matter on KSL NewsRadio. What do you think? Comment below — we’d love to hear your thoughts!
Warning: If you suffer from heart disease of any kind, proceed with caution. Cannabis use can decrease blood pressure, making the heart beat faster. This could be cause for concern for those with heart issues, especially when physically active. Talk to your doctor before mixing cannabis and exercise.
* Some physical activities may not be well-suited for cannabis use. Use your best judgment.
It is fair to say that the amount of scientific study relating to cannabis safety and efficacy pales in comparison to studies of almost all other medications. There are lots of reasons for that, reasons we will not get into in this post. Rather, we want to discuss a 1970s cannabis study that offers a valuable lesson today.
The study in question, conducted in 1973 by researchers at Worcester, Massachusetts’ Mason Research Institute, was designed to determine lethal doses of THC in mammals. Researchers showed a particular interest in primates, using rhesus monkeys as test subjects.
Setting ethics aside for the time being, animal testing is fairly common in the medical field because it allows researchers to carefully study the effects of new drugs without endangering human lives. Primates are often utilized as test subjects because of their biological similarities to humans.
All vertebrates have endocannabinoid systems. Therefore, researchers had their pick in terms of test subjects. They chose rats, dogs, and the previously mentioned monkeys. Unfortunately, the rats fared worst. A majority of them died within the first 72 hours of the test.
Only two dogs died, but even their deaths were not attributed to the THC. Rather, they died of asphyxia after regurgitating and aspirating the material being pumped into their stomachs. As for the monkeys, not a single one died despite being given massive doses of delta-8 and delta-9 THC.
Again, the intent of the cannabis study was to determine a lethal dose of THC in the three test subjects. The fact that there was no lethal dose in either the dogs or monkeys says something particularly important: that different cannabinoid receptors in various animals respond to THC in different ways.
Despite being some fifty years old, the Mason Research Institute study still teaches a valuable lesson. The lesson is even more important when considered alongside the fact that there are no documented cases of human beings dying of THC overdoses.
The fear of overdosing is one of the things that keeps some people away from Medical Cannabis. They hear stories and assume such stories are true. They hear that cannabis is a gateway drug and they do not want to get started and then find themselves drawn to other drugs.
Those fears are understandable given what we have all been told about cannabis over the years. But they really are unfounded, based on the limited amount of research we already have.
There is good news in the fact that there doesn’t appear to be a lethal dose of THC for primates. But that does not mean all the data that came out of the 1973 cannabis study was good. Suffice it to say that the monkeys still suffered some pretty serious side effects from so much THC.
Some 90% of them suffered what we refer to as ‘cannabis toxicity’. If you know anything about cannabis toxicity, you know it can show itself in many different ways including paranoia and loss of motor skills. In the case of the monkeys from the 1973 study, they were observed sitting for hours on end, acting lethargic and holding their heads in their hands.
Different animals react to THC differently because their cannabinoid receptors deal with THC in different ways. A lesson in all of this is that primate endocannabinoid systems seem to be able to withstand massive amounts of THC without the threat of death. Dying from a THC overdose is highly unlikely, if not impossible. That gives Medical Cannabis patients one less thing to worry about.
Utah Marijuana works to educate patients about Medical Cannabis and help them obtain their Medical Cannabis Cards. As part of our educational efforts, we remind patients that applying for a card requires a valid, government-issued ID. If you cannot prove your identity, you cannot get a card.
The state recommends four options on their Medical Cannabis website: a state identification card, a state driver’s license, a U.S. passport, or a U.S. passport card. Most of the patients we work with have driver’s licenses, so the ID requirement isn’t a big deal. If you don’t have a driver’s license and can’t get one, we recommend getting a state ID card.
The first thing to know is that you cannot possess both a driver’s license and a state ID card. It is one or the other. If you want to get an ID card, you have to visit a state driver’s license office. They will take your photo and verify your identity with something like your birth certificate. You will also need to take your Social Security card and two documents proving state residency to your appointment.
It is a smart idea to download the ID application so you can complete it prior to your visit. The time you spend in the driver’s license office shouldn’t be long if all your documentation is in order. Also note that there is a $23 fee to get your State ID card.
ID cards have to be renewed just like driver’s licenses. Any state resident 16 years old or older can get a card. Even non-citizens can get ID cards valid for the duration of their stays, as long as they are in the country legally. As far as driver’s licenses are concerned, we won’t get into those here. Getting a driver’s license is an entirely different process.
When most people think of a U.S. passport, they think of a small book they carry with them whenever they travel overseas. At each new destination, the book is stamped to verify the individual has traveled in that country. However, there is another type of passport document known as the passport card.
A passport card is not a book. It is a small, plastic card about the same size as a credit card. It’s cheaper to get and more convenient to use. However, it has its drawbacks. You can only travel to Canada, the Caribbean, Mexico, and Bermuda with a passport card.
For our purposes, both are considered suitable identification for obtaining a Medical Cannabis Card. Possessing a valid passport or passport card would allow you submit your application without the need for a state driver’s license or ID card. We are guessing that most people with valid passports and passport cards also have driver’s licenses. Still, we figured we would pass along the information just so you would have it.
Despite the ID requirements, getting your Medical Cannabis Card doesn’t involve a hard process. It’s actually pretty straightforward. You start by going to the state’s Medical Cannabis website and filling out the initial part of the application. Then you make an appointment to see a QMP.
If your QMP recommends Medical Cannabis for your qualifying condition, they will complete the provider portion of the application. You will then go back online to finish your portion and submit the application along with your payment. That’s it. Then you just wait for your card to arrive via email. You can carry it on your phone or print it if you like.
Utah is similar to most other states with Medical Marijuana programs in that we maintain a list of qualifying conditions for which Qualified Medical Providers (QMPs) can recommend Medical Cannabis. The list is comparatively short when you consider how many different illnesses, injuries, and maladies people suffer with. Still, you might wonder if medical cannabis can be used for non-qualifying conditions.
The answer is not black-and-white. It has to be looked at from multiple angles, beginning with what the Compassionate Use Board (CUB) has to say about it. Then there is also the issue of obtaining a Medical Cannabis Card.
Right off the bat, you need to know that Utah law does not give patients the right to self-medicate. Qualifying condition or not, you are not allowed to grow marijuana plants in your backyard for the purposes of treating yourself. All Medical Cannabis consumed in Utah must originate from a Utah cultivator. It must be processed by a Utah processor and sold through a Utah Medical Cannabis pharmacy.
If you are using marijuana products in any unapproved way consider joining Utah’s Medical Cannabis program and make your use of cannabis legitimate. Getting a Medical Cannabis Card is no more complicated than filling out an electronic application form and visiting with a QMP.
When legislators were crafting Utah’s Medical Cannabis laws, they were fully aware that there may be times when Medical Cannabis is appropriate despite a patient not being diagnosed with a qualifying condition. They created the CUB for that very reason.
If you and your doctor believe you suffer from a condition that would be well-served by Medical Cannabis despite it not being on the qualifying list, you can always petition the CUB. The CUB is a panel of seven experts given the task to approve Medical Cannabis use outside normal state rules.
The CUB routinely reviews applications from people diagnosed with non-qualifying conditions. They also review applications from minors, given that state law prohibits children from using Medical Cannabis. At any rate, your condition will generate one of three results:
In the third case, you would have 90 days from the completion date of your application to provide the additional information. The CUB would review that information and render a decision from there.
Petitioning the CUB used to involve downloading a PDF application form, completing it, and sending it to the state. That is no longer the case. The CUB now utilizes an online form. Furthermore, it is a form you would never see as a patient. Instead, your QMP completes it.
To get the ball rolling, you would apply for a Medical Cannabis Card online. You would then see a QMP with whom you would discuss your condition. If you have non-qualifying conditions, your QMP would note that on the application. Next, the state would send the QMP an invitation to fill out the CUB petition form. Then it is a matter of waiting on a decision.
Medical Cannabis can be used to treat non-qualifying conditions under certain circumstances. Ultimately though, that decision rests with the CUB.
