There is a well-known phenomenon in Western medicine known as the ‘biphasic response’. This response is normally associated with a negative reaction to prescription medication. But the word ‘biphasic’ simply means ‘having two phases‘. When we talk about biphasic response in Medical Cannabis, we are talking about something completely different.
We believe it is important that Medical Cannabis patients understand the biphasic nature of cannabis itself. While a biphasic response to a more traditional prescription medication could be cause for alarm, that is usually not the case in the Medical Cannabis realm.
Let us start with the normal definition of biphasic response with prescription medications. Nearly every prescription medication comes with side effects. In a biphasic response scenario, you would experience those side effects twice. The first experience would occur shortly after taking the medication. The second experience could occur much later – perhaps at 7-10 hours.
Allergic anaphylaxis is often associated with this sort of biphasic response. No doubt anaphylaxis is something to be concerned about. But not all biphasic responses associated with prescription medications are serious. In fact, most are not. They can be uncomfortable though.
As a reminder, the word ‘biphasic’ simply means ‘having two phases’. When we apply the term to Medical Cannabis, we are simply saying that a single cannabis product can have opposite effects on the same person. Those effects occur in two phases.
For example, a small amount of Medical Cannabis could go a long way toward relieving your anxiety. But adding a second dose to your first, in too short a time, could reverse the effect. You could actually feel more anxious. Similarly, a particular dose could help you sleep better. A higher dose could keep you awake by boosting your energy.
The Cannigma’s Emily Earlenbaugh, PhD explains the biphasic response by using alcohol as an example. Your first drink of the evening might leave you energized and sociable. You are happy to be hanging out with your friends. But a few drinks later, you begin to feel just the opposite. You are sad, lethargic, and really don’t feel like socializing. Similar effects can be experienced with Medical Cannabis.
So, how do you avoid the biphasic response? By working closely with your Qualified Medical Provider (QMP) and Pharmacy Medical Provider (PMP) to find the optimal dosage and delivery method.
We like to say that Medical Cannabis is more of a journey than a medicating event. Patients respond differently to varying products, ingredients, and doses. But that’s not all. A single patient’s response can actually change over time. What you started your Medical Cannabis journey with is likely not going to be the same a few years down the road.
One of the goals of working with your QMP and PMP is to find the optimal dosage. You want to consume enough Medical Cannabis to experience symptom relief without consuming more than necessary. Finding that optimal dosage can keep the biphasic response at bay.
Making it all work is open communication between you and your medical providers. We recommend tracking your Medical Cannabis consumption on a daily basis. We also recommend sharing the data with your medical providers.
If you are ever concerned about a biphasic response, please do not hesitate to talk things over with your QMP or PMP. Either of your medical providers is qualified to help you determine whether you should be concerned. Your medical provider can also help you adjust dosage and delivery to avoid additional biphasic responses in the future.
Most cannabinoid discussions within the Medical Cannabis sphere are related to CBD and THC. That is not surprising, given the fact that the Medical Cannabis movement was founded on leveraging THC for its medicinal benefits. But now we see an emerging interest in minor cannabinoids. Do they have a place at the Medical Cannabis table?
Often referred to as ‘alternative cannabinoids’, minor cannabinoids are basically any and all cannabinoids that are not CBD or THC. There are lots of them. Some estimates peg the total number of cannabinoids in a typical cannabis plant at somewhere around a hundred. That said, it is probably important to distinguish between natural and synthetic cannabinoids.
For the purposes of this post, let us define minor cannabinoids as those that are produced naturally. Alternative cannabinoids are synthetic, derived in a lab. Delta-8 and delta-10 THC are prime examples.
On the other hand, CBDA is a good example of a minor cannabinoid. CBDA is known formally as cannabidiolic acid. It is actually the precursor to CBD. In its natural state, a cannabis plant does not offer CBD per se. Rather, CBDA becomes CBD when it is decarboxylated.
Despite its nature as a CBD precursor, it would appear that CBDA might have some pain-relieving properties. We don’t know for sure because research has been so limited over the last several decades. But a small scale study involving 150 Cannigma readers may provide at least some evidence in support of CBDA for pain relief.
The study challenged participants to use a particular brand of CBDA topical lotion over a 4-week period. They were asked to report their experiences with pain relief, or the lack thereof. This particular brand is a favourite among athletes who swear by its ability to relieve pain. Now we are waiting for the study results to be released.
To tell you the truth, the team here at Utah Marijuana will not be surprised if research data confirms what athletes have been saying about the topical lotion all along. We already have access to a ton of anecdotal evidence from people who report that topical CBD lotions relieve all sorts of muscle and joint pain. Why wouldn’t the new study data back them up?
Full disclosure requires admitting that we still do not know the mechanisms behind how all of this might work. We do know that the human endocannabinoid system plays a predominant role in a large number of biological functions. We just aren’t sure of all the details.
We mention all of this to say that CBDA is considered a minor cannabinoid. If it does indeed provide pain relief for aching muscles and joints, then it is a legitimate part of the Medical Cannabis equation. Likewise for any other minor cannabinoids that could ultimately prove to offer medical benefits.
If you are a Medical Cannabis user in Utah, we would encourage you to not count anything out. Keep an open mind. Stay abreast of all the news and happenings within the Medical Cannabis community. There is more to learn every day, and things are moving at a brisk pace right now.
We feel like there is a lot more to minor cannabinoids than medical science knows. They could end up making big contributions to Medical Cannabis in the coming years. Count the Utah Marijuana team among those who wouldn’t be surprised to see CBDA medications on store shelves in the very near future. We have every reason to believe in minor cannabinoids as much as we believe in CBD and THC.
One of our goals at Utahmarijuana.org is to educate consumers about Medical Cannabis. To that end, we often say patients can “find more relief with less risk than harsher prescription medications.” Patients ultimately want to know more about harsher prescription drugs and why Medical Cannabis is referred to as less harsh.
When the medical community refers to a prescription medication as harsh, the reference is mainly to side effects. Every prescription medication comes with side effects of some sort. Most are mild and minimally uncomfortable. But some side effects are just the opposite. The more serious and uncomfortable a drug’s side effects are, the harsher that drug is said to be.
The harshness of a medication is relative. Making any kind of judgment about a particular medication requires looking at a number of different things. Primarily though, the drug in question needs to be compared against alternatives. Take ether, for example.
Ether has long been regarded as an effective anesthetic. It used to be the standard for surgical procedures. But ether’s downside is its potential for severe side effects, which include nausea, vomiting, and dizziness. It was not unusual for surgical patients to experience severe discomfort after ether anesthesia.
Today, we have more effective anesthetics that do not produce nearly the same uncomfortable side effects. So when you compare ether to these other medications, it is considered more harsh. Modern anesthetics are less harsh.
In order for us to confidently say that Medical Cannabis is less harsh than other drugs, we need to quantify what those other drugs are. An easy way to do this is to consider the number one complaint listed by Utah Medical Cannabis patients on their Med Card applications: pain.
Here at Utahmarijuana.org, our KindlyMD clinics have assisted untold numbers of chronic pain patients obtain their Med Cards. Many of those patients came to us after having tried more traditional treatments that included prescription narcotics. There is our baseline for discussing Medical Cannabis as less harsh.
Prescription narcotics have their side effects. Those side effects can be extremely harsh. What’s more, many patients report that the level of pain relief they experience from their prescription medications is not enough to warrant the side effects those medications produce. They report finding more relief with Medical Cannabis along with side effects that are more manageable and less uncomfortable.
We can take this one step further by comparing Medical Cannabis medications containing both THC and CBD. As you know, THC and CBD are naturally occurring cannabinoids found in cannabis plants. Both can be used as medicines to treat pain, nausea, seizures, and a long list of additional conditions.
In terms of side effects, THC is less harsh than prescription narcotics. CBD is less harsh than THC. But that’s not all. There is also the issue of addiction potential. Research has shown that THC has a lower potential for addiction and dependence than prescription narcotics. CBD presents little to no addiction risk at all – because it is not psychoactive. So when comparing all three, CBD is the least harsh.
Now you know what medical science is talking about when they refer to harsh medications. One of the reasons we believe so much in Medical Cannabis is that it has shown itself to be less harsh than other medications while still offering the relief patients are looking for. If you have been diagnosed with a qualifying condition and would like to know more, make an appointment to see a Utah QMP.
Whenever society promotes a substance with psychoactive effects, there are usually impairment questions. Concerns over cannabis users driving while impaired are the perfect example. However, a new study out of Australia seems to suggest that proper Medical Cannabis consumption does not impair driving.
Researchers define “proper’” consumption as consumption that adheres to prescription recommendations. Another way to put it is to say that a patient is following a medical provider’s recommendations to the letter. When that is the case, driving ability is not impaired – at least according to the researchers.
In order to get a better understanding of the impacts of Medical Cannabis on driving performance, researchers at Australia’s Swinburne University of Technology’s Centre for Human Psychopharmacology enrolled 40 study participants utilizing Medical Cannabis for a variety of chronic conditions.
Each participant’s driving abilities were assessed in a simulator both before and after taking a prescribed dose of cannabis medication. Additional post-consumption simulations were performed at 2.5 and 5 hours. Researchers did not observe any notable impairment at either follow-up period.
The 5-hour post-consumption assessment is of particular interest due to the longstanding belief that residual THC can affect driving abilities for hours after cannabis consumption. We now know that is not the case based on data from this study.
Full disclosure dictates that we acknowledge the small-scale nature of the study. A cohort of just forty study participants is not enough to unequivocally say that a Medical Cannabis patient would not be impaired by their medications. Still, the evidence is strong enough to be compelling and we hope to see the results of further research on this topic in the future.
We should also point out that the study is by no means an excuse to be careless with Medical Cannabis. Patients who use their medications according to medical provider recommendations should still pay close attention to how they feel before getting behind the wheel of a car.
As for the broader implications of the study, they point to the fact that driving while impaired is probably not something we have to worry about among Medical Cannabis patients who follow their provider’s instructions. Medical Cannabis appears to be no more impairing than an over-the-counter cough medicine.
If you are ever concerned that your medications are impairing your ability to drive, do not hesitate to talk to your medical provider. Whether it is the Qualified Medical Provider (QMP) such as Utah Marijuana who helped you get your card or the Pharmacy Medical Provider (PMP) at your Medical Cannabis pharmacy, trained medical professionals are the most qualified to answer your questions and offer advice.
The same is true for any other concerns you might have. Maybe you feel like your current medication isn’t working well enough. Talk to your PMP about it. Have a discussion if you don’t like the way your medication makes you feel.
Remember that using Medical Cannabis is a journey – it takes time to figure out the ideal doses, delivery methods, and products for any given patient. A willingness to work with your QMP and PMP can help you get there faster.
As for the Australian study, we can sum up our thoughts in a simple statement: always approach driving cautiously. You can never be too safe about taking to the road while medicated. Impairment is not likely to be a problem if you use Medical Cannabis according to your provider’s advice. Still, you don’t need to take any chances.
Do you remember when your first Utah Medical Cannabis Card was only good for 90 days? Regulators have changed the rules to allow cards to have up to a one-year term. They have also simplified the renewal process. Renewing a card is easier than ever before.
We have outlined a basic three-step renewal process below. If you are a current Medical Cannabis Card holder, and you haven’t gone through your first renewal yet, you might want to familiarize yourself with the process. It is by no means difficult. However, knowing what needs to be done ahead of time could save you a few headaches when your renewal deadline approaches.
The process for renewing is pretty straightforward. Most of what needs to be done is managed online. If you’ve had your card before, you already have an account with the state’s Electronic Verification System (EVS), so there isn’t a whole lot that needs to be done in terms of administration. Here is the renewal process broken down step-by-step:
The EVS is programmed to automatically send out renewal notices to current cardholders. You should receive an email notice 30 days prior to expiration. That is your reminder to log in to the EVS and verify your personal information.
If your address or ID information has changed since you last logged onto the system, now is the time to update it. Whether or not your ID information has changed, it needs to be resubmitted for certification before your card can be renewed.
You will need to visit your QMP to get your card renewed. Contact your QMP’s office to let them know that you need to schedule a renewal visit.
Just as when you got your initial card, your QMP will evaluate your condition and inquire as to how well Medical Cannabis is working for you. Provided everything is in order, the QMP will renew your certification within the system.
Once the new certification has been entered into the EVS, you should be able to log back into your account and verify your status as ‘awaiting payment’. That is your cue to pay the State of Utah’s $15 renewal fee. Just click on the payment tab and follow the instructions to make the payment. Your status should change to “Renewal Completed” as soon as the payment is processed.
If you have completed these three steps before your current card’s expiration date, Utah will email your renewed card on the day after your current card expires. If you are renewing a card that has already expired, you should receive the renewed card within 24 hours of paying the renewal fee. Renewals for expired cards are often completed within an hour or two.
The online steps for renewing a Medical Cannabis Card are nearly instantaneous. The hardest thing about renewal might be scheduling an appointment with your QMP. We advise not waiting until a week before expiration to try to get in to see your provider. Make an appointment as early as possible. You don’t even have to wait until the 30-day mark to make an appointment.
Whether you need to renew a Medical Cannabis Card or you’re getting one for the first time, our Qualified Medical Providers are ready to help.
Fortunately, regulators have made renewing a Utah Medical Cannabis Card fairly easy. It is a simple matter of verifying your personal information, seeing your QMP, and paying the renewal fee. Click here to schedule a visit with one of our QMPs.
If you have been involved in Medical Cannabis to any extent over the last several years, you know that medical opinions about efficacy differ widely. At the root of many of the differences is a lack of clinical research. No doubt clinical research is growing by the day. Still, it pales in comparison to most FDA-approved medications and therapies. Enter real-world data.
The Cannigma’s Elana Kirsh recently put together a fantastic post outlining the challenges of clinical research in Medical Cannabis and the importance of paying attention to novel data sets, including real-world data. What is real-world data? It is data gathered from actual users and their medical providers rather than through clinical studies.
Kirsh began her post by acknowledging The Cannigma’s reliance on scientific information to create its posts. But then she went on to further explain that not all their scientific data comes from clinical research. That is because clinical data can take years to produce. Therefore, her employer also collects data directly from the website’s audience.
The company partners with MoreBetter, a well-known data and software company, to conduct community research among audience members. Since June 2023, they have launched five data collection efforts targeting specific products. The goal has always been to encourage audience members to use the products and then share their experiences.
Reading Kirsch’s post makes it abundantly clear that relying exclusively on clinical data is not conducive to fully understanding the benefits of Medical Cannabis in real-world settings. As this post already stated, clinical research can take years to produce. This is by design, and it is good. The FDA needs to be incredibly careful about approving new drugs and therapies. They require extensive research and clinical study data before they ever make a decision.
Unfortunately, this presents challenges to the Medical Cannabis community. First and foremost, clinical research is time-consuming and expensive. How many Medical Cannabis patients would not have access to the medications they need if they had to wait for clinical research?
Moreover, we still face challenges regarding encouraging research into Medical Cannabis. There are not nearly as many research entities willing to look at Medical Cannabis efficacy thanks to a variety of reasons we will not get into here.
Anecdotal “real-world” data acts as an alternative source of data capable of informing decisions at the local level. Armed with it, a Utah Pharmacy Medical Provider (PMP) can offer patients advice on products and delivery methods. Likewise, real-world data informs Qualified Medical Providers (QMPs) as they seek to answer patient questions.
Many of us in the Medical Cannabis community believe that real-world data is just as important to making wise decisions as its clinical counterparts. Clinical studies are tightly controlled, and for good reason. But they rarely reflect real-world settings. On the other hand, actual Medical Cannabis patients are the epitome of real-world users experiencing real-world circumstances. The knowledge they offer is invaluable.
It is safe to say that we need as much data as we can get our hands on. The more data we have to inform our decisions, the wiser our decisions are likely to be. We applaud the effort to gather and analyze real-world data to better understand the vast potential of cannabis to treat a long list of diseases and illnesses. We firmly believe that real-world data has a significant role to play in informing our decisions.
Utah’s Medical Cannabis law allows for several different delivery methods, including cannabis topical products. A topical product is a lotion or cream applied directly to the skin. As a pain medication, topically applied THC and CBD can actually work quite well for some patients.
We are still learning exactly how cannabinoids interact with the human cannabinoid system to offer pain relief. That being said, medical science does have a working theory about how topical cannabis medications might help alleviate certain kinds of pain. The important thing to note is that topicals really do work for untold numbers of Medical Cannabis patients who swear by them.
Medical Cannabis topicals are very similar to other creams and lotions in terms of practical application. They are easy and safe to apply, and they rarely create those feelings of euphoria normally associated with other delivery methods because THC doesn’t make it to the bloodstream.
Applying a cannabis topical is as easy as applying any other cream or lotion. You put a dab on your finger and rub it into the skin. If a product contains additional ingredients like menthol or camphor, a patient might feel the hot/cold sensations typically associated with pain lotions.
The most likely explanation for how topical cannabis medications relieve pain lies in two different types of receptors in the skin. The first are cannabinoid receptors. Believe it or not, these receptors are found throughout the body. They are not limited exclusively to the brain.
Limited evidence seems to suggest that topically applied Medical Cannabis stimulates CB1 and CB2 receptors located in the outer layers of the skin, primarily the epidermis. The proper amount of stimulation can reduce pain, inflammation, and even itching.
The other type of receptor is the transient receptor, frequently known as the TRP. Although TRPs are considered part of the endocannabinoid system, their functions are more limited compared to cannabinoid receptors. TRPs help the body make sense of changes in temperature, salinity, and other environmental properties.
If you want more information about how Medical Cannabis works as a topical product, check out this great article from The Cannigma. It offers a lot more detail than we can provide here in this post.
Despite the fact that many Utah Medical Cannabis patients utilize topical medications for pain, topicals are not guaranteed to work for everyone. That’s just the nature of Medical Cannabis itself; state law allows for multiple delivery methods for that very reason. So, what works for someone else might not work for you.
We routinely advise patients to talk with their medical providers or pharmacists about the pros and cons of topical products. The Pharmacy Medical Provider (PMP) at your favorite Utah Medical Cannabis pharmacy could probably offer a ton of helpful advice about delivery methods. Pharmacists are trained in both pharmacology and the human endocannabinoid system.
It is interesting to note the demographics relating to topical Medical Cannabis. According to The Cannigma post, studies demonstrate that topicals are most popular among new Medical Cannabis patients and those aged 60 and older. The data seems to suggest that topicals are an option for gradually easing into the Medical Cannabis journey.
If you use Medical Cannabis for pain, what is your preferred delivery method? Topical products may be an option for things like joint and muscle pain. They are definitely an option that could provide pain relief without the euphoric side effects of other delivery methods. Consider giving them a try.
Have you ever wondered what it takes to get a job in the Medical Cannabis industry? Here in Utah, we have four basic categories of jobs: cultivation, processing, testing, and retail sales. Some jobs require extensive education, training, and even cannabis certification, such as to be a Pharmacy Medical Provider (PMP). However, most do not have such stringent requirements.
Certification? Yes, indeed. Believe it or not, professional cannabis certification is a thing. Schools and training programs are popping up all over the country in an effort to help more people launch their careers in cannabis. The Cannabis Training University is just one example. They offer a 12-week online training course they refer to as the Master of Cannabis Certification Program.
Here at Utahmarijuana.org, one of the many resources we offer Medical Cannabis patients is our Utah in the Weeds podcast. It is not uncommon for us to interview cannabis professionals who were patients before getting into the industry. We have heard from plenty of patients who were so overwhelmed by the difference Medical Cannabis made that they decided they wanted to get involved in helping others.
There weren’t many recognized training and certification programs when the push for legal Medical Cannabis began more than 25 years ago. Even today, the number of certification programs is scant compared to other industries, like healthcare and IT. But as the cannabis industry grows, the demand for certification and training seems to be growing along with it.
It goes without saying that training programs will vary from one organization to the next. The things a student might learn will depend on the type of career they want to pursue. For instance, a career in cultivation would dictate training with a heavy emphasis on agriculture, botanical science, and so forth.
In the processing sector, training could include everything from proper extraction methods to creating cannabinoid and terpene profiles. These days, cannabis processing is a more scientific endeavor thanks to the ongoing pursuit of better and more effective products.
Even pharmacy technicians can now be certified. A pharmacy tech is someone who works in a Medical Cannabis pharmacy to dispense medications and answer product questions. Pharmacy techs work in concert with PMPs to ensure that patients get the right medicines for their particular needs.
Certification isn’t necessarily required to get a job at a Utah Medical Cannabis pharmacy. Obviously, hiring requirements vary. But the one thing we do know is that the industry continues to grow with each passing quarter. There are jobs out there in nearly every sector of Medical Cannabis.
The way we see it, the Medical Cannabis industry has nowhere to go but up. Things continue to happen here in Utah and the rest of the country, things that paint a very bright future for Medical Cannabis. With that being the case, we expect that even more jobs will be created as time goes by.
If Medical Cannabis is something you are passionate about, and you’re looking to embark on a new career, think about getting into the industry. Cannabis is still considered an emerging industry, so there are bound to be plenty of opportunities from the time you get in until the day you’re ready to retire.
Professional training and certification programs are there to help you get started. And even after you land that first job, you cannot go wrong by earning additional certifications. The more training you have under your belt, the further you can go in an industry that seems to have few limits right now.
Medical Cannabis is available in multiple forms here in Utah. Though patients cannot smoke cannabis, they can vape or dry heat it. Patients also have access to tablets, capsules, waxes and resins, aerosols, tinctures, and transdermal products. That leads us to the subject of this post: whether transdermal cannabis products for pain are effective or not.
This post was partially motivated by a Q&A piece on the Cannigma website. Codi Peterson, a Doctor of Pharmacy, answered a question from a reader who was interested in transdermal patches. The reader had respiratory health concerns and needed to find an alternative to smoking cannabis.
Transdermal products are similar to topical products in that they are both applied to the skin. But, unlike topicals, transdermal products use specialized chemicals to deliver the active ingredients through the skin and blood vessels, into the bloodstream.
According to Peterson, “most doctors around the world still do not have access to cannabis patches.” However, Utah’s Medical Cannabis patients do have the option to buy transdermal patches with THC and other cannabinoids.
“It is a discreet way to experience full-body relief all day and night. This type of topical can also provide users with psychoactive effects,” a posting on the WholesomeCo website says.
Several of the local cannabis pharmacies carry transdermal patches. If your nearest pharmacy doesn’t have them, you may want to check the inventory of another pharmacy that can deliver products to your home.
Moving on to the main question, how well transdermal preparations work to relieve pain is an individual matter. Why? Because pain is an individual matter as well. We don’t all experience pain the same way. Some of us have higher pain thresholds than others. And most importantly, the drivers behind the pain experience are many and varied.
The pain caused by a shower that is too hot is actually a warning sign. It is telling you that you are in danger of burning yourself. You need to turn down the temperature or get out of the shower. On the other hand, pain caused by injuries sustained in a car accident could be the result of tissue damage.
We tend to offer the same advice when these types of questions are asked: talk to your medical provider. The same QMP or LMP who helped you get your Medical Cannabis card should be able to advise you about transdermal products. And if not, your Pharmacy Medical Provider (PMP) can definitely help.
Medical providers and cannabis pharmacists are the most qualified to recommend different Medical Cannabis products. An open and honest discussion between you and your provider or pharmacist will get you both on the same page. Hopefully, you will feel better in no time.
You might discover that using transdermal cannabis products for pain does wonders. If not, don’t get discouraged. You have other options. Talk with your provider about vaporizing, using edibles, or even trying a tincture. You may have to experiment with different delivery methods and dosages to find what works best for you.
Transdermal products are definitely an alternative to smoking. Since smoking cannabis is not allowed in Utah, it’s good that we have the option. Transdermals are one of his many options patients can choose in the search for a medicine that helps them find the pain relief they are looking for. Transdermals might be the way to go for you, too.
