Pothead or Patient: 10 Tips for Medical Marijuana Use

1. Know Your Symptoms- It helps to know why you are using medical marijuana (mm). If you received a prescription from a doctor it will say something like “Use for (symptoms) related to (disease or condition). Mine said, “Use as needed for pain and fasciculation related to Charcot-Marie-Tooth.” Notice I wasn’t told how much to take or how often to take it. Because marijuana isn’t standardized and research is banned by the federal government, there is little or no guidance on how much mm to take, what type to take, nor how often to take it. Since the recreational cannabis market predominates it is easy to get stronger mm than is needed; and without instructions, it is easy to take more than inecessary, or more often than necessary. You will need to determine for yourself what constitutes a medicinal dose, what type of mm works for you, and how often you need it.

You can do that by making a list the symptoms you hope mm will help with. Tune in and note how mild or severe those symptoms currently are on a scale of 1 to 10. Take a dose and give it time to kick in (5-10 minutes if smoked, 45 minutes to an hour if eaten) then measure each symptom on the same 1-10 scale. Is your pain or neuropathy or sleep better or worse or the same? Does a larger dose help or can you get the same relief with half as much? What is the smallest effective dose? That is what you are looking for—the smallest amount that meets your needs.

Notice if you start to use marijuana for other reasons. For instance you started using pot for pain but you notice it helps you sleep. Or you were prescribed for neuropathy but have found it helpful with PTSP symptoms. Track any symptom that you using mm for and keep notes on how much you are using and how much it helps.

Tracking will distinguish you as a medical marijuana user—one who is using medicine in a consistent and responsible way. There can be stigma attached to marijuana use, and encouragement to use it recreationally.  Tracking helps us know that we are using marijuana in a responsible way, and not using more pot or stronger pot than is needed.

2. Find the Kind of Medical Marijuana That Will Help You the Most- Medical marijuana stores offer cannabis and related products with listed percentages of THC to CBD. THC is a psychoactive cannabinoid that gets you high, while CBD is a cannabinoid that works throughout the body to calm nerves and reduce inflammation and is not psychoactive. Both cannabinoids have medicinal properties. Cannabis grown for the medical market typically contains ample CBD, while recreational pot contains almost no CBD.

The best pot to try first is straight CBD. CBD effects are far more subtle than the effects of THC. CBD helps reduce pain and inflammation, is calming and helps with sleep, but doesn’t get you high so don’t expect it to. If straight CBD doesn’t help add in some THC.

Patients seeking pain relief are typically helped by doses of 1:1 THC to CBD. Epilepsy patients are helped by doses of straight CBD. Some PTSD patients find that high THC helps them avoid dissociation when their PTSD is activated, but most days lower THC with medium CBD will manage their anxiety and hyper-vigilance just fine without making them feel goofy. The general rule for medical marijuana use is “start low and go slow” and that typically means building on a base of CBD mm.

If you live in a state where medical marijuana is not available, you may only be able to get high THC pot that was grown for the recreational market. Be warned, recreational marijuana is has very high levels of THC with little or no CBD. High THC pot can create anxiety, hallucinations, and a racing heart. The solution is to find CBD pot to mix in. CBD oil is available nationwide and can be ordered online. CBD pot is available at medical marijuana stores and comes from hemp plants.

Another choice marijuana patients have to make is how to take their medicine. Should I smoke it? Or eat it? Or use a tincture? If you decide to buy edibles or make your own, the “start low and go slow” plan is essential. Edibles are the most common way to overdose. Novice edible users get impatient when they don’t feel anything after half an hour and take a second or third dose. When it all kicks in they feel way too stoned and may end up at the emergency room. The recommended average dose for an edible is 10mg of THC per dose.

Assume that any marijuana brownie, lollypop, chocolate, oil, etc., is strong but will take an hour of so to kick in. You may start to feel it sooner but you won’t know the full effect for an hour or longer. If you take your edible on a full stomach it may take up to two hours to kick in. Give your first dose plenty of time before deciding to take a second dose. While marijuana overdoses are not fatal, they are highly unpleasant. If you are buying your edible make sure you know how many doses are in the product you’re buying. I have seen small squares candy of sold in mm stores that are meant to be divided into several doses, but the print is so small it’s hard to see and it looks like a single serving. Ask questions, read labels, look for low or moderate THC /high CBD cannabis, and go slow with edibles. Make “start low and go slow” your medical marijuana mantra.

3. Know Your Risk for Addiction- Overuse of mm can easily become a problem. You don’t need a genetic test to know if you are at risk for addiction. Taking the ACE test will give you a good idea if you are likely to develop an addiction. If you have a high ACE score, or are a person in recovery from an addiction, you will need to be vigilant. While the next section is recommended for everyone who uses medical marijuana, if you have addictive tendencies tracking is a must.

4. Track Your Use- Tracking is the best possible way to make sure you are using mm effectively and moderately. Your first task is to establish a medicinal dose and that involves tracking what you are taking, how much you are taking, and how often you take it.  You will need to dedicate a notebook for writing down this information.

Establishing a medicinal dose will be easier if you know the name of the strain, so you can look up the THC and CBD content and ratio. Online sites such as Leafly can tell you the THC/CBD content of many strains and what they are used for. If you are buying pot in an illegal recreational market you generally won’t know what you are getting and will have to guess based on how it affects you. Pure THC pot can produce anxiety, and render one incapable of social conversation. Pure CBD will have no psychoactive qualities. Most agree that they work best together, as they naturally occur together in the cannabis plant.

Once you have established which mm helps with your symptoms, see if you can get enough to last for three months. This allows you to use an established dose on a schedule for an extended period of time.

It is recommended that you track the following each time you take marijuana:

a) What type of pot are you taking? Describe it in terms of THC/CBD. Does it make you anxious or calm? Is taking it a pleasant experience? Do you get “couch-lock”?  Can you talk and work after a dose?  

b) How much are you taking? What exactly is your medicinal dose? Depending on your route of ingestion (e.g. smoking, eating, tinctures, oils), write down number of puffs smoked, or amount of edibles eaten, or number of drops of a tincture taken per session or dose.

c) How often are you taking marijuana? How often do you need to take it? Some people only need one dose before bedtime. Some use medical marijuana only occasionally when there is a flare up. Do you use more when you are under stress? What time of day should you take your first dose? Tracking will show you what your normal pattern is and if you are using more or less.  

d) Is marijuana actually helping with your symptoms? Continue to track effectiveness. As mentioned earlier, list symptoms and rate them for current severity before you take your dose then rate symptoms again after mm use.

 e) Is your ACE score high? Do you or your family have a history of drug dependency or abuse? If so there are other things to track on a regular basis to make sure you are not slipping into overuse. Here are some things not pay attention to: How many hours per day are spent under the influence?  How much money do you spend on marijuana? Has your mm use gone up, down, or stayed the same in the last month? How much time is spent getting marijuana, thinking about it, or recovery from use? Has your social life diminished? Have you given up on hobbies or activities you used to enjoy?  Are you using more than you want to? How are feeling about using medical marijuana?

5. Don’t Drive Stoned- Driving while stoned is driving while intoxicated. If you have an accident you will be charged with a crime. Just like an alcohol DUI or DWI, being charged with driving under the influence of marijuana can cost you a lot of money in lawyer fees and fines. Besides driving while stoned isn’t fun or easy. So don’t do it.

6. If You Are a Former Smoker- Avoid smoking marijuana. I quit smoking cigarettes many decades ago but found out quickly that if I rolled a joint I would smoke more than was necessarily. I love to smoke and smoking a joint brought it all back. I switched to vaping and that reduced my intake. Edibles, tinctures and oils are other ways to avoid smoking.

7. Don’t Bond Around Pot- Don’t tell your friends that you have been prescribed medical marijuana. Why? Because they will want to talk about it. Or try it, or offer some of what they like. It that bad? No, but I doubt you have ever sat around talking about antibiotics. Pot has a culture, and it was built around getting high, having fun, and sharing with friends. If you maintain privacy it is easier to avoid social use. If you do decide to use pot socially make it a rare and occasional event. Commit to being a patient, not a pothead.

8. Know Your Local Laws- It is important to know exactly how much risk you are taking when you buy, grow, sell or use marijuana. Expect to be prosecuted in states where pot is illegal—they probably won’t recognize your use as medicinal although tracking records make a case that your pot use was indeed medical. According to Drug Policy Alliance in 2016 there were 574,641 arrests in the USA for marijuana possession alone. That’s more than half a million arrests. Don’t be one of them. Even if you live in a state where marijuana is legal, you need to know the limits. How much marijuana or marijuana products can you have with you? What are the fines and jail time for excess possession? What amount constitutes a misdemeanor? A felony? Know your local laws.

9. Find a good source for your medical marijuana- Try to find a supply from a grower who grows their plants organically. Some growers use pesticides, hormones, and other chemicals that may not be good for you. Try to find a steady supply for the type of medical marijuana that works best for you. Avoid buying from strangers.

10. Buy a K-Safe- That’s is a “kitchen safe” made of hard plastic that locks with a timer. The timer can be set for minutes, hours, or days. Once the timer is set the safe locks and cannot be opened until the time is up. Using a K-Safe allows you to set the time of your first dose. And establish how long you can go between doses. If multiple doses per day are needed, how long can you go between doses? Want to take the weekend off? Set the timer for 48 hours. Another reason to buy a K-Safe? It allows you to keep your marijuana products locked up in one place so kids or roommates don’t get into your medicine.