Medical marijuana is now legal in 33 states and the District of Columbia. In 11 of them, you don’t even need a medical marijuana card – anyone 21+ can purchase pot. Buying cannabis is easy. But selecting medical marijuana is difficult.
People at midlife and beyond are turning to cannabis for the relief they aren’t finding with traditional medicine. They’re using medical marijuana to deal with arthritis, chemo-induced pain and nausea, as well as other conditions.
My last post covered what you need to know about medical marijuana at midlife. This one will tell you about my personal experience selecting medical marijuana for my achy knees.
Why use medical marijuana?
Since marijuana became legal in California, I’d been thinking about taking it for my arthritic knees.
I had an arthroscopic procedure nearly 15 years ago. That helped a lot at the time, but things have started to go downhill again in recent years. Now like lots of people in midlife, I’m running low on knee cartilage.
My orthopedic doctor tells me that sooner or later, I’ll need at least a partial joint replacement in one or both knees. But I’d like to delay that as long as possible. Thus I’ve been searching for interventions that potentially might help me continue an active lifestyle in spite of knee problems.
Something else to try
I’d tried the conventional stuff you do for bad joints: rest, ice, physical therapy, anti-inflammatory drugs, cortisone and Orthovisc injections. I’ve even done two rounds of platelet rich plasma (PRP). But that was expensive and didn’t seem to make a difference in how my knees felt.
I’d heard that pot could help stiff joints feel better. In fact, 62% of medical marijuana users cite chronic pain as the reason for their marijuana use.
I figured cannabis was one more thing I might try before resigning myself to knee surgery.
First step: online research
My first step in selecting medical marijuana, as in any project nowadays, was to learn as much as I could on the internet. But as I mentioned in my previous post, there are thousands of websites offering information on cannabis, and the information can be confusing.
It’s hard to tell which ones are truly impartial. Sites can represent specific producers, sellers, collectives or regular people who love weed and enjoy publishing their opinions.
But it can be hard to tell who’s behind a particular site that claims to have expert knowledge. So you don’t know whether you should trust the information.
My last post summarized research on the medical marijuana industry and in particular, what you need to know before ordering CBD oil. To select medical marijuana, however, I had to learn more about my options and exactly how to buy what I needed.
How you take it makes a difference
Given how easy it is to buy CBD now, taking CBD oil is becoming as common as taking a multivitamin. It’s showing up in shampoo and skincare products. Lots of sources recommend taking CBD for general wellness, as well as for more specific medicinal purposes.
One important thing to know is this: how cannabis enters your body and/or bloodstream matters. If you inhale CBD or THC (the cannabinoid that causes a “high”), it passes through the lungs, into the capillaries and pulmonary arteries, then on to the brain. Without going through the liver.
If marijuana is ingested (as with capsules or edibles), it passes through the small intestine and on to the liver, where 85% of its THC content is metabolized on a first pass. In this fashion, ingested cannabis resembles any other oral medication. It takes 45-75 minutes before enough of it is in the bloodstream to exert a therapeutic effect.
Which form is best for medicinal purposes?
Leafscience summarizes the various ways to take cannabis as follows:
- Fastest absorbing: inhalation or taking a tincture under the tongue. Both methods go directly to the bloodstream.
- Medium absorption: edibles or capsules that must process through the liver
- Least effective/quantifiable absorption: creams and ointments that must pass through the skin barrier before reaching the bloodstream.
So while you may prefer a localized treatment like a topical ointment, this type of medical marijuana is the least well-absorbed. It may not work the way you need it to.
In selecting medical marijuana, personal preference also plays an important role. For example, I’ve never smoked cigarettes. And I have no desire to start smoking pot. So for me, inhaled or vaped products are not an option.
Like other things, it makes sense to try different forms and see what works best for you.
My initial plan for selecting medical marijuana
After learning about the various forms of medicinal cannabis, I decided to select medical marijuana according to a few guidelines:
CBD oil seemed appealing since it had no psychoactive impact. But I was still confused about which brand of CBD oil to try. Even online lists of “best CBD oils” varied all over the place.
I thought I should try a CBD tincture that would be absorbed quickly. And I also wanted to get a cream or ointment I could apply directly to my knees.
Even with the advice that products applied to the skin might not be well-absorbed, to me it seemed logical that I should direct the cannabis to where I needed it. I also was worried that I wouldn’t like the taste of a tincture I had to hold under my tongue.
I had read about the entourage effect, which in essence suggests that combination products work better than those based on only one type of molecule. So I also wanted to compare results between a product that included both THC and CBD with one that contained only CBD.
But I also wanted to avoid a THC-induced euphoria. So I decided to stick with the more conservative approach of a topical balm.
Although to be honest, it occurred to me that a little euphoria might make some of my USTA tennis matches more fun…
Selecting medical marijuana: logistics
There are 4 main ways to acquire cannabis legally. Procedures and amounts you can buy vary by state. Consult the chart from the National Conference of State Legislatures to see what applies in your area.
In California, these were my options:
- Online (CBD only)
- In-person at drugstores or other retailers (CBD only). The selection varies and more focus is on beauty products right now, but the landscape is changing rapidly.
- Delivery (recreational and medical marijuana)
- In-person at a dispensary (recreational and medical marijuana)
I’d been given some CBD rub (hemp rub) as a sample at a conference I attended. But it hadn’t helped me at all. So I resolved to visit a dispensary first, then see if I wanted to place any online CBD orders after that.
I looked for local dispensary recommendations on Yelp. Most seemed to have high ratings. I understood why later – signs at the dispensary checkout offered discounts if you would agree to do a Yelp review.
It was still helpful to check out dispensary websites, though, because I learned what to expect on my first visit:
- To enter a dispensary, you have to show an ID and provide a phone number. If recreational marijuana isn’t legal in your state, you’ll also need to show a medical marijuana card.
- Most dispensaries don’t allow photos
- Dispensaries accept cash only. But most provide an ATM at the back of the store so you can withdraw cash to pay your bill. (The ATM receipt will probably be marked with only the address or another discrete identifier. Don’t worry: you won’t get a bank statement that lists Joe’s Pot Shop!)
- You’ll need to work with a “budtender” to select your product(s). Most of the items are kept behind the counter, so you can’t browse the shelves the way you might do in a regular store.
My visit to select medical marijuana
I decided to try Medithrive in the Mission District of San Francisco. The greeter who recorded my ID and phone number was friendly and welcoming – kind of like a Walmart greeter, actually.
I went straight for the line of people waiting for their turn to speak with a budtender. There were several employees assisting customers, so my wait time was only about 5 minutes.
Medithrive’s home page has a photo that shows the inside of their dispensary. The most eye-catching elements are their glass-domed displays containing different marijuana plants. These displays give the place a professional, museum-type authority.
It was a weekday afternoon. Folks were chatting with the budtenders and enjoying themselves. I don’t know whether most of the customers were there for medicinal or recreational marijuana.
I do know that I felt old and square. But I feel that way just walking around the Mission District. So the fact that I felt out of place at the dispensary wasn’t out of the ordinary.
If my budtender thought I was old and square, she didn’t show it. In fact, she was friendly and non-judgmental. Which was great, because explaining why I was there made me feel even older. I asked if she could recommend a cream or ointment to ease arthritis pain in my knees.
She immediately pulled out a jar of something called Canna Care and said it was the best thing for arthritis. I asked if there were other products I might compare to it. She said no, that this was the best one.
I noticed that it had CBD and THC in a 1:1 ratio and asked, “Do I really want the THC? I don’t want a rub that’s going to make me high.”
My budtender replied, “No, you want the 1:1 ratio because it will really help your muscles and joints to relax.” I was beginning to get the feeling that maybe this was their only product in the arthritis category.
So then I asked whether she might also suggest a tincture or capsules. Maybe something with a blend of THC and CBD and/or something with CBD only. She reiterated that I was best off with the rub.
Bottom line: as a customer, you’re totally dependent on your budtender to help you select medical marijuana. And mine didn’t seem as “awesome” as some of those who were mentioned in the Yelp reviews.
No surprise here: I decided to go for the Canna Care rub. I asked whether I should use it before sports, after, or both.
By now I could have predicted my budtender’s response: “Before, after, whenever your knees are bothering you.”
Then she added, “Just remember: a little goes a long way.”
My budtender rang up my sale and I paid in cash. I’d come prepared, so I didn’t need to use the ATM at the back of the store.
Just like bartenders, budtenders accept tips. There were tip jars by every register (right by the signs promising discounts for Yelp reviews). She put my Canna Care rub in a plain blue bag, and I left a tip in her jar.
I’ve used the Canna Care rub a few times now. Here are my impressions of it to date.
I paid $85 (including tip) for a 4 oz jar. It was much more expensive than Biofreeze, TigerBalm or other best-selling sports rubs. But the cannabis component promised better relief than I’d found elsewhere.
Smells like pot
The product I bought was labeled as a ginger-scented rub, but the ginger smell was faint. I rubbed a little on one knee and wondered if other people were going to smell it and think I’d been smoking weed.
Granted, I have a sensitive nose. But I don’t like the aroma of marijuana, so the smell was a turnoff.
Later I decided to put a couple of drops of essential oil on my fingers with the rub. This way I could mask the smell a bit as I rubbed in the cannabis.
Depending on my mood, I’ve been using peppermint or lavender oil. This trick definitely helps make the smell less noticeable. But I still know it’s there.
No psychoactive effect
As predicted, the rub didn’t produce a “high” or other psychoactive effects. Even though this is what I had expected, I almost felt a little disappointed…
Not a miracle treatment so far
I may feel a little better when I use medical marijuana rub than when I don’t. But the improvement isn’t dramatic. It’s certainly not something I’ll want to buy again for $85. At least not yet.
It could be the case that my knees are too compromised to benefit from this product. Or that I need to continue using it over time before I see an effect.
I’ll keep you posted.
Next steps in selecting medical marijuana
I wanted to compare the cannabis rub with another product, so I decided to order a CBD tincture. Since it was 100% CBD, I could order it online.
I went with a tincture by Populum. It’s the type that you take under your tongue once a day. This helps the CBD absorb directly into your bloodstream.
Why I chose it
I chose this brand because it was one recommended by others online, and I liked their website. They work with hemp growers in the US, produce full-spectrum CBD oil, provide 3rd party test results, and offer a 30-day money-back guarantee.
I especially liked the fact that Populum infuses its CBD oil with orange essence. Some people don’t mind the hemp taste, but I knew it would bother me.
My order arrived a few days ago. So far I’ve been taking a dropper of in under my tongue in the morning. The orange flavor helps to mask the plant smell, but there’s still an aftertaste that reminds me of marijuana.
However, you only need to keep the tincture under your tongue for 30 seconds. I make coffee while holding the CBD in my mouth and then chase the cannabis aftertaste with my morning caffeine.
Some people claim that CBD oil’s benefits build up over time. I haven’t noticed any differences yet, but I’m on the lookout for them.
I’ve saved the packaging and plan to return my tincture within 30 days if I don’t notice a difference in how I feel.
How do you go about selecting medical marijuana? Do you have any favorite products? Have you found any type of absorption (topical, edible, tincture, inhalation) to be more effective than others?
In the spirit of trying lots of therapies in search of wellness and reduced pain as I age, I’m interested to hear your views. Let me know in the comments or send me a message at firstname.lastname@example.org.