With the opening of Puerto Rican medical marijuana dispensaries earlier this year – the U.S. territory followed Jamaica to become the second Caribbean island to make medical marijuana legal – you might be wondering what items are available for the growing amount of patients who have registered for medical marijuana cards.
There are a wide variety of options to suit almost everyone hoping to alleviate medical problems with the therapeutic herb.
While many dispensaries don’t offer them yet, pills – encapsulated cannabis extracts and oils — treat a variety of different conditions. Some contain simply THC, with others contain more varieties of cannabinoids, the therapeutic compounds found in marijuana, including cannabidiol (CBD), which gives marijuana its relaxing effects.
Pills are more controlled than edibles, since the dosage is regulated.
Marijuana edibles have come a long way since pot brownies. Today’s legal edibles come in either food or drink form and contain cannabinoids, the psychoactive compounds in marijuana, including THC.
Edibles are available as cookies, gummy candies, hard candies, cakes, chocolate bars and other preparations, and are introduced into the body through the gastrointestinal tract, which produces slower but more intense, longer lasting effects.
It’s important to check labels before you ingest edibles, however. Some may contain as many as 100 milligrams of THC and are intended for multiple doses, while others have much lower THC levels and can be consumed in one serving.
Edibles are considered not only safer than smoking because it does not negatively impact the lungs, but they also can be consumed discreetly, so your coworkers will have no idea that your lunchtime treat is actually medicinal.
Cannabis essential oils
Cannabis oil, also known as tincture, was the main form of cannabis as a medicinal in the United States until it was banned in 1937.
Tinctures are taken orally by placing the oil under the tongue, where it is rabidly absorbed through the sublingual artery, the body’s main blood supply, allowing the medicinal marijuana to more quickly reach the brain. Drops are the preferred method of ingestion for those with gastrointestinal issues – ulcers, celiac disease or digestive problems – that could be exacerbated by edibles.
Drops are also easier for children or for people who are older with conditions that could benefit from medical marijuana but have a harder time taking in food.
While drops also work slower than smoking, they are quicker than edibles, to it is easier to calculate a proper dose for easing significant symptoms.
While drops are traditionally not swallowed, they can be mixed with tea, juice or food, which will slow absorption up to two hours.
Oil is traditionally used to reduce stress and anxiety issues, improve insomnia, boost appetite for those with illnesses and reduce chronic pain.
Creams are used topically to help ease inflammation associated with rheumatoid arthritis and other conditions.
Although they are absorbed into the skin, creams and lotions do not enter the bloodstream, so they are best suited for working with pain receptors at a localized site.
Dr. Audra Stinchcomb, an assistant professor at the Albany College of Pharmacy, began researching the medical marijuana patch in 2000, hoping to create a product that would help ease nausea and other side effects associated with chemotherapy in cancer patients.
She began her research after a 1999 report from the Institute of Medicine found that cannabinoids relieved cancer symptoms, but also found that marijuana smoke was more toxic than cigarette smoke, requiring a new method of consumption.
The patch was designed as a way to harness the benefits without the risk factors.
The transdermal patches allow the cannabinoids to be absorbed through the skin, working in a way that while similar to creams, also provides whole-body benefits similar to oil because it allows the cannabinoids to be absorbed into the bloodstream.
Her research was backed by a grant from the American Cancer Society.
Like cannabis oil, concentrates are extracted from marijuana flowers – the buds that are traditionally smoked – and are available with a wide variety of THC strengths, some with only cannabidiol and no THC, depending on the medical need.
Concentrates, which can be waxy or thick, can be smoked in pen vaporizers resembling e-cigarettes.
Smoking: Joints not allowed
Despite the legalization of medical marijuana, smoking marijuana and growing marijuana for personal use are still against the law in Puerto Rico, although prosecuting marijuana possession-related offenses are low on the list of priorities for the current administration.
Marijuana in traditional bud form will not be available in Puerto Rican medical marijuana dispensaries.
“Smoking marijuana is not being contemplated as part of a medical treatment,” Justice Secretary Cesar Miranda said in an interview with the Associated Press.
The move raised concerns from two vocal proponents of medical marijuana.
“A lot of patients prefer to inhale the cannabis than take it orally,” said Amanda Reiman at the New York-based Drug Policy Alliance, an organization that supports the legalization of marijuana. (New York also bans smoking as a way to administer medical marijuana.) Reiman said that it is more difficult to gauge what the correct dosage might be through a pill or edible, making smoking a preferred method of consumption.
Too, according to Ethan Nadelmann, executive director of the Drug Policy Alliance, smoking marijuana acts almost instantly to ease pain or nausea associated with chemotherapy, while other methods take longer to have a beneficial, therapeutic effect.
“You want them to take the medication in the form that works best for them,” Nadelmann said.