MEDICAL MARIJUANA BASICS
How do you choose your medicine? by Debra Kimless, MD
Once you successfully obtain a medical card and walk into that dispensary, it can become overwhelming. This is what my patients tell me all the time. There is a myriad of products offered, and the choice is up to the patient, who may or may not have an understanding that each type of dosage administration form has its own pros and cons. The effects of the medicine will differ depending upon whether you choose inhalation, oral, or topical dosing. It is important to understand the differences so when you visit a dispensary, you will have the basic knowledge to discuss which medicine makes the most sense to treat your condition. FIRST, AN OVERVIEW ON SOME BASIC CANNABIS CHEMISTRY. Cannabis produces bioactive chemicals. These chemicals number over 400 different constituents, and there are over 100 of these chemicals specific to the cannabis plant, aptly called cannabinoids. For the sake of this article, we will only discuss CBD and THC. As cannabis grows, the chemicals that are made in the plant are in a raw form also known as an acid form. It is called an acid because there is a chemical group called a carboxyl group that is, chemically, an acid. So, CBD and THC don’t really exist in the plant. Instead, CBDa and THCa—the raw (or acid) forms of CBD and THC—are found in the raw plant. The “a” stands for acid.
When the plant is heated for a specific time at a specific temperature, the carboxyl group turns to CO2. This chemical conversion is known as decarboxylation, and this is when the chemicals are converted from the CBDa and THCa to CBD and THC. This is known at the neutral form—as the molecule is neither an acid or a base. Interestingly, there is a lot of overlap in the medicinal effects between CBDa and CBD and between THCa and THC. The one major difference is THCa has no intoxicating effects, but when you apply heat to THCa it will become intoxicating after it converts, through decarboxylation, to THC. So, to recap: the plant manufacturers CBDa and THCa. These molecules have potent medicinal effects. When heated, CBDa converts to CBD, and THCa converts to THC. THCa, CBDa, and CBD do not have intoxicating effects, i.e. you don’t get high from consuming them. THC does have intoxicating effects if enough is consumed. Now that the chemistry lesson is over, we will move to methods of administration, or how to take your medicine. INHALATION Inhalation method is permitted in Florida as long as the medicine is vaporized and not smoked. The difference is a perceived safety. Smoking creates chemical products of combustion which could potentially be harmful to your health. Although there have been no reported studies linking smoked cannabis with an increased risk of lung cancer, there is a higher incidence of bronchitis and chronic cough associated with smoking. Vaporizing heats the product to its boiling point where it creates steam just before it combusts. The steam or vapor is inhaled. Because the temperature is high enough to create a vapor, it is also high enough to convert the medicine from its raw form to the neutral form. So, if you are vaporizing cannabis flower with THCa, it will be converted to THC, and if enough is used, then the intoxicating effects of THC will be felt. If you are vaporizing flower that has mostly CBDa, then it will be converted to CBD, and you will not experience intoxication since CBD does not cause intoxication.
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