CANNABIS IN MISSOURI: IN What Know to

E xp er ts share advic e for novic e users followin g st atewide legalization

By Connie Mitchell

On Dec. 8, 2022, cannabis became a legal substance in Missouri, giving dispensaries the green light to expand their medical-use operations to include recreational services. The first converted licenses issued by the State Department of Health and Senior Services are expected in early February, after which people 21 and older will be legally authorized to purchase up to 3 ounces of cannabis in a single transaction for recreational or personal use. The drug remains illegal at the federal level, and possession is prohibited on public or private school property, including University of Missouri system campuses.

Consumers interested in legal cannabis should educate themselves before purchasing, local experts say. First, keep in mind that every dispensary is different. “Check out as many dispensaries as possible in your area before settling in with one or two of your favorites, ” advises Carlie Bell-Biggins, a naturopathic physician and adjunct instructor for the Saint Louis University Medical Cannabis Science and Therapeutic Management Certificate Program “Differences could include inventory stock, brands carried, budtender education and training, customer service, pricing, convenience and additional offerings.”

Bell-Biggins recommends first-time buyers ask themselves a few key questions before their initial purchase: “What are you trying to achieve with recreational cannabis use? Are you wanting to relax or increase your appetite? Perhaps you are wanting to get better sleep, decrease pain or minimize anxiety. Knowing what your end goal is can help your budtender point you in the right direction.”

Other experts emphasize that cannabis, whether taken for medical or recreational use, is an herbal medicine and should be respected as such. “Herbs should be taken in consideration with current health, medications and experience,” says Jamila Owens-Todd, a naturopathic physician and adjunct instructor for the Saint Louis University Cannabis Science and Operations Certificate Program.

Cannabis is available in various forms that affect the body in different ways and address different issues. Inhaling the smoke of the dried cannabis flower in a joint or in a more concentrated form, such as from a vape pen, has the most immediate effect and is best for anxiety and acute pain, Owens-Todd says. However, despite the physical and mental benefits some users experience, maintaining good lung health should still be a priority for those who choose to inhale cannabis smoke directly

“Edibles have a prolonged effect, meaning you will not feel the effects until one to two hours after consuming,” OwensTodd says. “The effects of edibles can last the longest due to the liver converting active THC – the compound that gives ‘pot’ its high – into another molecule called 11-hydroxy THC, which has more intense and prolonged effects on the body. This is helpful for pain or insomnia.” Sublingual products can act faster than traditional edibles, and topical preparations can be useful for localized pain relief without causing a noticeable high, she adds. Even suppositories are available for inducing calm and relaxation, while decreasing the sense of being high that comes with smoking or eating cannabis products.

Choosing the appropriate cannabis strain is also important Bell-Biggins recommends looking at the cannabinoid and terpene profile. Cannabinoid provides sedative effects, so strains high in CBN are best taken at night. Terpene limonene, on the other hand, is energizing and has antidepressant properties, making products that are higher in this substance better for daytime use. THC, perhaps the best-known substance in cannabis, can provide relief from pain, nausea and anxiety when taken at low levels but can also have unpleasant effects if the dose is too high – even sometimes exacerbating the very issues you hope to address.

“We may call it ‘recreational, ’ but many people use cannabis to support their health and healing,” Owens-Todd says. “As with any medicine, you should always exercise caution while consuming.” Side effects can include dry eyes, nausea, decreased motivation and paranoia

Although some people assume cannabis is not addictive, one study from the Centers for Disease Control and Prevention reported that about three in 10 users have marijuana use disorder, meaning they are “unable to stop using marijuana despite it causing health or social problems in their lives.” Another study, also conducted by the CDC, estimated that people who use cannabis have about “ a 10 percent likelihood of becoming addicted, ” and the risk of developing marijuana use disorder is “greater in people who start using marijuana during youth or adolescence.”

Despite these precautions, OwensTodd advises that cannabis can and should be considered as an alternative to opioids and anti-anxiety medications and be part of palliative care plans for those living with cancer or undergoing chemotherapy “ When used with caution and consideration, it can be a powerful healing tool, ” she says. “The enormous amount of science – considering cannabis for neurological conditions, pain management, PTSD support and overall mood support – makes it a viable alternative for many people when treating these conditions. It is time to consider cannabis ’ benefits and to incorporate it, when applicable, as viable medicine. ”

Jamila Owens-Todd, Naturopathic Doctor ; Saint Louis University Cannabis Science and Operations Adjunct Instructor ; MINT, 314-677-4041, minthealth.org

Carlie Bell-Biggins, Naturopathic Doctor ; Saint Louis University Cannabis Science and Operations Adjunct Instructor, carlie.bellbiggins@slu.edu