In a move that surprised many advocates, California Governor Gavin Newsom decided to veto SB 305, a bill that became known to many as “Ryan’s Law.” The bill was designed to allow patients with a medical marijuana prescription to use medical marijuana in a hospital setting.
Tom Angell, writing for Forbes, reported that Newsom said he “begrudgingly” vetoed the legislation because it would “create significant conflicts between federal and state laws that cannot be taken lightly.” In a message that accompanied the veto, the governor suggested facilities would be at risk of losing Medicare and Medicaid funds if they allowed use of federally illegal cannabis.
According to Thadeus Greenson, editor of the North Coast Journal, the issue facing hospitals in California and elsewhere is that the Federal Drug-Free Workplace Act prohibits the use or distribution of federally “controlled substances” in workplaces that receive federal funding or federal grants, which most hospitals do. Consequently, most hospitals have policies prohibiting cannabis.
It’s been reported that the California Hospital Association initially opposed Ryan’s Law but eased its stance after lawmakers included a “safe harbor” provision that would essentially allow staff not to comply with the law if faced with a federal crackdown.
After some revisions designed to mitigate potential risks for hospitals, instead of requiring health care facilities to allow patients’ medical cannabis use, the law would simply prohibit health facilities from interfering. In the end, it appears the Governor felt that the risk, even with such a provision, was just too great at this time.
However, Newsom did sign SB34 into law. That bill was created so businesses could provide free medical cannabis to low-income patients, and exempts those products from state taxes.
To learn more you can read Tom Angell’s reporting in the October 13, 2019 issue of Forbes and Thadeus Greenson’s coverage of the bill in the North Coast Journal.com.
https://www.northcoastjournal.com/humboldt/ryans-law/Content?oid=15434547
Ask The Pharmacist
In this issue consultation pharmacist Jay Sochoka addresses what mature consumers need to know about vaping.
Media has recently focused on vaporization safety and has raised concern about the potential link to lung disease and possibly death. There has been discussion around black market cartridges and it has been suggested that illicit cannabis cartridges are cut with vegetable glycerin and propylene glycol, as well as polyethylene glycol and multi-chain triglyceride oils. Other ingredients that may be present in illicit cartridges include heavy metals, such as lead.
This discussion has led to concerns about the safety of medical cannabis programs. The medical cartridges carried in Pennsylvania’s dispensaries do not use any of the aforementioned cutting agents, and the manufacturers fill premium cartridges with pure cannabis oil. The extracted oils are derived right from the cannabis plant and are not diluted with any additional ingredients. All of the medical cannabis products manufactured in the Commonwealth are sent to three separate labs and undergo rigorous testing for cutting agents, heavy metals, pesticides, fungal growth, mold and purity.
While cannabis vapor may irritate the lungs, no causal relationship has been established between cannabis vapor and lung cancer. It has been shown that mild bronchitis may be associated with inhaled cannabis, but usually subsides when the products are discontinued.
Some patients may want to avoid vaporizing cannabis oil entirely, especially those with underlying pulmonary conditions or predisposition to bronchitis. Oral preparations available in the medical market are often effective at treating many of the symptoms treated with inhaled cannabis. No edible cannabis products are available for sale in Pennsylvania at this time.
In states where ingested cannabis is available, it is important to remember that it may result in a more intense feeling compared to inhaled forms, but the onset of action takes longer. While the effects of inhalation are felt within minutes, tinctures take about 30-60 minutes to take effect. Oral products, such as capsules, take about 1-2 hours to reach peak effects.
The key with ingested preparations is dosing around the clock to adequately address symptoms. While inhaling allows for instant, short-term relief, ingestion provides a longer and more consistent cannabinoid level in the blood. Once the proper dosing schedule is determined, inhalation may be eliminated altogether.
Inhalation remains the preferred route of administration for many patients. My personal preference is to use a combination of available products in order to treat my baseline symptoms and also any breakthrough symptoms. As a pharmacist, I’m confident in the testing employed by the Commonwealth, and trust that the products available through the program are safe.
Jay Sochoka, R.Ph. is a consultation pharmacist at Columbia Care, LLC dispensary in Scranton, Pennsylvania.
Getting The Results You Want From CBD
When it comes to questions about how long it takes for a person to begin to feel the effects of CBD the appropriate answer in many cases is, it depends. For instance it can depend on the type of CBD you are taking, the results you hope to achieve, how you take it, how much you take and how often you take it. You see, it depends.
Reporting for Real Simple, Betty Gold posed a number of questions about CBD effectiveness to Boris Shcharansky, the chief operating officer at Papa & Barkley, a California company that makes a variety of hemp-based products designed to “alleviate pain and promote wellness.”
According Shcharansky, the length of time it takes before a person begins to feel the effects of CBD depends largely on how it is taken, or what he calls “the dosing method.”
For instance, he told Gold that CBD topical products, such as a balm or ointments, and lotions, should take effect pretty immediately. He believes a person should start feeling relief within about 15 minutes of applying it to their body.
On the other hand, when it comes to products that are taken by mouth, such as tinctures, capsules, gummies, and the like, the results are both different from topicals and can differ from each other. For instance when a tincture is placed under the tongue, typically it will absorb within 30 seconds. Shcharansky says the effects of CBD taken this way are felt within 15 minutes. However when ingesting CBD by swallowing it or when consuming a food that contains CBD, it can take a person anywhere from 45 minutes to two hours to feel the effects.
Shcharansky also made the point to Gold that if you are taking CBD to soothe aches and inflammation, you must be patient and wait for the CBD to take effect. Taking more is not the answer. He explained that taking “CBD is typically associated with more attentiveness, less anxiety, and less inflammatory-related pain.” However, higher doses—say over 200 milligrams—may lead to drowsiness.
For those who are hoping to feel the effects of CBD as quickly as possible, Shcharansky suggested to Gold it might be best to take a tincture sublingually, meaning dropping it under your tongue, waiting a few seconds, and then swallowing.
However, he emphasized that the benefits of CBD are less about immediate effects and more about cumulative benefits over the long haul. He explains, “If you take CBD daily, you’ll continuously reduce your inflammation, which over time, should reduce your pain and keeps flare-ups at bay.”
In a previous article in Real Simple, Gold made the point that how much a person needs to take to get the result they desire can depend, to a great extent, on how they take it. For example, according to Gold, a person would need to use less of a dose when taking it in a tincture that goes under the tongue (sublingual) than than they would when taking an oral product, such as a gummy or a capsule. This is because some of the active ingredients are lost to the GI tract when taken orally. Tinctures under the tongue bypass this route, and therefore a person gets more of the active ingredient from sublingual delivery versus oral delivery.
You can learn more by reading Betty Gold’s thorough and informative article in the October 11, 2019 issue of Real Simple. Her comprehensive guide to CBD in the July 12, 2019 issue of Real Simple is also an excellent resource.
https://www.realsimple.com/food-recipes/recipe-collections-favorites/popular-ingredients/cbd-effects
https://www.realsimple.com/food-recipes/recipe-collections-favorites/popular-ingredients/cbd-dosage
Travel Tips
When mature consumers who use medical marijuana want to travel, the advice from experts is “know before you go.” A little preparation before you travel can help to keep you healthy, safe and on the right side of the law.
That’s the word from Sandra Gordon in her article on travel and medical marijuana for the website Marijuanadoctors.com.
For starters, she recommends telling your doctor where you plan to go and the length of your stay. She suggests this for several reasons. First, if you are taking medical marijuana for a specific condition some locations may be off limits, particularly is there are limited medical resources at your destination. Also, depending on the scope of your treatment and the severity of your condition timing could be an issue.
Gordon also stresses that if you are traveling by air in the U.S it’s important to leave your medical marijuana at home. She makes the point that even if you’re a registered medical marijuana patient in your home state, airport authorities can arrest you under federal drug trafficking laws.
Remember, according to the TSA it’s federally illegal to possess marijuana and “certain cannabis infused products, including some CBD oil,” at the airport.
Trying to travel internationally with medical marijuana is even riskier. Here, she sites the opinion of the United Patients Group, a medical cannabis organization for physicians and patients. It contends that it’s never a good idea to travel internationally with a controlled substance, even if you have a prescription, unless you’re willing to risk being detained or arrested.
Make sure as you pack for your trip that there is no cannabis of any kind in your luggage or in any of the clothing you intend to bring.
A better option is to research where and how to buy medical marijuana in the state you’ll be visiting before you leave.
Gordon suggests going to the Wikileaf website for a list of states that accept out of state medical marijuana cards and the requirements for obtaining medical marijuana there. For example, some states do accept out-of-state patient cards, but it may take contacting the state and applying for a visitor’s card prior to your arrival.
As with any other medication, it’s not wise to start taking medical marijuana just before you leave on your trip. Gordon recommends giving yourself enough time—at least a week—to know you can tolerate any new medication before leaving home, including medical marijuana.
To learn more, read Sandra Gordon’s helpful article in the June 14, 2019 edition of the website Marijuana Doctors.com. You can also click on the Wikileaf link below to visit a list of states that recognize out-of-state medical marijuana cards.
www.marijuanadoctors.com/blog/travel-tips-for-people-taking-medical-marijuana/
www.wikileaf.com/thestash/medical-marijuana-states-accept-out-of-state-licenses/
Tips On Storing Cannabis
Nothing lasts forever and that include the potency of the marijuana you have purchased. Many mature consumers, particularly those using medical marijuana, are new to cannabis culture and how best to care for their cannabis.
To help reduce the strain you may be feeling about how to best keep the strain you have purchased, here are some tips from the folks at Leafly.
To begin with, to prevent mildew and mold it’s best to keep cannabis in a cool, dark place. Also too hot an environment can can dry out the cannabinoids and terpenes in your cannabis and make for a smoke that is hot and harsh.
Controlling humidity is also important. Experts recommend keeping your cannabis in a space that is between 59 percent and 63 percent relative humidity if you want to maintain its color, consistency, aroma, and flavor. Much below 63 percent risks drying out your cannabis.
Storing your cannabis out of direct light will also help you control the temperature and help keep UV rays from degrading your cannabis.
Medical marijuana purchased at a dispensary often comes in an airtight container designed to protect it from sunlight. Even so, it’s best to not store it in a refrigerator or freezer since fluctuations in humidity and temperature can increase the chance of mold and mildew. The folks at Leafly suggest it’s best to store your cannabis container on a on a shelf in a low cupboard, or in the basement of your house, much like a wine cellar.
You can learn more in Will Hyde’s article “How long is my cannabis good for? Leafly’s guide to storing cannabis” in the Cannabis 101 section of the website.
www.leafly.com/news/cannabis-101/how-long-is-my-cannabis-good-for-leaflys-guide-to-storing-cannabi
Senior Cannabis Digest is compiled and edited by Joe Kohut and John Kohut. You can contact them at joe.kohut@gmail.com or at 347-528-8753.