The process of getting cannabis used to be difficult because it was illegal.  Now that marijuana is legal in various forms in various locations, it’s difficult to know where to go, what to get, and whom to trust when looking for a reputable medical marijuana dispensary. Not only have the types of products multiplied enormously but also the sources have expanded into a confusing morass.  Let’s take a good look at these sources, the types of product they sell, and their general trustworthiness. 

Confusing Terminology

There are basically three sources of cannabis-related products:  medical dispensaries, recreational stores (all too often also called dispensaries), and ordinary stores selling hemp-derived products (like gas stations or Whole Foods).  Let’s look at the pros and cons of each. 

A reputable medical marijuana dispensary is a state-regulated source that conforms to high levels of regulation to protect patients.  Most of these protections center around purity – assuring patients that there are safe levels of cannabinoids, mold, pesticides, and heavy metals.  Most states do a good job with these regulations, but these regulations are not federal, so they can vary from state to state.  For example, until recently Arizona did not have protective regulations for medical products and Maine still doesn’t.  Ironically their recreational regulations are stronger.

Aside from purity regulations, medical dispensaries aren’t required to levy taxes on patients. They often have products that are reserved for patients, and if they also do recreational sales, give priority service to medical patients.

In Massachusetts, uniquely at this time, the medical system provides information to physicians that helps them provide appropriate care.  

Recreational stores, in states that have them, are very much like medical dispensaries. However, consumers will pay tax on products and may not be able to get “deals” like in a reputable medical marijuana dispensary.

Bad Places to Get Advice

Neither medical nor recreational facilities are good places to ask about products to use for medical benefit.  Both will readily volunteer to provide guidance on treating your issues, but no one at such facilities are trained or qualified to give such advice.  While they may claim not to be giving medical advice by dancing around it with statements like “our patients tell us that…” or “people use this for such and such condition”, don’t be fooled.  They are trying to give medical advice while professing not to. 

This sort of thing has led countless of my patients into dangerous territory over the years and has to stop.  I would strongly advise you to ignore their commentary and ask your Cannabinoid Specialist those questions.  I would support not returning to any dispensary or store that gives this sort of advice.

Hemp-derived Products

Just to confuse things further, there is a third source of cannabinoid products – hemp-derived.  Due to the utter stupidity of the Farm Bill of 2018, hemp and all its derivatives became legal.  Yet, there is no regulation of these products at all.  None. 

As a result, these products are untested and scientific studies have shown them to be anything but safe.  There are two issues.

First, many of the cannabinoids are not understood.  Products like CBD, CBG, CBN, and CBC are naturally derived, but have never been adequately studied.  Consequently we don’t know if they’re safe, particularly since they occur in tiny amounts in normal cannabis.  In fact, CBD is the best researched to date and has yet to shown to have benefit in adult humans.  There are some data that it can be dangerous under certain circumstances.  The other cannabinoids are even less well known. 

Delta-8 THC, Delta-10 THC, HHC and Others

To make matters even worse, greedy companies have now figured out how to convert legal hemp-derived cannabinoids like CBD into intoxicating cannabinoids to skirt around the law in places that don’t yet have legal cannabis, or to provide lower-cost (because they’re unsafe) alternative to safe sources.  Delta-8 THC (d8) is one of these manufactured cannabinoids that does occur naturally in cannabis, but at such low levels that it’s never been studied on its own.  Delta-10 THC and other cannabinoids like HHC are not natural and we have no idea what they do.  It’s mind-blowing that people are selling completely unstudied and potentially unsafe chemicals for human use.  Worse they’re still saying it’s good for what ails you!

The second issue is that converting CBD into these other intoxicating cannabinoids is not simple.  It requires a fair bit of complex and dangerous chemistry involving high temperatures and strong acids.  This sort of chemistry is not uncommon or difficult in the pharmaceutical industry. However, the cannabis world just doesn’t have that sort of expertise.  As a result, analyses have shown these product to be contaminated with these dangerous chemicals and other unpredictable byproducts of the conversion. 

The companies and their “chemists” are so ignorant that they cannot filter out these dangerous impurities.  Due to their lack of skill, money, and caring, they don’t often know how contaminated their products are.  You just can’t trust hemp-derived products at present. 

Ultimately, hemp-derived products will have to be regulated either at the state or federal level to achieve the same safety as cannabis products.  Of course, then those products will cost just the same as cannabis products making them moot. 

On another note, there have been studies that have shown that unregulated products like those from hemp can also contain adulterants:  substances added deliberately like opioids or benzodiazepines. 

So What Are You Supposed to Do?

First, go nowhere near any hemp-derived products until they become regulated by the government.  It’s not clear when or how this will happen, so it won’t be any time soon. 

Second, avoid recreational stores if you are a patient.  While they are multiplying rapidly, you’ll pay extra for the convenience, may not get the best products for your illness, and may be inadvertently bypassing part of the information your doctor needs to keep you healthy.  If you go to a store that has both recreational and medical, be sure to use your card. 

Third, your Cannabinoid Specialist doctor should be available to talk to you about specific products that are most appropriate for your regimen.  If she isn’t available or doesn’t seem to know about the products and how to use them, you can contact the Association of Cannabinoid Specialists (ACS) for a referral to someone who can help.  ACS can also help educate your doctors on this topic if they are interested. 

Consult with a Qualified Boston Medical Marijuana Expert Today

Those considering using THC, CBD, or any type of medicine found in cannabis to help manage their condition should consider speaking to a trained medical expert who is knowledgeable about using cannabis therapeutically. Massachusetts medical marijuana doctor Jordan Tishler, M.D. sits on the faculty of Harvard Medical School and has years of experience helping patients treat pain and other ailments using cannabis. He and the team at InhaleMD stand ready to assist patients in determining whether medical marijuana is right for them.

For more information, or to set up a virtual consultation with the team at InhaleMD, call us at (617) 477-8886 today.

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