Ask the Expert – Cannabis Education

Do you recommend cannabis for the treatment of migraine? If so what THC/CBD ratio do you recommend and what route of administration?

I have recommended medical cannabis in the management of migraine headaches when standard therapy is either ineffective or associated with intolerable side effects.  Although oral medical cannabis oils with consistent absorption and metabolism are the usual recommendation for most conditions, acute migraine treatment often requires inhaled administration because of the necessity for a fast onset […]

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Do you have any good websites you would direct patients to that discusses cannabis use for cancer related pain?

Websites that patients may access for information on medical cannabis and cancer related pain include the Canadian Cancer Society, American Cancer Society, the National Cancer Institute, Canadian Pain Society and even WebMD.  A number of these websites indicate that medical cannabis may be useful for not only analgesia in cancer but also for other related […]

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How do police check for cannabis if you are pulled over while driving and they suspect intoxication?

This is a question that many people are concerned about with much existing confusion over the process and guidelines to determine whether an individual is intoxicated secondary to cannabis. If a police officer witnesses a person driving erratically, part of their investigation focuses on whether the individual may be under the influence of alcohol or […]

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How can clinicians and educators assist chronic medical cannabis patients transition from smoking to other delivery methods?

Education! Take home point: vaporization is safer, cheaper and more efficient than smoking. Smoking involves combustion of plant matter at approximately 600-900°C and produces tars, ammonia, PAH, carbon monoxide and other potential carcinogens. If cannabis contains pesticides or synthetic fertilizers, combustion of these compounds produces additional toxic biproducts. Cannabis has four times more tar than […]

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With so many available products on the market, how do you differentiate them?

Licensed producers (LPs) can vary in cost, customer service and education, inventory/stock and the variety of products they carry. These are some of the factors to consider when choosing one company over another for your patients. LPs that are dedicated to medical cannabis (vs recreational cannabis) patients should have outreach teams with representatives who can […]

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What evidence exists for the use of medical cannabis? In particular, in the management of mood disorders?

An extensive systematic review of more than 10,000 cannabis articles was published in 2017: The Health Effects of Cannabis and Cannabinoids: The Current State of Evidence and Recommendations for Research. This report was written by an expert, ad hoc committee, of the National Academies of Sciences, Engineering, and Medicine. It offers nearly 100 conclusions related […]

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When do you use CBD vs THC (or both)?

THC-mediated side effects are more pertinent and dose-limiting, and are dose-dependent; using a ‘start low and go slow’ dosing strategy mitigates most adverse events of THC, and combining CBD with THC can further reduce side effects CBD-predominant chemovars (cannabis varieties) produce fewer adverse events than THC-predominant chemovars Although THC can cause psychoactive adverse events, it […]

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Dosing of cannabis oil is in mg , but when talking about dried product it is in grams. Can you explain more. Is there a conversion which needs to be done?

Cannabis oils are extracts of cannabinoids and terpinoids from cannabis plants; they generally contain CBD, THC, other cannabinoids, aromatic compounds (terpenes), and a carrier oil of some sort (e.g. usually sunflower oil, olive or grapeseed oil). Health Canada has mandated that any licensed producer that provides fresh marijuana or cannabis oil must determine the quantity […]

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