Dear Nurse Susan,
I went to a dispensary for the first time to get something to help me sleep, and was overwhelmed by the number of products to choose from! Can you narrow it down for me? Sincerely,
The first visit to a dispensary is often overwhelming, and can create a little uncertainty when you’re not sure what you are buying. You’ll typically turn to the dispensary staff for assistance and some are definitely better informed than others, which can making things even more confusing. Whenever you are buying cannabis products, there are 4 things to consider:
- Safety: Ask to see the lab results to confirm the product is safe, without pesticides, mold or bacteria. Reputable companies will lab test their products and will post the Lab Report on their website. If the company does not lab test their products, does not make them readily available, or they post expired lab reports, do not use that product! There are companies that see cannabis as a “get-rich-quick” opportunity and quickly bring low-quality products to market, especially over-the-counter CBD/hemp products. Buyer beware!
- Cannabinoid Profile: There are hundreds of cannabinoids and terpenes (therapeutic compounds) in cannabis, the most popular being THC, CBD, THCV, CBN etc. Each cannabinoid has its own therapeutic effects, although their effects often overlap. For example, THC and CBD both alleviate pain, but if your pain is severe, you will want to use more THC than CBD because THC is more effective than CBD for severe pain. It is a good idea to consult a cannabis nurse for education and consultation on cannabinoid and terpene profiles that best relieve your symptoms.
- Method of Administration: The method of administration is not just a personal preference. Each method has its own time to onset, duration of action, and bioavailability. Many times, a patient will use more than one method. For example, for immediate relief of nausea, pain, etc., vaping is the best method, because the time to onset is within 15 seconds, but lasts for only a couple of hours. For sleep, you may want to use an edible because, although they have a slower onset (up to 2-3 hours) they last the longest, up to 6-8 hours. So, if you take a low dose edible a couple of hours before bed, the sedation will last throughout the night, and help you stay asleep. And, if it’s dosed appropriately, you will not have a hangover, or be groggy when you wake up. Make sure you use an Indica at night, and Sativa during the day.
- Cost: Medical cannabis can be very costly, and insurance doesn’t reimburse. So, how do you know if a product is overpriced? Figure out how much you are paying per milligram of cannabis. For example, if a 30ml tincture has 500mg of cannabinoids (THC, CBD, etc.) and costs $50, you divide the cost by the number of milligrams, which in this scenario comes to $0.10/mg. The average cost per milligram for tinctures/sprays is between $0.10 - $0.20/mg. For full extract cannabis oil, the average cost is between $0.03 - $0.06/mg. Expect to pay more for CBD-rich products than for THC-rich products.
If you follow these steps, you will considerably narrow down your choices. Cannabis works differently for different people. You may want to go to sites like medicaljane.com, Hellomd.com, or my site dearnursesusan.com to get more information on the specific condition you are dealing with. It takes some experimenting with different products, doses and methods of administration, plus a little patience, to discover the best product, dose and method of administration that works for you. In my opinion, it’s worth the effort!
I hope this simplifies your cannabis journey of discovery!
(Susan Marks RN, BSN, PHN is a medical cannabis educator and consultant based in Los Angeles. Send your questions and comments to Nurse Susan at firstname.lastname@example.org.)