Frequently Asked Questions and Resources
Here are answers to frequently asked questions. We do have a knowledge base (click here) you can access, which has more information.
And there are educational videos and several patient resources at the bottom of this page.
Click on an subject for information.
How do I become a patient?
In order to schedule an appointment, we would need a copy of your medical records stating the diagnosis you’re seeking cannabis for. If you do not have your records, we can send a records request to your email so that we can request them from your doctor.
When records are available, we can schedule your initial appointment at our clinic where our staff will guide you through the process.
Feel free to email our support team: email@example.com
What Days and Times are Appointments Available with Your Clinic?
Appointments are available Tuesday through Friday from 9am to 5pm. Please contact our Support Team by completing our quick form on our Contact Page, by calling or texting our clinic at 772-218-7262, or by visiting our clinic.
Have you received my medical records?
Once we received medical records, we will contact you to schedule your first visit. If you have not heard from us, we did not receive your medical records needed for the office visit.
We fax over your records release form, but the doctor legally has thirty days to send them to us.
You may also reach out to them as well to help expedite the process.
What is the cost of an office visit?
The cost of an office visit is $165.00 at the time of your appointment. We do offer a $20 discount to all military veterans and first responders. If you’re a veteran or first responder, don’t forget to take advantage of this discount by letting our staff know of your status.
(Please bring military ID, DD214 or ID badge to verify military or first responder status).
The Florida Department of Health manages the identification cards and assess an additional charge to issue the identification charges.
Will insurance cover my visit?
Insurance does not cover visits for medical marijuana because federal statutes still consider it to be illegal.
Who qualifies? What are the next legal steps?
Our Physicians are certifying that our patients really have a debilitating condition, having tried previous therapies without success, and that the use of medical marijuana outweighs the health risks. Because of this tremendous professional responsibility, our Physicians may have to turn patients away who have not yet met criteria or are missing documentation.
By definition, debilitating, adj: something that seriously affects strength or ability to carry on with regular activities. As per Amendment 2, included in the list of debilitating conditions are: “Cancer, Epilepsy, Glaucoma,
HIV/AIDS, PTSD, Amyotrophic lateral sclerosis (ALS), Crohn’s disease, Parkinson’s disease, Multiple sclerosis,
or other debilitating medical conditions of the same kind or class as or comparable.”
Next Legal Steps:
1.) Get medical records. This can be your Doctor’s last office visit note. You can submit any records in advance for the physician to review and if it is not sufficient or not qualifying, you will not be charge for such consult.
2.) See the Physician (you cannot be certified by meeting with any other staff alone). Unlike other offices, we want you to have success, so we provide extra levels of education for the use of cannabis with safe and effective strategies, as well as up-to-date information about Dispensaries. We can provide trouble-shooting/Consult appointments throughout the year if you need additional help finding the right dosage program.
3.) Finish the Application. The Physician certifies medical approval, the State certifies identity. The State application is the second step after the physician issues an ID#. Most offices will discuss the Paper application which needs to be snail-mailed; which not only may take more time for approval, but also in our experience has a higher risk of rejection. We will walk you through the Electronic application process for the ID Card, which can take 5 or 10 minutes to complete for most people on the OMMUR Patient portal.
4.) Buy your Medicine from a MMTC/Dispensary. The State will send an approval email (2-3 weeks) which allows you to start your Cannabis Medicine! The ID Card will come in the mail afterward.
5). Followup appointments * Our office will place orders/certify for the next 6 months. We are available for consult visits if you need to be seen sooner. Other clinics will have different policy about followup times, but the LEGAL requirement is twice a year if you want to be able to purchase medication for the full year. This followup has to be in-person with a physician and State consent forms signed. Be careful if other physicians want to see you sooner for extra fees or advertise that certifications are for the year (which isn’t possible).
Is 210 days the maximum order duration for medical marijuana?
Yes. 210 days is the legal maximum order duration for medical marijuana. Per Florida Statute 381.986, “A qualified physician may not issue a physician certification for more than three 70-day supply limits of marijuana or more than six 35-day supply limits of marijuana in a form for smoking.”
What are some other legal considerations?
Southern Comfort Marijuana Clinic is not a legal attorney group and all information below should be verified by independent consult with your attorney. Below are the interpretations of the current laws by citizens. As the legislation in the State of Florida continue to evolve regarding medical marijuana, information below may become quickly outdated; but we try to continue to revise as new publications are reviewed.
FREEDOM FOR DOCTORS TO DISCUSS MEDICAL RISKS/BENEFITS:
We would like to bring attention to the legal case Conant v. Walters, 2002, with the decision from the Ninth Circuit Court of Appeals (does not include FL but sets precedence), stating that the federal government could not even threaten to punish a doctor for discussions about the therapeutic benefits of medical marijuana, given protection under the First Amendment of Free Speech. To this end, Southern Comfort providers give patient’s documented consults and recommendations, not prescriptions, for the use of medical marijuana. The clinic is not involved in the procurement or sale of marijuana or cannabis products.
REGARDING CBD OVER-THE-COUNTER:
Some businesses online and at smoke shops advertise CBD oils for sale (these are coming from Hemp plants). We want you to consider the following technicalities before you invest in products that may be unsafe or put you in legal jeopardy. First, medical CBD is still a Schedule I chemical designated by the DEA and therefore Federally illegal to possess as a medicine, and there has been a few but limited persecutions of this law. It slides by when CBD is marketed as a nutritional supplement, but note still at users risk as not regulated for quality in any way compared to the Florida CBD coming from Marijuana plants.
Take extreme caution when purchasing or transporting these products across state lines as even with an ID card you may not be immune to Federal enforcement and each state has their own laws about marijuana use. Be respectful and use responsible, not near public facilities.
Case law has upheld that a registered Marijuana User will fail the ATF 4473 form questioning illicit drug use, and be can be denied purchase of a firearm. Concealed carry is a per-state law system and Florida has yet to set precedence. In fact, view the links below to see what would technically disqualify someone from their Concealed Carry permit and a statement from the Florida’s Agriculture Commissioner, Nikki Fried:
Can You Have Both A CWFL And Medical Marijuana Card
Nikki Fried [Florida’s Agriculture Commissioner] Interviewed on The Marijuana Solution:
Checking on Status of Medical Records Request
When we receive medical records from a provider we sent a patient’s records release forms to, we immediately reach out to the patient to schedule their appointment.
If we do not receive medical records timely from other providers, we reach out to their records department to attempt to obtain the medical records. In many cases when records are not produced from other doctor’s offices, these offices will respond if the patient inquires why they have not fulfilled the records request.
Doctor’s offices have varying times for responding to Records Request forms (legally up to 30 days), so please nudge them along if time has lapsed to confirm if records were sent. If the offices report records were already sent, make sure to ask the date so we can review our inbound fax history but request they be resent anyways (772-873-7398).
Sometimes, an effective way to get records is by going in person to that office and submitting the written request.
Some mental health providers will only send records with an in-person request on their letterhead. Ask if there is a cost to sending records – many offices have policies that faxed records are at no charge, others will hold records from being sent until an invoice is paid.
If you are able to obtain the document that shows your diagnosis, please call our office and so we can schedule your appointment and we can scan them at that time. Many patients can access their records via a patient portal if their physician offers one.
How often do I need to renew my medical marijuana certifications?
In order to renew your medical marijuana certifications (commonly referred to as “prescription” or “orders”), state law requires that you need to schedule an appointment with our doctor once every 210 days (or seven months).
How long until I can make a purchase at a dispensary?
It takes about 10-15 days after you complete your state application before you can make a purchase. The applications are processed by the Florida Department of Health and can vary based on current demands.
For the most up-to-date list of the Dispensaries which includes their product website link, contact info and storefront locations, etc. please check out the Department of Health’s list of approved MMTCs: https://knowthefactsmmj.com/mmtc.
Furthermore, the link https://knowthefactsmmj.com/smoking/#mmtc includes the list of Dispensaries that are approved to sell Flower products.
What type of Medical Marijuana is available for me?
Any product that a Florida dispensary has available is open for purchase. Available products do vary by dispensary, so you should contact the available dispensaries to verify their available products.
Typical products available in Florida consist of the following:
- Prerolled Flower
- Tincture Oil
If my driver's license is expired, can you accept this?
The Florida Department of Health will not accept any expired driver’s license. This will not allow us to register a patient for a card.
Can I get an ID Card before I have a visit?
Florida law requires a visit to occur in order to obtain a card. You will have see Dr. McCain or Dr. Dattila before you can apply for your state application for a card.
After your visit with the doctor, our Medical Assistants will guide you on how to obtain your medical cannabis card.
How much does my ID Card cost?
The Florida Department of Health adminsters the identification cards. They charge $75.00 each year.
How do I renew my ID Card?
Full instructions for renewing ID cards can be viewed at https://knowthefactsmmj.com/patients.
This is an annual process, and the expiration date is printed on the front of the ID card with the website for renewal on the back, although you can submit a paper application as well. The renewal can be done on the same site as the Registry, https://mmuregistry.flhealth.gov, which is considered to be the patient portal. We suggest to start the renewal process several weeks prior to the expiration date to avoid any lapse in medicating.
The dates of the ID card renewal will be different from the required dates to see the physician for medication renewal. This is per law, as the maximum time that a patient is allowed to have renewals is for 7 months (30 weeks). So the renewal of the ID Card and office visits for renewal of orders to allow purchasing will not coincide in timing.
Department of Health
What is the Website for the Patient Portal at the Medical Marijuana Registry?
Registering a caregiver
A registered Caregiver allows a patient to have a legal representative purchase and possess their medical Cannabis as an assistant to the administration of the medicine. A Caregiver needs to have a separate ID card and go through the similar process to be approved, paying $75 to be issued the card. If you are interested in having a legal representative, then this person needs to come to the clinic to have their Driver’s License on file with our office and sign a HIPAA consent form. We will also need to collect data including their Social Security number and other personal data to input into the Registry. If the Caregiver wants to finish the application online, then a separate email address also needs to be provided. There is no fee to register a caregiver.
A “Caregiver” means a resident of this state who has agreed to assist with a qualified patient’s medical use of marijuana and has a caregiver identification card.
(a) The department must register an individual as a caregiver on the medical marijuana use registry and issue a caregiver identification card if an individual designated by a qualified patient meets all of the requirements of this subsection and department rule.
(b) A caregiver must:
1. Not be a qualified physician and not be employed by or have an economic interest in a medical marijuana treatment center or a marijuana testing laboratory.
2. Be 21 years of age or older and a resident of this state.
3. Agree in writing to assist with the qualified patient’s medical use of marijuana.
4. Be registered in the medical marijuana use registry as a caregiver for no more than one qualified patient, except as provided in this paragraph.
5. Successfully complete a caregiver certification course developed and administered by the department or its designee, which must be renewed biennially. The price of the course may not exceed $100.
6. Pass a background screening pursuant to subsection (9), unless the patient is a close relative of the caregiver.
(c) A qualified patient may designate no more than one caregiver to assist with the qualified patient’s medical use of marijuana, unless:
1. The qualified patient is a minor and the designated caregivers are parents or legal guardians of the qualified patient;
2. The qualified patient is an adult who has an intellectual or developmental disability that prevents the patient from being able to protect or care for himself or herself without assistance or supervision and the designated caregivers are the parents or legal guardians of the qualified patient; or
3. The qualified patient is admitted to a hospice program.
(d) A caregiver may be registered in the medical marijuana use registry as a designated caregiver for no more than one qualified patient, unless:
1. The caregiver is a parent or legal guardian of more than one minor who is a qualified patient;
2. The caregiver is a parent or legal guardian of more than one adult who is a qualified patient and who has an intellectual or developmental disability that prevents the patient from being able to protect or care for himself or herself without assistance or supervision; or
3. All qualified patients the caregiver has agreed to assist are admitted to a hospice program and have requested the assistance of that caregiver with the medical use of marijuana; the caregiver is an employee of the hospice; and the caregiver provides personal care or other services directly to clients of the hospice in the scope of that employment.
(e) A caregiver may not receive compensation, other than actual expenses incurred, for any services provided to the qualified patient.
(f) If a qualified patient is younger than 18 years of age, only a caregiver may purchase or administer marijuana for medical use by the qualified patient. The qualified patient may not purchase marijuana.
(g) A caregiver must be in immediate possession of his or her medical marijuana use registry identification card at all times when in possession of marijuana or a marijuana delivery device and must present his or her medical marijuana use registry identification card upon the request of a law enforcement officer.
(h) The department may adopt rules pursuant to ss. 120.536(1) and 120.54 to implement this subsection.
How do I know when my Identification Card expires?
An easy way to know when your license expires is to look at your license itself which shows the day it expires.
Your card expiration date is in the bottom right-hand corner of your medical cannabis card. If you never received a card, you all the Florida Department of Health at 1-800-808-9580, and they can tell you your expiration date.
No Password for Registry
Please review all the instructions for activating your ID card at the Department of Health website https://knowthefactsmmj.com/patients. Our clinic registers you into the state system called the Medical Marijuana Use Registry (MMUR) and provides you with an ID number – this alone does not give you permission to make any purchases; it is solely proof that the physician has done the medical certification part of the process. You will need to complete the state application to be issued an ID card, and this is renewed annually separate from any physician visits.
You do have the option to do the entire ID card application by mailing in a paper version, which we can give you at our office or you can print from that website. The Registry website is https://mmuregistry.flhealth.gov, and this serves as a patient portal where you can complete the application electronically and see the doctor’s orders. At login, the Username will be the email address you provided to us at the time of check-in. The Department of Health will send you the password for the Registry website, however the sender will be “MedicalMarijuana” so please check your spam/junk boxes if it is not received. This temporary password expires in 24 hours, but you can request a new one if needed by selecting “Forgot Password.” Some email domains do not work well with the Department of Health IT system, and if you still do not get the password, please contact them for additional assistance. We suggest using popular email domains such as “@gmail.com” to ensure success.
Notification of approval will be done via email in less than 2 weeks. Please contact the Department of Health if you of unsure of your status after this time lapses. The ID card will be printed and mailed to your physical address but this may be a delay of several months, and is not necessary to have when making a purchase from a dispensary.
Contact Information: Office of Medical Marijuana Use at: (800) 808-9580, firstname.lastname@example.org
Problems with application; proof of residency
The final approval of the application process is done by the Department of Health. The Physician certifies that you meet medical criteria and issued you a patient number, but the DOH needs to verify your identity prior to issuing an ID card. Therefore, please contact the DOH if you have any issues with the rest of the application process. Full instructions on how to complete the application can be reviewed at https://knowthefactsmmj.com/patients/cards. Not only does this website outline the steps of the Application and Approval Process, but also listing the Application Requirements or acceptable alternatives. Additionally, there is information about adding a Caregiver, information about changing the information on your ID card or Surrendering your ID card, and the rules for renewing your card annually.
Proof of Residency
For online applications:
The Registry is connected to the Florida Department of Highway Safety and Motor Vehicles’ (FLHSMV) demographic database. If there is a match to the information on your profile, your state residency status can be automatically added to your application and approved.
Per Florida law:
Adult applicants (patients and caregivers) must submit a copy of a valid Florida driver license or Florida identification card.
Seasonal residents who do not possess a valid Florida driver license or Florida identification card must submit a copy of two of the following documents:
A deed, mortgage, monthly mortgage statement, mortgage payment booklet or residential rental or lease agreement.
One proof of residential address from the seasonal resident’s parent, step-parent, legal guardian or other person with whom the seasonal resident resides and a statement from the person with whom the seasonal resident resides stating that the seasonal resident does reside with him or her.
A utility hookup or work order dated within 60 days before registration in the medical use registry.
A utility bill, not more than 2 months old.
Mail from a financial institution, including checking, savings, or investment account statements, not more than 2 months old.
Mail from a federal, state, county, or municipal government agency, not more than 2 months old.
Minor patients must submit a certified copy of a birth certificate or a current record of registration from a Florida K-12 school, and a copy of the minor patient’s parent or legal guardian’s valid Florida driver’s license or identification card.
The science behind Cannabis
Various studies, anecdotal reports, and scientific literature summaries have been reviewed to the best of the Physician’s ability. Given that the FDA will not approve medical marijuana or its extracts for traditional pharmaceutical use, we are obligated to share the warning that this therapy option is not a guarantee, and is not indicated as a cure, preventative measure, diagnostic tool, or means to mitigate a medical condition. We must keep in mind that some studies are more subjective in comparisons; conclusions of “some benefit” may mean that while the study did not find it statistically significant, while others may still benefit. The best type of study is a randomized clinical trial with humans, but research is banned basically in the US except for special programs; therefore, much data is brought from international sources, in vitro or with animal research.
All this being said, with our philosophy to support a patient’s choice in a setting that minimizes risks/harms, we intend to educate based on the science available and provide recommendations. As new data is revealed about the potential benefits of medical marijuana or the risk of side effects, the information below will be updated so that you and your physician can make the best healthcare decisions together. Studies have primarily been done with patients having a terminal condition, and now we are realizing the benefits can also relate to other more common conditions, as long as the correct ratio of CBD and THC are used. Finally, while there is a lot of evidence that medical marijuana can be help numerous conditions, we keep entertain the science with an open mind but will comply with the regulations foremost related to Amendment 2.
- Pain: relief from severe pain caused by neuropathies or visceral/somatic pains from cancers, by itself or as adjunct with opiate medications (which have cardiopulmonary and GI risk issues not found with medical marijuana.)
- Muscle Spasm: studies showed good benefit for patients with Multiple Sclerosis when in ratio of 1:1 THC and CBD in studies using mucosal doses and capsules
- Nausea: calming of nausea to prevent vomiting associated with chemotherapy, through indirect activation of 5HT91a receptors in dorsal raphe nucleus, though studies report variability in benefit
- Anorexia: studies with dronabinol (synthetic THC) were of smaller doses with statistically neutral effects, used most commonly in patients with HIV/AIDS to prevent wasting
- Cancer: no clinical data yet to suggest direct anti-cancer effects (replication is independent of CB1 and CB2 receptors), however an abundance of pre-clinical data suggest an anti-proliferative and pro-apoptotic (self destruction counter attack) that affects cell migration, adhesion, and invasion. The animal tissues studied so far included cancers like breast, brain gliomas, lymphoma/leukemia, lung, prostate, and colon cancer.
- Seizure: anticonvulsant proprieties have long been known of medical marijuana but the mechanism is still under investigation. Early studies showed that high dose THC could actually increase seizure activity but the CBD component provides better results and safety profile. It’s believed that CBD affects many transporter receptors such as the ENT, GPR55, TRPV1, 5HT1a, a3 and a1 glycine receptors to work directly on the nerves to reduce the excitability and transmission of signals, as well as through anti-inflammatory paths TNFa or affecting adenosine uptake to prevent seizure potentials. Many participants or parents of children who were included in these studies using cannabis extract also reported improvement in developmental skills (motor, language), alertness or sleep, and mood.
- Psychiatry: acts on limbic system to help regulate mood (borderline personality, PTSD, anxiety more than depression, affective disorders), stress, and reward. It may be used as therapy for dystonia, a side effect of some psychotropic medications. For those with sleep disorders these studies showed medical marijuana was weakly beneficial.
- Anti-inflammatory – decreased TNFa. Very high doses would not be good for an immunocompromised patient.
- Neuroprotective – possible mechanisms include prevention of oxidative damage, moreso than would Vit C or E. Additional theories suggest an increase cerebral blood flow, with potential for improved stroke recovery.
- Immunomodulatory- the CB2 receptors in skin have shown such autoimmune conditions like psoriasis, as well as mice having less joint destruction from similar rheumatoid disease.
- Glaucoma – potential to reduce the optic pressures moderately, benefit with protection of the nerves of the eyes
- Metabolic – surveys of regular medical marijuana users revealed that they were actually less likely to develop Metabolic Syndrome, meaning lower BMIs, and subsequently less incidence of diabetes (less insulin resistance) and cholesterol issues (with better HDL). The biological pathways are yet to be discovered.
- Other- the Florida Medical Association Certification course for Physicians also detailed some emerging science yet to be validated in human studies, but these include to potential to increase blood flow to the heart after a heart attack (increased perfusion in mice) or after stroke (less MCA infarct volume). The serotonin system may have a role in this process.
We keep up with Cannabis science, and have a database of articles related to the condition we will be addressing. This is a legal requirement to provide to the State if we certify based on an “other condition.”
Here are some other websites that are very good for education:
www.healer.com (Dr Sulak @ Integr8Health)
https://www.green-flower.com/ Green Flower Media
More about the plant and your natural Endocannabinoid System
Your body has it’s own cannabinoid system, with two receptors called CB1 and CB2 and two ligands called anadamine and 2-AG, plus regulatory enzymes. This system has a role in pain, appetite, mood, memory, inflammation, insulin sensitivity, metabolism, etc. The CB1 receptors are all throughout the brain/nervous system, gastrointestinal tract, reproductive system, adrenals, heart, lung, and bladder tissues. CB2 receptors are primarily found in the immune system. The marijuana plant has >100 phytocannabinoids, which are chemicals that mimic our own system. The glandular structure of the plant, called the trichome, produces resin phytocannabinoids including terpenes, which give the plant its characteristic smell.
THC – aka Delta-9-tetrahydrocannabinol
Works by activating mostly CB1, but also CB2 receptors and others not mentioned. Therefore, medicinally it can be used for its psychotropic features, anti-inflammatory, anti-cancer, analgesic, muscle relaxant/anti-spasmotic, and antioxidant with neuroprotective properties.
CBD- aka Cannabidiol
Non-psychotropic, used as a “entourage compound” to reduce side effects of THC. The list of potential uses includes anti-anxiety or anti-psychotic, anti-emetic via modulation of central feeding behavior, anti-arthritic, anti-inflammatory, neuroprotection, and immunomodulation with additional anti-fungal and antibacterial properties. While additional research is needed, initial reports are that CBD is nontoxic to non-transformed cells.
Third most prevalent phytocannabinoid, it has properties beneficial as anti-inflammatory, sedative, analgesic, antifungal and antibacterial agent. Animal studies also suggest use as antidepressant.
CBG – aka Cannabigerol
This chemical weakly activates CB1 and CB2, but also antagonizes 5HT and allows GABA neurotransmitters to maintain function in the brain. Strong anti-inflammatory properties suggest use in IBD like Crohns Disease and colon cancers, use with glaucoma, and as a powerful antibacterial.
CBN – aka Cannabinol
Found in aged cannabis, is a product of THC breakdown with less CB1 and great CB2 affinity, therefore with less nervous system and psychotropic potential, but influence over the immune system, as anti-inflammatory and antibacterial.
THCA – aka Tetrahydrocannabolic acid
Found in raw, undried cannabis, Non-activated form of THC, with animal studies ongoing to show neuroprotective effects and benefit with nausea and vomiting, and anticancer benefits.
THCV – aka Tetrahydrocannabivarin
It can activate CB2 and block CB1, which allows for antioxidant and possible antipsychotic and anticonvulsant properties. In studies it shows promise to delay progression of Parkinsons symptoms.
Medical Marijuana Safety
There are numerous articles to compare the health effects, both good and bad, with use of medical marijuana. To summarize all would be difficult on our website, so please see the referenced links. Below are some good points.
Adverse Effects (*combined list for THC and CBD):
Changes in perception- visual, time
Dry mouth and associated dental issues, Reduced tear flow and blink rate
Sedations, Dizziness, Reduced coordination, Ataxia
Bradycardia, orthostatic hypotenison
Anxiety, Dysphoria (these are dependent on ratios of CBD:THC)
Reduced sperm count (decrease testosterone)
Prospective memory and executive function decline
Bronchitis (resolves after cessastion), Cough (side note: data suggests no long-term change to lung function, ie no increase risk COPD, and little evidence to correlate as cause for lung cancer)
Medical Cannabis is regarded as having a fairly positive safety profile. There is a low to moderate dependence potential. Compared to prescription drugs or illicit drugs, there is low likelihood of overdosing, and the dose needing to obtain medical value is far below lethal doses. It should not be used at time of acute psychosis. Relative contraindications include severe cardiovascular (potential risk for arrhythmia), immunological, liver, or kidney disease, or acute illness. Extraction products should also be avoided if there is risk of hypersensitivity; cannabis extracts are often mixed with oils, ie. safflower oil, and patients need to be mindful and contact the dispensary or their product inserts to avoid allergic reaction. It is also important to get your product from reputable, regulated companies, as there has been issues of pesticide and fungal/bacterial contamination pending on oversight of other jurisdictions.
Pregnancy / Lactation – given the limitation on studies in pregnancy and lactation, it cannot be recommended through our provider to use medical marijuana. Mixed studies showed decreased fetal growth but does not appear to cause congenital defect, and may lead to perterm birth. Heavy use may diminish the neurodevelopment leading to subtle delay in milestones and cognition. THC does cross through the placenta and can be found in breast milk. Dispensaries have recommended use of contraception for men and women up to three months after the discontinuation of use.
There has been demonstrated decrease in brain volume (medial orbitofrontal and inferior parietal lobe) in adolescent medical marijuana users. This can associate with poorer complex attention. When used under the age of 18 years old, the long-term result was lower IQ at subsequent testing 20 years later. They also may have an increase of psychosis symptoms later in life. Proclivity to dependency peaks at age 20-24yo. We require that along with the provider at Southern Comfort medical marijuana clinic, the pediatric patient has their other physician sign consent for trial of therapy, with shared decision making regarding weighing risks:benefits.
People already experience individual benefit of all pharmaceuticals due to psychological makeup; particularly, liver enzymes, ie. some people are sensitive to all medications seemingly and others are very “tolerable” and need higher dosing. Reliable medical companies like Medscape evaluate the studies on drug-medical marijuana interactions and develop databases to classify the risk of side effects. You can look up your medications on their website, which then provides explanations of why they would interact here. Obviously, no database will be completely inclusive, it hasn’t been tested on everything!
There are no endocannabinoid receptors in the brainstem, which is why people can’t die from excessive medical marijuana intake; but can expect an uncomfortable response when taking an excessively high dose regardless. Some other meds, like opioids and benzodiazepines, there is risk for overdose as the receptors in the brainstem become bonded by the medicine and suppress the heart or lung function. We will teach you how to use the medication correctly and handle any bad sensations, which might mean changes in titration the next time.
Predictions can be made and dosing should be mindful to use minimum doses and monitoring. Many chemotherapeutic, antiepileptic, or cardiac arrhythmic medications have a narrow window of dosing, meaning toxicity or subtherapeutic levels that can be risky if not closely monitored. When looking at the pharmacology of medications that are sympathomimetic, such as nervous system depressants (including alcohol, sleep aids, benzodiazepines, opiates, barbiturates antidepressants), and anticholinergics, we recommend caution when used with medical marijuana, maybe to avoid completely. It is a relative contradiction for patients with history of cardiac arrhythmias or atherosclerosis, severe immunological, liver, or kidney disease, or in setting of acute illness to be using medical marijuana.
Common sense wisdom – too much of a good thing can be a bad thing. But if you want to get technical …. some pharmaceuticals will compete with THC and CBD in the liver to break down the chemicals to metabolites. CBD is metabolized by CYP3A and CYP2C19, and as an inhibitor of CYP2D6 will increase concentration of drugs metabolized by this enzyme. THC is metabolized by CYP3A4 and CYP2C9, and can decrease other drugs’ concentration as a metabolized by CYP1A2 inducer.
THC vs CBD --- key to success: you need both, the experiment is finding the balance
This is a fun question to answer and very misunderstood! Both are chemical components of medical marijuana that can be used for therapeutic purposes. THC has more psychotropic properties (“the high”) but when used with CBD, together are more tolerable and therapeutic. Most people do not realize that you do not have to feel “high” to get the medical benefits of medical marijuana as CBD cancels those effects at understood ratios. Some conditions benefit from specific ratios of these chemicals. Recreational plants are grown to be high in THC, sometimes up to 20+%. And the synthetic 100% THC, such as the prescription Marinol/dronabinol can cause a lot of people unwanted side effects.
We will guide you on how to titrate (increase your dose) to find what amount works best for your symptoms- unlike pharmaceuticals there is no standard dose for any person or condition, and more doesn’t necessarily mean better. Our natural body has an Endocannabinoid system, discovered in 1993, that when it becomes deficient from chronic stress or illness, can be supplemented back with the plants’ equivalent Phytocannabonoids- specifically THC and CBD! More is explained on our YouTube Channel video, the “Science of Cannabis.”
Why not Hemp? Can't I just get CBD from the corner store?
CBD is a molecule that can come from Medical marijuana or Hemp, but it’s not exactly the same. First of all, hemp is legally defined as having less than 0.3% THC so these CBD products may miss the benefit of the Entourage effect of combining the chemicals. Second, hemp growers also are Federally limited so much that the majority of hemp products are still imported, and therefore not comparable to medical cannabis which requires independent lab testing to verify for contaminates and potency. CBD is under Schedule 1 drug classification similar to THC, technically therefore not approved for medical use and the hemp industry works around the legalities by claiming use as nutritional supplement rather than medicine. This is commonly advertised falsely and some States are taking punitive action.
Hemp is a Cannabis plant variant that has been specifically inbred to be used for industrial and food purposes, whereas medical marijuana is more medical use- and the science can be easily explained by the difference in the plant. Medical marijuana is a very oily plant, with glands called trichomes releasing resins that give the plant its smell and oil that can be extracted for medical properties. Hemp’s agricultural goal is for the seeds and fibers, so the plant is dry and fibrous; leading to extract processes that may be more harsh. Hemp agriculture also likely has a degree of pesticide exposure by farmers- but that’s not to say medical marijuana is without pesticides (in FL most do operate as organic with the use of beneficial bugs but also nurseries in FL are required to undergo bath testing for 14 possible contaminates, so that is product safety).
Cannabis plants are very good at cleansing the soil. Historically, up to 80% of hemp was imported, so those soils may contain high levels of lead, arsenic, etc and there have been reports of nationally renown CBD companies testing high in these contaminates. Due to lack of regulation on CBD products bought from corner stores, we cannot make any recommendations due to these product safety concerns and advise you get CBD from a dispensary where it is known to be grown and tested in Florida.
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