One of the most empowering parts of Medical Cannabis is the freedom to control your own routine and settle in on a regimen that best suits your symptoms and conditions. In Florida, all medical cannabis is grown and produced entirely within the state. Dispensaries are vertically integrated, meaning they are responsible for all aspects of production from seed to sale. As this is a significant operation, some companies only focus on flower and a limited menu, while others stock a wide array of delivery methods and products.

Far too often, patients find the first dispensary near them and never experiment elsewhere, locking themselves into limited choices with no awareness of what else is available on the market. They miss out on product types and cannabis strains that would be very helpful. The sheer growth of the Florida Medical Marijuana market in the last 2+ years has made way for a much wider variety of medications and options. We have far more dispensaries than ever before. While this vast landscape of options can be very empowering for patients, it can also be overwhelming to a new patient. Understanding the basic differences between products and medication options can help reduce the overwhelm, increase confidence when shopping around, and help you get the most our of your medical cannabis journey. 

Whole Flower (Smokable)

Typically, when people think about cannabis or marijuana, they immediately picture whole flower, or “smokable” buds. It’s what many patients are looking for and are used to - the good old plant. Whole flower is on the menu at most, if not all, dispensaries in Florida, however stock, strain availability, and quality vary widely. 

While Florida law refers explicitly to whole flower as “smokable,” it can be vaporized using a dry herb vaporizer or used to make homemade edibles, tinctures, and other products. At the time of this post, it’s the only Florida product to be limited by law in regard to purchasing and possession amounts. While physicians can recommend less if they choose, patients can purchase a max 2.5oz every 35 days and possess 4oz at any given time.

Edibles

While always allowed under the law, Florida waited years for medical cannabis edibles to hit the shelves as the agencies involved took their time developing rules and regulations.  A newer option for patients (August 2020), they are also a popular choice. Edibles have longer-lasting effects than most other administration routes, which can help patients looking to address symptoms for a longer period of time - 6 to 8 hours. This can be particularly helpful for things like insomnia, muscle spasms, and severe and chronic pain. 

Like any food product, edibles from Florida dispensaries can also come with counterproductive ingredients to a patient’s conditions. Some are unhealthy sugar-based treats, while others have added ingredients that can be triggering for symptoms. For example, edibles sold as “mints” often contain a sweetener, Sorbitol, which may have a laxative effect on patients treating gastrointestinal symptoms. If this is a concern, be sure to read ingredient labels before purchase. Don’t assume because it’s a medicine, it’s healthy.  Brownies, even when infused with cannabis, probably aren’t the healthiest choice!

Topical and Transdermal

Topical and transdermal cannabis medicines are applied via the skin and can be a great addition to a patient’s routine, even if just for infrequent as-needed use. Topical balms, lotions, and salves are applied locally, typically for pain relief. The cannabinoids are absorbed through the skin and will not reach the bloodstream, resulting in no psychoactive effects. Transdermal products have an entirely different mechanism of administration. Transdermal patches, or lotions, are meant to be applied near veins. They include ingredients that allow the cannabinoids to permeate into the bloodstream.  Because of this difference, transdermal products may have psychoactive effects, whereas topical products do not. They are a great option for long and discrete relief (8-72 hours). Patients suffering from migraines and headaches often find transdermal lotion or gel applied to the temples at symptom onset to be helpful! 

Oral Oils, Capsules, and Sublingual Tinctures

Many patients find oral and sublingual dosing to be a familiar and easy way to get a consistent amount of medicine, even preferring oral capsules, oils, and sublingual drops to edibles. These options can be easier to dose, while still providing long-lasting relief like an edible. Oils and sublingual tinctures are also an excellent choice for patients new to cannabis. They come in bottles with a syringe or dropper to measure out each dose.

Oil based oral oils can be used for cooking too! This allows much more precision and control than a premade edible or capsule, which are sold in predefined dosing increments. It makes it painless and easy to get the same dose and expected effects. Like commercial edibles, if ingredients are a concern, be sure to check these before purchasing. Sublingual options often include alcohol, as it helps with sublingual absorption.

Vape Cartridges, Distillate Syringes, & Concentrates

Typically reserved for experienced patients, vape cartridges, distillate syringes, and other concentrates are best for patients needing extremely high doses of THC. These concentrated products can be beneficial to many and even help save money, however, they do come with drawbacks and things to be aware of. Because of the high concentration, they can be easy to overuse and raise tolerance quickly. Going low and slow with dosing is extra important.

Some concentrates, like vape oil and distillate, are also “lacking.” The entourage effect is the idea that cannabis works best as a sum of all its parts, primarily cannabinoids, and terpenes. These terpenes are destroyed when making distillate and vape oil, so cannabis companies add them back in. The drawback to this -  many dispensaries are not using cannabis-derived terpenes. Instead, they use food-grade terpene profiles that are intended to mimic the strain effects. Some patients find these added terpenes to be irritating to airways. Some dispensaries preserve and then reuse the cannabis terpenes from the extraction process. These concentrated products certainly stand out among the rest. Like the other categories, knowing what you are consuming and asking questions about ingredients can be extremely helpful. 

While this is only a brief overview of medical cannabis products, we hope it helps to increase your understanding of some of the basics to be aware of. For a deeper dive into delivery methods, check out this post.

Post Written By: Josh Kerrigan, Patient Educator & Kristina Risola, MA, CRC, NBC-HWC

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