Cannabis Education
All About Medical Marijuana
From the Facebook group "Mississippi Forum for Cannabis Education"
When marijuana is inhaled, cannabinoids like THC are rapidly absorbed through the lungs and enter the bloodstream directly. With an edible, it passes through the digestive system and absorbed more slowly through the stomach and intestines before first-pass metabolism in the liver. This delays effects up to 2 hours and causes some patients to use more than intended.
In the liver, THC turns into 11-hydroxy-THC which is more potent than THC and has longer lasting effects. This is why you can feel the effects of an edible for up to 8 hours.
With smoking and vaping, the effect is more immediate and controllable with fairly predictable results. With edibles, the effect is often described as more intense and often sedative. Edibles may be safer for your lungs, but the risk of overconsumption and delayed effects can make them more challenging for some patients.
Here's a quick video - https://www.youtube.com/watch?v=v1rMOt9mMqk.
Fun fact - The fabric for the first American flag, sewn by Betsy Ross, was made from hemp.
The word "marijuana" refers to a cannabis plant that contains 0.3% or more of THC by dry weight, and "hemp" contains less than 0.3% of THC - that's it.
Hemp plants are tall, dense, and grown for their stalk and seeds. It grows rapidly outdoors, improves the soil, and requires little water and pesticides. Hemp is used in textiles, paper, plastics, construction materials, and biofuel. Hemp contains more CBD than marijuana and its seeds are a superfood.
In Mississippi, marijuana is required to be grown indoors by a licensed cultivator. The THC content is as high as 30% (maximum by law) and there are strict testing requirements.
The term "hemp derived cannabis" describes products that are made from hemp, but contain a level of THC more common in marijuana - like gummies at a drug store with 5% THC. Imagine condensing 50 non-alcoholic beers (they contain a small amount of alcohol) into a single regular beer. Because these products are made from hemp, they are not regulated in Mississippi.
This video https://www.youtube.com/watch?v=Jk51ALfjeYo from Suterra Wellness does a good job of explaining the differences between hemp and marijuana.
Fun fact of the day - In 1983 when I graduated from Tupelo High School, the average THC content of marijuana was only 3.2%.
One of our group members uses cannabis to help treat her MS. The terpenes most important for treating MS have anti-inflammatory, pain-relieving, anti-spasmodic, and neuroprotective properties.
Caryophyllene - The most important terpene for MS due to its anti-inflammatory and pain-relieving effects. It interacts directly with the CB2 receptors in the endocannabinoid system, which help reduce inflammation.
Myrcene - Known for its sedative, muscle-relaxing, and analgesic properties, it can help reduce muscle spasms and promote relaxation and better sleep.
Linalool - MS patients often experience anxiety and stress, which can exacerbate physical symptoms like muscle spasms and fatigue.
The strains below are grown in Mississippi and have Caryophyllene, Myrcene, and Limonene as primary terpenes.
Animal Mintz
Biscotti
Blueberry Muffin
Bruce Banner
Chemdawg
Death Star
Girl Scout Cookies
Gorilla Glue 4
Jelly Breath
Orange Creamsicle
Pac Man
Soul Assassin
Sour Diesel
Starfire Chem
Super Runtz
Here's a report from CBS News on using cannabis to treat MS - https://www.youtube.com/watch?v=2ghSVEAAykI.
Fun fact - There are over 2,300 strains of cannabis.
A few weeks ago, I was speaking with a group of about 15 resident physicians from around the world at the hospital in Tupelo and asked how much total training they have had on the endocannabinoid system. They chuckled and one finally said "about two hours." The other 14 physicians said they had less.
The endocannabinoid system (ECS) is the cell-signaling system found in all vertebrates, including us! It was discovered in the 1990s and is crucial to maintaining homeostasis - or "balance" - in our bodies including pain perception, mood and stress responses, appetite and digestion, sleep cycles, memory and learning, and even reproductive health.
It is important for all of us in the Mississippi cannabis community to understand that most physicians and health care providers have had very little training on the medical benefits of cannabis. Just like Mississippi patients are starting to learn more about cannabis, so are our Mississippi health care providers. This video from a physician is a good one to share with others who are interested in learning more - https://www.youtube.com/watch?v=8GsmTFytBYI.
Fun fact - Anandamide, one of the key endocannabinoids, is nicknamed the "bliss molecule" because it plays a role in promoting feelings of happiness and relaxation. It’s thought to contribute to the "runner’s high" experienced after intense exercise.
In Mississippi, glaucoma is a qualifying medical condition and optometrists can become prescribers.
THC is the most effective cannabinoid for lowering intraocular pressure (IOP). It also may help safeguard the optic nerve from damage. While CBD may not directly lower IOP, it can help reduce oxidative stress and inflammation around the optic nerve. CBG has also shown promise for lowering IOP and improving blood flow to the eye.
Here's a brief video on where we are now in the scientific research.
CO2 full spectrum cannabis extraction is clean and solvent-free, and it preserves the natural terpenes and cannabinoids - major and minor. Distillate carts are made by using solvents like ethanol, and refining the plant into highly purified THC oil with fewer terpenes and minor cannabinoids.
Most Mississippi patients are surprised to learn that with distillate carts, the name on the package is almost never the actual strain used to produce the cart.
Supplemental terpenes derived from cannabis and other plants, as well as supplemental cannabinoids, are added to try to mimic different strains or flavors. The name of the strain on a distillate vape cartridge package is almost always simply for marketing.
CO2 full spectrum carts usually have a more natural taste because the terpenes are from the original plant. They also provide a more balanced experience because of the minor cannabinoids that are so important to the entourage effect.
Patients often choose full spectrum CO2 extraction if they prefer a more natural experience with inherent cannabinoids and terpenes, and distillate carts for higher potency and customizable flavors.
Here is a one-minute video showing how distillate carts are made.
https://www.youtube.com/watch?v=5qEl2bsHgYo
Note - the CO2 extraction process can also produce distillates.
Live resin is extracted using solvents like butane or propane to remove cannabinoids and terpenes. Live rosin is made by applying heat and pressure to bubble hash (which is made from ice water-extracted trichomes), and no chemicals are used.
Live resin comes in various consistencies like sauce, sugar or badder, and live rosin has a more buttery and sappy texture. Both are highly potent, and live resin may have slightly more THC because the solvent extraction process removes more cannabinoids.
Live rosin is usually more expensive because of the labor intensive extraction process, and is favored by purists who prefer the smoother and more natural taste.
Here's a three minute video from Compassionate Care explaining the differences - https://www.youtube.com/watch?v=f_2Pv5JgxdM
There are a number of serious health risks due to a lack of oversight, safety standards, and quality control. Below are five of the main risks along with a quick video.
Contaminants - These products have a higher chance of contamination from pesticides, solvents, heavy metals, and other toxins.
Unsafe Additives - Some cartridges contain harmful cutting agents like propylene glycol or vegetable glycerin which can break down into harmful byproducts when heated.
Unpredictable - There isn't any standardized testing, so the product in the package can be vastly different from what is described on the label.
No Third-Party Testing - These are unregulated products and the "testing lab" results on some packages are from labs that don't even exist.
Fake Delta-8 - Some products are laced with synthetic cannabinoids which are created in labs and can be far more dangerous than natural cannabis. These products can cause extreme anxiety, hallucinations, and even seizures.
Unfortunately, Mississippi has a high number of gas stations and convenience stores that legally sell these unregulated, untested, and dangerous products.
The terms Indica and Sativa originally referred to characteristics like plant size, leaf shape, and origin. Indica plants are short and bushy, grow faster, produce more buds and are better suited for indoor growth like is required in Mississippi. Sativa plants are tall and lanky with narrow leaves, take longer to mature, and grow better outdoors.
Indica plants originated from cooler, mountainous regions like Afghanistan and Pakistan, and sativa plants are native to warmer climates like Southeast Asia, Central America, and Africa. In Mississippi, approximately 80% of strains grown are majority Indica.
Over time, the cannabis industry began associating these terms with effects which is misleading. Also, there is no universal standard for labeling strains. People often oversimplify the effects of cannabis by equating Indica with "relaxing" and Sativa with "energizing." While this can sometimes be true, the actual effects depend on the strain's chemical composition like terpenes and cannabinoids.
For a list of 250 strains currently grown in Mississippi that shows Indica/Sativa makeup, visit thc.ms/cannabis-guide which also shows the genetics of each strain and its top three terpenes by dominance.
Here is a quick video by Dr. Cheryl Fee describing the differences between Indica and Sativa - https://www.youtube.com/watch?v=GHSwL_3Yvkw.
Fun fact - Afghan Kush is a well known pure Indica strain, and Durban Poison is a pure Sativa strain.
Myrcene is the most abundant terpene in cannabis, and it is in other plants like hops, mangoes, thyme, basil, and lemongrass. It has an earthy, musky, and lightly fruity scent. It is the dominant terpene in many Indica-dominant strains, and the term "Indica" often describes a strain with .5% or more of myrcene.
It can promote relaxation, improve sleep quality, and may help reduce pain and swelling with arthritis and other inflammatory diseases. It also has antioxidant properties that help combat oxidative stress.
Myrcene enhances the absorption and effects of cannabinoids through the "entourage effect" and may increase the permeability of the blood-brain barrier which enhances the effects of THC and CBD.
Here's a 5-minute video from Dr. Anthony Andreoni discussing myrcene -
https://www.youtube.com/watch?v=tpPVoSGm0tI.
Fun fact - If you eat a mango 30 minutes before using cannabis, the effects are reported to be more intense.
This is best answered by the many Mississippi prescribers who have seen the lives of their patients addicted to opioids changed through the responsible use of cannabis. I speak with prescribers almost daily, and don't know one who hasn't seen this first hand.
Cannabis can reduce the intensity of pain allowing patients to rely less on opioids or stop them entirely. It also enhances the pain-relieving effects of opioids, allowing for a lower opioid dose to achieve the same level of pain control.
It has anti-inflammatory and neuroprotective properties which supports brain health during recovery, and may mitigate some of the long-term neurological effects of opioid addiction. Cannabis, especially CBD, alleviates opioid withdrawal symptoms like anxiety, insomnia, muscle pain, and nausea which makes tapering off opioids more manageable.
Here's a good 3-minute video on how it works - https://www.youtube.com/watch?v=9IJaoHjNrDo
There are around 150 active dispensaries in Mississippi that range from organizations like Good Day Farm which is based in Arkansas and has nearly 40 dispensaries in four states, to dispensaries with one location owned by life-long Mississippians.
Some dispensaries only sell products they grow and manufacture, and others offer products from many different cultivators and processors. Independent dispensaries buy cannabis products from Mississippi-based cultivators and processors, and price them at their discretion. Prescribers aren't allowed to recommend a specific dispensary, but they can recommend products.
Because marijuana is still illegal on a Federal level, dispensaries are not allowed to deduct usual business expenses even though they are licensed and legal in Mississippi. On average, this results in dispensaries paying an effective tax rate of around 70%.
Most dispensaries have an on-line menu so patients prescribers can see products and pricing. Two of the most common sites to search for dispensaries are leafly.com and weedmaps.com. There is also a list of Mississippi dispensaries at thc.ms/dispensaries.
The video for today is 53 minutes long and outstanding. It is the full documentary from NOVA called "The Cannabis Question" and a good one to share with others -
CBG (Cannabigerol) is called the “mother cannabinoid” because it is the "parent" of other cannabinoids like CBD and THC. As a cannabis plants matures, most of the CBG is converted into these other cannabinoids leaving only trace amounts in the final plant. CBG does not produce psychoactive effects and will not get you high.
CBG can reduce inflammation, particularly in conditions like inflammatory bowel disease, and it may protect neurons and support brain health. CBG can increase appetite and can reduce pain by interacting with pain signaling receptors.
Here's a nine-minute video on CBG with pharmacist Kylee Shumway -
Pinene is the most common terpene found in nature. In addition to cannabis, it is also in basil, parsley, dill, and pine trees.
Anti-Inflammatory - Pinene has potent anti-inflammatory effects and helps with arthritis, IBS, and asthma. It also is shown to work well for chronic inflammatory conditions.
Bronchodilator - Pinene acts as a bronchodilator and especially helpful with respiratory issues like asthma and COPD. It also has antimicrobial and antibacterial properties against bacteria.
Strains currently grown in Mississippi with pinene as the primary terpene include:
Baker's Dozen
Black Razz
Devil Crasher
End Game
Louis XIII
Purple Canyon
Sun Cake
Tropical Banana
Here's a three-minute video on the medical benefits of pinene https://www.youtube.com/watch?v=TgCoqaUDXRo
Even though it is difficult to "prove" something can't happen, there is a plethora of convincing evidence showing that it is impossible to fatally overdose on cannabis.
Cannabis interacts with receptors that are in our brain, but sparse in the brainstem which is where our vital functions like breathing and heart rate are controlled. Unlike opioids and alcohol which can significantly suppress respiration, cannabis does not. If you consume a very large amount of cannabis you may have unpleasant side effects like nausea, vomiting, dizziness, and paranoia, but these typically stop within a day or less.
In practical terms, you would need to consume an astronomical amount of marijuana - tens of thousands of times the typical amount - in a short period to reach a lethal dose which is why there are no documented cases of death due to cannabis overdose.
Here's a quick video from a physician explaining why.
In Mississippi, PTSD is a qualifying condition for medical marijuana. PTSD often involves a sense of heightened arousal and anxiety, and cannabinoids like CBD and THC calm the nervous system and decrease anxiety. Cannabinoids interact with receptors in the brain to reduce hyperactivity in the amygdala which influences fear and emotional responses.
Sleep difficulties, including frightening nightmares, are common with PTSD and cannabis can aid in falling and staying asleep. Cannabis can also help regulate mood end emotions in PTSD patients.
One hallmark of PTSD is the inability to process or extinguish traumatic memories. THC and CBD reduces the emotional intensity associated with traumatic memories, allowing patients to process them more effectively.
If any group members have experience using cannabis to treat PTSD or you know someone who has, please comment.
This three-minute video explains how cannabis helps with PTSD - https://www.youtube.com/watch?v=6gFkVeDUl4g
The fist documented use of cannabis was in 2727 B.C. - which is 4,752 years ago. In just the last 20 years, here are a few things we have learned about the potential medical benefits of cannabis.
Epilepsy Treatment - Especially effective in treating epilepsy in drug-resistant forms like Dravet syndrome and Lennox-Gastaut syndrome.
Pain Management - Effective in managing conditions like neuropathy, arthritis and multiple sclerosis (MS).
Anti-Inflammatory Effects - Helps treat Crohn's Disease, ulcerative colitis, and rheumatoid arthritis.
Mental Health & PTSD - Its anxiolytic (anti-anxiety) effects help with generalized anxiety disorder (GAD), PTSD, nightmare reduction, and depression.
Neuroprotection & Alzheimer's Disease - Emerging research suggests cannabis may help protect brain cells and slow diseases like Alzheimer's, Parkinson's, and Huntington's disease.
Cancer Treatment Support - Cannabis is not a cure for cancer, but it can help reduce chemotherapy side effects like nausea, vomiting, and appetite loss.
Sleep Disorders - Cannabis is widely used to improve sleep quality.
Autism Spectrum Disorder (ASD) - New research shows cannabis may help reduce aggression, anxiety, and sensory overload.
Opioid & Addiction Recovery - There is clear evidence that cannabis helps reduce opioid dependence, withdrawal symptoms, craving reduction, and pain relief.
Marijuana is a Schedule I drug under the Controlled Substances Act which means our government considers it to have:
- A high potential for abuse
- No currently accepted medical use in treatment in the U.S.
- A lack of accepted safety for use under medical supervision
Researchers have to get approval from the DEA, FDA, and NIDA (National Institute on Drug Abuse), which stalls the process. Most institutions rely on federal funding, and since it is illegal at the federal level, they cannot conduct cannabis research. Also, obtaining approval to conduct clinical trials is much more complex compared to drugs in lower schedules.Hundreds and hundreds of studies and real-world patient experiences show that marijuana effectively treats conditions such as chronic pain, epilepsy, multiple sclerosis, and more.
Other drugs with much higher risks of dependency and fewer medical benefits like opioids, fentanyl, and oxycodone, are classified as Schedule II, while marijuana remains in Schedule I.Here's a two minute video - https://www.youtube.com/watch?v=Rq_208u89F4
Suppositories are absorbed through the rectal or vaginal mucosa - the key is "absorption" rather than going through your gut like an edible.
For pain management, suppositories are especially effective for endometriosis, pelvic inflammatory disease (PID), interstitial cystitis, neuropathic pain, and fibromyalgia.
Gastrointestinal disorders are treated well for patients with Crohn's disease, ulcerative colitis, and irritable bowel syndrome (IBS). It also helps patients who have difficulty swallowing or absorbing oral cannabis.
Vaginal suppositories help relax uterine muscles and reduce inflammation, and help after procedures like a hysterectomy or pelvic surgery.
Suppositories avoid liver breakdown, effects can be felt within 10 minutes, and some reports suggest rectal absorption reduces the intoxicating effects of THC.
This short video talks about CBD suppositories with similar benefits -
Mississippi has cultivators that use hydroponics and living soil methods of growing cannabis. We're still waiting on the first to use aquaponics.
Hydroponics does not use soil and the plants are grown in water infused with nutrients. Since they deliver nutrients directly to the roots, the plants can grow 30 - 50% faster. Since there is no soil, there's no risk of soil-borne pests or diseases.
Living soil uses organic compost, worm casings, and fungi with no synthetic nutrients. This diversity helps boost plant immunity, and the microbes and organic matter develop over time. Some patients report more complex and aromatic terpenes from cannabis grown in living soil.
Aquaponics combines hydroponics with raising fish. The fish waste provides organic nutrients for the cannabis, and the plants help clean the water for the fish. This seems like a fantastic business opportunity for a Mississippi catfish farm!
This very interesting video shows how Tilapia are used to help grow thousands of pounds of quality cannabis.
Marijuana transdermal patches provide a steady release of cannabinoids over an extended period of time by delivering cannabinoids like THC and CBD through the skin directly into the bloodstream.
Transdermal patches bypass the digestive system and liver, and have a more direct and consistent effect. They release cannabinoids at a slow and steady rate for a longer-lasting experience. The effects take anywhere from 30 minutes to 2 hours to begin, and last from 8 to 12 hours.
Transdermal patches are especially beneficial for people who need long-term, consistent symptom management for conditions like chronic pain, anxiety, PTSD, sleep disorders, and muscle spasms.
Here's a two-minute video explaining how they work - https://www.youtube.com/watch?v=dS8PNjzrvNI
FSO is extracted using ethanol, CO₂, or other solvent-based techniques that preserve the entire range of cannabinoids, terpenes and flavonoids. It maintains a balanced ratio of cannabinoids making it closer to the original plant’s chemical composition which increases the entourage effect. FSO can be used as tinctures, capsules, or vape oils, and for general wellness, pain relief, anxiety, sleep disorders, and inflammation.
RSO is made using isopropyl alcohol or ethanol, which is evaporated to make a thick, dark oil. RSO typically has small amounts of other cannabinoids and lacks a full terpene profile. It was originally promoted by Rick Simpson for cancer treatment and is commonly used for chronic pain, cancer therapy, severe inflammation, and neurological conditions.
In general, FSO is better for balanced therapeutic benefits with milder psychoactive effects, and RSO is better suited for more serious conditions requiring a high level of THC.
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