Medical Marijuana or Recreational?

Woman doctor holding a cannabis leaf and oil.alternative medicine

BY Sarah Donahue

While the medical marijuana program has existed in the state for years, many Arizona residents probably never thought they’d see the day when the state voted to legalize its recreational use.

But with the passage of Proposition 207, that day has come, and marijuana will soon be here to stay.

Proposition 207 legalizes the possession and use of marijuana for people older than 21. It also allows the state to enact a 16% tax on marijuana sales and requires the Department of Health and Human Services to make rules to regulate marijuana businesses.

The recreational sales of marijuana could start around March, according to reports.

For many, this raises the question of how to use marijuana products and how to find the right dose. Some have perhaps dabbled with cannabis in the past or have a medical marijuana card. For others, it may be their first time trying it.

Dr. Elaine Burns, one of Arizona’s first doctors to receive cannabis credentials, weighed in on the matter. The Scottsdale naturopath reminds that even though recreational use is on its way, “the medical program does not go away.”

“It’s going to get confusing,” she says, emphasizing that recreational marijuana does not replace the medical marijuana program. “People are going to start seeking out recreation for their medical treatment, and it’s going to be a bit of a problem.”

Recreational use of marijuana can be great for relaxation and socialization in the same ways that alcohol is used, Burns says.

On the other hand, cannabis can also be used medicinally for relief of a variety of health ailments, like chronic pain, sciatica, migraines, Alzheimer’s, cancer, rheumatoid arthritis or autoimmune conditions, Burns says.

However, “If you have a medical condition, you don’t go to the liquor store,” she says.

Burns, 64, is the founder and medical director of North Phoenix’s Southwest Medical Marijuana Physicians Group and says older Arizona residents are the predominant demographic with whom she works.

For the last 10 years, Burns has worked with the physicians group to help design detailed treatment plans for patients, also educating patients on how to find a proper THC dosage and what to look for while purchasing marijuana products.

“(Southwest Medical Marijuana Physicians Group) is not a certification center,” she says. “It’s not about getting a card in the medical program; it’s about learning how to use cannabis medicinally to get better.”

People seeking relief from health ailments should not use marijuana recreationally, she says, adding that they should get a medical marijuana card and a treatment plan.

It’s important for people to make the distinction as to what they’re using marijuana for, because if one doesn’t know what they’re doing, “it could be very dangerous,” she explains. “The doctor needs to know what medications they’re on.”

To avoid a “mix of contraindications of cannabis with opioids or sleep aids,” it’s important to have a discussion with a physician on how to get off of those medications and how to start a treatment plan with cannabis, Burns says.

She also mentions those looking to treat their medical ailments with recreational marijuana will be hit with the 16% sales tax from the state, which can be avoided with a medical marijuana card.

For medical and recreational use, inexperienced marijuana users should start “low and slow” with THC dosages, Burns emphasizes, recommending a THC content of 10% or lower. THC is the psychoactive ingredient that makes users feel “high.”

Depending on preference, users can choose to administer marijuana products a variety of ways, including vaping, smoking, consuming edibles or applying topical products.

Whether its marijuana flower or edible products, too much THC can cause anxiety, agitation or increased heart rate, she says. “That’s where they’re going to get into trouble.”

New marijuana users should start with something simple like vaping flower with a low percentage of THC and steer clear of edibles, Burns recommends.

Vaping devices provide a healthier alternative to smoking marijuana, because it’s “cooler and cleaner for the lungs,” she says.

“I’m a proponent of vaping the flower for the obvious reason that you avoid the combustion,” Burns says. “You’re not applying a flame and you’re not getting all the byproducts of combustion that gets also inhaled into the lungs.”

When someone vapes flower, they can take “a puff or two” and get an immediate reaction within 5 to 10 minutes, she explains. This makes the chances of overconsuming THC very low because they can slowly dose until they feel the desired effects, Burns adds.

With edibles, however, “you swallow it, you wait 90 minutes and you hope it works,” she says. “Most people don’t think it’s working, and they take more. And now they’ve doubled down on their dose.”

“You’ll never lethally overdose, but many people have ended up in the emergency room,” Burns says. “They think they’re having a heart attack. I’m not saying they are, but it can cause anxiety, increased heart rate, heart palpitations—they don’t know what’s going on.”

THC in an edible form is processed in the body differently, Burns says. Edibles are very strong, and they can lead to problems for some, which is why it’s so important to be careful and start “low and slow.”

Another thing for new users to avoid is marijuana concentrates, which are sometimes referred to as wax, shatter and oil, she says.

“The word concentrate should scare a new person away,” Burns says. “That means it’s concentrated. The word concentrate equals strong.”

For those who want some of the benefits of marijuana without the psychoactive effects, cannabidiol, commonly known as CBD, can be an easy way for someone to dip their toe in the water, Burns says.

CBD is a naturally occurring compound found in the marijuana plant and has grown in popularity over the years. It can be purchased without a medical marijuana card. CBD products are very similar to THC products and can be administered in many of the same ways.

From a pharmacology standpoint, CBD works and has shown to be anti-inflammatory and can help with anxiety as well as muscle spasms, Burns says.

“The problem is (CBD) is on literally every corner, and they have to be careful of quality.”

Many people will use CBD and say it doesn’t work, she says. “It’s a quality and quantity issue,” Burns explains, saying that low-quality CBD and a lack of knowledge of how to dose properly can make it so people are unable to reap its benefits.

Whether it’s CBD or THC, the same thing holds true. It’s vital to understand what you’re taking and to find the proper dose, she says.

The legalization of recreational marijuana leads people to a fork in the road, Burns says. The most important question to ask one’s self is, “Am I doing this for social reasons? Or am I doing this for medical reasons?” And come up with a game plan from there.