A caregiver is an individual certified by the state to purchase and deliver cannabis to patients. In some cases, a caregiver may be a parent or a loved one authorized to buy cannabis products for an individual who can’t physically go to a dispensary or legally can’t purchase cannabis alone because they’re under age.
In other cases, a caregiver may be a nurse or another healthcare professional certified to administer cannabis to their patients. The laws vary by state on how many patients a caregiver may support at a time.
Furthermore, the exact role of a caregiver in each state varies. For example, in Pennsylvania, caregivers are only allowed to purchase cannabis at dispensaries for their patients. But in Michigan, caregivers can grow and cultivate cannabis at home for their patients.
In either circumstance, serving as a caregiver is a big task. Being educated on cannabis, what products might work best for your patient, and what to do if your patient feels ‘too high’ are important so you can properly support them.
Cannabis 101: Starting with the Basics
Cannabis is a genus of wind-flower plants native to Asia. It’s also one of the oldest cultivated plants in human history! Although it remains federally illegal as a Schedule I substance, cannabis is legal recreationally, medicinally, or both in 37 states.
The varying legal status from state to state also means the types of products available in each state may vary. For example, some states allow dispensaries to sell pre-rolls and edibles, while others don’t.
Generally speaking, though, cannabis products fall within three general categories:
Inhalable Cannabis Products
“Inhalable” cannabis products include flower that can be smoked or vaped, vape cartridges, and concentrates. Dispensaries also sell “disposable” vape cartridges, which means the cartridge and the battery are built in one, rather than having to buy the cartridge and the battery separately.
The effects of inhalable cannabis products are felt almost instantly and last 1-3 hours.
Consumable Cannabis Products
Consumable cannabis products are those that are eaten/swallowed. This is a slightly larger category, as consumables can range from pills, capsules, and tablets to gummies, chocolates and baked goods. RSO syringes are considered a consumable product, as well.
Pills, capsules, tablets, and gummies are great for patients who aren’t comfortable smoking/vaping cannabis. They also provide an easy and accurate way to dose cannabis.
Cannabis tinctures also fall into this category. When using cannabis oil from a tincture, patients should hold the oil under their tongue for at least a minute before swallowing. This will allow for full oral absorption of the oil.
Like pills, capsules, tablets, and gummies, tinctures are very easy to dose. They’re great for patients who have trouble chewing and/or don’t want to inhale cannabis. Tinctures are also very discrete.
RSO (Rick Simpson Oil) syringes are potent, full-spectrum cannabis oil syringes. The oil is thick, sticky, and has a very potent plant flavor. RSO and cannabis oil from tinctures can be masked in food for easier consumption.
For example, you could give your patient a peanut butter cracker with some RSO on it. You could also squeeze a few drops from a cannabis tincture into some tea.
Unlike inhalable products, it can take 30 to 90 minutes to feel the effects of a consumable cannabis product. When you light cannabis on fire or vape it, the cannabinoids are already activated and instantly make their way through the bloodstream after inhaling.
But when you consume cannabinoids, they must make their way through the digestive system and be metabolized by the liver before they travel through the bloodstream.
However, the effects of a edible generally last much longer than an inhalable product, ranging from about four to eight hours.
Topical Cannabis Products
Topical cannabis products are applied directly to the skin for pain relief or moisturization. Lotions, balms, salves, creams, and patches are all examples of topical cannabis products.
There are CBD skincare products designed to alleviate acne or scarring, too. Though, these generally aren’t sold in dispensaries.
Topical cannabis products generally don’t cross the blood-brain barrier once absorbed by the skin. This allows patients to feel relief without any of the psychoactive effects of THC.
Some topical cannabis products are menthol-infused, which enhances their pain-alleviating effects. These products are great for reducing inflammation or neuropathic pain.
However, menthol-infused products should not be applied to particularly sensitive areas of the skin, as this will cause an unpleasant burning sensation. If your patient is looking for relief from eczema or psoriasis, it’s best to opt for products that aren’t menthol-infused.
Indica, Sativa, Cannabinoids, and Terpenes
Now that we’ve covered the basics let’s dive a little deeper into what the product labels mean.
Cannabis products may either be labeled “sativa,” “indica,” or “hybrid.” While there’s no genetic correlation between what products are considered “sativa”/“indica”/“hybrid,” these terms are used to help communicate to consumers how a product might make them feel.
Continue Reading: Indica vs. Sativa: What’s the Difference?
Products labeled “sativa” may have more of an uplifting effect. This means they might make you feel energized or motivated. “Indica” products, on the other hand, have more of a sedating effect. These products are best for use before bed or when relaxing for the rest of the day.
“Hybrid” products are supposed to offer a blend of both sativa and indica effects. They may make you feel mellow, but not to the point of falling asleep. Or they might make you feel “energized” but not bouncing off the walls with energy.
However, everyone is different. What one person might think feels like an indica might actually be energizing or uplifting to another person. Thus, it’s best to rely more on a product’s cannabinoid and terpene profile than on the sativa/indica/hybrid label.
A Brief Primer on Cannabinoids: THC, CBD, and More
There are over 140 different cannabinoids in cannabis plants, though the main ones include:
- Δ9-tetrahydrocannabinol (THC)
- Δ9-tetrahydrocannabivarin (THCV)
- Cannabidiol (CBD)
- Cannabinol (CBN)
- Cannabigerol (CBG)
- Cannabichromene (CBC)
- Cannabidivarin (CBDV)
THC is the primary psychoactive component in cannabis products. It’s also the only cannabinoid that stimulates CB1 and CB2 receptors. THC has anti-inflammatory, analgesic (pain-relieving), and neuroprotective properties. Additionally, THC reduces intraocular pressure (fluid pressure behind the eyes), muscle spasticity, and muscle tension.
However, too much THC can cause unwanted side effects, such as paranoia, anxiety, sedation, and increased heart rate.
Unlike THC, tetrahydrocannabivarin (THCV) is not psychoactive. Instead, it possesses anorectic effects, meaning it decreases appetite and increases energy metabolism. THCV also has neuroprotective and antioxidant properties. That being said, THCV is not very prevalent in cannabis plants and is quite rare to find in cannabis products.
Conversely, CBD is a non-psychoactive cannabinoid with anti-inflammatory, anxiolytic (anxiety-relieving), antioxidant, antibacterial, anticonvulsant, and antiemetic (anti-nausea & vomiting) properties. Using CBD with THC can reduce some of the side effects associated with THC.
The cannabis plant itself doesn’t produce CBN. Instead, it is the oxidized form of THC. On that note, CBN is slightly psychoactive, but not necessarily as potent as THC. It is very sedating and has antibacterial properties.
CBG is the “mother of all cannabinoids.” All cannabinoids start as CBG within cannabis plants before turning into other cannabinoids. Yet, CBG on its own still has bioactive effects. CBG is neuroprotective, gastroprotective, and antibacterial.
CBC is another non-psychoactive cannabinoid that doesn’t interact with CB1 or CB2 receptors. But CBC does appear to have antibiotic, antifungal, anti-inflammatory, and analgesic effects. Animal studies on CBC have also shown it may have antidepressant effects.
CBDV has a very similar chemical structure to CBD, but CBDV is its own cannabinoid. Primarily, research thus far has focused on the anticonvulsant effects of CBDV.
Toe-Dip into Terpenes: What Do They Mean?
Terpenes are aromatic compounds that are ubiquitous throughout plant life. They aren’t exclusive to cannabis plants and have long since been studied for their uses throughout the aromatherapy industry.
Cannabis plants produce over 200 different terpenes, though only 30 of them are present in significant enough quantities to have observable therapeutic effects.
Some of the most common terpenes in cannabis include:
- β-Myrcene is the most prevalent terpene in cannabis plants. Although it can be found in sativa and hybrid varieties, it is primarily associated with indica strains due to its relaxing and sedating properties. β-Myrcene is also anti-inflammatory and analgesic.
- β-Caryophyllene is another very common terpene in cannabis plants. It is said to have mentally stimulating effects and actually activates CB2 receptors! It has a peppery scent and displays anti-inflammatory, analgesic, and immunomodulatory activity.
- Pinenes (α-pinene and β-pinene) carry the scent of evergreen trees. It is thought both pinenes aid with short-term memory, almost canceling out the negative effects some high-THC varieties can have on memory. These terpenes are also said to have a myriad of positive effects, including antibiotic, anticoagulant (anti-blood clotting), antimalarial, antimicrobial, antioxidant, anti-inflammatory, gastroprotective, and anticonvulsant effects, among others.
- Limonene, as its name implies, is associated with citrus fruits. It is a very energizing terpene that is said to have antidepressant, anti-inflammatory, and anti-tumor effects. Limonene also “enhances” the effects of THC and CBD.
- Linalool, by contrast, is a very relaxing and sedating terpene associated with lavender plants. Linalool has analgesic and anxiolytic effects, too.
- Terpinolene is a citrusy and uplifting terpene associated with “cognitive clarity.” It also displays antibacterial activity and potential anti-tumor effects.
What to Do When You Feel “Too High”
Although cannabis has a lot of therapeutic potential, too much of anything can sometimes be a bad thing. Some of the most common side effects of THC include:
- Paranoia and anxiety
- Rapid heartbeat
- Dry mouth
Fortunately, these feelings do eventually pass. If your patient has just used cannabis and feels overwhelmed, have them lay down for 30 minutes and relax. It may also be helpful to put on some calming music or TV shows.
There are a few other methods you can try to help relieve the side effects faster, including:
- Chewing black peppercorn: Black peppercorn has β-caryophyllene in it, which is said to help relieve some of the unpleasant side effects of THC.
- Using CBD: Although using CBD in this case might sound like fanning the flames, it isn’t. CBD blocks THC from fully binding to CB1 and CB2 receptors. So using CBD can help relieve the anxiety and other side effects of using THC.
- Drink water: Have your patient or loved one drink plenty of water to help flush the THC out of their system. It’ll also help with the dry mouth that THC can cause!
Key Takeaways: Education is Key to Caregiving
A caregiver is an individual legally authorized to purchase cannabis from dispensaries and administer or deliver it to their patients or loved ones. In some states, such as Michigan, caregivers are also authorized to grow plants for their patients.
The circumstances that motivate an individual to become a caregiver vary. Caregivers may be parents who are certified to purchase medicinal cannabis products for their children or nurses who are caring for individuals in assisted living facilities.
In either case, being educated is the first and most important step to providing the best care for your medical marijuana patient. In this article, we covered:
- The various cannabis product categories
- The differences between Sativa, Indica, and Hybrid
- The effects of different cannabinoids
- The effects of different terpenes
- How to help someone who feels “too high” from THC
This knowledge is key to knowing which products might work best for your patient and how to ensure they have the most beneficial experiences while using cannabis.
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