The world of medical cannabis products is different than the world of recreational cannabis products. While medical cannabis can certainly be consumed in “traditional” ways, including smoking, vaporizing, or ingesting dried flower, patients may also have access to pharmaceutical medical cannabis products. With so many options available, doctors and patients must work together to find a medical cannabis solution that works best for the patient’s unique needs.

In this article, we’ll try to simplify the world of medical cannabis products. We’ll go over some of the most common legal medical cannabis products available in Canada, and discuss the ways Canadians can access cannabis medicine through their healthcare providers.

What is Medical Cannabis?

With recreational cannabis being legalized in Canada, it can be difficult to understand the difference between medical and recreational cannabis. Medical cannabis is cannabis that is prescribed by a healthcare practitioner for the purpose of treating a medical condition.

Medical cannabis can be prescribed for a number of conditions, but some of the most common ones include chronic pain, nausea, inflammation, epilepsy, multiple sclerosis, and gastrointestinal disorders.

Healthcare practitioners and patients can discuss the various medical cannabis product options available to determine which one would work best for the patient.

What are THC and CBD?

THC and CBD are two major cannabinoids found in cannabis, and they have different effects on both the mind and body. THC is psychoactive, responsible for the psychoactive cannabis “high.” CBD, on the other hand, is non-psychoactive, and offers a variety of medical benefits without the mind-altering side effects of THC. According to Health Canada, CBD may even reduce the unpleasant side effects of THC.

Cannabis Flowers vs. Cannabis Pharmaceuticals

Medical cannabis can be consumed in all the same ways as recreational cannabis. This includes smoking, vaporizing, and ingesting dried cannabis flowers, as well as using concentrates, oils and capsules. However, medical cannabis must be sourced from a licensed producer with a medical order provided by a healthcare practitioner. A licensed producer is a cannabis producer that has been approved by Health Canada for providing medical cannabis to Canadians. Health Canada also enforces regulations impacting licensed producers.

Some additional forms of cannabis therapy are uniquely available to medical patients. These include cannabis pharmaceuticals, which are extracts of cannabis offered in specific ratios and dispensed by pharmacies, not licensed producers. For example, they are usually easier to dose because the production is standardized. Furthermore, they allow medical professionals to prescribe exact ratios of THC and CBD. Finally, these products are more rigorously tested for their efficacy for specific conditions.

The medication Epidiolex is manufactured by GW pharmaceuticals and is FDA-approved for the treatment of Dravet syndrome, a rare form of epilepsy. This medication contains CBD only, and no THC. Because CBD is non-psychoactive, this can offer benefits to patients who do not wish to experience the high from cannabis products with a higher proportion of THC. The medication Sativex, which is also manufactured by GW pharmaceuticals, contains CBD and THC in a 1-to-1 ratio. Different pharmaceuticals offer different CBD to THC ratios, giving healthcare providers more options for treating their patients.

Typically, cannabis pharmaceuticals must be prescribed for very specific approved conditions, while medical cannabis in general can be prescribed for any reason a healthcare provider sees fit.

Of course, licensed producers of dried cannabis also provide information about the levels of THC and CBD in their products. However, because of the nature of dried cannabis, it can be more difficult to dose accurately. Some patients may prefer oils and capsules for this reason, since the dosage is more standardized. That said, it’s important for all new users to sample a small amount and wait at least an hour to gauge the body’s response.

What To Do If You Are Interested In Medical Cannabis

Canadians who are interested in medical cannabis should discuss it with their healthcare provider. Note that only doctors and nurse practitioners can provide a medical document for cannabis. Your discussion should cover the various medical cannabis products, and which ones might be the best fit for you.

If you do not have a healthcare provider or if your healthcare provider does not have in-depth knowledge about medical cannabis, you can find healthcare providers who specialize in this area. You may set up a consultation with these providers either in person or virtually via video conference. Ontario residents can schedule a free video consult through Well.ca’s partnership with O Cannabis Clinic.

If your healthcare provider recommends you use medical cannabis, they will provide you with a medical order and list the max quantity (grams) per day for the order. They may also indicate details around the CBD and/or THC content appropriate for your medical need. It will be up to you along with your healthcare provider to determine to which licensed producer your medical order is then sent. Once the selected licensed producer receives your medical order, they will contact you to complete your registration to enable your account for product purchase. Note that all medical cannabis orders are fulfilled by the licensed producer and shipped directly to your home in a non-descript package. Medical cannabis today cannot be fulfilled through pharmacies like other medications.

Before talking to a healthcare practitioner, it’s a great idea to do your own research online. We recommend consulting the Health Canada website, as there can be misinformation about cannabis from disreputable sources across the internet.

Regardless, if you are suffering from a medical condition, it is recommended that you speak to your healthcare provider before purchasing cannabis, even if recreational cannabis is accessible to you. Cannabis may interact with your other medications, or there could be another medical reason why you’re not a good candidate for cannabis therapy.

Legal Medical Cannabis Products: How to Use Them and Where to Find Them

Oils and capsules

Licensed producers of medical cannabis offer cannabis oils and capsules as a treatment options for medical patients. Cannabis oils are oils mixed with a cannabis extract that contains a specified ratio of cannabinoids such as CBD and THC. These can be packaged in a dropper, or manufactured into capsules with discrete doses.

These products may be “full-spectrum,” meaning they also contain other minor cannabinoids and scented terpene molecules, or “isolates,” meaning they contain nothing but oil and cannabinoids. A person might choose a full-spectrum product if they are interested in benefitting from the “entourage effect” that occurs when combining the compounds found in cannabis.

Many patients like the discreet nature of oils and capsules, which may be taken in a public setting and do not produce a strong cannabis smell. The products are also easier to dose and therefore typically offer consistent results. Healthcare practitioners may prefer their patients use these products, since it mimics a typical prescription with an exact dosage. Note that while healthcare providers may also recommend the dosage for dried flowers, strains and strengths are variable, whereas oils and capsules offer more consistency.

For medical patients with a prescription, oils and capsules can be sourced from a licensed producer online. The licensed producer selected by you and your healthcare practitioner will give you more information on how to fulfill your medical order once they receive your prescription. Usually, your health care practitioner will securely e-fax the medical order directly to the licensed producer.

Dried flower

Licensed producers also offer dried cannabis flower products, which can be smoked or vaporized. Health Canada recommends vaporizing over smoking, because smoking may present more health risks.

Smoking involves combusting (lighting) the cannabis in a joint, pipe, or water bong, and inhaling the resulting smoke. This releases the active compounds in cannabis, but it also creates potentially harmful or irritating by-products which can result in bronchitis, lung infections, chronic cough, and increased mucus buildup in the chest.

Vaporizing cannabis refers to the act of heating cannabis to the point where its active compounds are released, but not to the point where combustion occurs and smoke is released. This is considered a safer alternative to smoking, and it also offers the benefit of producing less of a strong odor.

Dried cannabis flowers can also be incorporated into edible cannabis products—however, edible cannabis products are still illegal in Canada. Legislation in Canada around edible cannabis products is expected in late 2019.

Cannabis pharmaceuticals

Cannabis pharmaceuticals include products like Epidiolex and Sativex, both manufactured by GW pharmaceuticals, and Marinol, a form of synthetic THC. These products are typically prescribed for specific, approved use cases, such as for the treatment of epilepsy. They tend to be rigorously tested for their efficacy in treating these disorders.

Medical patients who are prescribed cannabis pharmaceuticals can source these items from their pharmacist, although it may be considered a specialty product that needs to be ordered in by your pharmacy or sourced from a specialty pharmacy.

Summary

• Doctors and patients should work together to determine the best product for the patient’s unique needs.
• Medical cannabis can be consumed in the same ways as recreational cannabis, including smoking, vaporizing, and oils and capsules.
• Current research indicates that most medical patients choose to use capsules and oils due to their ease of use and dosage consistency.
• Medical cannabis also comes in the form of cannabis pharmaceuticals, which are used to treat specific conditions.
• Canadians who are interested in medical cannabis should speak to their healthcare practitioners about their options.
• Your healthcare provider will provide a medical order that will be fulfilled by a licensed producer that you select jointly. The licensed provider will give you more information on how to fulfill your medical order once they receive your prescription, which is usually securely e-faxed to them by your healthcare provider.