Issue link: https://www.e-digitaleditions.com/i/1442004
16 doctor focus cannabis patient care | vol. 2 no. 4 cannapatientcare.com par ticularly the addiction doctors. But in general, if the doc- tors are like, you don't use marijuana, do you? The patients would be like, Oh, no, no doctor. Of course, I don't use mar- ijuana. And then that's the end of the discussion. I mean, I've written before that if you're a physician regardless of your own personal feelings about cannabis—whether you're pro, neutral, anti, couldn't care less about it, huge advocate, whatever—you have to be open in your discussions with pa- tients and non-judgemental, or find some way to not convey your judgement because otherwise patients just won't bring it up. And it's ver y dangerous not to have open communica- tion with patients," he explained. When a person uses pharmaceuticals, they may experi- ence a negative reaction or drug interactions. This is the same with cannabis. To be safe while using cannabis, com- munication on dosing and also outside factors come into play and help create a better outcome for patients. With his veteran patients, they are used to being dismissed, ignored, and penalized for bringing up cannabis with their physicians which is why Dr. Grinspoon likes to make his first step build- ing trust and rappor t. "And then, we just have the usual dis- cussion, which is, what do you hope to get out of it? What are your experiences in the past? Did you have any bad side ef- fects? I ask about any of the things that might give me con- cern, like, is there any family histor y of schizophrenia or psy- chosis? Because those are not absolute, but those are red flags that we have to be ver y careful about. Any histor y of addiction that we might want to be careful about. I also want to know what other drugs are they on. Then we want to dis- cuss what their goals of treatment are and the different op- tions. Do you want to inhale it? And then we talk about the safest way to do that, which is grinding up the flower and us- ing a vaporizing machine so that you don't harm your lungs or at least as much or a tincture under the tongue or an edi- ble," said Dr. Grinspoon. "We also just talk about dif ferent types of cannabinoids that they could use, and then we tr y to come up with a way to get them on board that is ver y gentle and safe," he explained. Aside from helping patient s explore cannabis as a treat- ment option, Dr. Grinspoon spreads himself out in other ways to help others. He is cer tif ied as a health and well- ness coach and is currently working on building a private prac tice for health and wellness coaching. He is also work- ing on a book focusing on cannabis, the big pic ture, and his perspec tive. When he's not seeing patient s, he's tackling how he can help people see the benef it s of medical canna- bis. One thing he hopes to see change in the medical can- nabis industr y is how edibles are labeled and not marked well. Dr. Grinspoon was shocked from what he was seeing when he visited a dispensar y, "I don't love the edibles that aren't marked that well, that are ver y palatable to kids. I was at a dispensar y this weekend and they had a chocolate bar that had 1100 milligrams of THC, which is an absolutely insane amount to put in a chocolate bar. And then you look at the wrapper and you need an elec tron microscope to see the word cannabis. It's really not safe at all. So I asked about it and they're said 'oh, it's in individual pieces.' But that means each of the 10 chunks has 110 milligrams. Again, that's an absolutely insane dose. Manufac turers have to f ind a way to make edibles safer because I've heard sever- al stories of someone taking someone else's chocolate ac- cidentally and getting really sick," he said. "At another dis- pensaries, they have a soda with 100 milligrams. Nobody drinks half a soda and 100 milligrams again is an insane dose for an edible. Maybe if you have a major injur y and have to take a huge amount like you're on the bell cur ve— the top 1%, you take 100 milligrams—but most people would take like 2.5, 5, or 10 milligrams. Why would you have a soda that has 100 milligrams in it in a medical dispensar y? " Although there is a lot of work needed to be done to help others gain better access to cannabis for medical conditions and also to prevent negative experiences such as those from poor labeling, cannabis is a growing industry and will contin- ue to prove how beneficial it can be used as a medical treat- ment option over pharmaceuticals which carry many negative side effects. For people looking to educate themselves more about can- nabis, feel free to visit www.petergrinspoon.com for medical cannabis consultation or for wellness coaching. To learn more about Doctors for Cannabis Regulations, you can visit www.dfcr.org.