Purpose

Naturally Healing M.D.’s Introductory Guide
For New Medical Marijuana Patients 2020

This brief introductory guide to medical marijuana use is intended to provide the basic information I believe Naturally Healing MD medical marijuana patients need to initiate safe medical marijuana usage. In my experience, over time, by following the guidelines provided, patients will find that medical marijuana can effectively reduce many symptoms that may impact their quality of life, like pain, anxiety, and insomnia. I look forward to helping you find the relief you seek!

Helpful Terms

At the end of this guide you will find a list of terms that might be useful to understand because they are often used within the context of medicinal marijuana.

Legal Framework for Medical Marijuana in the State of California

After your visit with Laurie Vollen, MD, Naturally Healing MD’s founder and a Board Certified Preventive Medicine physician, licensed by the state of California, you will be given a valid medical marijuana recommendation for the State of California. Most recommendations issued by Naturally Healing MD are valid for one year – although on some occasions the duration may be shorter.

This medical recommendation is your legal document that entitles you to the benefits of Proposition 215, the Compassionate Use Act, passed by the state of California in 1996. This groundbreaking law allows Californians with valid medical recommendations legal access to ALL legal dispensaries in the state of California, where marijuana is sold in compliance with the Bureau of Cannabis Control, California’s lead agency regulating commercial cannabis.

In November of 2016 California passed Proposition 64, the Adult Use of Marijuana Act, which allowed anyone 21 years of age or older to purchase marijuana in dispensaries licensed by the Bureau of Cannabis Control.

Dispensaries operating under this Adult Use Act began opening in California in 2018 and are now plentiful in the Bay Area, as are delivery services that have no brick and mortar dispensaries, but are also licensed by the Bureau.

A few dispensaries remain strictly medicinal – selling their products only to those with valid physician-issued medical marijuana recommendations. But the vast majority of dispensaries sell their cannabis products to adults 21 years or older, regardless of their status as medical marijuana patients.

If access to any dispensary in California is your goal, a medical marijuana recommendation will insure you have access to dispensaries in the state of California as well as a few other states with reciprocity. According to CaNORML, the go-to-

site for California’s legal framework for marijuana (www.CaNORML.org): “Arizona and Montana have reciprocity in their medical marijuana laws. Maine allows out-of-state patients to exercise their rights for 30 days. Rhode Island respects out-of- state recommendations for any “debilitating medical condition.” Since laws outside of California determine reciprocity and they are now changing more than in the past, it is best to check a state’s current laws if you are trying to use cannabis in that state.

Many patients think that they need a “card” from the physician providing the medical marijuana recommendation. However, a physician-issued card is simply a convenient way to carry your medical marijuana recommendation around in a wallet (for the purpose of gaining entry to medical marijuana-only dispensaries or getting discounts that some

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dispensaries offer only to those with valid physician-issued medical marijuana recommendations) . You do not need a physician-issued card for this purpose.

Furthermore, a physician issued card IS NOT THE STATE CARD, which only the county can provide. For further information on the State Card, please see the County-Issued State Card section under Resources.

Obtaining your Medicine

Naturally Healing MD does not sell Cannabis. For that, you will need to go to a licensed dispensary to purchase your product or order your medicine from a licensed delivery service. The good news is that California’s regulated dispensaries must meet stringent testing standards for the products that they sell. This protects consumers from unwanted contaminants – like pesticides – and promotes accurate labeling of key ingredients. The bad news is that California’s highly regulated dispensary system is so complex and labor intensive that many producers cannot afford to implement the regulatory requirements and for those that do, it increases the costs of their products.

Because of the costs of dispensary products, there remains a robust black market selling marijuana in California. Studies have found that many black market products have a high rate of residual pesticides. For this reason, patients are strongly advised to purchase their products through the regulated marketplace.

Naturally Healing MD will provide its patients with a list of dispensaries and delivery services that operate within a five mile radius of our office in Albany. However, there are many others that might be more convenient for some patients. To find other dispensaries, you might find there two websites helpful:

www.weedmaps.com

www.leafly.com

Be aware that dispensaries pay for their listings on these sites, as well as their relative prominence on the sites. If a dispensary is not listed at the site(s), it may simply be that they are trying to save money.

Price, products, and “ambiance” do vary from place to place. I believe that high quality, reliable medicinal products can be purchased in the Bay Area.

However, since the transition from California’s 1996 Compassionate Use Act to the 2016 Adult Use Act, the overwhelming majority of products now sold in California’s dispensaries are strictly recreational. These recreational products are very difficult to use to alleviate symptoms without unpleasant side effects. One of Naturally Healing MD’s services is to help patients secure products that can be used medicinally without untoward effects.

There are price differences amongst dispensaries on the same product. Shopping around is recommended – after you settle on a product(s) that works best for you.

All dispensaries require proof of age (e.g., California Identification Card, California Driver’s License, or passport) regardless of your age.

Those dispensaries serving medical marijuana patients require that you show your current medical marijuana recommendation, along with your age identification. Naturally Healing MD medical marijuana recommendations are internet verifiable, so the dispensary can check the validity of your recommendation 24 hours a day.

Beginning to Use Medical Marijuana

Naturally Healing MD’s services are designed to offer patients the comprehensive support they need to begin to safely use cannabis.

Unlike pharmaceuticals, which entail taking a fixed dose in pill form as directed, medical marijuana entails an adjustment process to determine the best product, dose, and frequency of use for your particular goals.

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Since there are now a vast number of products to choose from, finding the straightest path to meet your goals through medical marijuana usage is not easy without guidance.

Naturally Healing MD takes the guess work out of using marijuana. Our First Timer’s Package is designed to help get you started safely on medical marijuana usage. It includes an individualized treatment plan based on a patient’s medical history, current condition and personal goals, as well as a follow-up appointment to assess progress and adjust treatment.

The remainder of this Introductory Guide is designed to help you understand the basics of marijuana as a medicine, including many of the options for how best to begin your cannabis usage. Please try and read it before your appointment.

The Four Ways to Administer Marijuana

There are four ways to “take” or administer cannabis – through the lungs, through the oral cavity/mouth, through the stomach, and through the skin. What follows is a brief synopsis of these methods and important differences.

Lungs (Inhalation)

There are three ways to “inhale” marijuana: Combustion (Smoking) Marijuana

Herb Vaporizing

Concentrate (or distillate) Vaporizing (also known as “Pen Vaporizers”)

The effects of inhalation are felt within minutes, peak within ten to fifteen minutes, and begin subsiding in one to two hours.

Combustion (Smoking) of marijuana is typically done with a pipe, bong, or “joint.” It entails lighting the marijuana with a flame.

Herb Vaporizing entails heating up marijuana with a heating device – called a vaporizer. No flame is involved.

Pen vaporizers are a trendy and discrete way to inhale cannabis oil. However, the safety of inhaled concentrates has not been established. There are also a number of concerns, both theoretical and very real. In 2019, there were over 50 deaths associated with vaping – and most of those deaths had one thing in common – the overwhelming majority of victims were vaping marijuana, not tobacco, as many were led to believe.

No single substance has been shown to cause the illness, but the most common ingredient found in products associated with vaping related deaths is Vitamin E acetate. Vitamin E is a supplement considered safe when ingested or applied to the skin and is used in vaping products as a thickener. It was found in about half of the products associated with the lung disease that began afflicting pen vaporizer users in 2019 and killed over 50 users in 2019 and 18 more in early 2020.

However, Vitamin E acetate is not the only concern. Samples taken from inside the airways of patients who have developed severe respiratory disease after using pen vaporizers have shown that numerous chemical components of the products are left behind in the airways of users, including triglycerides, plant oils, petroleum distillates, and terpenes.

In the wake of the 2019 vape crisis, many vape manufacturers are now advertising additive-free products. But that does not address the larger problem with vaping – no long-term studies have proven that this kind of product is safe for the lungs over the long haul. Until large groups of pen vaporizing patients are followed for 10+ years or more, the health impact of this form of administration cannot be known.

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Unbeknownst to most, there are many long term studies examining the effects of smoking marijuana that began in the 1980s and continue to this day. The results of well-designed studies that began over thirty years ago strongly suggest that combusting the flower is not a cause of long term lung disease, such as cancer or emphysema. However, a small-to- moderate percentage of marijuana smokers do develop cough and increased phlegm (commonly called “bronchitis”) as a direct result of smoking marijuana. The use of an herb vaporizer, in which the flower itself is heated but not burned, significantly reduces the incidence of bronchitis in marijuana smokers.

Given the small doses of inhaled flower that are sufficient for medicinal uses of marijuana, I believe that smoking or heating lab tested flower in an herb vaporizer poses no long-term risks for the medicinal inhaler. I cannot say the same for inhaling manufactured distillates of marijuana using pen vaporizers. There is simply no safety data to suggest inhaling such a product is safe.

For the sake of the many thousands of people who are currently using pen vaporizers, I hope they prove to be safe. But it is important to keep in mind that: THERE ARE NO STUDIES DEMONSTRATING PEN VAPORIZERS’ LONG TERM SAFETY. I recommend waiting for safety data before trying this method. In addition, concentrates are often HIGHLY concentrated. The dose can be difficult to control, which is one more reason Pen Vaporizers are not a good starting method for new patients.

Oral Cavity (Sublingual)

The oral cavity – particularly underneath the tongue – has many arteries and veins. A properly designed product can be well absorbed underneath your tongue. Sublingual (under the tongue) products currently on the market include:

Sprays Drops Strips Tabs

The effects of sublinguals are usually felt within minutes after usage (although not as quickly as inhaled flower), start wearing off in 2 hours, and are appreciably gone after 4 hours. Inevitably, a small amount of sublingual product is swallowed and goes the digestive route. This prolongs the effect of the medicine. Sometimes, this can be beneficial. Rarely is it problematic.

There are far fewer sublingual products on the market than —”buds” (the marijuana flower). And, per dose, they are more expensive than the flower. For patients who are not currently “inhaling ” marijuana, sublingual products are the easiest and safest way to begin cannabis use.

Stomach (Edible or Ingested)

Marijuana products that are swallowed – also called edibles – are absorbed through your stomach and can have an EXTREMELY different effect than inhaled or sublingual products. In my experience, this is where patients get into “trouble” the most. Unfortunately, MANY PATIENTS HAVE GOTTEN INTO TROUBLE using edible products.

After an edible product (e.g., cookies, candy, drink, swallowed tincture, tab, or pill) is consumed, it lands in the stomach where it mingles with other recently ingested items. It can remain in the stomach for up to five hours before it is absorbed. But before it is absorbed into your bloodstream (where it is then delivered to the rest of your body for its medicinal effects), it is metabolized by the liver. How quickly the product is metabolized by the liver and sent into the bloodstream depends on the contents it intermingles with in the stomach, especially the fats in your stomach, as well as individual variation. Herein lies one of the problems: the time of onset.

Patients who ingest cannabis-containing products may unwittingly assume that, after some time has passed with little to no effect, they have not taken an adequate dose of cannabis. They then consume more product. If they end up consuming more than what they need, patients may feel “stoned” several hours later and remain so nine or more hours after the last dose.

Further complicating matters, the metabolism of cannabis by the liver creates a product different from what enters your bloodstream when you inhale or absorb it sublingually. The liver turns THC into a longer-acting, more sedating, and

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more psychoactive substance than the inhaled or sublingual THC that enters your bloodstream. This liver-metabolized THC product is different from the THC that enters your bloodstream after inhaling or absorbing it under the tongue. The THC that enters into your blood stream after inhalation or sublingual administration is shorter acting, less psychoactive, and less sedating. Therefore, patients often find that the effect of edible products is noticeably different from the effects of inhaled or sublingually administered product. Edible products result in more sedating, longer-acting and more psychoactive THC effects.

Ingested products are rarely my first recommendation for initiating cannabis use. Typically, I advise starting with other forms of administration. However, edible products have an important role to play for some patients. Some patients benefit from the unique properties of the liver produced THC that enters the bloodstream as well as the sedative and longer acting effect of this form of THC. But because of the high variability in absorption, it is more difficult to determine an effective dose, I usually reserve ingested products for patients who have not found success through other modes of administration or those who need to supplement their other forms of administration.

For example, when patients are looking for a product to kick in while they are sleeping, edible products, with their delayed onset, might be appropriate. For those needing help falling asleep and staying asleep, a product that you suck on (like a lollipop or chew) can produce both immediate sublingual effects as well as more delayed effects from swallowing the product.

For those patients relying on ingested products, they are most effective when taken at about the same time every day and coordinated with eating/drinking times. Tinctures or liquids are most readily absorbed. Solid products, like cookies and brownies, might have unevenly distributed ingredients, complicating the effect of each bite. However, new regulatory requirements mandate consistency and manufacturers are striving for uniformity of dosage of cannabis in their products.

Skin (Topical)

There is very little scientific literature on topical application of medical marijuana. Currently there are two types of products applied to the skin: liquids (lotion/oil/cream) and patches.

Liquids are only appropriate for a localized condition – such as highly localized neck pain or joints in the hands or feet. It is important that patients buy lab-tested products, to ensure there is cannabis in the product. If you buy CBD creams outside of a dispensary, make sure that they too are lab tested. Apply a small amount to a limited area to reveal any potential allergic reaction before using the product more liberally. To achieve maximum benefit, topical products should have a cannabis concentration of 4% or more.

Transdermal patches are the newest form of administration of cannabis. The product is applied to the skin and the ingredients are supposedly slowly absorbed into the body’s bloodstream. However, the companies that market transdermal products have yet to produce the scientific data showing significant blood levels of cannabinoids after application. Hopefully, they will be able to produce such data in the future.

Despite the lack of scientific evidence regarding their effectiveness, many patients who use topical products on localized areas have found them to be remarkable in reducing pain, so I do not discourage their use.

Marijuana’s Active Ingredients

There are about 500 different components in marijuana that have been identified. The two most researched components are Tetrahydrocannabinol (THC) Cannabidiol (CBD).

THC is the psychoactive substance in marijuana. Taken in appropriate quantities, it helps with many symptoms (e.g., pain, sleeplessness and anxiety). Taken in high quantities, it results in an alteration of consciousness. At a level that usually exceeds what patients need for medicinal relief, some describe their alteration of consciousness as feeling “high” or “stoned”. Some find this state pleasant and others find it unpleasant. Taken in even higher quantities, THC can produce anxiety. Patients do not need to use quantities of THC that produce unpleasant side effects or feeling “stoned” or “high” to get the medicinal effects of cannabis.

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CBD is a non-intoxicating substance. It also reduces the psychoactivity of THC. CBD has been found to have many of the same effects as THC – it can reduce pain, anxiety, muscle spasm, nausea and loss of appetite – but it does not necessarily have the same amplitude of the effects of THC. For example, the pain reducing effect of CBD is far less than that of THC.

Short-term memory loss is a well-documented side effect of THC – you do not remember as much while you are under the influence of THC as when you are not (although low dose marijuana has not been well studied). However, CBD in small quantities used either with or before THC may counteract this effect.

How CBD and THC interact is gaining more research attention, now that both components of marijuana are in higher usage today. Hopefully new clinical findings will help better guide patients on the interactions between these two key ingredients of cannabis.

In a similar vein, terpenes – the aromatic compounds that give cannabis its distinctive smell and contribute to its medicinal effects – are gaining the attention of the research community which will help shed light on how they can be deployed for specific effects on patients.

Hemp Products versus Marijuana Based Products

Hemp-derived products are sourced from industrial hemp plants originally grown for products such as fiber and seeds. By Federal law, hemp must contain 0.3%THC or less. Marijuana-derived products use marijuana plants that have no use other than human consumption (and now some pets). They are physically lusher plants and develop flowers that have higher concentrations of THC.

Hemp products, sold for their CBD content, are highly unregulated. Many have been found to contain drastically different concentrations of CBD than their labels claim. CBD manufactured from hemp is usually pooled from multiple sources that may be contaminated with heavy metals, in addition to pesticides. In addition, Hemp products lack the terpenes and flavonoid components that are found in the marijuana plant. These components may play an important role in the effectiveness of the medicine for certain conditions. Finally, most of the research on the effectiveness of cannabis for medicinal usage examined either marijuana or synthetic cannabinoids, not hemp. For these reasons, I rarely recommend Hemp based products. The one exception is topical medications – but consumers are still urged to find topical products with verifiable lab test results so they can be sure of the actual ingredients in their purchase.

Marijuana “Strains”

Many marijuana dispensaries divide marijuana into two different types or “strains” of marijuana – Indica and Sativa. They differ genetically, making Indicas generally more sedating and Sativas more stimulating. Hybrids combine genetic features of Indicas and Sativas. These genetic distinctions are particularly relevant when the mode of administration is inhalation.

In general, patients wishing to be “actively engaged in activities“(housecleaning, cooking, reading, athletics, etc.) should use a Sativa or Sativa-dominant hybrid. Those wishing to go to sleep or physically relax should use an Indica or Indica- dominant strain. Many patients use a Sativa or Sativa-dominant strain during the day and an Indica or Indica-dominant strain at night.

The Indica/Sativa distinction is outdated. Once terpene testing is widespread, the Indica/Sativa distinction will be replaced by a more detailed lab analysis of the terpenes present in the product. Terpenes are the component of marijuana that are responsible for how it smells. Terpenes are also responsible for the more energizing effects of Sativas and the more relaxing and sedating effects of Indicas. Eventually, strains will become “Chemovars” – identified by their distinctive distribution of terpenes, cannabinoids, and possibly flavonoids. That day has not yet arrived.

Unfortunately, the California Bureau of Cannabis Control does not require terpene testing on Cannabis products unless a specific terpene claim is made by the manufacturer. Therefore, terpene tested Cannabis is hard to come by.

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Dosage

The key to using marijuana effectively is finding the right product, taking the right dose, and using it at the correct frequency. I always recommend starting low and gradually increasing the dose until finding how much you need to get the desired effect. Below are starting doses I recommend for most patients. However, my recommendations vary according to a patient’s specific condition – including history of usage, medical conditions, current medications, and concerns.

Some patients describe themselves as “highly sensitive” to medications. And, indeed, I have found a few patients to be astoundingly sensitive to THC – although they are a rarity. For patients who believe themselves to be among this group, I recommend much lower starting doses than the ones listed below.

Inhalation: 0.5mg THC 1mg CBD

Sublingual: 1.00 mg THC 2.0 mg CBD

Edible:
2.00 mg THC 4.00mg CBD

Frequency

Starting Dose

Frequency of marijuana use depends on the symptom being treated. For example, chronic pain that is experienced all day and perhaps all night is usually treated with multiple doses of marijuana (e.g., three to four times a day for inhaled and sublingual products) throughout the day or twice a day in the case of longer acting edibles. For other symptoms – like difficulty falling asleep – once nightly might be sufficient.

In general, the frequency depends on the underlying symptom being treated and the chosen mode of administration (inhalation versus sublingual versus edible). But there is also quite a bit of individual variability that effects the duration of marijuana’s effect and these differences probably stem from genetic factors as well as variables like mind set, context, and diet.

Below is the generally accepted duration of action time frames for the three major modes of administration of marijuana:

Inhalation: 2-4 hours

Sublingual: 3-5 hours

Edible: 4-6 hours

THC taken through the edible route for some patients can last considerably longer than six hours. This can be the result of slow metabolism of the product or large doses.

Adjusting the Dose

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With “Cannabis-Naive” patients, there are three phases I recommend using for developing your marijuana routine: — initiation, titration, and maintenance. Naturally Healing MD’s Treatment Plan, provided for patients who sign-up for the First Timer’s Package, gives specific instructions on all three of these phases, and is developed in concert with the patient’s needs.

Initiation is to introduce your body to Cannabis. It is typically a small dose, begun when there are no responsibilities for the day – like driving, work, or childcare – which is usually in the evening and sometimes during the weekend. This initiation phase is around three days long and the dose may have no appreciable effect. For patients that are not Cannabis-Naive, the initiation phase might not be needed.

After initiation, the dose is titrated up. The duration of the titration process is anywhere from a few days to a few weeks. The duration of the titration provided in the Treatment Plan is highly individualized, based on a number of factors, including urgency of the symptom being treated, concern about psychoactive effects, and concurrent medications. Once you have titrated to the desired level, I typically recommend giving the product and the dose about 5 to 7 days before assessing for the need for further changes.

How much CBD and THC you need to achieve symptom control is highly individualized. It depends on a number of factors, including the genetics of your cannabis receptors, the mode of delivery, previous experience, mindset, and context. So the right dose for you might be very different from the effective dose for another person with the same symptom.

The usual minimum and maximum effective dose range for the three most common symptoms I have worked with over the years are:

Anxiety:

Insomnia:

Pain:

2.5 – 25 mg Predominantly CBD inhaled, sublingual, or edible – three to four times a day. 1.0 – 30 mg Predominantly THC inhaled, sublingual, or edible – once a day
2.5-10mg Predominantly THC inhaled, sublingual, or edible – two to three times a day.

As you can see, some patients will need more and less for the same degree of effect. The RIGHT dose is the one that

works for YOU!

Some highly experienced users may be using too much marijuana. This usually occurs with 30 mg THC per day or more of long-term usage. Often it is the result of smoking joints for relief, although occasionally patients take high dose edibles.

For those patients using high levels of THC for long periods of time, the medicinal benefits of marijuana might be lost. In addition, high dose usage can be associated with depression, and what some call a-motivational syndrome.

Typically I recommend they consider abstinence from marijuana for several days and resuming at a lower dose with considerably more self-monitoring and self-assessment. This strategy helps regain the medicinal properties of marijuana for a more effective deployment of Cannabis. However, it can be a hard process for some patients who have relied on high-dose THC for prolonged periods of time.

Adjusting Your Medication

There are many options when it comes to adjusting treatment – manipulating different medicinal components, trying different forms of administration, finding the most appropriate for you among tens of thousands of products, and adjusting your medication to better meet your needs. Guiding you through these options is one way Naturally Healing MD is trying to make Cannabis more accessible as an effective medicine.

With so many options, patients should not be deterred if their initial foray into Cannabis does not result in unmitigated success. The good news is that nearly 80% of patients who follow-up with Naturally Healing MD six months after being initially seen, have found some symptom relief from at least one significant symptom( e.g., pain, anxiety, insomnia, or

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depression). Many, but not all, find that relief in just one or two visits. Studies that are known as “Pills to Pot Studies“ have found that ongoing professional support to facilitate Cannabis usage increases the percentage of patients who successfully transition off pharmaceuticals onto Cannabis.

On-going Medication Management appointments are offered to help you find the medication that works for you! Some patients need to try several different products before landing on one that works for them. Others need to incorporate a different mode of administration to get the relief they seek. Medication Management appointments are available for that purpose, after a patient uses the free follow-up appointment included after the First Timer’s Package. To encourage patients to take advantage of on-going support, the cost of Medication Management appointments for active patients are kept low ($49).

Keep a Diary

To track the effect of the medicine on your health, it is highly recommended you keep a diary.

The format for each entry is:

Date: _______ Time: _______
Intention: (i.e: read, make decision, clean, stretch, sleep)_______

Symptom Level (i.e.: anxiety, pain, on a scale of 1-5, with 1 being the least and 5 the most)________

Product or Strain Used (i.e.: the name of the flower “Harlequin”, or the name of the product, such as Care By Design Sublingual Spray)________

Dose: (e.g. number of sprays or spoons of flower) __________
Set a timer for one to two hours (unless you are going to sleep) and when it goes off, answer the following questions: Intention Achieved? Yes_______ No_________
If yes: Enjoyed? Yes________ No____________
Symptom level:_________________

BEFORE YOUR APPOINTMENT

It is easy to get a “medical recommendation” from a physician. Figuring out how to use marijuana effectively to treat your medical symptoms is the hard part. Most patients new to marijuana expect that one visit to get their recommendation and one visit to the dispensary to get their product is all they need to get the relief they seek. This expectation is misguided.

While Cannabis is an extraordinarily versatile and effective medication, it is also extraordinarily complex. And harnessing that complexity to match the needs of each patient takes time. Naturally Healing MD’s main mission is to give each patient the guidance they need to safely and effectively harness the medicinal properties of marijuana to serve their particular needs.

Many patients who come to Naturally Healing MD are afraid. Some have had one or more bad experience with marijuana back in “the day” – oftentimes with one too many bites of a marijuana-laced brownie or, more recently, with one “hit” of the super high THC buds on the market today. If you have a bad experience in your past, that doesn’t need to be repeated.

Naturally Healing MD’s guidance is designed to take the fear (and drama) out of the process.

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If you follow the treatment plan provided in your First Timer’s Package, your journey should be a peaceful one, without the drama that so many fear.

Before your appointment, choose the one symptom you want to focus on first. It is not uncommon for patients to come to Naturally Healing MD with a list of symptoms that looks like this: Insomnia, back ache, stress, neck pain, GI problems, depression. While cannabis may be of help for all, to begin treatment, a single symptom to focus on will help organize the best initial strategy for cannabis usage. Oftentimes, success with one symptom significantly improves others. For example, anxiety reduction through cannabis can reduce pain, depression and insomnia. Decide which problem is most important to you to address first.

Finally, I have worked with over 10,000 patients in the past twenty years and have learned that marijuana is an enormously versatile and effective medication for some of the most common problems encountered in medical care, including pain, anxiety, insomnia, and depression. To harness its medicinal properties, it is best if patients LEARN about the medicine, experience how their body reacts to it, and make adjustments accordingly. I suggest patients look at this process as a journey and Naturally Healing MD – and its educational resources, individualized treatment plans, on-going support, and free classes – as your guide.