The stigma appears to be falling away.
Ari Greis, a physician at the Rothman Orthopaedic Institute in Philadelphia, was asked to speak tonight in Old City about how adult children who use medical marijuana might gently break the news to their parents. But Greis, director of the Medical Cannabis Department at the Institute said the script has flipped.
It’s the adult kids who are hearing about marijuana from their parents.
“I see it from the other end," Greis said. “I see mostly older patients with an average age of 65, and they’re the ones asking me about medical marijuana recommendations. Now they’re the ones telling their children. Though sometimes it’s the younger generation telling the older generation that it’s OK to try it.
Greis will be addressing the 420EDx event at Old City’s Stratus Lounge tonight with fellow physician Lynn Bornfriend. Both are doctors who have recommended cannabis for hundreds of their respective patients who primarily use it to relieve their chronic pain.
“I’m not pushing it at all when it comes to treatment options,” Greis said. “But if they have already tried other treatment modalities with limited results, they’ll ask me what else is there. So I mention that medical marijuana is an option for chronic pain in the state of Pennsylvania.”
Some people, he said, are immediately dismissive. They think of it as an illicit substance, burdened with decades worth of stigma. “Or they just don’t want to be high all day,” he said.
But given the varieties of medical marijuana available, Greis said "if they choose the products I recommend, I can almost guarantee they won’t get intoxicated.”
In the past year Greis has certified more than 520 patients with the state to become card-carrying medical marijuana patients.
“Of those 520, the majority have seen some benefit,” Greis said. "Some think it’s amazing. Other patients say it takes the edge off and only get a 20 to 30 percent improvement. But even those say they’re sleeping much better, and that helps them deal with the pain. "
For people who have never tried marijuana Greis recommends a sublingual tincture, an oil that is placed under the tongue. He suggests a solution that primarily contains CBD with no more than few milligrams of THC in a 10 to 1 ratio. (THC is the compound in cannabis associated with intoxication.)
“I haven’t had anyone reporting any negative side effects,” he said. Some of the concentrated products with higher levels of THC may cause some patients to become dizzy or lightheaded. “But it’s a matter of common sense. Start with a low dose and work your way up as needed.”
There are certain strains, or varietals of the plants, that he suggests to new patients. Those low THC strains include Harlequin, AC/DC or Harle Tsu. “By and large there’s a way to teach people how to avoid intoxication.”
Patients that use intoxication-strength doses are usually consuming them before going to bed. “They feel a little high and fall asleep.”
Topicals, which are oils and lotions that can be spread on the skin, have been “surprisingly effective” for many patients suffering from back pain.
Greis also has had success weaning “a lot of patients” off lower doses of opioids with cannabis products.
“You get used to taking those pills and it’s hard to stop,” Greis said. “[Medical marijuana] gives them a reason to get off opioids. And they do it. It motivates them to wean off and start something different.”
Greis has been collecting data about the effectiveness of cannabis products. He’s hoping to publish some results this summer in conjunction with a June conference on cannabinoid research.
“We’re seeing some trends that are encouraging,” Greis said. “On opioids, one of the studies I’m trying to get going is looking at the data from my certified patients and tracking what other drugs they’ve filled at pharmacies. With drugs that have a potential for being abused like sleep aids, hopefully we’ll see some impact and reduction after they access medical marijuana.”