My First Medical Marijuana Dispensary Visit

I selected The Green Door, my neighborhood dispensary, for my first medical marijuana 'access point' experience. In addition to their convenient location, they had over 40 reviews online and were voted best medical marijuana dispensary by the Seattle Weekly in 2011. They are discreetly tucked into a multi level strip mall at 12th and Jackson in the International District.  The exterior could be mistaken for a spa - I went past it twice before locating it.

The Green Door: discreetly tucked away in a strip mall in Seattle's International District

I rang the bell and was buzzed into the humid, skunky smelling waiting room. The walls were green with dark wood accents and a flat screen television playing a Bob Marley documentary. Mike, the gentleman working there, introduced himself through the glass window. He was an easy going 30ish guy with long dreadlocks tied up in a turban. He reviewed my medical authorization paperwork and my drivers license. I had to complete a single page of paperwork which included a reminder of the limits of how much marijuana I can legally posess in Washington State (24 ounces of dried cannabis) and a statement to the effect of designating the Green Door as one of my medical cannabis care providers through some sort of collective gardening agreement. After reviewing my paperwork, they took my photograph and ushered me back toward the bud room.

The legal marijuana experiences I've had in Europe were heavily slanted toward hashish - coffee shops in Amsterdam and the open air hash market in Christiana, Denmark have relatively little cannabis flower selection. But the Green Door is a legitimate enterprise with a wonderful selection of cannabis. There were over two dozen different varieties of dried cannabis available - not including concentrates.

Really?? Really... Collards with Cannabis! Fun new product from CannaHaute cuisine

The bud room was well organized, clean and inviting. One wall had all the dried cannabis arranged in jars from 100% Indica to 100% Sativa, with hybrids in between. Another Mike, a mid-twenties gentleman with short brown hair, served as my budtender. I followed Dr. Z's advice and described my condition to him and asked for recommendations. I wanted to try a range of different products, so I selected a full indica, a full sativa and a few hybrids. Information about the producers and analytical data on the strains were not available.

For the full Indica, I went with one of Mike's recommendations and selected the Grandaddy Purple.  The medium sized buds were indeed quite purple and had the classic floral sweet 'purple' aroma and a decent frosting of crystals. It gave a soft, pleasant smoke that conveyed a fragrant 'purple' taste with a bit of a kick to it.

Cannabis from the Green Door

I decided to go with the Sour Diesel for a Sativa dominant strain (90% Sativa, 10% Indica). The buds were small and compact with an aroma dominated by a waxy fuel-oil aromatic note which was disappointingly subdued. A slightly musty aromatic note came through during smoking that tasted a bit flat. This Sour Diesel was intensely psychoactive, but not a flavor I'd seek out again.

My favorite strains tend to be Indica dominant hybrids and I've been curious to try some of the 'cheese' strains I have heard about these past few years. The Blue Cheese (80% Indica, 20% Sativa) came as nice chunky nuggets, but they lacked the aroma intensity I would expect from a strain named after something as pungent as blue cheese.

Medibles from the Green Door

The best strain in the bunch was the Ace of Spades (70% Indica, 30% Sativa). I asked Mike the budtender about the provenance of the strain, and he told me was a hybrid of Jack the Ripper and Black Cherry Soda. The aroma intensity of the Ace of Spades was stronger than the other strains I obtained from the Green Door. The smoke was thick and strong, without being harsh or hot in the throat. Psychoactively speaking, this delivered a pleasant buzz that was relaxing without giving the partial lobotomy feeling. I did, however, get the Motorhead song 'Ace of Spades' stuck in my head for a few days which didn't make me feel like much of a genius either.

In general, prices ranged from $10/gram to $12/gram, some strains were on special for $8/gram. Volume discounts are available for all strains. For being a first time patient, I received one pre-rolled joint - I chose the sativa strain Cynex as my free gift.

There was a case of medibles which were all expensive ($10 for a brownie, $8 for a bon-bon, $10 for a soda) but I tried a few products anyway. I was a little disappointed in the chocolate caramel brownie from The Chocolate Cure. Its portion was generous and its potency was good (one brownie was at least two, and probably more safely four doses). Unfortunately, the cannabis butter flavor was a bit dirty - something that could be easily improved by incorporating an additional water washing step in their oil/butter extraction process to suck out some of the chlorophyll contributing to that grassy taste.

All of my medicine was labeled with my name and the name of the strain. While Mike was weighing and packing my order, I thumbed through a copy of 'The Emperor Wears No Clothes' by Jack Herer. Thinking back to reading the book back in college about 20 years ago, I was saddened that hemp is still not legal in the US. But I was heartened when I realized that I was purchasing better quality marijuana, at a better price, from a better selection than ever before. Maybe the legalization of industrial hemp is next!

-------------(c) 2013 Stoner Living Blog

My Medical Marijuana Experience- a lupus patient comes clean about going green

As a sufferer of a chronic ailment - Systemic Lupus Erythematosus - I've had medical professionals unofficially recommend cannabis for years. This week I decided to get assessed to see if I was eligible for an authorization to use medical marijuana in Washington State.


'Green Wellness' Medical Authorization Clinic had an established online presence in addition to offering 24 hour a day, 7 day a week phone verification service. In order for a patient to visit a medical cannabis provider, the provider needs to verify the medical recommendation.  A specialty clinic that offers easy verification is desirable because a medical marijuana patient can spontaneously visit any medical cannabis provider (including farmer's markets) without having to wait two days for a doctor's office to return the phone call.

The Green Wellness online intake form was straightforward. After submitting it, they called me within an hour and sent a confirmation email saying I was 'pre-qualified' and offered me a variety of appointment times. I scheduled my appointment for the following afternoon. I did not have a copy of my medical records, so I was told my fee would be $178 ($20 less if you have your records). Although they did not take health insurance, they accepted cash, debit and major credit cards.

Their Seattle location is on the ground floor of a high rise at the foot of Capitol hill tucked by the freeway. Their lobby was a standard higher-end medical practice waiting room with leather couches and a pod style coffee maker. The office demeanor was professional, and I was given seven pages of paperwork to complete along with an authorization to release my medical records from my doctor (in my case, my rheumatologist).

The paperwork asked about the condition I was seeking to use cannabis for, along with questions about if I had tried cannabis for the condition. They were particularly interested in conditions where I could reduce my use of other drugs by using cannabis. Ironically, I had to add a section to their form because I find that using cannabis can help me stay compliant with one of the medications I take (Methotrexate) which is effective but has unacceptable side effects.

Medical Authorization to Use Cannabis in Washington State

Dr. Z came out and invited me back to the consultation room. We discussed my lupus: the onset of symptoms in 2004, the difficulty of getting diagnosed (common with autoimmune diseases) and the impact of my symptoms on my quality of life. My biggest complaints are joint pain (particularly in hands and wrists, but the hips, knees and feet too) along with appetite loss and fatigue. I explained the symptoms that came on in 2004 - a rash on my face I mistook for adult acne that wouldn't go away, fingers turning blue (a condition I would learn is called Raynaud's phenomena) and debilitating arthritis which developed primarily in my hands. I had always been healthy and strong, a bit of a tomboy and the one time recipient of a perfect attendance award at school. The formal diagnosis of lupus came in 2005 after my  blood chemistry showed a variety of antibody markers typically used to diagnose lupus.

Lupus is incurarable, and there hadn't been a new treatment approved for lupus in 50 years until Benlysta was released last year. Many of the medicines used to treat lupus (like Methotrexate) are off-label uses doctors have found to be effective. Methotrexate is prescribed for rheumatoid arthritis - a condition related to lupus. Methotrexate is a chemotherapy drug,  I take it orally once per week (in doses about 1/100th of the dosage used when give for leukemia). Although it helps reduce my inflammatory arthritis and some of the skin issues; the nausea, appetite loss and patchy hair loss are unpleasant. To reduce these side effects, my rheumatologist has also prescribed a drug called 'leucovorin' which I take 5 hours after taking my weekly methotrexate dose. The leucovorin hasn't been particularly helpful. Other suggestions to deal with side effects weren't viable (like taking it on Sunday so I could feel terrible on my day off instead of on a work day) or learning to inject it ('you'd only have to do it once a week!'). Benlysta, the new lupus drug, is an 'infusion' drug which is delivered through a multiple hour intravenous infusion every month along with an annual price tag approaching 30k.

I have a prescription for opiate pain medication, Vicodin, which I take for major flare-ups. But narcotics are habit forming and constipating and something I would like to use with moderation. I explained that cannabis seemed to make the vicodin more effective and that the marijuana was oddly effective in its own right. I don't think it actually quells the pain, but it makes me not care about the pain either.

Over the years I've learned to cope with pain, but appetite and related issues had taken the greatest toll on my overall well being and quality of life. Over the years my appetite faded and eventually disappeared; at the same time, horrible sores in my mouth made it excruciating to eat. I lived on coffee, instant breakfast and gelato. Food had once been the central theme of my life - I am a food scientist by vocation - and now I would forget to eat for hours at a time. I stopped making plans to eat meals with others because I couldn't eat.

Marijuana absolutely, unequivocally improves my appetite. Not every type of marijuana out there, but most of them. Now that I am eating again, I realize what a significant effect the lack of eating was having on my life. From a mood perspective, I imagine I was a beast to be around. With lupus, I am accustomed to aches and pains, so perhaps I just lumped the bad feeling from not eating into lupus  malaise. I had forgotten the joy of a delicious meal enjoyed with family and friends.

Routes of Administration for Medial Cannabis

Dr. Z recommended medical cannabis to me and provided some advice about how to use it. As a past cigarette smoker, he suggested I might consider a vaporizer to spare my lungs further damage. He also said that while he could not recommend a dispensary directly, that I should check out reviews online from other medical patients (there are a number of sites like leafly.com had such information available). He said there were a wide range of levels of quality in the dispensaries out there, but that at a good one the 'budtender' would be able to recommend ideal strains or products for my specific complaints.

I got an extra certified copy of my medical recommendation (a total of 3). I will keep one copy in my wallet, one at home and one will go to a care provider if I find someone willing to grow plants for me. A certified copy of my recommendation letter and my WA state identification is all I need  to begin exploring the dispensaries and farmer's markets sprouting up all over town.

Next Article: My first dispensary visit

------------------------(c) 2013 Stoner Living Blog

Cannabinoids and Medical Marijuana - what all those hard to pronounce components in Cannabis do for you

Some of our readers will remember when Cannabis was called grass, you could buy it by the lid, and Thai stick and Panamanian Red were the stuff of connoisseurs. The intervening years have seen a revolution in potency and overall quality as well as consumer awareness of the product itself. The first legitimate forays into contemporary marketing of marijuana have been under the medical model, so it should be no surprise that a plethora of information about the active ingredients in marijuana is available to consumers from medical marijuana dispensaries and seed companies alike. So what do all those difficult to pronounce components do for you?

A plant's cannabinoid profile refers to the specific mixture of the quantity and type of cannabinoids produced by a given plant. Think of it as a window on a strain’s effect and potency.

Table: Cannibinanoids and Their Effects

Over 475 compounds have been identified within the Cannabis sativa plant; of these 66 are classified as ‘cannabinoids’ unique to the Cannabis plant. RaphaelMechoulam (discussed in a previous article) dedicated much of his career to understanding the natural product chemistry of the marijuana plant. The most famous cannabinoid, delta-9-tetrahydrocannabinol (Δ9-THC), is the substance responsible for the majority of the psychoactive effects of marijuana. Other cannabinoids, including cannabidiol and cannabinol, alter the subjective experience of the ‘high’ by interacting with the way THC impacts the brain.

Much of the cannabis breeding of the past 30 years has focused on increasing the potency (ie. – the % THC) in strains, with considerations such as yield, pest resistance and other qualities getting some secondary attention. Furthermore, for years many in the breeding community held a belief that strains high in CBD had more of a ‘downer’ high and were seen as undesirable. Modern medical research has shown cannabidiol (CBD) to have tremendous potential as an anti-inflammatory compound with pain mitigating and possible anti-cancer effects.

Q. Why would anybody want a low/no THC strain of marijuana?

A. Medical marijuana users may desire a strain high in medically important anti-inflammatory CBD compounds without the psychoactive effects of a high THC strain.

The advent of the medical marijuana movement has seen the development of some high CBD strains, but it remains difficult for consumers to obtain high CBD/low THC strains even in medical contexts. One example of such a strain is The Remedy, available to qualified medical marijuana patients from the Dockside Coop in Seattle, WA.

Commercial interests have invested time in such ventures; GW Pharmaceuticals, the company behind Sativex, has done extensive research on cannabis breeding. Their website is clear they rely on traditional plant breeding techniques and do not use GMO technology. According to GW Pharma, four genetic loci control the cannibinoid profile of cannabis. They have a nifty explanation of their breeding strategy on their website here. They have numerous patents with specific genetic profiles – including high THC strains and 0 % THC strains.

There are a variety of techniques available for obtaining a cannabinoid profile, including specialized labs offering testing services such as Analytical 360. Other firms offer extremely portable thin-layer chromatography techniques, such as the one produced by Cannatest. Cannatest is a Seattle area business that offers home testing kits as well as testing services. The power to bring analytical testing in-house to cannabis breeding operations is critical at a time when shipping samples via USPS is in violation of federal law. The people at Cannatest also offer a mobile testing service in the greater Seattle area.

HPLC Plate of Cannabis Analysis Performed Using Cannatest Kit

The advent of legalization will see technologies for analytical testing of marijuana becoming commonplace – possibly even required – for the benefit of cannabis consumers. Opportunities for research abound and cannabis with a wide range of cannabinoid profiles (especially the hard to find high CBN/low THC strains) will soon be readily available to the public.



----© 2013 – Stoner Living Blog

Raphael Mechoulam: The Father of Medical Marijuana Research

Israeli pharmacologist  Raphael Mechoulam was a part of the research team responsible for identifying and synthesizing THC over 50 years ago. He continues to explore the chemistry and pharmacology of cannabinoids.

Raphael Mechoulam

“I believe that the cannabinoids represent a medicinal treasure trove which waits to be discovered,” says Mechoulam.

Dr. Mechoulam officially retired 15 years ago but continues to write grants and works from his lab at the Department for Medicinal Chemistry and Natural Products at the Hadassah- Hebrew University medical school in Israel.

Early in his research, he had difficulty obtaining high potency cannabis for his studies. Indeed, this remains a significant problem for researchers today. He contacted the army buddy of a colleague, who was the head of the investigative branch of the national police. Unaware of official protocol, the officer provided the young faculty member with five kilograms of seized Lebanese hashish. He credits some of his success to working in a small country where such connections were possible.

1963
Mechoulam and his research partners revealed the structure of cannabidiol (CBD), an ingredient in cannabis with anti-inflammatory properties.
1964
Mechoulam and his research partners isolated THC, the main psychoactive compound in marijuana, for the first time, established its structure and synthesized it.

Some of Mechoulam's latest research is focusing on the chemical basis of personality. "We have started looking at something nobody has yet really looked at thoroughly: The chemical basis for why eight billion people in the world have different personalities. The same compounds are found in all our brains; however, they all go up and down constantly.”

Thanks to Dr. Mechoulam for his contributions to science and we wish him the best on his future research endeavors.

-------- (C) 2012 Stoner Living