AUSTIN, Texas — There is no shortage of products to choose from when it comes to medical cannabis.
From cannabis oil to edibles, the options are vast.
But the most common question patients ask about the cannabis plant, or the cannabis market at large, is: How do I buy a plant?
It is a difficult question, one that some patients may struggle to answer.
“It’s complicated, honestly,” said Dr. James Sutter, an internal medicine physician at Austin’s Baylor College of Medicine.
“I have to explain the process to them.”
As the federal government prepares to reclassify cannabis, doctors, pharmacists and dispensary owners are scrambling to figure out how to get cannabis to patients.
“We need to make sure that patients know how to use the plant safely,” said Sutter.
The federal government has designated cannabis as a Schedule 1 controlled substance, meaning it has a high potential for abuse and no currently accepted medical use.
The Department of Justice (DOJ) has warned that there are no guarantees that patients will be able to get the cannabis they need for medical reasons, and many patients may be unwilling to get a cannabis extract that can help alleviate pain or help them manage their symptoms.
Some cannabis products have a lower THC (the chemical component in marijuana) content than other cannabis strains.
Others, such as cannabis-infused creams and capsules, may contain a higher amount of THC.
But some strains are more potent than others.
“I have a patient who I work with who has been using cannabis for pain and who is currently taking two different creams,” said Chris O’Neill, an external medicine physician with Austin’s Methodist Healthcare.
“He was prescribed one cannabis extract, and it’s really, really potent.
He has never been able to take it for medical reason, so he’s taking that every day.”
O’Neill said he and his colleagues at his clinic have been experimenting with the cannabis extract as part of a trial.
“My patients are getting a really good result with that,” he said.
O’Neil has also seen patients who have used the extract to manage symptoms related to epilepsy and fibromyalgia.
“They have had very severe symptoms and are getting better,” he added.
“The patients I work for are very happy with it.”
There are some advantages to being able to use cannabis as medicine, according to Dr. John Cavanagh, an anesthesiologist and a board certified internal medicine practitioner at UT Southwestern Medical Center.
Cavanagh said that many of his patients prefer using the extract for pain relief, but that there is a benefit to being a medical cannabis practitioner as well.
“One of the things that has gotten better over time is there are fewer side effects with cannabis,” he explained.
“There’s been a decrease in the number of side effects.”
Dr. Cavanah, who is also an instructor in internal medicine at UT, said that the cannabinoids found in cannabis can have a wide range of effects on the body.
“You have a variety of effects,” he told The Austin American-Statesman.
“It’s one of those drugs that is really hard to explain.”
Cavanah said he has seen a decrease of fibromyalgias in patients who use cannabis extracts.
“Most of the fibromyphalias are fibroid, and the fibroid has many different pathways,” he noted.
“One of them is that it’s getting to the root of the problem.”
Cavanagh also said that patients who take cannabis products may not be getting the best quality of care from the doctors who prescribe them.
“The patient’s going to end up with more side effects than what they’re getting from the doctor,” he stated.
Cavansays that the patients he sees are happy with the product they have been given.
“Many people will take cannabis as an aid in pain management, and there is certainly anecdotal evidence that that’s what’s happening,” he continued.
“But I think it’s important to keep in mind that many patients are not going to get any benefit from using the cannabis as treatment for pain.”
Caving in to the DOJ, the U.S. Department of Health and Human Services (HHS) has decided to make cannabis extracts legal for medical use in Texas.
The announcement comes just months after the federal drug czar, Dr. Nancy Grace, announced that she would reclassification cannabis.
“This is a very important step forward for cannabis reform, and we welcome the Department of HHS’s move toward the legalization of cannabis products,” said Nancy MacKay, chief medical officer of the American Civil Liberties Union of Texas.
MacKay added that she and other officials from the organization are working with the Texas Medical Association to find a way for patients to use extracts as their primary form of treatment for chronic pain.