The leading edge of a quiet revolution in healthcare reached the Eastern Shore on Valentine’s Day. That’s when Ash + Ember, a licensed medical marijuana dispensary, opened its doors. The owners of the facility—sisters Ashley and Paige Colen—say they are seeing lots of early demand. The dispensary is located at 202 Coursevall Drive #108 in Centreville. Visit their website here.
Maryland is now one of 29 states (plus Washington DC) that provide legal access to hemp and marijuana derivatives to treat medical problems such as pain, nausea, depression, sleeping disorders, epilepsy, and other health issues. The medical marijuana movement, however, is increasingly global. Australia, Argentina, Canada, Germany, Israel and many other countries already provide similar access. The process in Maryland requires prospective patients to get a doctor’s recommendation, then register with state authorities and receive a specialized ID card, and then to work with a licensed dispensary to identify the particular formulation and mode of delivery that best meets their needs.
Ash + Ember offers to help would-be patients with the registration process and with finding a doctor who will recommend medical marijuana therapy, as well as with finding a formulation that best suits each patient. Since the dispensary is limited to suppliers in Maryland (federal regulations make it illegal to ship marijuana across state lines), it’s stock is fairly limited at present, but the local grower and processor industry is scaling up fast and the Colen sisters expect a much wider selection in coming weeks and months. For now, they accept cash only but expect to accept credit cards in the near future and to offer home delivery of their products.They can also be reached at 443-262-8045 and are open 10am-7pm weekdays and 10am-6pm weekends.
One of the barriers to full realization of the medical and health benefits of cannabinoids—the generic term for the active ingredients in hemp and marijuana plants—is widespread ignorance about them among both patients and doctors. Many people associate marijuana with the underground growing and smoking of “weed” to get high—a practice still illegal in most states. An informal survey suggests that many doctors in private practice on the eastern shore still won’t have anything to do with medical marijuana.
But medical cannabinoids don’t have much to do with getting high. Medical scientists have now identified as many as 80 different cannabinoids, most of which produce no buzz or high at all. Indeed of the 8 cannabinoids commonly found in the now bewildering array of commercial medical marijuana products, only one—THC—interacts with receptors in the brain to produce that kind of psychotropic effect. The other most common form—CBD, the mainstay of most medical/therapeutic uses—has no psychotropic effect at all and acts on receptors that are part of the body’s own cannabinoid system. That system, found in nearly all cells, produces cannabinoids to help stabilize the body’s internal processes.
Moreover, smoking marijuana is probably the least common form of administration. Instead, the active ingredients are extracted from the plant by solvents and used as oils (directly on the skin, or ingested in capsules or food, or vaporized and inhaled) or alcohol-based tinctures (delivered as drops under the tongue). Extraction allows manufacturers both to concentrate the active ingredients and also to more precisely control concentrations and purity. And the variety of ways of using medical marijuana gives patients more control as well. Inhaling a vapor has an almost immediate effect, but may be too strong for some circumstances or not a comfortable mode of use for some. Ingesting the drug means a much slower but longer-lasting effect (for controlling pain at work, for example). Putting a drop or two under your tongue also gives immediate effect, but the concentrations in tinctures are typically lower.
Clinical research on specific cannabinoids and their impact on health conditions is still in the early stages—in large part because the federal government had made it very difficult to get permission to do such research. But last year a randomized clinical trial found that high-CBD extracts helped markedly to control epileptic seizures in children. Another study in a mouse model of autism showed that CBD has promise as a treatment there as well. Canadian studies have provided evidence that cannabinoids can help with post-traumatic stress disorder, chemotherapy-induced nausea, sleeping disorders, and arthritic pain. More research is coming.
Arguably one of the most important potential impacts of medical marijuana is likely to be easing the opioid epidemic, the leading cause of preventable deaths in the United States. If pain can be treated with non-addictive cannabinoids, why use opiods—and enrich the pharma companies that make them—in the first place? Indeed, research studies have reported fewer opioid deaths and reduced opioid use in states where medical marijuana is available. That in itself would be a major benefit of widespread adoption of medical cannabinoids. And if cannabinoids can be used to help wean people already addicted from opioids, as some research suggests, even better.
Of course, medical marijuana is not the only revolution going on—more and more states are legalizing recreational marijuana as well, and the dominant brands for recreational use usually include quite a bit of THC. One genuine concern about recreational marijuana is its potential impact on adolescents: cannabinoids—especially THC—can have a significant impact on the development of adolescent brains. But the more tightly controlled distribution channels for medical marijuana seem far less likely to “leak” into adolescent culture, as well as focusing more heavily on CBD.
Another concern is work-related drug tests: will medical marijuana use show up on these tests and cause someone to lose a job? As it turns out, the tests that follow a federal standard are specific to THC, so using a low-THC/high CBD formulation to control pain should not trigger a positive test.
Another barrier to use is simply social: we’re not yet to the stage where people talk openly about their medical marijuana use. But if you have medical concerns that are not well met by conventional medicines, or want to avoid opioid use or anti-depressants with bad side effects, you might want to look into what’s available—and legal—in medical marijuana, now conveniently at hand on the eastern shore.
Seeking creative solutions, counselor Melissa Stuebing developed the “Literacy-Free 12 Step Expressive Arts Therapy” curriculum under the editorial oversight of Dr. Lauren Littlefield. It was made for people with co-occurring mental health and substance use disorders, as well as for illiterate participants and those with self-expression difficulties.
