A medical marijuana patient's red card is scanned by a budtender at a dispensary. (Lindsay Pierce, Denver Post file)

Cannabist Q&A: treating rheumatoid arthritis, red card renewal, bad breath

Welcome to our Ask The Cannabist column. Clearly you have questions about marijuana, be it a legal concern, a health curiosity, a Colorado-centric inquiry or something more far-reaching. Check out our expansive, 64-question Colorado marijuana FAQ first, and if you’re still curious, email your question to Ask The Cannabist at askthecannabist@gmail.com.

Hey, Cannabist!
I am turning 70.  25 years ago I was diagnosed with rheumatoid arthritis, a condition that is painful and debilitating. I am currently on Remicade (a biologic that I take as an infusion every 6 to 8 weeks). Lately, I have been having severe flare-ups (swollen joints, pain, stiffness and chronic fatigue). My doctor gave me prednisone and Arava. I read the side effects of Arava and I don’t think my body can handle this assault. I have taken the prednisone and the worst thing is I have developed brittle bones from using it. It also exacerbates overactive bladder. Please let me know if there is a marijuana oil that can help me. I am desperate to get relief from the symptoms. I am getting very depressed and I cry every day. –Elder on Evans Ave.

Hey, Elder!
You might find arthritis relief by using topicals — balms, creams, lotions or salves containing marijuana-infused oil.  According to Ah Warner, founder of Cannabis Basics, a Washington state medical marijuana topicals company, topicals can provide relief from arthritis by reducing inflammation.

Topicals do not induce euphoria, so you won’t experience that “high” effect from using a topical. Warner says most topicals do not enter the bloodstream unless it’s specifically designed to do so, like a transdermal patch.

Because your needs are medical, you will want to get a state-issued medical marijuana card. You will need to get a doctor recommendation from either your current physician or a medical marijuana evaluation clinic, like Amarimed or Healthy Choices Unlimited, among others. Healthy Choices Unlimited provides medical dosage recommendations and treatment tracker plans for their patients.

Colorado has a handful of licensed topical companies that manufacture infused products for  medical and recreational marijuana centers. Apothecanna, Dixie, Tincturebelle and Mary Jane’s Medicinals are a few examples of products you’ll find in a medical marijuana center.

Warner pinpoints in her research, the study of medicinal properties has advanced to the point scientists have identified specific plant compounds within marijuana.  The different cannabinoids are being linked to various medicinal  benefits. One of these isolated plant compounds is THCA, a precursor acid form of the most well known and maximized cannabinoid, tetrahydrocannabinol (THC).

According to Warner, THCA is believed to have anti-inflammatory properties and recommends medical marijuana products that contain THCA. Warner also mentions cannabidiol (CBD) as another cannabinoid being touted for its growing anecdotal evidence of medical benefit. A topical or a tincture containing either THCA or CBD is a good starting point. (Tinctures are administered sublingually, under the tongue.)

Some medical marijuana dispensaries like Botanacare offer dosage and result-tracking charts for patient treatment plans, as well as a choice of products for various ailments. Check our Colorado map for dispensaries in your area. Make some calls to find out if they have a patient program, ask about a good time for your first visit and inquire about what kind of topicals and tinctures they stock. XO

Health matters: Why health insurance is still a no-go for medical marijuana

Hey, Cannabist!
I have had a “red card” since 2009 and had a real shocker when I returned to the same doctor as last year to get my card renewed.  This doctor acted like a totally different person. Her questioning was rather odd and basically wanted to know how much and how often I was missing work and what it was that I couldn’t do because of my severe pain. I was rather dumbfounded.  She finally explained that she had to prove to the state that my disability was keeping me from work in order to qualify for the card.  After discussing my issues, she said that I was wasting her time, tore up my app, tossed it in the trash and promptly kicked me out of her office. WTF?

After my head stopped spinning, I figured out what is going on. It’s obvious that the state government has resisted the legalization of marijuana. They purposely jack with any process/action involved. And they have already made public the decline in registry numbers. There is something going on here. They are trying to prove that there were many on the registry that didn’t belong. And by cracking down on the few doctors that are willing to sign off, they will make that number go down.  What do you think? –Ticked on 23rd St.

Hey, Ticked! 
Wow, sounds like you were unprepared for the doctor visit. If you’ve had a medical marijuana card since 2009, maybe you were expecting a rubberstamped easy renewal and were caught off guard by the doctor’s legitimate medical questions.  As a result, the doctor didn’t give you the recommendation. Schedule another appointment, write down notes and talking points, bring any updates to your medical records and be prepared to talk about your health, the condition you utilize medical marijuana to treat and the impact it has on your life.

Although your doctor visit  did not have the outcome you wanted, it’s not part of a state government conspiracy.  The patient numbers on the state medical marijuana registry have actually increased since recreational sales began this year. On Jan. 31, a total of 111,030 people held active red cards, and as of April 30, the most recent date statistics were available, there were 116,180 patients.

Although board-certified doctors who work at medical marijuana evaluation clinics write more patient recommendations,  more than 800 doctors have signed recommendations, showing broader support for medical marijuana in the state.   I think the doctor visit will go differently if you are a prepared patient. XO

Medical views: Why Drs. Gupta, Oz and Besser changed their stance on marijuana

Hey, Cannabist!
I work with a guy who smokes regularly, and you can tell by his breath, which is often foul-smelling (a la halitosis). I mentioned it to him, and he swears he brushes his teeth regularly. But I’ve also read that it’s more about what’s happening inside your body after smoking pot — not inside your mouth — that makes your breath off-base. What recommendations do you have for him and others? Are there prescriptions out there (or anything else) to help improve his situation? –Somebody’s Mother in Westminster

Hey, Somebody’s Mother!
Yikes!  He may brush his teeth regularly, but it sounds like he doesn’t visit the dentist regularly! When you say you’re working with a regular pot smoker, does he smoke pot at work and come back stinking, or do you mean his pot smoking during personal non-working time is creating perpetually foul breath?

If he comes backs stinky from lunchtime, he needs to wash his hands, drink some water to rinse out his mouth and pop a breath mint. It sounds like this is a deeper problem, though, a problem so deep, it might not be marijuana-smoke related.

There is medical knowledge of tobacco smoker’s breath and oral health problems associated with tobacco use, but the same cannot be said for marijuana specifically. That has not been studied and it is not known if marijuana has a similar effect as tobacco in creating smoker’s breath. There may be some commonalities, but we can’t jump to conclusions based on tobacco studies alone.

It will be challenging to broach the subject of your coworker’s bad breath again, but it is important to resolve discreetly. When you bring up the topic either directly or indirectly, make sure you have a private conversation and don’t involve other coworkers. Be sensitive of his feelings and hopefully he can appreciate your concern and take your cue. XO

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