Accurate Education - LA Marijuana Products - Selecting Flower Products

LA Marijuana Products:

Selecting Flower Products

Marijuana plant flowers and buds are now available for medicinal use. As the number of different marijuana strains continues to grow, it is becoming somewhat problematic when attempting to select the right strain for ones therapeutic goals.

To facilitate making the best choice, please read the following sections first:

Cannabis Clinical Application

Marijuana (Cannabis):

Chronic Pain Overview
Fibromyalgia
Anxiety (coming soon)
Headaches (coming soon)
Inflammatory Bowel Disease (coming soon)
Neuroinflammation (coming soon)
Sleep (coming soon)

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Links to other Pertinent Educational Pages:

Links to ALL Marijuana Educational Pages

The medical information on this site is provided as a resource for information only, and is not to be used or relied upon for any diagnostic or treatment purposes and is not intended to create any patient-physician relationship. Readers are advised to seek professional medical guidance regarding the diagnosis and treatment of their medical concerns.

Key to Links:

Grey text – handout
Red text – another page on this website
Blue text – Journal publication

First, a reminder: vaping flower is preferred to smoking flower. It is healthier and is a more efficient means of extracting THC and terpenes from the flower, allowing for almost twice as much content per puff.

See: Smoking vs Vaping

Choosing natural flower products over other forms of cannabis

The choice of using natural marijuana flowers as the formulation for therapeutic use instead of vape cartridges, tinctures and edibles has advantages over these other formulations beyond simply being more affordable. Because the flowers have not been processed they contain all of the more than 100 pharmacologically active constituents typically associated with the particular strain of the flower. It is believed that the ultimate therapeutic benefits related to marijuana are determined not solely by the singular constituents’ independent effects but instead they are determined by the synergy of all, or at least many, of the constituents acting together, known as the “Entourage Effect.” The distillates processed for vaping or tinctures are selectively limited and may not contain the optimal constituent profile to achieve the desired therapeutic benefits. Additionally, the carrier oils used to manufacture the vape cartridges are also being inhaled yet they offer no benefits of their own and may potentially contribute to detrimental side effects. Other vape products on the market for recreational purposes have been associated with safety concerns.

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Selecting the Individual Flower Product for Personal Needs

Remember, the three components of marijuana that primarily determine its therapeutic benefit are THC, CBD and the terpenes. While other components found in cannabis likely do play a role in benefits, including CBG and other cannabinoids and flavonoids, they are not likely to enter into the decision making of selecting a flower due to a lack of information regarding them.

Of these, CBD is not present in any of the flowers so it’s content does not come into the decision making. THC is present in all of them, some more than others, so sometimes the amount of THC comes into play. But largely it is the difference in terpene content that distinguishes one flower strain from another. Therefore it is important to evaluate the terpene profile present in a strain to predict the choice of flower stain most likely to meet personal needs. To learn which of each of these components offer benefits for pain, anxiety and sleep, please review “Introductory Principles“ before proceeding.

Regarding the cannabinoid and terpene profiles reported for the flowers, it should be noted that the relative content and percentages indicated will vary with growing conditions and from grower to grower as well as from crop to crop with the same grower. In the LA medical marijuana industry, however, the plants are cloned and grown in essentially the same conditions for every batch. According to the grower, there is no greater than 15% variability from one batch to another. This constituent consistency is an important advantage over buying illicit-source marijuana products or even commercially available products in marijuana-legal states.

The reported profiles are provided to allow for ballpark predictions of constituent contents. Constituents with content of 0.05% or greater are purportedly considered to be potentially significant. The information available on this website for the terpenes remains limited at this time but more is added frequently, please check back.

See: Terpenes, an Overview

While there are many terpenes present in the different flower strains, the following summary list represents the most common and the most relevant:

Caryophyllene is a powerful anti-inflammatory and in especially effective against neuro-inflammation and neuropathic (nerve) pain.
Humulene helps pain and is a strongly anti-inflammatory
Limonene reduces anxiety, is sedating and is synergistic with CBD for these benefits. It is also an antioxidant and may help oxidative stress
Myrcene is sedating, aids insomnia and reduces anxiety. It also helps pain, reduces inflammation and is a muscle relaxant.
Pinene has anti-inflammatory and analgesic benefits along with sedative, hypnotic, and anxiolytic properties
Terpinolene is purported to be sedating and calming,

Decision Points

Since it is impossible at this time to provide completely accurate and reliable, specific identifications as to which flower is best for any specific therapeutic goal, one can make predictions based on two methods only:

(1) Predictions based on how much and which constituents are present in the flower (when they are known)

This page offers guidance based on what is known about the therapeutic benefits believed to be associated with specific constituents, with the caveat that our knowledge of the pharmacology of all known constituents remains in its infancy

(2) Predictions based on the experiences of others (if they are accurate)

Learning what other people say or believe about their experience with a particular flower strain is most reliable when there are large numbers of opinions tallied for review and when opinions are as unbiased as possible and not associated with someone attempting to sell the flower product. Resources for these reviews potentially include informed pharmacists at the designated marijuana dispensary pharmacies and popular websites such as www.Leafly.com and www.AllBud,com. When available, a summary of these reviews is included in the description of each flower strain summarized on the section: LA Marijuana Products: Flower Products.

Ultimately, in the final analysis it often boils down to trial and error to gain experience with any particular strain to assess its benefits for any individual. Individuals may have their own unique response to a given strain and predictions based on cannabinoid and/or terpene profiles cannot be relied upon but only used to provide suggestive guidance.

THC

Although all strains have THC, some have more than others, so the strains with more THC may offer greater benefit, again depending also on their terpene content. Benefits generally ascribed to THC include analgesia, relaxation, sleep and anti-nausea. But the higher the THC content, also the more likely the strain will trigger anxiety and paranoia. It is recommended that relatively inexperienced users start with lower THC dosing at less than 20% THC content to avoid side effects and only experienced long-term marijuana users should turn to flowers with THC content >20%.

Flower strains with THC content of less than 20%:

- Grease Monkey (THC 17-22%)
- Lilac Diesel (THC 13.%)
- Mandarin Zkittles (THC 11%)
- Lumpy Space Princess (THC 19%)

Flower strains with THC content of greater than or equal to 20%:

- Grease Monkey (THC 17-22%)
- Mandarin Cookies (THC 25%)
- Pillow Factory (THC 21%)
- Planet of the Grapes (THC 27%)

Adding THC with a THC-only tincture

The use of supplemental THC-only tincture offers a longer duration dose of THC to improve pain, stress and relaxation, thus allowing less frequent need for smoking or vaping as break-through doses. Adding more isolated THC however may add more psychoactive side effects, including anxiety or paranoia.

Another consideration is that the use of an oral tincture is not just longer-lasting but it involves the metabolism of THC to 11-hydroxy THC by the liver before entering the blood. The 11-hydroxy THC may provide enhanced analgesic or other therapeutic benefits compared to inhaled THC and/or less side effects. However, more THC will contribute to greater tolerance to the benefits of THC.

Terpenes

Since none of the flower strains have CBD and all of the flower strains have THC, it is the terpene profile that likely provides the most therapeutic distinction from one strain to another. The terpene profile of a selected flower may not be optimal for one’s desired therapeutic goals. If one prefers greater therapeutic results than perceived with a particular strain, it is recommended to rotate to a different strain with a more beneficial therapeutic terpene profile rather than simply turning to a different strain with more THC. Or, another alternative is to add additional terpenes.

Adding Specific Terpenes

Anxiety

Supplementing with specific terpenes targeting specific symptoms is currently limited primarily by a lack of existing knowledge regarding terpenes. For anxiety, one specific product of terpenes can be recommended for supplementation, CalmAid – an inexpensive OTC product containing the terpenes linalool and limonene derived from lavender oil which has good evidence for benefit for anxiety. It is commonly available at pharmacies and on the internet, costing $10-15 for a month supply.

Flower strains with higher content of linalool and/or limonene:

- Lumpy Space Princess (Linalool (0.03%), Limonene (0.19%)
- Grease Monkey (Linalool (0.06%), Limonene (0.15%)
- Mandarin Cookies (Linalool (0.04%). Limonene (0.15%)
- Pillow Factory (terpene profile not available, Limonene listed as dominant)

Pain and Inflammation

The terpene β-caryophyllene may be an advisable supplement for pain and inflammation. A topical CBD-rich supplement with β-caryophyllene is effective for pain, including pain induced by cold weather. Oral supplements of β-caryophyllene isolates are available and may be beneficial, but specific products or doses cannot be recommended at this time.

Flower strains with higher content of β-caryophyllene:

- Grease Monkey (0.23%)
- Mandarin Cookies (0.24%)
- Lumpy Space Princess (LSP) (0.12%)
- Lilac Diesel (0.1%)
- Planet of the Grapes (percentage not available, β-caryophyllene listed as dominant)
- Mandarin Zkittles (percentage not available, β-caryophyllene listed as dominant)

Sedation

Because THC can be sedating, all strains offer sedation as a potential benefit. However, the terpene myrcene is known to be potentially very sedating and anxiolytic. Strains that contain 0.5% or more of myrcene are usually indicas with sedative and anxiolytic effects. It is thought to be the component mostly responsible for “couch lock,” the term for heavy sedation associated with marijuana use.

Flower strains with higher content of myrcene:

- Lumpy Space Princess (0.46%)
- Grease Monkey (0.31%)
- Mandarin Cookies (0.23%)
- Pillow Factory (percentage not available, but listed as a dominant terpene)

CBD

Also, remember that THC works better when accompanied by CBD, which is NOT PRESENT in significant amounts in any of the flowers offered. If one prefers greater therapeutic results than perceived with a particular flower strain, it is recommended to first seriously consider supplementing use of the flower with a source of CBD, preferably one with a good terpene profile as well.

Adding CBD with terpenes

The use of supplemental CBD with terpenes may be less expensive than increasing a dose of a THC-based formulation. The additional CBD and terpenes will supplement the pain benefits of the THC and terpenes in the flower while also adding anxiety and sleep benefits. Additionally, the CBD may reduce any anxiety triggered by the flower’s THC. Oral dosing of CBD for treating anxiety ranges from 10 mg to 200 mg and sometimes even up to 500 mg/day.

Selection of a CBD/terpene product can be challenging since identifying the terpenes and their amounts in a product is often difficult or impossible unless one can obtain a certificate of analysis of the product from the manufacturer. The best commercial products currently recommended that are highly concentrated with both CBD and a terpene profile that is excellent for pain, anxiety and sleep, are the CBD tinctures carried by CarolinaCannabinoids.US,

CBD formulations with No THC

Included in the CarolinaCannabinoids line of products are those that provide broad spectrum formulations (with no THC) and 30 mg CBD/ml, with a full profile of terpenes high in BCP and beneficial for pain, anxiety and sleep.

Full spectrum CBD formulations (with <0.3% THC)

In addition, CarolinaCannabinoids offers full spectrum formulations (with <0.3% THC) that contain 100-200 mg CBD/ml. Importantly, these stronger formulations also utilize a Self Micro Emulsifying Delivery System (SMEDS) that enhances the bio-availability of all the included cannabinoids and terpenes, including CBDA and β-caryophyllene.

These water-soluble formulations contain 3000 mg or 6000 mg/CBD per 30 ml bottles. Although they are somewhat expensive with initial purchase, their high concentrations will likely allow for multiple months use from just one bottle. Also, because of their THC content they may trigger a positive drug screen for marijuana use.

CBD from Hemp

If one simply cannot abide the use of liquid tinctures because of their taste, one can purchase hemp flower with high content of CBD, up to 20% or more, which can be blended with the cannabis flower for inhaling. The terpene content of most hemp is generally limited but one should look for the best terpene profile available. It is recommended to at least match the THC content of the flower with an equal amount of CBD from the hemp for pain benefits and even higher CBD content for anxiety and sleep benefits. Hemp flowers are available over the counter at CBD shops but, unfortunately, are not yet carried by the designated marijuana dispensary pharmacies in Louisiana.

Based on the anecdotal information currently available, the following recommendations can be made for choosing which flower to try:

Grease Monkey if pain is your main concern
Mandarin Zkittles if sleep is a dominant concern
Mandarin Cookies if anxiety and/or depression are dominant concerns
Lilac Diesel may be best for feeling happy, relaxed and uplifting one’s mood while offering some pain benefit
Lumpy Space Princess appears to mostly offer an uplifting effect, with an energizing euphoria rather than relaxation, but it does not seem to stand out for pain benefit.
Planet of the Grapes should be avoided by the inexperienced or those sensitive to the side effects of THC

All strains should provide relaxation, except Lumpy Space Princess which is more energizing, and all should provide some pain benefit.

Resources:

National Academy of Sciences

The Health Effects of Cannabis and Cannabinoids: The Current State of Evidence and Recommendations for Research

These lay-person websites appear to be good resources for exploring medical marijuana:

References:

Medical Marijuana – Dosing

Medical Marijuana – Louisiana Law

Cannabidiol (CBD)- Overviews

CBD – Anxiety

CBD – Interaction with THC

CBD – Metabolites

Human Metabolites of Cannabidiol – A Review on Their Formation, Biological Activity, and Relevance in Therapy – 2016

CBD – Drug-Metabolic Interactions

Medical Marijuana – Prescribing Guidelines

Medical Marijuana – Opioids

Medical Marijuana, Chronic Pain – Cannabinoids & Palmitoylethanolamide

Medical Marijuana –Misc

Medical Marijuana – Products

Medical Marijuana – Product Evaluation

Medical Marijuana – Flower/Bud Products

Wellcana (Good Day Farm):

Medical Marijuana – Topical Products

Emphasis on Education

Accurate Clinic promotes patient education as the foundation of it’s medical care. In Dr. Ehlenberger’s integrative approach to patient care, including conventional and complementary and alternative medical (CAM) treatments, he may encourage or provide advice about the use of supplements. However, the specifics of choice of supplement, dosing and duration of treatment should be individualized through discussion with Dr. Ehlenberger. The following information and reference articles are presented to provide the reader with some of the latest research to facilitate evidence-based, informed decisions regarding the use of conventional as well as CAM treatments.

For medical-legal reasons, access to these links is limited to patients enrolled in an Accurate Clinic medical program.

Should you wish more information regarding any of the subjects listed – or not listed – here, please contact Dr. Ehlenberger. He has literally thousands of published articles to share on hundreds of topics associated with pain management, weight loss, nutrition, addiction recovery and emergency medicine. It would take years for you to read them, as it did him.

For more information, please contact Accurate Clinic.

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Accurate Education – LA Marijuana Products – Selecting Flower Products