I am a medical cannabis patient in Michigan and I use cannabis to treat painful neuropathy in my legs. I need to use cannabis every few hours to keep the pain levels down. I was working from home, which allowed me to do this easily. However, I was recently promoted (yeah!) but the catch is that now I have to work in an office setting. My boss is very understanding and said that she does not have a problem with me using cannabis during the day as needed for pain, but the office building has a no smoking policy and she said I will not be able to consume my cannabis via smoking. I am nervous about edibles because I have heard they are really strong and I know there are vape pens but there are so many, I don’t know where to start. Do you have any advice?
Employed in the Motor City
Congratulations on your promotion! Anti-smoking policies are a common barrier for medical cannabis patients who need to use their medicine out and about during the day. Fortunately, there are many options available besides smoking that patients can take advantage of.
Edible preparations, such as food or tinctures, are great because they are easy to transport, usually do not have a cannabis odor and can be consumed anywhere, even sitting at your desk, like any other medication.
You are correct that titrating your dose can be difficult. This is because, unlike smoking, edible effects take longer for you to feel them. So, you might end up taking more than intended waiting for the effect to happen.
There are ways to improve the safety of using edibles. It is wise to start with a very small piece or amount of liquid tincture, and then wait at least two hours before taking more. A good dose to begin with is no more than 5-10 mg of THC. You can increase the dose when you know more about how the product affects you.
You might also want to ingest cannabis in this way for the first time over the weekend at home, or when you are not at work, until you know the appropriate dose for you.
An easy alternative to smoking for many patients is vaporization, which involves heating the plant matter or extract to a temperature at which the active ingredients are released as a vapor. Patients like vaporization because it allows them to titrate their dose, they feel the effect right away, and it can reduce the harms associated with inhaling burnt organic matter into the lungs.
In terms of vaporizers that you can take with you, the vape pen has emerged as the go-to travel device for medical cannabis patients. There are two types of vape pens: ones that you fill with your own oil or herb, and pens that use pre-filled oil cartridges that you can throw away. Many newer patients and naïve users prefer the pre filled cartridges for ease of use. However, be aware that some additives in pre-filled cartridges are known to cause some long term health issues, and have not been evaluated for long-term use by medical cannabis patients.
Patients are advised to seek out cartridges that do not contain additives, or to use pens that can be manually filled by the patient with their own oil or herb.
Another preparation that does not get as much attention are topical preparations. Products such as creams and salves can provide relief for localized pain and spasms without any intoxication. You can also apply these products anywhere, so they are great for the workplace.
However, because they target localized pain, join and muscle activity, they might not be as effective for neuropathic pain, which is not localized, and is more related to neuro pain signaling than local function. That being said, it is a low risk treatment to try.
There is a still a need to push for employment protections for medical cannabis patients. You are lucky to have an understanding boss. Most patients are not protected from employment discrimination. Most patients are trying to maintain employment, and accommodations should be made similarly to the allowances for the use of other medications on the job.
I wish you the best of luck in your new position!
Amanda Reiman, PhD, holds a doctorate in Social Welfare and teaches classes on drug policy at the University of California-Berkeley.
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