Pubdate: Sun, 11 Dec 2011 Source: Edmonton Journal (CN AB) Copyright: 2011 The Edmonton Journal Contact: http://www.edmontonjournal.com/opinion/letters/letters-to-the-editor.html Website: http://www.edmontonjournal.com/ Details: http://www.mapinc.org/media/134 Author: Jodie Sinnema, Edmonton Journal USERS WHO (REALLY) NEVER INHALE From Capsules to Brownies to Oils and Even Tea, Medical Marijuana Comes in Many Forms for Patients With Low Tolerance For, or Health Concerns About, Smoke Ian Layfield met a man at this year's medical marijuana conference in Toronto who was waving around his federal licence to show people he could legally use 150 grams of pot a day. He seemed quite proud of the fact, Layfield remembered. It seemed obvious the man had many chronic ailments that left him in poor health. But even so, Layfield, who is legally allowed to use nine grams of medical marijuana a day to fight pain from severe arthritis, remained skeptical. "I think the 150 was a PR (public relations) stunt, that anything over 60 grams a day would be a waste," Layfield said from Victoria, where he runs a mailorder marijuana company called MedMe. "I don't even know how you could afford that" - especially given that many people in need of marijuana for medical purposes are on disability pensions for severe pain associated with HIV, arthritis, spinal cord injuries or diseases, cancer or epilepsy. At $5 a gram from the government's marijuana supply, or $8 to $10 a gram at compassion clubs, the man would need $750, $1,200 or $1,500 a day for his weed supply. And that didn't sound possible to Layfield. He believes one patient could use a maximum of 50 grams a day, then would likely sell the rest on the black market to generate income. Health Canada recommends that patients use an average of one to three grams a day, either by inhaling or in brownies, capsules, oils or other baked goods. But between 2001 and 2007, only 777 medical marijuana users were at that level out of a total 3,891 registered with Health Canada. Most - 1,609 people, or 41 per cent - were granted a licence to use five grams a day. One Kelowna, B.C., man born in 1959 was approved to use 56 grams a day for multiple conditions related to spinal cord disease and injury. Given that the government estimates one joint contains 0.5 to one gram of pot, 56 grams seems like a lot of puffing. But David May, head of security at the Medical Compassion Clinic in downtown Toronto, said some patients may need that amount of marijuana because they are converting it from the dried leaf form into caplets or oils which they are better able to ingest. Janice Cyre, 61, has fibromyalgia and lives on a farm outside Edmonton. She can legally use 22 grams of marijuana each day. But she's only allowed to inhale or vaporize three grams a day, and another gram in a homemade cream she can apply to her hip and shoulder when she is in extreme pain. She steeps the last 18 grams in tea, making six cups of three grams each. That, she explains, reduces the level of Delta 9 THC in the pot - - a cannabinoid that bursts when its heated in a joint, bringing the typical high and euphoria with it - and gives her better access to the anti-inflammatories and other cannabinoids in the pot. People with HIV, AIDS, hepatitis C and lung cancer can't smoke joints or pipes because the plant matter burns their lungs, May said. They may place their dried marijuana into special machines that spin and tumble the leaves and buds and allow the trichome crystals on the plant to fall into a glass underneath. The crystals - which hold much of the Tetrahydrocannabinol or THC, the main active substance in the cannabis plant - can then be ingested in capsule form. But May said 10 to 14 grams of dried marijuana is needed to make one edible capsule, which can supply pain relief for a long time. So someone allowed to use 56 grams of pot each day might be using it to make just five or six capsules. "A lot of people who cannot smoke anymore will only use the trichomes," May said. "They won't even use the plant anymore, and that's why their numbers (per daily dosage) are so high." About 28 grams of pot are needed to make one gram of oil, May said. That can be used for baking. One pinhead of oil - equivalent to one joint, May said - can be spread on rolling paper or dabbed onto a metal pad in a pipe. "It's pure. It's a lot cleaner and it works better," he said. "A lot of people are getting away from smoking because smoking is bad and everybody knows it, so everybody is trying to move into different ways of consuming it without hurting themselves." But that also puts compassion clubs in a pickle. While individual users are allowed to convert dried leaves into other forms of medication for themselves, Canadian law makes it illegal for them to sell the capsules or oils. Edmonton's compassion club sells only dried leaves and usually only one or two different strains at a time. Others, such as the B.C. Compassion Club Society in Vancouver - the oldest and largest in Canada - sell half cups of butter or jars of cannabis-infused pesto for $15. Olive oils, baked gingersnap cookies - three for $7 - and alcohol tinctures or drops for under the tongue or in tea are available as well as dozens of leaf strains. Lengthy menus of Blueberry, Bella or Sugar Shack marijuana describe "spicy," "smooth" or "resinous" tastes and frosty nuggets that specifically target nausea or pain, or give people energy or help them sleep. May said most people don't have the chemistry expertise or the money to convert their marijuana leaves into other forms. Machines such as vaporizers, which convert the buds into vapours rather than smoke, cost between $200 and $1,000. "That's why compassion clinics exist now to teach people how to learn it better, do it healthier," May said from Toronto. "A tincture is what the Royal Family has been using for over 200 years. That's the recipe we use, the Royal Recipe." Yet Isaac Oommen, communications co-ordinator for the B.C. Compassion Club, said his club sells a maximum of 15 grams of marijuana a day to each patient. Dr. Brian Knight is an anesthetist and pain physician in Edmonton. The highest daily dosage he has prescribed is 10 grams a day, though he usually begins at two grams. People in the industry agree: Patients should start with small doses, and if they are ingesting rather than inhaling marijuana, they need to give themselves more time to feel the effects. In the end, prescriptions have to be personalized. Someone with chronic epileptic seizures may need 56 grams of marijuana a day to keep control of their body. "I've seen this do miracles for people," May said. "I've seen people come off crack cocaine. I've seen people with Tourette syndrome that were totally dysfunctional, totally functional now. They actually want to go to university." - ------------------------------------------------------------ [sidebar] Alberta statistics (2001 - 07) - - Highest dose: 20 grams per day, for patient with multiple sclerosis - - Smallest dose: 0.1 grams per day, for patient with multiple sclerosis - - Most common dose: 5 grams a day Who is doing the most prescribing? - - General practitioners accounted for 103 prescriptions - - Physicians in neurology accounted for 94 prescriptions - - Psychiatrists wrote 68 prescriptions 378 Albertans are registered with Health Canada to use medical marijuana: - - Males: 236 - - Females: 140 - - Unknown: 2 - - Edmonton: 149 patients - - Calgary: 49 patients At end of 2007: - - Oldest: 81 - - Youngest: 18 - --- MAP posted-by: Richard R Smith Jr.