Mississippi medical marijuana dispensaries started opening in January 2023 in the industry expected to bring in millions of dollars in revenue while providing patients with options for treating a wide variety of health conditions. Pain, Crohn’s disease, ulcerative colitis, Parkinson’s disease and post-traumatic stress disorder are said to benefit from marijuana. After obtaining a medical marijuana card, patients can make informed choices about what delivery methods and strains of marijuana will work best.
Ken Newburger, executive director, Mississippi Medical Marijuana Association, said most of the new dispensaries in Mississippi are reporting that the majority of their patients are over 50, and not sure what products will be most helpful for their medical conditions.
“The dispensaries want their employees to be able to talk intelligently to patients to help them navigate that,” Newburger said. “Right now, the industry is just getting off the ground, and not all types of products that are permitted under the law are being manufactured in Mississippi. It will take some time for the industry to have all the different types of products available.”
Patients who take time to educate themselves are going to be ahead of the game, according to Gustin Tubbs, who has been involved in starting about 40 different medical and recreational businesses in 16 states and three countries.
There are several different types of inhalable products. Tubbs said an advantage of inhalables is that you can better determine the correct dosages, and results are almost immediate. In addition to the raw bud, which can be vaporized with an inhaler, smoked in a pipe or rolled into a joint, other inhalable options are raw concentrates and dabs that can be smoked in a rig or inhaled with a vape pen.
“Dabs are probably the most potent form of inhalables,” Tubbs said. “Dabs and concentrates are to be approached with caution. If your threshold isn’t high enough that you need to take a dab, don’t take a dab because it will ruin your day.”
Liquid in cartridges used with a vape pen are a favored by many because they are easy to use, convenient and contain high amounts of Tetrahydrocannabinol (THC), the most psychoactive ingredient in cannabis. Some people find only one or two hits are necessary. The cartridge provides vaporization so there is no need to use a match or lighter.
Tubbs said if you have any respiratory issues like asthma, avoid inhalables.
“The cannabis products are transferred from liquid to vapor without combustion,” Tubbs said. “A benefit of the concentrates is they strip out a lot of the waste. There are none of the cannabis fats and acids, things you don’t necessarily want. They aren’t as stinky. With the inhaler, you are getting the most strain-specific and the full-spectrum benefits. Be cautious when you inhale because you don’t want to have a coughing fit. Go low and slow until you know with any form of cannabis.”
Edibles are a category preferred by people who want a more long-lasting effect. The impact of smoking cannabis is usually an hour or two while edibles can last up to eight hours or even longer, depending on the person.
“Digestion is actually quite an effective method, but the enzyme synthesis changes the active compound, which creates a less strain-specific, more ‘all around’ effect people can find more potent, but also more useful to some conditions,” Tubbs said. “You can build up tolerance to any form of ingestion, but some people’s natural tolerances can be high, especially to edibles. People may need a higher dose of edibles to get the same effect as inhalables. That impacts cost effectiveness. If you are taking 20 to 30 milligrams of THC in edibles per day, it starts to get expensive.”
While some people use cannabis for the feelings of relaxation or euphoria, others find the most compelling reason to use cannabis is to reduce or eliminate pain without using stronger drugs like opiates that have potential for addiction and are the leading cause of overdose deaths in the U.S.
The industry standard is 10 mg doses whether it comes in a gummy, a piece of chocolate, a pill or tincture. Tubbs said many people find that dose too high. He recommends starting with a 2.5 mg microdose dose that can provide medical properties without making you high. People can go up to 5 or 10, if necessary.
“A benefit of edibles is they provide a more full-body, rounded benefit of psychoactive and physical effects,” Tubbs said. “They also last a long time. For people with conditions that need benefit through the day or night, an edible is the way to go.”
Most dispensaries have a lot of information about products online including whether it is cannabis sativa, cannabis indica or a hybrid. Other information includes the amount of THC and (Cannabidiol) CBD, which is not psychoactive but is believed to have medicinal qualities.
For a long time, cannabis sativa has been described as the more energetic strain while cannabis indica is more relaxing.
“Indica and sativa are botanical terms that were marketed to have a specific benefit for a long time, which was useful for patients,” Tubbs said. “But the industry has educated itself past thinking that indica or sativa necessarily indicates what type of effect to expect. Nor can you tell much by strain names. For example, sour diesel is the name of a specific lineage. But you don’t know if the sour diesel you purchase today is the same as the sour diesel at the shop next door. My brother and I have the same genetics but are very different people. There is genetic drifting in cannabis plants. As a strain gets older, it tends to change properties. No one really knows what genetics they have.”
Tubbs said that just concentrating on getting the highest THC content could mean people are robbing themselves of the best strains for their health condition. Some information that can be used includes test results looking at the ratio of cannabinoids and terpenes, which are essential oils that can have added benefits.
“With inhalables, you can smell a cannabis product’s terpenes and associate a certain smell with the effect it has on you,” Tubbs said. “Terpene smells people are familiar with include citrus, pine, clove and lavender. THC is the gas pedal, and all the other compounds are your steering wheel. Use the odor of the cannabis product to get past just looking at the THC percentage.”
Suppositories are considered effective for people with colon cancer, IBS, lower back pain and Crohn’s disease.
If you do get too much of a cannabis product, and start feeling anxious and uncomfortable, Tubbs said to remember it is not going to kill you.
“You might think you need to go to the hospital, but the hospital can’t do anything about it,” he said. “You can push through it. Although it is counterintuitive, CBD is known to counteract the effects of a negative THC high.”
Another tip is that while gummies are popular, some people prefer cannabis pills that don’t have any sugar.
“There is less chance of an overdose with a capsule,” Tubb said. “Edibles usually take effect in 45 minutes but can take up to two hours. If you feel you aren’t getting a benefit, you might eat another piece of chocolate bark, but you aren’t likely to take another pill. Also, this is a method that is more comfortable for people new to the industry. Grandma is used to taking pills. Throw a THC capsule in there and she doesn’t feel she is doing anything different.”
Regarding recommendations for which products are best for certain health conditions, that can be hard to know.
“There has not been enough credible research and there are no government certifications, plus there is a lot of individual variation,” Tubbs said. “You can work with an experienced doctor or a budtender with some knowledge, and you will start out in a better place.”
Tubbs said Mississippi is later to the market than many states but has a more competitive marketplace and is more industry and patient friendly than some other states.
A percentage of the population can have adverse reactions to even small amounts of cannabis. Others can inadvertently ingest too much. In both cases, cannabis can be very disorienting and even have hallucinogenic properties. It is common for people to end up in emergency rooms when they have this kind of reaction. People’s tolerance will vary. Caution is advised.
[Editor’s Note: Article originally published July 10 in the Mississippi Business Journal. Gustin Tubbs, the expert quoted, is a former resident of Eureka Springs.]