Category: Education

Cannabidiol (CBD) and delta-9-tetrahydrocannabinol (THC) are the two major cannabinoids found in the Cannabis Sativa plant. In recent years, CBD has been more widely discussed as preclinical and clinical studies suggest its therapeutic use across multiple conditions. 

 

A published 2018 study sought to understand why consumers were flocking toward CBD products. It found that nearly 62% of CBD users reported using it to treat a medical condition. The odds of using CBD for these reasons was greater among non-regular users of cannabis than among regular users. 

 

The regular cannabis user, who leans towards THC products of various strains may question: why add CBD to my current regimen? While it may not be for everyone, here are some reasons why you might want to consider it. 

 

CBD + THC: Synergistic benefits 

 

CBD and THC have researched benefits of their own. They also have benefits that may be amplified when administered in combination or that are complementary to one another. There is evidence to suggest that the observed therapeutic properties of THC are not solely dependent on the presence of THC, rather the interplay of phytocannabinoids. These cannabinoid combinations may mitigate side effects or improve the therapeutic activity of THC. 

 

A recent study examined effects of THC-dominant cannabis, CBD-dominant cannabis, and THC/CBD-equivalent cannabis on self-reported anxiety among 26 healthy recreational cannabis users. It was found that, when baseline anxiety was low, CBD completely counteracted THC-induced anxiety. In conclusion, the study showed that THC/CBD-equivalent cannabis induces less state anxiety than THC-dominant cannabis.  

 

THC and CBD are both known for their anti-inflammatory, antioxidant, and sleep benefits. It has also been proposed in research that targeting both cannabinoid anti-tumor pathways simultaneously, by combining THC and CBD, may lead to enhanced anti-tumor activity. Therefore, when taken in tandem, benefits may be realized more noticeably and/or at lower administration levels. Researchers believe that while they have impressive benefits on their own, they are best when they are taken in such a way that more closely resembles the plant’s natural state (taken together along with other minor cannabinoids, terpenes, and flavonoids). This synergy between the compounds in cannabis is commonly referred to as the entourage effect. 

 

CBD is a negative-allosteric modulator (NAM)

 

Within our endocannabinoid systems (ECS) are cannabinoid receptors CB1 and CB2. CB1 receptors are expressed in high levels throughout the central nervous system. THC binds to and activates CB1 and CB2 receptors. This action may have several therapeutic benefits for regulation of homeostasis. For example, activation of CB1 receptors may lead to an induction of sleep and activation of CB2 receptors can produce anti-inflammatory effects. 

 

CBD is known to modulate the activity of receptors throughout the brain and body. It has long been proposed to reduce or block THC-associated euphoria. The ability of CBD to inhibit CB1 signaling, observed in one study, offers a potential mechanism for the reduction of select, unwanted THC side effects. 

 

It is the same action of CBD that might contribute to its medicinal value. The negative allosteric modulation of CB2 activity by CBD might explain its action as an anti-seizure as well as benefits for other neural disorders. 

 

CBD’s role in the brain’s hippocampus

 

A study published in 2019 looked at the counteractive effects CBD could have on the intoxicating side-effects of THC. They looked to the hippocampus, as the ventral hippocampus is responsible for emotional arousal through dopamine neuronal activity states. 

 

Despite the complexity of cannabis, there is increasing evidence to suggest differing effects of THC and CBD, as they relate to euphoric effects. THC may induce dysregulation of subcortical dopamine transmission; therefore, when used at increased concentrations, may lead to short-term side effects to include anxiety, perceptual changes, disorientation, nausea, and/or headache. CBD normalizes dopamine signaling and regulates affective stimulus processing, therefore possesses antipsychotic and antianxiety properties. 

 

Researchers in this study demonstrated that THC induced cognitive abnormalities resembling neuropsychiatric symptoms in the hippocampus, while dysregulating dopamine activity states by modulation of the extracellular signal-regulated kinase (ERK) signaling pathway. Comparatively, when coadministered with THC, CBD blocked the THC-induced ERK activity and prevented the THC-induced behavioral and neural abnormalities. The findings illustrate how the CBD molecule’s mechanism of action can mitigate side effects of THC. 

 

How do I incorporate CBD into my cannabis regimen?

 

If you are looking for ways to enhance your current regimen by incorporating CBD, the first thing you can do is find a product to complement what you are already doing. The Realm of Caring is here for free guidance on understanding the additional, potential benefits as well as souring a quality product. You can reach our care team by calling 719-347-5400, emailing info@realmofcaring.org or scheduling an appointment. 

 

When you are visiting your local dispensary, you can also keep an eye out for ratios. A cannabis product with a ratio on it is indicating the concentration of one cannabinoid to the other. Most often this will be a CBD to THC ratio, but more recently we have seen additional, minor cannabinoids represented in this way. Having more weight on the CBD or THC side depends on the outcome you desire. Again, our care team is here to help you navigate so you can step up to your dispensary counter feeling more confident in the decisions you are about to make for your health. Connect with us today! 

 

Breast cancer is the most common cancer in women worldwide. Despite advances in early detection, it remains the second leading cause of cancer death in American women, mostly attributed to drug-resistant refractory tumors. 

 

A study published this year showed that out of 612 participants, 42% reported use of cannabis for relief of symptoms and 49% believed cannabis could be used to treat cancer itself. In recent years, as the legalization of cannabis expands, cannabis and the endocannabinoid system have increasingly become topics of interest for the treatment of various conditions. 

 

The dysregulation of our endocannabinoid system has been associated with several diseases, including cancers. Evidence reveals that the endocannabinoid system is altered in breast cancer. An increasing number of studies also highlight the role that cannabinoids have in cancer spreading. Specifically these report on invasion, angiogenesis, migration, and metastasis. 

 

The Endocannabinoid System (ECS)

 

Our ECS is the largest neurotransmitter system in the body composed of endocannabinoids, cannabinoid receptors, and metabolizing enzymes. Endocannabinoids are arguably one of the most widespread and versatile signaling molecules known to man; two key endocannabinoids that have been identified are Anandamide (AEA) and 2-Arachidonoylglycerol (2-AG). The endocannabinoids activate different receptors throughout the body and brain called CB1 and CB2 receptors. CB1 receptors are found in high levels in the brain and central nervous system; whereas CB2 receptors are found in numerous immune cells and the peripheral nervous system. 

 

Modulation and activation of the cannabinoid receptors by these endocannabinoids can have various effects within the body. It is likely that endocannabinoids impact several cancer-related signaling pathways. For example, AEA has been shown to inhibit breast cancer cell growth and migration in multiple mouse model studies. It is known that in breast cancer, CB2 receptors are over-expressed and CB1 is present in lower quantities

 

Findings of the endocannabinoid system have inspired further studies to take place with exogenous or phytocannabinoids, that mimic the actions of endogenous cannabinoids and their interactions with cannabinoid receptors. 

 

Anti-tumoral Effects

 

Most existing cancer therapies are not developed to specifically target metastatic progression, despite tumor metastasis accounting for 90% of cancer-related deaths. Breast cancer, in particular, has been noted as typically incurable once clinically apparent metastases develop, therefore there is a need for non-toxic therapeutic interventions to target this progression. 

 

There has been compelling evidence of the anti-tumoral activity of cannabinoids in preclinical models of breast cancer, both witnessed in cell culture systems and clinically relevant animal models. In recent years, the two most abundant cannabinoids found in Cannabis sativa, cannabidiol (CBD) and delta-9-tetrahydrocannabinol (THC), have been more closely studied for their anti-tumor activity against a variety of aggressive cancers, with each compound having its own unique mechanism of action. It has been proposed in research that targeting both cannabinoid anti-tumor pathways simultaneously, by combining THC and CBD, may lead to enhanced anti-tumor activity.

 

A study published in the British Journal of Pharmacology in 2014, demonstrated that moderate doses of CBD were effective at inhibiting metastatic progression in female mice, leading to prolonged survival in multiple preclinical models of breast cancer. This study also discovered that while moderate doses of CBD could have this inhibiting effect, higher doses were required to inhibit tumor growth. 

 

Although the strength of experimental data is different for each case, evidence obtained so far suggests that cannabinoid therapies may be useful for these breast cancer subtypes:

 

Hormone-sensitive (ER+ / PR+)

HER2-positive 

Triple-negative 

 

Cell Death and Cell Growth

 

Apoptosis is a form of programmed cell death. Apoptosis in cancer aids specifically in cancer cell death. This activity is well documented across several cancer models while undergoing cannabinoid therapy. Published research from 2011 shows that CBD induced not only apoptosis but also autophagy-induced death in breast cancer cells. CBD was shown to preferentially target breast cancer cells by inducing estrogen receptor (ER) stress and enhancing reactive oxygen species (ROS). 

 

Another study published in 2006 explains that CBD exerts its effects on these cells through a combination of mechanisms that include either direct or indirect activation of CB2 and TRPV1 receptors and induction of oxidative stress, which may all contribute to induce apoptosis.

 

Antiproliferation is the suppression of cell growth. Data gathered in 2015 for the American Association for Cancer Research studied the effects of CBD, THC, CBN, and CBG on proliferation of breast cancer cells. Among the tested, CBD was the most potent inhibitor of human breast cancer cell aggressiveness.

 

Considering other cannabinoids

 

When it comes to cancer models, the anticancer activity of CBDA was investigated on acute lymphocytic leukemia, promyelocytic leukemia cells, and human prostate carcinoma androgen receptor positive cells. CBDA was found to be less active than CBD for all of these, until tested towards MDA-MB-231 cells, a highly aggressive triple negative breast cancer. CBDA was found to inhibit breast cancer cell migration. The data in the report showed that CBDA offers “potential therapeutic modality in the abrogation of cancer cell migration, including aggressive breast cancers”.

 

Initial findings in literature and research show CBG potential as a therapeutic agent in helping slow the proliferation of breast cancer cells, therefore possibly lessening tumor severity. CBG may also be useful as an anti-emetic or anti-inflammatory to complement traditional cancer treatments. 

 

Terpenes and Flavonoids

 

Terpenes are compounds found in all known life forms, including fruits, trees, herbs, and a range of other plant species that are responsible for determining their distinct scents. There is a complex diversity and varying concentration of terpenes in cannabis plants. Yet, quality research is available in regard to terpene-specific benefits, although not all research is available in living models as of yet. B-Caryophyllene, limonene, pinene, linalool, bisabolol, humulene, terpineol, and nerolidol are among those studied for apoptosis effects. As well, limonene, pinene, linalool, eucalyptol, terpineol, and camphene are associated with reduced tumor growth. 

 

Flavonoids account for nearly 10 percent of compounds known in cannabis and may represent up to 2.5 percent of cannabis’ leaf and flower dry weight. They are the largest class of polyphenols. Kaempferol, apigenin, cannflavin B, silymarin, and luteolin are among those researched for tumor-reduction abilities. Kaempferol is also associated with reduced metastasis. Orientin, vitexin, and isovitexin have been studied to induce apoptosis.  

 

Additional benefits of cannabinoids in breast cancer

 

A feature of cannabinoid anti-tumor action in breast cancer, as well as other cancer types, is that there is no toxicity observed in non-tumor cells. With this, and other observations, cannabinoids have adopted the reputation as having safe profiles. In fact, they have proven safe in thousands of individuals among many clinical trials in cancer patients.

 

Preclinical and clinical evidence suggests the efficacy of CBD and THC in targeting cancer-associated pain, anxiety and depression, sleep issues, nausea and vomiting, and oral mucositis that are associated with cancer and traditional treatments. These same studies also suggest that cannabinoids may enhance the efficacy of traditional treatments such as chemotherapy and radiation therapy, as well as protect against neural and organ damage. 

 

The most realistic approach in clinical trials has been introducing this therapy in combination with standard treatment. The evidence has shown the combination does not have negative effects and that anti-tumor effects were actually improved. 

 

Hormone-receptor positive breast cancer

 

Around 70-80% of breast cancers are hormone receptor-positive (HR+) 

 

There is preclinical evidence that the molecular pathways between the cannabinoid receptors within our body and estrogens overlap, which may impact the pathogenesis of common diseases including HR+ breast cancer. In one study, researchers concluded that the endocannabinoid, AEA, blocks human breast cancer cell proliferation, however evidence for anti-tumor cannabinoid action in HR+ breast cancer is less clear. There are many possible interactions between HR+ breast cancer and exogenous and endogenous cannabinoids but currently there are no clinical trials evaluating the effect of cannabinoids on treatment outcomes and/or prognosis. 

 

The interactions between HR+ breast cancer and exogenous and endogenous cannabinoids, specifically, are reported as nearly impossible to predict. The use of cannabinoid therapy in palliative medicine is well established, but researchers indicated that clinical trials are needed to determine the safety of cannabinoid therapy in various other breast cancer settings. Until we have this further evidence there should be an emphasis on close monitoring when using cannabinoid therapy in an HR+ breast cancer setting. 

 

Pro-tumor controversy 

 

Although the majority of reports published to date show that cannabinoids induce anti-tumor responses, not only for breast cancers but many other types, there are a reduced number of articles that have reported pro-tumor actions in response to cannabinoid therapy. In two published cases, both observed pro-tumor effects of cannabinoids were either undetectable or very low levels of cannabinoid receptors were present; therefore the interaction between cannabinoids and cannabinoid receptors was not fully observed or understood. As well, it has been hypothesized that pro-tumoral versus anti-tumoral effects may be explained by the biphasic effects of cannabinoids, where too little or too much may result in opposite effects. 

 

Therefore, it is important when starting out with cannabinoid therapy to be transparent with your doctor so you may be closely monitored and to ease into your therapy so you may understand how the cannabinoids interact with your body and specific diagnosis. 

 

A call for more research 

 

Among the published articles that are available, there is a common call to additional research to further provide evidence for the use of cannabinoid therapy for specific conditions. Results obtained are optimistic thus far, however breast cancer is diverse and we have a long way to go before we fully understand the role of cannabinoids in each breast cancer subtype. 

 

This is one of the many reasons why Realm of Caring has partnered with Johns Hopkins University School of Medicine for our Observational Research Registry. This allows individuals to self-report their condition, products being used (or not being used), how much they are taking, and when they are taking it in their natural environment. This observational data helps to further pave the way for clinical research, legitimize plant-based therapies, and destigmatize the cannabis plant. 

 

Free one on one support

 

If you want to reach out to us to discuss anything cannabinoid therapy related one on one – we are here for you! From quality product selection in your area to dosing guidance along the way, our care team is available. ​​You can call our free hotline at 719-347-5400, email info@realmofcaring.org, or schedule an appointment. 

 

Though more individuals are turning to cannabis to treat a variety of ailments, this medicinal plant still carries an undeserved stigma, largely in part due to misinformation online and in conversation. Such misunderstandings have created many cannabis myths and misconceptions, and we’re here to set the record straight. 

 

Myth #1: Cannabis use leads to less motivation.

Fact: The “lazy stoner” stereotype has been discredited by new research that in fact shows teens and adults who consume cannabis are “no less likely to be motivated”. While mainstream media has frequently suggested cannabis use can lead to apathy and loss of interest in pleasure from rewards, this is often grossly exaggerated. As part of the study 274 adults and teens were included, on the basis that they had smoked or consumed cannabis at least weekly.

“Our results suggest that cannabis use at a frequency of three to four days per week is not associated with apathy, effort-based decision-making for reward, reward wanting, or reward liking in adults or adolescents…[O]ur study, one of the first to directly compare adolescents and adults who use cannabis, suggests that adolescents are no more vulnerable than adults to the harmful effects of cannabis on motivation, the experience of pleasure, or the brain’s response to reward.”

 

A separate study also proves that cannabis does not create amotivational behavior, focusing on effort-related decision making and cannabis use among college students.

 

Myth #2: Cannabis is a gateway drug.

 

Fact: The Gateway Drug Theory dates back to the 1930s when the head of the Federal Bureau of Narcotics, Harry Aslinger, campaigned heavily against cannabis use, arguing it would lead to criminal acts and violence.  However, the National Institute on Drug Abuse (NIDA) said that most people who use cannabis do not use other, “harder” substances. It was more often their subsequent social interactions with others who do use drugs that actually increased their chances of trying said other drugs. 

 

In fact, cannabis use actually has been shown to decrease opioid consumption or prevent opioid dose escalation. “Patients who self-report consuming cannabis following hip or knee surgery are less likely than non-users to engage in the long-term use of prescription opioids,” according to data in the journal Arthroplasty Today.

 

Additionally, according to a study by the Institute of Medicine, there is “no conclusive evidence that the drug effects of [cannabis] are causally linked to the subsequent abuse of other illicit drugs.”

 

Myth #3: All types of cannabis will make you high.

 

Fact: Cannabis contains chemical substances known as cannabinoids, e.g. CBD, CBG, CBN, and THC. The psychoactive cannabinoid responsible for the typical ‘high’ feeling is tetrahydrocannabinol (THC). The second most abundant cannabinoid is cannabidiol (CBD), and it has no psychoactive effects. CBD can be used to target symptoms of a variety of ailments, from sleep disorders, to epilepsy, and even menopause. Whether the cannabis you consume has THC or not will determine whether it will make you ‘high’.

 

Myth #4: Prenatal cannabis use is associated with symptoms of ADHD in children.

 

Fact: In-utero cannabis exposure is not linked to elevated risk of ADHD in children. A study evaluated the relationship in 2,408 children.  “In our study, we did not find any association between in-utero occasional or regular exposure to cannabis and the risk of ADHD in children, as well as overall exposure to cannabis and the risk of ADHD in children,” authors concluded.

 

Those with ADHD have actually reported self-treating with cannabis, claiming that it helps some of their more severe symptoms (e.g., agitation, irritability, lack of control) while also carrying fewer side effects to prescription medications. 

 

Myth #5: CBD elevates liver enzymes to dangerous levels.

 

Fact: While the FDA has recently warned that CBD can harm the liver, research has reported no evidence of liver toxicity associated with CBD. 

 

“Observational data gathered from 839 participants — ages 18–75 from across the U.S. and known to be taking hemp-derived CBD products orally for a minimum of 30 days — showed that CBD at the doses consumed in the study is not associated with clinical liver toxicity. Previous studies have suggested that prescribed cannabidiol (CBD) products may cause elevations in liver tests (LT).” 

 

Most of the LT elevations having been reported are likely due to the conditions or medications for which the individuals are taking CBD.

 

Another study, requested by the FDA, shows that CBD products do not cause liver damage when taken orally. The analysis was 7 months long, and evaluated the impact of CBD on liver health through clinical trials with 839 participants.

 

Advocating for Cannabis

 

With so many common misconceptions about cannabis, being as educated as possible helps to ensure the important work can be done. Simple conversation starters can be powerful tools for initiating change! Having a well-rounded knowledge of the benefits and drawbacks of the cannabis plant can also help lead to greater informed policy.

 

Our blog is a great place to start learning more about cannabis. For any further questions, Realm of Caring is here to help! From quality product selection in your area to dosing guidance along the way, our care team is available. ​​You can call our free hotline at 719-347-5400, email info@realmofcaring.org, or schedule an appointment. 

 

In July of this year, Headcount released a report that looked in depth at the turnover rate of cannabis retail associates, otherwise known as “budtenders”. It was found that 55% of budtenders across the United States and Canada who worked at any point over the previous 12 months had left their place of employment by the end of the time period. In both countries nearly a quarter of all budtenders hired in 2021-2022 did not even complete one full month of work.

 

The report had found that the better performing the budtender was, the more likely they were to stay in their position. But what are potential reasons for why they leave?

 

Expectations

 

Budtenders have been compared to coffee shop baristas and bartenders; when, in reality,  working as a budtender is a unique role of its own. Among the five most popular questions that budtenders receive, per cannabis.net, the one that sets budtenders on a different level than nearly all other professions in the retail industry is: how do I dose my cannabis? Budtenders are faced with difficult questions from customers seeking medical or legal advice. 

 

Determining therapeutic amounts of cannabis often needs individualized attention, where comprehensive training is required to provide such information. Budtenders may be equipped with the knowledge to assist, but there are two main reasons for why they cannot provide that assistance to their customers. First, it might not be possible to find the time to offer appropriate guidance when they are serving over 100 customers per day. Secondly, for those without a medical license or a disclaimer to protect them, they are prohibited in certain dispensaries from offering specific dosing advice. One may be left with the feeling that reasonably fulfilling the needs of every guest who walks through the door is unachievable. Lack of control or unclear expectations can quickly lead to burnout. 

 

Support (or lack thereof)

 

Is leadership providing the support needed to fulfill the demands of the job? An online survey published in 2016 evaluated the training, knowledge, attitudes, and practices of medical and non-medical dispensary staff. It was found that 94% mentioned providing specific cannabis advice to patients, while 20% reported receiving medical or scientific training. While providing dosing may be problematic, budtenders can still offer non-medical, educated recommendations to their customers. 

 

Findings from the study emphasized the importance of consistent, evidence-based training of dispensary staff who provide specific recommendations for patient medical conditions.  Therefore, budtenders should be offered educational opportunities to support their role. 

 

Legitimizing the work

 

When it comes to cannabis, it’s not just that we need to legitimize the therapy, we need to legitimize the work. Policies are changing but the stigma remains. Lack of social support is another cause of job burnout, where feeling isolated or in constant defense, can lead to stress. 

 

Being a budtender is a difficult job. It takes an endless amount of energy, patience, and intelligence to stand on the other side of the counter. A budtender is expected to know enough to direct the novice in the right direction as well as keep up with the well-read cannabis connoisseur. 

 

Budtenders also carry the heavy burden of the industry. Statistics lead to findings that state: 

 

Budtenders quitting hinders the cannabis industry. 

 

Retail sales go down with turnover. 

 

For a budtender, on one side you have a group in society that does not take your job seriously and on the other hand you have a group blaming you when the industry is hurting. While we still may be a long way off of eradicating the stigma that was created decades ago, we can recognize that without budtenders there would not be a $33 billion dollar industry. 

 

Changing the way we look at the profession

 

The first solution in uplifting budtenders experiencing burnout may be to offer ample opportunities for them to excel in their position. Realm of Caring (RoC) care specialists can offer two things to dispensaries: consulting budtenders on how to carefully answer difficult questions, and offering a place for customers to go to if they need free, research-backed guidance, from product selection to dosing advice. RoC is an ally in the field, lean on us for the support you need. 

 

How do I know I’m burned out?

 

Project Helping identifies the main signs of burnout. These include: 

 

• Chronic fatigue
• Insomnia
• Forgetfulness
• Headaches or chest pain
• Increased illness
• Loss of appetite
• Cynicism
• Increased irritability
• Loss of interest in activities

 

Mayo Clinic shows that job burnout can result from various factors, including:

 

• Lack of control. An inability to influence decisions that affect your job — such as your schedule, assignments or workload — could lead to job burnout. So could a lack of the resources you need to do your work.
• Unclear job expectations. If you’re unclear about the degree of authority you have or what your supervisor or others expect from you, you’re not likely to feel comfortable at work.
• Dysfunctional workplace dynamics. Perhaps you work with an office bully, or you feel undermined by colleagues or your boss micromanages your work. This can contribute to job stress.
• Extremes of activity. When a job is monotonous or chaotic, you need constant energy to remain focused — which can lead to fatigue and job burnout.
• Lack of social support. If you feel isolated at work and in your personal life, you might feel more stressed.
• Work-life imbalance. If your work takes up so much of your time and effort that you don’t have the energy to spend time with your family and friends, you might burn out quickly.

 

When on the verge of, or experiencing, burnout there may be several helpful techniques to help you overcome the burden. Leadership in the cannabis industry can help by outsourcing support from within the industry. 

 

Who is Realm of Caring?

 

Founded in 2013, Realm of Caring (RoC) is an independent 501c3 non-profit organization. They serve anyone in need of more information about cannabinoid therapies. Through revolutionary research, innovative education, and empowering global community connections, RoC seeks to facilitate and encourage the mainstream acceptance of transformative, plant-powered therapies to benefit individuals and families and serve healthcare providers as well as the hemp and cannabis industries.

 

Since becoming a formal non-profit in 2013, RoC has cherished a vision that has remained unchanged: the belief that the quality of life matters.

 

If you want to reach out to our care team to discuss anything cannabinoid therapy related one on one – we are here for you! You can call our free hotline at 719-347-5400, email info@realmofcaring.org, or schedule an appointment. 

 

Cannabis hangovers, also referred to as “weed hangovers,” refer to the range of effects that may take place the day after consuming cannabis products. These unpleasant sensations, which range from feeling drowsy and fatigued to headaches and nausea, might ruin the experience or discourage someone from using cannabis.

 

Research is limited in understanding the consumer complaint of cannabis hangovers. While one report shows that undesirable, residual effects of cannabis consumption can be felt the day after smoking, another reports that any effects are minimal at most. Regardless of the available data, consumers tend to blame the product formulation or overconsumption.

 

Why is it that some products may leave us feeling sluggish the next day, and how might we avoid it? For further information, we got in touch with Michael Backes, Cofounder and Chief Product Officer of Perfect, and the author of Cannabis Pharmacy: The Practical Guide to Medical Marijuana.

 

“I believe that old cannabis products, such as old vape cartridges, can lead to hangovers. Fresher cannabis products appear to produce fewer lingering effects,” says Backes.

 

The combination of freshness and terpenes may contribute to reducing any negative consequences the next day. 

 

Terpenes are compounds found in all known life forms, including fruits, trees, herbs, and a range of other plant species that are responsible for determining their distinct scents. They have an impact on individual and population survival. The compound squalene, for example, belongs to a larger class of terpenes present in both plants and animals. Squalene is secreted by the liver and sebaceous glands in humans. In the human body, squalene serves as a precursor for steroid hormones and cholesterol.

 

How Terpenes Help Eliminate the “Hangover”

 

“A rich terpene entourage reduces the likelihood of cannabis hangovers,” continues Backes. “A traditional Moroccan remedy for cannabis hangover includes a glass of cold, fresh lemonade with black pepper sprinkled on top. This works because of its terpene entourage of limonene from the lemons and beta-caryophyllene from the pepper. Both limonene and beta-caryophyllene possess potent anti-inflammatory activities.” 

 

Limonene has also been studied for its anti-nausea, anti-vomiting, and uplifting properties, reported to boost mood and metabolism while decreasing stress and anxiety. 

 

Myrcene, on the other hand, is a terpene known for its sedative effects. Considering that terpenes are so vast they account for nearly one-third of all compounds in the Dictionary of Natural Products, research is still in early stages. However, evidence remains that they work in synergy with other cannabinoids, and there is a consensus among consumers regarding their different properties.

 

If you want to avoid residual feelings of grogginess the next day, it may be best to pay attention to the terpene content, quality of the product, and how much you are consuming. 

 

“Sip, Don’t Rip”

 

Backes explains, “Most consumers inhale too rapidly. Reducing the intensity of inhalation also reduces the combustion temperature, which results in a smoother, less harsh experience. I advise taking a gentle inhalation (sipping) rather than hitting hard (ripping).”

 

Starting low and increasing slowly enables one to find their therapeutic dose at the lowest amount possible. Finding your individual threshold can also help to prevent effects that carry over into the following day. While you may have a good indication as to where to stop with smoking cannabis, it may become more difficult with edibles given the slow rate at which they will metabolize in the body. 

 

When in Doubt, Get Support

 

Realm of Caring is here to help with lingering questions about finding the most success from your cannabis experience. From quality product selection in your area to dosing guidance along the way, our care team is available. ​​You can call our free hotline at 719-347-5400, email info@realmofcaring.org, or schedule an appointment. 

 

On October 26th, 2022 at 4pm MST, Michael Backes will participate in a webinar hosted by Realm of Caring. Beforehand, send any questions by email to info@realmofcaring.org. Register using this link! 

This November, several individuals in the United States will have the opportunity to change cannabis laws. Currently, four states have secured the necessary number of signatures to place their measures on the ballot. Decisions will also need to be made at the local level, affecting laws around recreational sales and depenalization of personal possession. 

 

Before you fill out your ballots, it may be helpful to have a deeper understanding on the terms that will be presented.

 

Depenalization vs Decriminalization vs Legalization 

 

Depenalization can be defined as the reduction of the use of existing criminal sanctions, which may be considered a de facto intervention because it does not require a large change in legislation. In Ohio, for example, the November ballot measure would eliminate penalties for the possession of misdemeanor amounts of cannabis. 

 

Decriminalization means that possession of cannabis is still illegal, however individuals are subjected to less harsh punishments, such as a civil fine or drug education versus jail time. When drugs are decriminalized, the production and sale is still prosecutable by law. Some believe that it is a positive path to legalization. 

 

Legalization makes cannabis legal, whether that be by state or federal law. When legalized, cannabis becomes a regulated product in a legal market, whether that be for recreational or medical use. Rules and directives are established largely by government agencies who create a framework for how cannabis will be legalized, manufactured, and distributed. 

 

Federal Law vs State Law

 

When both the House of Representatives and Senate pass a bill that is then signed by the President, it becomes federal law. State law is enacted by each state legislature, signed by the governor. State law exists in parallel and sometimes in conflict with United States federal laws. In cases of explicit conflict, federal law overrides state law. 

 

For example, the 2018 Farm Bill changed federal law by removing hemp from the Controlled Substances Act, legalizing hemp under certain restrictions. Hemp was further defined as the plant species Cannabis sativa L. with a delta-9 tetrahydrocannabinol (THC) concentration of no more than 0.3 percent on a dry weight basis. Bills state by state varied widely in response to the new federal policy. 

 

As it currently stands on a federal level, all cannabis that does not fall under the definition of hemp remains illegal. The federal government still classifies marijuana as a Schedule I drug, meaning there is a high potential for abuse and little to no medical benefit. This is an example of the conflict between state and federal laws, as residents may purchase marijuana, whether recreational or medical, in compliance with their state law but violating federal law. 

 

Medical vs Recreational

 

A state who has legalized medical cannabis, requires individuals to follow specific steps before purchasing. This involves becoming a patient with the state’s medical marijuana (MMJ) program, after qualifying with an eligible condition. Medical cannabis is available to patients 18 years or older, patients under 18 must have a legal guardian register as a caregiver. Medical cannabis is typically more cost-effective than recreational as it is distributed for medical purposes and taxes are much lower. Medical patients may also have access to cannabis with higher potency levels and some states permit growing plants at their residence. Telehealth services have made it a more seamless process in many states to receive an MMJ card. 

 

Legalized, recreational cannabis requires that an individual be 21 years old for purchasing. Recreational consumers are subjected to higher taxes and limits on THC per serving or per package. Fully legal cannabis offers economic opportunity by increasing tax revenue to the state and decreasing enforcement and incarceration rates. 

 

Curious to know more about potential changes? 

 

Click below to find out more in your area:

 

Colorado Springs, Colorado: Recreational legalization

 

Lapeer, Michigan: Repeal recreational sales

 

Petoskey, Michigan: Licensing for recreational marijuana retail businesses

 

Granite County, Montana: Recreational sales, local sales tax

 

Ohio: Municipal depenalization measures (towns: Corning, Helena, Hemlock, Kent, Laurelville, Rushville, and Shawnee)

 

Rhode Island: Local recreational dispensary ban

 

Texas: Local depenalization for personal amounts (cities: Denton, Elgin, Harker Heights, Killeen, San Marcos)

Sleep disorders affect up to 70 million Americans each year. Causes may vary from person to person, but can include life stressors, unhealthy lifestyles, depression, chronic pain, and neurological disorders like Alzheimer’s or Parkinson’s disease. 

 

As more people turn to cannabis as an alternative healing modality, it’s important to understand the benefits terpenes may provide in the process. 

 

What are Terpenes?

 

If you’re wondering what terpenes are, you’re not alone! Like the terms cannabinoids, cannabidiol, and cannabigerol, terpenes are also compounds found in cannabis. In fact, there are about 400 known terpenes in the cannabis plant, but researchers have only begun to dive into the specific effects of a small fraction of them. Terpenes can cause different aromas, tastes, and even colors in a cannabis plant. But they aren’t limited to the cannabis plant alone. Fruits, other plants, herbs – these are all things that also have terpene profiles. Picture the smell of a forest. It’s distinct, it can be piney. This is an example of terpenes in action! The same goes for different cannabis strains. Some have a citrusy smell, while others smell more like woodsy herbs. 

 

Many consumers are looking to terpenes as a way to help predict a strain’s effects, similar to considering whether it is Sativa or Indica. Because terpene profiles work hand-in-hand with cannabinoids, they can produce different experiences even if the strain has the same THC content. 

 

Some popular terpenes include, but are not limited to: 

• Pinene
• Limonene
• Linalool
• Caryophyllene
• Terpinolene
• Myrcene

 

Can Terpenes Help Fight Insomnia?

 

Many advocate for the use of cannabis, CBD, and other cannabinoids as a sleep aid, and further research shows terpenes have their own set of helpful effects. Because each terpene has a unique chemical structure, some are considered better for sleep aid than others. If you’re looking for terpenes to help fight insomnia, try strains high in one of the following, known for their sedative effects. 

 

Terpinolene 

 

Terpinolene is a less common terpene, estimated to be found in around 1 of 10 cannabis strains. It is known for its woody, piney smell mixed with floral citrus aromas. Typically, this terpene is found in sativa strains with higher THC content. Because it interacts with the central nervous system, Terpinolene exhibits sedative effects that may promote drowsiness.

 

Other places you can find Terpinolene include lilac, rosemary, apples, and nutmeg. 

 

Linalool 

 

Linalool is a commonly-found terpene known for its characteristic intense lavender scent, and has a lot to offer in terms of healing properties. This terpene has been shown to reduce symptoms of anxiety and depression, often a cause of insomnia. Similarly, Linalool has been used in ancient medicinal practices as both a sedative and pain reliever. These benefits help to put you in the proper state for a good night’s sleep.

 

Other places you can find Linalool include over 200 types of plants, spearmint, oregano, and limes.

 

Myrcene

 

One of the most abundant terpenes, and often the dominant of all per strain, Myrcene produces very calming effects. While not just present in cannabis as a sleep aid, this terpene can also be found in lemongrass herbal teas as a sedative and muscle relaxant. Myrcene contains such sleep inducing properties that if a strain contains more than 0.5% of it, it is often considered an Indica. If you have experience with cannabis strains that keep you glued to the couch, and leave you feeling extra drowsy, these are probably high in Myrcene content. 

 

Other places you can find Myrcene include beers, lemongrass, ylang-ylang, and mangoes. 

 

Finding What Works For You

 

Understanding the varying effects each terpene may possess can help improve your smoking experience. While research around terpenes is still in its early stages, there aren’t as many definitive claims about their impacts on humans. However, there still remains evidence that they work in synergy with other cannabinoids, and there is a consensus among consumers regarding their different properties. Through trial and error you can find a strain and terpene profile that works for you and your goals! 

 

As with any cannabis therapy effective dosing varies widely by individual and condition. Our specialists at Realm of Caring are here to help you find a product and dose that works for each of us! If you would like to reach out to our Care Team (719-347-5400 option 1), they would be so happy to help you individualize your therapy and find a product that is right for you.

 

There is a lot of conflicting information out there about cannabis strains. Some say strains don’t matter, others say strains may help you achieve a specific feeling or benefit. When used to describe a cannabis plant or product, the word strain is used interchangeably in different contexts. To gain an understanding on what a cannabis strain is, let’s first take it back to the botany of one of humanity’s oldest crops.

 

Cannabis Botany

 

The Cannabaceae family includes about 12 genera and 170 species. A genus (singular for genera) is a classification below a family and above a species. Some conclude that the genus cannabis comprises a single species, Cannabis Sativa (C. sativa). It is proposed by others that the cannabis genus consists of three species, C. sativa, C. indica, and C. ruderalis. Others will even include a fourth species that can be identified as any hybrid between the aforementioned three. Sativa-types are characterized by their tall and narrow leaves, widely believed to produce a stimulating, cerebral psychoactive effect. Indica-types are short with wide leaves, reported to produce sedative and relaxing effects. Ruderalis is thought to be a descendant of indica, although adjusted to the climate where it originates, resulting in a shorter and stalkier plant. 

 

A 2015 study found a “moderate correlation between the genetic structure of marijuana strains and their reported C. sativa and C. indica ancestry and show that marijuana strain names often do not reflect a meaningful genetic identity”. The different species may have more to do with the structure of the plant alone, rather than an effect that may be produced. 

 

Indica, Sativa, or Hybrid?

 

Despite the debate among the scientific community, dispensaries and brands may still stick to three classifications for delta-9-tetrahydrocannabinol (THC) products: indica, sativa, or hybrid. Hybrid strains are thought to combine the effects of both indica and sativa. But if these don’t speak to the effect, rather just the genetic structure, how do you know what effect to expect from the product you are purchasing? Well, while indica and sativa speak to the species, taking a deeper look at the chemical profile will speak to the strain. 

 

Dr. Ethan Russo has stated, “the sativa/indica distinction as commonly applied in the lay literature is total nonsense and an exercise in futility. One cannot in any way currently guess the biochemical content of a given cannabis plant based on its height, branching, or leaf morphology…It is essential that future commerce allows complete and accurate cannabinoid and terpenoid profiles to be available”.

 

Cannabinoids and Terpenes

 

There are an infinite number of strains out there. Taking a look beyond the indica, sativa, hybrid classifications to the mix of cannabinoids and terpenes can give us more insight into what effect may be produced. 

 

Cannabis contains over 100 compounds called cannabinoids, the major ones being THC and cannabidiol (CBD). They may each provide different benefits. You may have observed products that are labeled as having a ratio of the two major cannabinoids, THC and CBD. These could be described as THC dominant (high THC, low CBD); CBD dominant (high CBD, low THC); or an equal balance of THC and CBD in a 1:1 ratio. Percentages of additional cannabinoids are also present in certain strains, as they may provide even further benefits. 

 

Terpenes are compounds produced by plants such as fruits, trees, herbs, and a variety of other plant species that are responsible for determining their distinct scents. Terpenes are so abundant in nature that they form the largest group of plant chemicals.

 

Plants use terpenes as a defense mechanism to protect themselves from the environment and predators. They release a strong odor and flavor that is intended to ward off certain insects or herbivores. Not only do they play a role in protecting plants, but research shows terpenes to have multiple health-promoting properties in humans.

 

Terpenes may enhance health benefits alone or synergistically with other terpenes and cannabinoids of the cannabis product, however little data is available to support an entourage effect directly through our cannabinoid receptors. Most research on the effects look at individual terpenes, rather than how they work in combination; therefore additional research is needed to allow us to understand further therapeutic potential of various cannabis strains and products. 

 

Do strains mean anything? 

 

When considering the biochemical components, strains do matter. Understanding the quantifiable amounts of cannabinoids of your product is an important step in knowing the quality of your product. Differences in observed effects can be attributed to terpene content. For example, it might not be the fact that a strain is labeled indica as to why one feels sedated. That feeling may actually be attributed to myrcene, a terpene with researched, sedative effects. 

 

It is equally important to recognize that a strain’s effects on one person could trigger a different outcome for someone else. Factors such as ailments, genetic predispositions, tolerance level, setting, consumption method, and others are all worth consideration in determining the result a product may have. Thankfully there are many resources more readily available to navigate the world of cannabis consumption. If you want to reach out to our care team to discuss anything cannabinoid therapy related one on one – we are here for you! You can call our free hotline at 719-347-5400, email info@realmofcaring.org, or schedule an appointment. 

 

The menopausal transition most often begins between ages 45 and 55, and usually lasts around 7 years, but can be as long as 14 years. Perimenopause and menopause can cause a number of symptoms that greatly affect quality of life. During this time, hormones go haywire, temperature regulation becomes more difficult, and mental clarity vanishes. Some symptoms may cause discomfort and others may leave women feeling emotionally unstable. As a result, an increasing number of women are turning to cannabis to alleviate menopause-related symptoms, according to new survey data. 

 

86% of participants reported presently using cannabis, and 78% endorsed the use of medical cannabis for symptoms associated with menopause, e.g. hot flashes, sleep disturbance, mood changes and vaginal dryness or pain. The top related symptoms women reported treating with cannabis in the survey were sleep disturbance and mood or anxiety issues. A majority of the participants smoked cannabis for their symptom relief (84%), while 78% reported they used edibles to treat ailments. 

 

Previous surveys, such as those here and here, have estimated that one-third of women consume cannabis for purposes of managing menopause-related symptoms. 

 

Some effects of perimenopause (e.g. depression, anxiety, mood swings, lower libido, and difficulty sleeping) may happen in response to lower levels of estrogen. Estrogen is an important part of the endocannabinoid system because it regulates fatty acid amide hydrolase (FAAH) and is responsible for breaking down certain endocannabinoids. This is why extra doses of cannabinoids, such as those received when using medical cannabis, may help with common menopause symptoms.

 

A primary cause for sleep disturbance during the menopausal transition is hot flashes, and one of the biggest triggers of hot flashes is anxiety. “When a woman finds herself in a high-stress moment, she may start to sweat and flash,” says Dr. Melanie Bone, Ob-Gyn. “This is often ameliorated with cannabis. I find that higher-CBD products are best to reduce anxiety, but years of practicing have taught me that every patient is unique and there are women who respond best to higher doses of THC to help mitigate anxiety.”  

 

While cannabis is often used to treat anxiety across a number of ages, there is a specific science behind the benefits among menopausal women. Our amygdala is the region of the brain considered the integrative center for emotions, behavior, and motivation. During menopause, these are especially heightened, and cannabis helps to suppress the negative responses, causing less anxiety and depression.

 

Products like cannabis-powered vaginal suppositories and topicals have also been mentioned by women to provide soothing relief for issues of vulvar dryness. Why choose a suppository? Unlike edibles, which go through the digestive system and become metabolized before entering the bloodstream, suppositories surpass the digestive tract and liver, and solely depend on body temperature in order to be absorbed by the surrounding skin. In addition, the female reproductive system has its own cannabinoid receptors that can interact with the suppositories.  This eliminates the variables of body weight, metabolism speeds, and stomach contents that come into consideration with edibles.

 

There are also other factors to consider, such as whether to treat symptoms with THC or CBD. THC can act as a sedative for some, while others report stimulating effects, particularly for those who are new cannabis users or take greater amounts. In these instances, the THC could cause further sleep disruption, whereas CBD, especially taken in larger doses, may induce sleepiness. 

 

Presently, there have been no peer-reviewed clinical studies of women in menopause using cannabis and so there is currently no one-size-fits-all approach, or can it be considered a proven therapy for menopause. This goes the same for replacing Hormone Therapy completely with cannabis to treat menopause symptoms. Some doctors report a dose reduction in hormones in a lot of women who use cannabinoids, and others urge cannabis be used in conjunction with hormones for best results. 

 

As with any cannabis treatment, effective dosing varies widely by individual and condition. Our specialists at Realm of Caring are here to help you find a product and dose that works for each of us! If you would like to reach out to our Care Team (719-347-5400 option 1), they would be so happy to help you individualize your therapy and find a product that is right for you.

Palliative Care can be defined as an approach that improves the quality of life of patients (adults and children) and their families who are facing problems associated with life-threatening illness. It prevents and relieves suffering through the early identification, correct assessment and treatment of pain and other problems, whether physical, psychosocial or spiritual.

 

The majority of adults in need of palliative care have chronic diseases such as cardiovascular diseases (38.5%), cancer (34%), chronic respiratory diseases (10.3%), AIDS (5.7%) and diabetes (4.6%).

 

Pain and difficulty in breathing are two of the most frequent and serious symptoms experienced by patients in need of palliative care. The search for therapeutic strategies is ongoing as poor symptom control and/or intolerable adverse effects are attributed to opioids and other medications currently utilized among palliative care patients.

 

Current guidelines

 

It has been stated by Dr. Claude Cyr that “if we are going to integrate cannabis products into medicine, palliative care is the best port of entry”.

 

Integrating cannabinoid based therapies into palliative care has been delayed by limited clinical research data, little knowledge in dosing guidelines, conflicting regulation, and stigma. Surveys in recent years have shown that a decent majority of US oncologists view cannabinoid therapies as a helpful adjunct to standard pain management strategies. In 2019, the Dutch government agreed to fully reimburse medical cannabis for terminally ill patients. 

 

There is a disconnect between substantial research and interest by patients and families, making it difficult for healthcare professionals when it comes to recommendations and support. Because of this, there is a sense of urgency to understand the pharmacology, mechanisms of action, and available research to support cannabis use in these circumstances. 

 

Pain

 

Definition of clear, clinical objectives with patients and their families is incredibly important among palliative care. The focus is often pain. 

 

Cannabis use for pain can be traced back thousands of years. Observationally in research, the response to pain in individuals has been favorable when compared to baselines or controls. 

 

A review of literature published through June 2017 examined trials regarding cannabinoid use for pain in patients with neuropathy and malignant diseases. Out of 18 trials, 15 demonstrated a significant analgesic effect of cannabinoids as compared to placebo, the reduction in pain intensity was considered clinically significant. The most commonly reported adverse effects were well tolerated. 

 

To date, however, the widespread use of medical cannabis is still controversial even in palliative care settings mostly because the plant may produce both therapeutic and psychoactive effects. There is strong evidence suggesting that the non-intoxicating cannabinoids, such as cannabidiol (CBD), can also alleviate chronic inflammation and pain in animals. CBD has been characterized as an ideal therapeutic agent for inflammation and neuropathic pain as it may suppress both without causing significant intoxicating side effects or analgesic tolerance. 

 

Difficulty breathing

 

This is another topic of major concern among the palliative care population. Based on the neurophysiology of labored breathing and the distribution of cannabinoid receptors within the central nervous system, it has been hypothesized that the unpleasantness of breathlessness will be relieved in humans by cannabinoids. Observational studies have shown some promise among individuals with Chronic obstructive pulmonary disease (COPD). However, there is still a need in clinical trials to observe significantly positive or negative effects on airway function and exertional breathlessness in adults. 

 

Other Symptoms

 

Many patients in palliative care may want to address other common symptoms at end of life, such as anxiety, depression, nausea, anorexia, or insomnia, which may all be relieved by cannabinoid therapy. Others may be looking to reduce or stop altogether certain medications, specifically opioids with serious adverse effects. 

 

An Israeli study published in 2018 on cannabis use in nearly 3,000 cancer patients showed significant improvement in the control of common symptoms other than pain, including sleep disorders (70.8%), fatigue (55.9%), anxiety and depression (74.1%) and nausea and vomiting (54.7%). 18.7% reported a good quality of life prior to treatment initiation while 69.5% reported good quality of life after 6 months. 

 

These findings align with published results from Realm of Caring’s observational research registry, where cannabis users self-reported significantly better quality of life, greater health satisfaction, improved sleep, lower average pain severity, lower anxiety, and lower depression compared with controls. Therefore, cannabinoid therapies may be beneficial across a broad range of symptoms realized in palliative care settings, beyond pain management. The argument may then be made that the role of cannabinoid therapy should not only be under consideration for a palliative care setting, but earlier in the course of palliative care strategy. 

 

Preclinical evidence and case studies have shown the potential for cannabinoids to have disease-modifying effects. Several studies have demonstrated their anti-tumoral, anti-inflammatory, and neuroprotective properties, for example. However, more clinical research is necessary to provide evidence necessary to fully support disease-modifying effects.

 

Opioid-sparing effects

 

When it comes to pain management, opioids in particular have considerable side effects, including constipation, impaired sleep, and respiratory depression. In recent decades, we have witnessed an increase in the prescription of opioids – therefore an increase in opioid use disorders and opioid-related mortality. Therefore, the need has increased to discover combinations of medications that complement each other’s actions for maximizing pain-alleviating responses to allow lower doses of each. The endocannabinoid system represents an ideal target because it is a key endogenous system in modulating pain-processing pathways. 

 

It has been observed that CB2 receptors indirectly stimulate opioid receptors located in the central nervous system. Therefore, in addition to having direct pain-relieving effects on their own, cannabinoids may work synergistically to enhance opioid effects. 

 

A published review looked at 28 studies providing data relating to the potential opioid-sparing effects of cannabinoids in the context of pain management. Most of the pre-clinical studies examined reported reduced opioid requirements when co-administered with cannabinoids. Two controlled clinical studies found no effect of cannabinoids on opioid dose requirements. One case provided low quality evidence and few controlled clinical studies measured opioid sparing as a goal, so findings relating to pain management were mixed. Controlled clinical studies demonstrated some beneficial effects of co-administration on outcomes of pain, sleep, and functioning in chronic pain patients. 

 

Despite the potential for cannabinoids to reduce opioid dose requirements and extend pain relieving effects, it is recommended that increased studies be carried out and observed as there is inconsistent data thus far. Future study considerations should carefully document adverse effects from co-administration to better understand potential harms and examine dose range and tolerability.

 

Spiritual and Existential Suffering

 

Cannabinoid therapy approaches may offer unique potential benefits known more through traditional medicinal and cultural uses and shown through anecdotal reports from patients and caregivers. Mild euphoria, sensory enhancement, and overall sense of well-being could play an important therapeutic role for patients faced with the despair of terminal conditions and the loss of function that tends to accompany it. 

 

Patient’s right to access

 

In cases where individuals expect medical cannabis to be presented as a strategy for their advanced health condition, this leads into a topic of palliative care that deserves to be mentioned: personal autonomy in medical decisions for alleviation of pain and suffering. The facilitation of a patient’s right to access experimental treatments and therapies in line with their wishes and beliefs, is something to be considered as research continues to evolve in this specific area of care.

 

Questions that remain

 

Finding support with cannabinoid therapy and palliative care can be difficult, but that is where Realm of Caring may step in to help. Our care specialists are trained to help with product and practical administration suggestions – whether you be an experienced user or novice. In general, cannabis is safe but responsible use and guidance, as well as oversight by a healthcare professional, are always recommended. We are here to help start and facilitate those conversations along the way through these extremely difficult times. 

 

If you want to reach out to our care team to discuss anything cannabinoid therapy related one on one – we are here for you! You can call our free hotline at 719-347-5400, email info@realmofcaring.org, or schedule an appointment.