Help arthritic nerd figure out (legal) drugs, please
September 5, 2018 9:21 AM   Subscribe

You are not my doctor. I am living in a place where marijuana is legal to purchase and use. I have longstanding chronic pain issues and recently diagnosed osteoarthritis, so this is exciting, but I'm having trouble finding a delivery mechanism that works for me, and I don't know much about this. Can you help me figure out how to source or make extracts or tinctures, or how to find the right questions to ask at dispensaries? (If you don't have answers for this, but have non-pot suggestions for managing osteoarthritis pain, that would also be great. Arthritis sucks.)

Through research and trial-and-error, I have found a few strains which work well for my pain, but I have sensitive lungs and tend to cough a lot from smoking. Vaporizers and distillate pens are better, but still make me cough. Most of the dispensaries here really focus on plant material, so non-smokable options are limited. The tinctures they sell are varying strengths of pure THC, pure CBD, or blends of the two, and they don't seem to work as well as the particular strains for symptom relief. I still notice effects, just not as many of the therapeutic ones. Also the dosage seems a little hard to control.

I guess buying plant material and making edibles would be an option, but they seem to require a lot of plant material, which looks expensive, and they also seem to have a really long wait period with unreliable effects -- either nothing, or too strong. Are there methods of making these at home which would allow one to make standard doses? Are there particular kinds of edibles that are more reliable in terms of effect?

I've tried several different dispensaries, but the best I've found are places that will maybe sell "sativa extract" or "indica extract." These are better, but still hit-or-miss compared to the strains that work for me, because there's no way of knowing which strains are in the extracts. They also tend to be sold by the capsule, which gets pricey pretty fast. Are there reliable resources, online or in print, for making tinctures or extracts of particular strains? Or ways to order such extracts legally?

Thanks for your help!
posted by anonymous to Health & Fitness (11 answers total) 2 users marked this as a favorite
You don’t mention your location but in Ontario the MOMs (mail order marijuana) are huge and carry a pretty diverse line of tictures and extracts. Have you looked at the online stores (if available in your jurisdiction)?
posted by saucysault at 9:44 AM on September 5, 2018

Making your own stuff (typically cannabutter AFAIK) is a hassle. You should definitely only give your business to the dispensaries with more non-flower options, edibles, tinctures. Some dispensaries here have many more non-combustion options than they do smokables.

I tried to find a menu that lists the myriad smokeless items, but pretty much all pot business websites are terrible so I couldn't find anything.
posted by rhizome at 9:49 AM on September 5, 2018

We made our own a bunch when we had ready access to plants (stems and leaves, our neighbor was a grower) and it was so worth it. Edibles are what help me the best with pain because it lasts long enough for me to get (most of) a night's sleep even when the pain is bad.

When we moved away, we had a porch where we could keep a few plants and ordered some seeds and grew them in full sun. We planted a dozen seeds, got nine plants, and are most of the way finished harvesting and processing - we're going to end up with about a year's worth of edibles for me for an initial cost of about $150 US for seeds and then another chunk for pots and dirt, which we mostly won't have to re-buy.

The processing is a multi-step process that is kind of a pain but if you have a nice big crockpot and a vat of coconut oil, it's totally doable.
posted by restless_nomad at 10:34 AM on September 5, 2018 [2 favorites]

Oh, and I buy bags of gelatin capsules and fill them, which is another minor pain but makes sure the dosage is reasonable consistent, unlike with baked goods. I'm happy to discuss in more detail if you want to drop me a line!
posted by restless_nomad at 10:36 AM on September 5, 2018 [1 favorite]

Have been using a 50/50 tincture thc/cbd with pretty good results for pain. Dispensary I use has some other options - 45/thc/55/cbd works less well for me - experiment but do find a dispensary that will focus on the kind of delivery you want.
posted by leslies at 11:26 AM on September 5, 2018

I love the PAX3 portable vapourizer. It vapourizes dried flower, has different heat settings (adjustable in-device over 4 settings, adjustable by discrete 5'C increments on your smartphone via bluetooth).

The lowest setting still works fine (although not as efficient as higher heat settings). I prefer setting 2 but setting 3 is more efficient. Setting 4 is mostly for extracts/ concentrates.

Bonus, it comes with an attachment for vapourizing concentrates, too. The 3 comes with a "half oven" cover so you can load less material but still get excellent vapour.

I recommend getting a high quality grinder (3 chamber is great; you can collect kif [dislodged trichomes] in the bottom chamber); in good metal grinders, the machining of the top two pieces (the grinding elements) is good enough that it prevents the ground material (residing in the middle chamber) from drying out.

Downside is that its a little pricey, also lots of people online complaining about vapour quantity - but that's mostly to show off "big clouds" rather than a comment on efficacy.
posted by porpoise at 12:17 PM on September 5, 2018

Making edibles can be super easy. Decarb the weed in the oven, put coconut oil+weed in a jar, and put in a sous vide bath (or double boiler) for a few hours. Strain and cool. You can even cool in candy molds if you feel like it.

It is a little bit of effort, but most of it is idle time, and I've found the dosing very reliable and efficient. If you record your ratios, you can adjust the next time. I've made very small (2g of plant material) batches successfully this way, and weigh out a dose in grams.

Edit: the most important reason to DIY is so you can use specific strains that work well for you.
posted by so fucking future at 2:19 PM on September 5, 2018

CBD is a powerful anti-inflammatory so if you have access to CBD derived from regulated cannabis (as opposed to unregulated hemp!) I recommend starting a regimen of that. I live in a place that gives me legal access to whole-plant, high-CBD RSO, and I take this every day. The way I understand CBD vs. THC is that (very broadly) CBD needs to be taken every day to have the best anti-inflammatory results, whereas THC can be taken PRN for pain and other symptoms. Depending on your jurisdiction/your sources, you're likely not going to get great or safe results if you order things online, just as an aside.

Re: easier DIY edibles, do your local dispensaries carry shatter/wax/whatever it is 'the kids' do for 'dabs'? If you can find concentrates in the strains you like, you can make your own edibles and precisely choose the dose you want. Purchase a known quantity of concentrate, dissolve it in a known quantity of oil, and consume that oil or turn it into an edible while knowing exactly how much you're taking, and from where.

E.g. you buy 1 gram of concentrate, dissolve it on the stovetop into 1 cup of oil/butter, make a batch of brownies with that, and if you cut it into 10 brownies, they each have .1 gram of concentrate. You can determine exactly how much THC/CBD is in .1 grams of concentrate, and therefore exactly what's in each brownie. There's probably more info on "making edibles from wax/concentrates" online.

Re: other tools to manage inflammatory pain, I did a contrast bath once or twice. I had painful hands/arms (no arthritis identified, just mystery inflammation, probably from working at a computer), and I LOVED CONTRAST BATHS. They were kind of a pain in the arse though. There's conflicting information online (how long to spend in each temperature? which to finish on?) but I believe I just filled each side of my kitchen sink in ice bath/hot bath, and then dunked for "as long as I felt like it" on each side, and finished with cold water. It sucks at first, but my limbs felt SO ALIVE AND WONDERFUL afterwards.
posted by opossumnus at 2:50 PM on September 5, 2018

You can make your own tincture of your favorite strains with alcohol or glycerin. There are plenty of instructions online but make sure you pay attention to your temperatures to avoid burning off the thc/cbd
posted by ShakeyJake at 2:23 PM on September 6, 2018

Can you call around or visit more weed shops to see if any has a better stock of edibles and other non-smoking options? Around here, the weed stores vary a lot in terms of what they carry, and only some have comprehensive selections of items that don't need to be smoked.
posted by Dip Flash at 8:04 PM on September 6, 2018

My situation is really specific, so I'll just describe what I do and hope you find useful bits. Excuse the length of this post; I'm trying to not leave anything out that might help. Please PM me if you have any questions as I am delighted to share my experiences.

I have a genetic defect called Ehlers-Danlos hypermobility type, which produces joint pain and inflammation. It is incurable and can only be managed so I have tried LOTS of stuff. I am very sensitive to THC and must have very small doses, so controlling dosage is paramount. Microdosing is NOT well met by the market and a lot of people need it. The market leans to big doses, not small ones, so small ones will come best from your own engineering. There's also good science showing that the less pot you use, the more sensitized you become to it, so you get better results by using as little as possible. Plus it's cheaper!

Coughing jerks my body horribly so I will not use a delivery method that risks it. I am also somewhat asthmatic. My experience is that I only cough if the pot is heated too much. The temperature at which the pot is activated also significantly alters the results and most pot works better at a medium temp where you get steam rather than smoke. Here's my system:

I vaporize using a wonderful little device called the VapCap M, which costs about $60 USD. I recommend it above any electric device unless you're in a position to spend 10x as much. It is extremely efficient; anecdotally I found many reports of people who found it gave them twice the result they got from other devices. It is easy to fill, and heats in seconds, which is wonderful during a flare. Although it is heated with a lighter, a little experimentation will help you learn the optimum way to heat it to get a predictable result. I use what is called a "piano" lighter which has a button I can press with my whole hand so it doesn't stress my finger joints. That was another $10.

It is possible to get a cough using a VapCap but in practice for me, this only happens every couple of months or so. I use 0.05g a day and the other user in the house uses 0.1g, the latter being a common daily dose for VapCap users. We save the used up pot because it still has plenty of good stuff in it, and extract it into coconut oil. This is dead easy to do and well documented elsewhere. We make the coconut oil into gummy bears, which is also extremely easy to do. The gummy bears give me about 6 hours of pain management that is superior to anything else I have tried (and I have tried some very heavy stuff). I wake, take a gummy, go back to sleep for an hour, then when I get up I feel as good as I'm going to feel all day. I take another after about 5 hours and another before bed. The coconut oil can also be used topically, baked with, etc. I like the gummies because they are convenient. I have also used a french fry press and cut the strips into cubes.

I have had best daytime results from pot strains that have "sour" or "fruity" terpene profiles; they give me energy and have fewer side effects. I prefer "hybrid" (part indica, part sativa) and pay more attention to the terpene breakdown than whether they are classified as indica/sativa/whatever. I only buy strains where I can find a terpene profile on somewhere like Leafly. "Sours" are best for my mind and mood and "fruit" or "berry" are best for my digestion, either stimulating appetite or relieving nausea. I also prefer pot that is around 10% THC and as high CBD as possible. Over 15% THC gives me more trouble than it is worth. I nth everybody who says to try CBD oil/honey/tincture/whatever. Some people do fine with only CBD; some need 1:1 CBD/THC, especially for sleep. Also be aware that pot can lower your blood pressure and I have to take beta blockers to control this effect. At night I take a high CBD indica and am still trying to find reliable strains. Sleep is hard.

I tried nabilone, which is a prescription synthetic form of pot, and it was a bad experience. But if you have insurance you might look into it anyhow.

Non pot fringey stuff:

I have had good results using homemade massage oil with juniper berry essential oil. It is 5ml of essential oil in 100ml of carrier (I use grapeseed oil from the grocery store but whatever you like is fine). I also add in essential oils that have been clinically shown to be relaxing or healing; I keep an eye on this on pubmed; I use lavender, sweet orange (anti-anxiety) and bergamot (shown to be as good as ativan! i've used it, it works, I just carry the bottle around). Also spruce oil is great in the bath to relieve joint pain and do other good stuff, 5ml in 100ml of bath oil; blue spruce is best but kind of pricey, Canadian black spruce is still good and much cheaper.

Bromelain, which is an extract of pineapple, is a great anti-inflammatory that is easier on your stomach than conventional NSAIDs. Try eating some fresh pineapple and see if it helps; if it does, try bromelain in capsule form. I use 500mg. It is pretty well documented on pubmed and golfers have been using it for their knees for a long time.

Chaga is another fringey thing I have had great results from. It is a growth that occurs on birch trees in cold areas such as Canada and Russia. It is a bit difficult to find at a good price and from a reliable supplier, but is available in New Brunswick for around $50/lb which will last you six months even if you use it every day. It is basically an souped up anti-inflammatory that you make tea or topical stuff from. If you search on eBay for chaga from Hopewell Cape, that is the guy I use, and he is a great human being. I really encourage you to read up on chaga as it may be a better option for you than pot.

Sangre de grado/croton lechleri/dragon's blood is amazing stuff if you can get it. It is a natural latex sap from South America that has recently begun appearing in beauty products in too small amounts to be meaningful. It is very hard to get and widely counterfeited. If you can get it from a reliable source I highly recommend it.

Light compression helped me a lot. Try what are called "travellers socks". Compression garments are measured in units of mmhg and you want 5-15mmhg, which you can find at department stores. I also wear "crafters gloves", which are similarly light compression. Some people just use disposable cotton gloves as that provides appropriate mild pressure. As with everything else, small doses can be much better than big ones.

Finally, if you can get bottled oxygen, that is the best anti-inflammatory in the world. Given your "sensitive lungs" your doc may be willing to prescribe, if you have insurance. No side effects!

Hope there's something in there for you. Again, PM me if you want any clarifications.
posted by gtaylor at 1:43 PM on September 7, 2018

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