A year ago, when we first moved to Oklahoma and I learned medical marijuana had become legal here, I was stoked. I was looking forward to getting my Oklahoma Medical Marijuana Authority (OMMA) patient license and buying legally controlled, tested, and verified cannabis products that would hopefully help with my anxiety disorder and chronic pain. I was hoping to find cannabis that I could use similar to benzodiazepines (Valium, Ativan, Xanax, etc.): A fast acting strain to end panic attacks after they had begun and a once-a-day strain that would hopefully level out anxiety to prevent panic attacks from happening in the first place. What I found, instead, was an industry that's the Wild West, with questionable "doctors", StarBucks-like dispensaries, and a whole lot of snake oil.
Getting The License
To get a license here in Oklahoma, one must first be recommended for cannabis use by a physician. The physician fills out the OMMA paperwork and the patient sends the paperwork, along with a photograph for the ID and fees for processing, to the OMMA office. Upon review, OMMA will decide to approve or deny the application. Unlike other medical marijuana states, Oklahoma doesn't require a specific reason for the prescription, although there is a section on the application where the physician can include why they are recommending cannabis use.
In theory, this sounds great. Presumably this is intended to create discussion between patients and their primary care doctors about cannabis as part of a comprehensive treatment plan. In practice, it's a completely different story. Since the legalization of medical marijuana a new service has appeared: cannabis telehealth. These are doctors who exist solely to recommend marijuana to patients for a fee. Find a telehealth cannabis service, pay a set fee, the doctor sees the patient for a few minutes, then rubber stamps the OMMA paperwork. Some of these services are full-service stops and will even take your picture through your computer's camera and submit the application on your behalf. Many of these cannabis doctors will also regularly attend dispensary-run "patient drives" where dozens, sometimes hundreds, of people can get their OMMA license recommendation in a single four-to-six hour evening.
As a new resident who was uninsured and had not yet found a primary care doctor, I had to turn to one of these cannabis telehealth practices. Having used regular telehealth before I assumed this would be similar. I was very wrong. I spoke with the doctor's administrative assistant for five to ten minutes to ensure my paperwork had been submitted properly before finally getting to speak to the doctor. The doctor saw me for less than five minutes, running down a checklist of questions. When he got to the end, he asked if I had any questions for him and I specified what I was hoping to get out of medical marijuana and if he had any recommendations for strains or products. He laughed and said that he couldn't really recommend anything because product availability and potency varied by region and grower and that I would need to discuss this with a budtender at a dispensary. Just like that he was gone and I was once again speaking with his administrative assistant for a final paperwork submission check.
The entire interaction felt wrong. If this is supposed to be for medical purposes, shouldn't the doctor be knowledgeable on what products to recommend for specific conditions? This would be like a psychiatrist handing me a prescription that just says "Rx: Antidepressant" and saying, "There are a bunch of available antidepressants that are similar, you should talk to your pharmacist about which ones you'd like to try."
I had at least 14-28 days to wait until my license showed up, so it was time to hit the research circuit.
"Would you like to upsize? You get a penny pre-roll."
Thanks to internet sites like Leafly and WeedMaps, a pair of books I picked up from Amazon, an some amazing cannabis science TikTok creators like @cannabichem and @miyabephd, when my license arrived I was fully armed with knowledge about cannabis. I knew that the old dichotomy of sativa and indica was largely marketing nonsense, I knew most of the different major cannabinoids besides THC and CBD, and I knew every predominant terpene and the various terpene profiles of popular strains. I knew which strains I wanted to start with and I knew I wanted them to have varying balances of THC to CBD.
I suspected that what I knew was just the tip of the iceberg so, when I went to my first dispensary, I planned on asking for their recommendations based on my conditions and treatment goals. When I got there, however, what I found was Starbucks for Weed. Most of the employees were younger twenty-somethings who knew very little beyond total THC content and their favorite flavor profiles. I asked the budtenders there for their thoughts on my list of potential strains and I was absolutely disappointed to learn that almost none of them understood terpenes or popular strains for specific medical conditions. Of the five employees I spoke to at that dispensary, only one knew of different terpene profiles: the dispensary's owner.
So clearly this dispensary wasn't going to be of much help. Luckily there were several more in town. Over the next three days, I visited five different dispensaries where the same situation as the first played out. Lots of focus on THC content and flavor, next to no real information on more advanced topics or how specific strains were useful for specific medical issues. This, for example, was the conversation I had at a dispensary when I asked if there were any strains that would be good for IBS:
Me: "Excuse me, I'm wondering if you know if there are any strains good for mixed IBS."
Budtender: "I've heard sour diesel is good for IBS."
Me: "Okay? Is it a particular type of terpene or cannabinoid that helps with inflammation?"
Budtender: *shrugs* "I don't know, I just had a friend who said sour diesel helped with her IBS."
Inexplicably, I knew more about cannabis than many of the people working at dispensaries that are supposed to be recommending cannabis for medical conditions. The doctor told me to rely on the budtenders, the budtenders in turn told me I should ask a doctor about strains, and neither of them really knew anything. THC content and various delivery methods (smoking, dabbing, dry and oil vaping, and edibles) was all they cared about. Dispensaries would regularly run specials designed solely to push product, promotions like giving random one-penny pre-rolls if you buy a particular new strain, upsize to a larger quantity, or spend X amount of money at once.
That's when I realized that I was entirely on my own in this experiment and these dispensaries weren't there to provide any medical benefit whatsoever -- they were just there to sell the highest amount of THC weed they could to get people high. This fact was made perfectly clear when, out of five dispensaries, only two of them offered any cannabis with CBD content. One budtender even laughed when I asked if they had any THC/CBD hybrid mixes, saying, "No one wants anything but THC here."
Doctor Bud's Miracle Remedy Oil
I was increasingly disappointed in how budtenders were claiming that their products would cure or alleviate damn near any malady. It reminded me of 19th century Snake Oil salesmen, peddling dubious cure-alls that, at best, were placebos or, at worst, were poison.
One such example was when I asked about the various topical balms one dispensary sold and if they would be useful in treating my costochondritis. The budtender assured me that the combination cooling THC/CBD balm would work wonders, and that his friend with arthritis swore by it (aside: I began to notice a trend that these budtenders all had "friends" with different diseases). I figured I'd go ahead and give it a shot because I didn't have anything to lose but the cost of the balm.
A few days of using it and I realized it wasn't doing any better or worse than my usual over-the-counter topical, Zim's Max Freeze. Upon inspection of the ingredients, it was no surprise why: They were essentially the same. Menthol and arnica extract made up the bulk of both, with THC and CBD extracts added to the other. Those extracts had no appreciable effect on my costochondritis and both topicals were worse than Voltaren Gel (a topical NSAID).
Keeping Records
Since realizing I was on my own, I turned once again to my research sites and books to begin my experimentation. Different strains, different profiles, et cetera. What I discovered was that high THC content cannabis wouldn't help with my anxiety attacks it immediately induced attacks. The attacks ranged from moderate to extreme. So I began journaling each strain I tried and recording the effects so I could come up with a list of products to buy regularly. Almost none of them helped because the sole focus by dispensaries here is high THC product to get people wasted. I found two hybrid THC/CBD strains -- Nightingale CBD and Black Harlequin -- that helped lower anxiety, reduced insomnia, and ended migraines, but they both caused significant GI tract side-effects, rendering them useless. I was effectively swapping anxiety and migraines for immediate IBS flares.
Almost a year after getting my OMMA license, I have discovered that my grand experiment with medical marijuana is just about over. It hasn't been a complete wash, though.
Recently a new form of cannabis has hit the market: Delta-8 THC. Regular marijuana is packed with Delta-9 THC whereas Delta-8 THC is kind of like "Weed Light". It binds to fewer receptors and therefore has fewer intoxicating effects and less pronounced side effects. Also, like CBD, it's quasi-legal nationally through a loophole in the law. No OMMA license needed. I decided to purchase a couple different D-8THC products and also bought some pure CBD, zero THC, hemp flower. I found that these products come closest to achieving the goals I'm looking for: CBD in the morning or just before bed helps stabilize my anxiety for a longer period while D-8THC, though still intoxicating (much like benzodiazepines), stops anxiety/panic attacks in their tracks.
But it's still the Wild West out here. D-8THC is still so new that there are a lot of questions about its safety and efficacy while both D-8THC and CBD can cause GI problems with prolonged usage. And now that I'm finally on Medicaid and will likely end up on actual, controlled, anti-depressants for anxiety, I doubt I'll be using these products much longer.
My take away from this last year is that the "medical" cannabis industry is just a legal pretense for recreational users. I'm all for to people smoking pot and just zoning out. I've been a proponent of recreational legalization for decades and it's less harmful than consuming alcohol in my opinion. But the vast majority of people out here with OMMA licenses have them for recreational purposes so let's just drop the pretense and make it legal recreationally for everyone.
Unfortunately, I will have to partake vicariously through the experiences of others.
