Cannabis might be a good solution but there is no quick answer.

With the legalization of cannabis in many states, you might be wondering whether cannabis and cannabinoids could be beneficial to you. So we checked in with Peter Gerbino MD for his thoughts.

Our timing couldn’t have been more perfect. This week Dr. Gerbino attended the Grand Rounds Tuesday hosted by Donald Abrams, MD at UCSF on cannabis and cannabinoids to get the latest insights.

We asked questions that you may have if you’re considering the use of cannabidiol [aka: CBD] to help manage pain or another medical issue. If you have other questions, please feel free to shoot us an email or book an appointment with Dr. Gerbino for personalized advise on the side effects, dosages and contraindications.

The medical cannabis industry is unregulated so the burden is on you to get good information and to make good purchasing decisions. Early cannabis pioneers are reportedly working to keep the industry safe but with no regulation and the potential to make money, there will surely be some “bad actors”. So be mindful in your approach to it and talk with your doctor or other expert.

Q+A with Peter Gerbino MD:

Q1/ Are you giving any guidelines on dose?

PG: Dosing is variable depending on source of cannabis, patient size and tolerance and effects desired. “Start low and add until desired effect is obtained.”

Q2/ What are the key ingredients that you should look for when making a CBD purchase?

PG: Proportion of THC to CBD is the critical balance. There are no guidelines as to how to determine what is best in each case.

Q3/ Are you referring patients to medical cannabis experts or do you think it’s okay to experiment?

PG: Everyone is experimenting. The best medical experts are few and far between. Dr Abrams waiting list is 6 months for an appointment. The best next level experts are the salespeople in the dispensaries.

Q4/ It sounds like there are several studies underway to better understand the benefits of CBD for pain. What types of pain do you think CBD is best suited for at this point?

PG: Cannabis and CBD are being studies for many types of pain. So far, nerve-related pain seems to respond best.

Q5/ What concerns you most about CBD use right now [extended use, overuse, addiction]?

PG: There is no evidence of addiction or ill effects from cannabis use. Anything can be abused and some may become psychologically dependent on any substance. My greatest concern is that some suppliers might be selling cannabis products with contaminants. Use in pregnancy has resulted in lower birth weight babies, but no measurable effects on the child.

Q6/ What form do you think is best [cigarettes, candies, pill or other method of consumption]?

PG: Each works differently. Smoking plant material works fastest, but has the risks of lung disease. Smoking oil has not been studied and risks are unknown. Sublingual and nasal spray work fast, but risks are unknown. Oral ingestion works slowly and seems to last longer. 

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