Questions
What patients actually ask at the counter, answered the way Tiffany answers them. Search, filter by topic, or open them all and read straight through.
Topic
15 questions.
Will I fail a drug test?
If the test looks for THC, then almost certainly yes. THC metabolites can stay in urine for days to weeks, depending on how often you use and on your body composition.
Inhaled THC clears the fastest. Edibles produce more 11-hydroxy-THC, which hangs around longer. Daily heavy users can test positive for 30 days or more. CBD-only products should not trigger a positive result, but cross-contamination is common, so do not count on them being clear.
Can I drive?
Not while you can feel any effect. In every U.S. state, driving impaired is a DUI even when the cannabis is medical.
Wait at least 3 hours after inhaling and at least 8 hours after an edible before you drive. Most patients feel fine long before they are legally clear, so the feeling alone is not a reliable guide.
Will I get addicted?
Dependence is real, though it is less severe than with alcohol or opioids. Roughly 9 percent of adult users develop cannabis use disorder, and the figure is higher when use starts in adolescence.
Daily use builds physical tolerance. Regular users who stop often go through irritability, poor sleep, and reduced appetite for 1 to 2 weeks. If your use keeps creeping up, ask your pharmacist about a planned tolerance break.
Can I mix it with alcohol?
You can, but the combination is stronger than either one on its own. Alcohol speeds up THC absorption, and both depress the central nervous system.
Will it interact with my blood pressure meds?
Usually the pair is tolerable, but THC can briefly lower your blood pressure or raise your heart rate. Stay seated for your first few doses.
For most patients on the common blood pressure drugs (lisinopril, losartan, amlodipine), the interaction is minor. Your pharmacist should still know that you use cannabis.
I take a blood thinner. Can I use cannabis?
Speak with your prescriber first. Both THC and CBD can push up blood levels of warfarin and similar drugs by slowing the enzymes that clear them.
If you take warfarin, expect more frequent INR checks when you start. With the newer anticoagulants (apixaban, rivaroxaban) the interaction is smaller, but it is not zero.
How much should I take the first time?
For an edible or tincture, begin at 2.5 mg of THC. Wait through the full onset window (1 to 2 hours for an edible) before you take any more.
Impatience is the leading cause of a bad edible night. If you are inhaling instead, take one small puff and wait 10 minutes.
Will it actually help my pain?
The evidence is good for chronic pain, nerve pain, and cancer-related pain. The response to short-term acute pain is weaker.
Cannabis tends to be more useful as a dose-sparing partner to opioids than as a stand-alone pain medicine. Most patients do not come off their pain medication entirely, but many are able to reduce it.
Does it help anxiety or make it worse?
CBD helps most people. THC helps some and makes it worse for others, especially at higher doses.
For anxiety, try a CBD-forward ratio first (2:1 CBD to THC or higher). High-THC flower is the leading cause of a bad anxiety experience in first-time users.
Do I need a medical card?
In Arkansas and most medical-only states, yes. In adult-use states, a card still brings higher purchase limits, lower taxes, and better access to a pharmacist.
Do cannabis products expire?
Flower loses potency and terpenes over 6 to 12 months. Edibles expire with their food ingredients. A tincture stored properly lasts 1 to 2 years.
How should I store cannabis?
Cool, dark, airtight, and out of reach of children and pets. A glass jar in a drawer beats a plastic bag on the counter.
Can I overdose?
There is no documented fatal overdose from cannabis alone. You absolutely can take an uncomfortable amount, though, and edibles are where that usually happens.
If you overshoot: drink water, eat something starchy, find a quiet dark room, and wait it out. Chewing a few peppercorns has a folk reputation for taking the edge off. The evidence is weak, but it does no harm to try.
My doctor seems uncomfortable talking about cannabis.
Many physicians were never trained in it and feel out of their depth. Ask your pharmacist instead; most pharmacy programs have updated their curriculum.
What about pregnancy or breastfeeding?
Tiffany's advice is to avoid it. The American College of Obstetricians and Gynecologists advises against all cannabis use during pregnancy and breastfeeding.
Did not find yours? Call Tiffany.
Tiffany Keathley, Pharm.D., Arkansas.