![]() ![]() These phytochemicals are responsible for the distinctive odor and flavor of the strains ( Andre et al. Terpenes are a family of over one-hundred molecules found in cannabis which are lipophilic compounds that readily cross the blood brain barrier. The plant Cannabis sativa contains at least seventy cannabinoids as well as over four-hundred other constituents including one-hundred and twenty terpenes ( ElSohly & Slade, 2005). Medical Cannabis is not a single homogenous substance which is unlike most US Food and Drug Administration approved drugs and has important pharmacotherapeutic implications. There are a wide variety of MC products which can be smoked, heated with a vaporizer which contains a heating source, edibles, topicals that can be applied to the skin, tinctures which are liquids administered in a small volume, or as concentrates which is a more potent preparation. Further, Medical Doctor (MD) and Doctor of Osteopathic Medicine (DO) trained physicians can certify patients and their qualifying conditions in Rhode Island while Certified Nurse Practitioners and Physician Assistants may also perform this function in Maine. For example, Post-Traumatic Stress Disorder (PTSD) is a qualifying condition for MC in Maine and Rhode Island but not in Vermont. Relative to Maine, Vermont has fewer certifiable conditions and places more limitations on who can authorize a patient to receive MC ( NORML, 2017). The New England states with MC programs differ somewhat with Maine having the first program which was passed by voter initiative in 1999 while Vermont’s received legal authorization in 2004 and Rhode Island’s in 2006. In addition to prevalence, there are also state level differences in the qualifying conditions, relationships of dispensaries with health care providers, and where the MC can be procured from (that is, from dispensaries or caregivers). The prevalence in Vermont (3.5/1,000 adults) and Rhode Island (13.6/1,000) is appreciably lower than Colorado (28.7/1,000, Fairman et al. It is challenging to even estimate the number of MC patients in the US because not all states require registries but it may be between 440,000 and 650,000 ( Fairman et al. Several nations at least partially condone MC including the Netherlands, Germany, Uruguay, Romania, Chile, the Czech Republic, Colombia, Jamaica, Australia, and Canada ( Collier, 2017 Davenport & Pardo, 2016 Rodriguez, 2017) as well as over-half of the US ( Mead, 2017). The Medical Cannabis (MC) patient population has changed during this period from primarily HIV and cancer ( Corral, 2001) to chronic pain ( Piper et al. Medical marijuana has experienced a substantial reemergence in the past two-decades. Further longitudinal and controlled investigations are necessary to identify the strains that are most efficacious for specific conditions. There is some general consistency across dispensaries in that hybrid strains and C. Many respondents mentioned that they had developed a time-dependent pattern with sativa use during the day and an indica for night-time use and for improving sleep. Strain preferences were highly state/dispensary specific with one-fifth of MC patients in Maine preferring Mother of Berries (M.O.B., 21.5%). Hybrids were significantly more likely than Cannabis indica strains to have a gustatory title. MC patients (N=455) from New England completed an anonymous online survey about their medical history and strain preferences in Study II. The goals of this investigation were to determine: 1) how many strains of cannabis are there? 2) which strains are used by Medical Cannabis (MC) patients? and 3) are there any differences in the strains used by patient condition? Study I involved quantifying the number of strains listed in the online database and categorizing these by whether the strain name included a gustatory component. Medical marijuana patients often believe that specific strains are more efficacious at treating their conditions.
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