Disclaimer
This information is for educational purposes only as of late 2025 and is not a substitute for professional medical or legal advice. Cannabis laws and clinical research are constantly evolving. This content is intended for adults age 21 and older. Always consult with a qualified physician and refer to your country’s or state’s official health department website for the most current information.
A Guide for Every Level of Interest | Frequently Asked Questions (FAQs)
This knowledge base is structured to provide clear, targeted information for our diverse audience.
Part 1: Foundational Information: An essential starting point covering the basics of medical cannabis, legal guidelines, and common terminology.
Part 2: Clinical Application & Practice: A professional-level guide focusing on patient care, dosing protocols, contraindications, and the pharmacology relevant to healthcare providers.
Part 3: Advanced Scientific Topics: A resource for researchers and academics exploring the frontiers of cannabinoid science, including molecular mechanisms, genetic influences, and current research gaps.
This information is for educational purposes as of October 2025 and is not a substitute for professional medical or legal advice. Cannabis laws and clinical research are constantly evolving. Always consult with a qualified physician and refer to your state's official health department website for the most current information.
The primary difference is purpose and oversight. Medical cannabis is recommended by a physician to treat a specific qualifying health condition and is subject to state regulations on dosing, purchasing, and use. Recreational cannabis is used by adults without a doctor's recommendation and is legal only in certain states, governed by different laws regarding age, possession limits, and taxation.
Reference: National Conference of State Legislatures. (2025). State Medical Cannabis Laws. Retrieved from ncsl.org
The process involves three key steps: 1) You must be diagnosed with a qualifying condition by a physician registered with the state's Medical Marijuana Use Registry (MMUR). 2) The physician enters you into the registry. 3) You complete the application online via the MMUR portal, provide proof of residency, and pay the state fee.
Reference: Florida Department of Health, Office of Medical Marijuana Use (OMMU). (2025). Patients. Retrieved from knowthefactsmmj.com
THC (Δ⁹-tetrahydrocannabinol) is the primary psychoactive compound in cannabis, responsible for the euphoric "high." It is therapeutically used for pain, nausea, and appetite stimulation. CBD (cannabidiol) is non-psychoactive and is studied for its anti-inflammatory, anti-anxiety, and anti-seizure properties.
Reference: National Center for Complementary and Integrative Health. (2025). Cannabis (Marijuana) and Cannabinoids: What You Need To Know. Retrieved from nccih.nih.gov
Methods vary in onset and duration. Inhalation (smoking, vaping) is fast-acting (minutes) but short-lived (1-3 hours). Oral ingestion (edibles, capsules) is slow to take effect (30-120 minutes) but lasts much longer (6-8+ hours). Sublingual tinctures offer a balance, with an onset of 15-45 minutes and effects lasting 4-6 hours. Topicals are applied to the skin for localized relief without intoxication.
Reference: MacCallum, C. A., & Russo, E. B. (2018). Practical considerations in medical cannabis administration and dosing. European Journal of Internal Medicine, 49, 12–19.
Yes. A subset of users can develop what is clinically known as Cannabis Use Disorder (CUD). The risk is higher for those who start using in adolescence or use cannabis daily. CUD is characterized by a continued desire to use cannabis despite it causing significant health or social problems.
Reference: National Institute on Drug Abuse. (2025). Is Marijuana Addictive?. Retrieved from nida.nih.gov
Yes. Despite having a medical card, you can still be fired. Florida law does not protect employees from adverse action based on a positive drug test for marijuana. Because cannabis is still federally illegal, employers have the right to enforce drug-free workplace policies.
Reference: Society for Human Resource Management (SHRM). (2025). Managing Marijuana in the Workplace. Retrieved from shrm.org
No. It is illegal and unsafe to operate a vehicle under the influence of cannabis. THC significantly impairs judgment, motor coordination, concentration, and reaction time, increasing the risk of an accident. A medical card is not a defense against a DUI charge.
Reference: National Highway Traffic Safety Administration (NHTSA). (2025). Drug-Impaired Driving. Retrieved from nhtsa.gov
In popular culture, Indica strains are associated with relaxing "body" effects, while Sativa strains are linked to energetic "head" effects. Hybrids are considered a mix of both. However, modern science suggests these labels are not reliable predictors of a product's effects. A product's specific chemical profile of cannabinoids and terpenes is a more accurate indicator.
*Reference: Clarke, R. C., & Merlin, M. D. (2016). Cannabis: Evolution and Ethnobotany. University of California Press.
Terpenes are aromatic compounds found in cannabis and many other plants that create its characteristic scents, such as pine, citrus, or lavender. Research suggests they play a role in the therapeutic effects of cannabis by interacting with cannabinoids, a theory known as the "entourage effect."
Reference: Russo, E. B. (2011). Taming THC: potential cannabis synergy and phytocannabinoid-terpenoid entourage effects. British Journal of Pharmacology, 163(7), 1344–1364.
Traveling across state lines with cannabis is illegal under federal law, even if you are traveling between two states where it is legal. A medical card only permits you to possess and use cannabis within the state that issued it. Transporting it over state lines is considered federal drug trafficking.
Reference: U.S. Transportation Security Administration (TSA). (2025). Medical Marijuana. Retrieved from tsa.gov
The maxim is "start low and go slow." Initiate therapy with a low dose of THC (1.25-2.5 mg), particularly with oral formulations, and titrate upwards every 3-7 days based on patient response and adverse effects. Utilizing a CBD-dominant product can mitigate THC-induced psychoactivity and anxiety. Patient journaling is critical for tracking efficacy and tolerability.
Reference: MacCallum, C. A., & Russo, E. B. (2018). Practical considerations in medical cannabis administration and dosing. European Journal of Internal Medicine, 49, 12–19.
Absolute contraindications include a personal history of psychosis or schizophrenia and allergy to cannabis. Relative contraindications requiring careful consideration include a history of substance use disorder, severe cardiovascular or cerebrovascular disease (due to THC's effects on heart rate and blood pressure), and pregnancy or breastfeeding.
*Reference: National Academies of Sciences, Engineering, and Medicine. (2017). The Health Effects of Cannabis and Cannabinoids. The National Academies Press.
Both THC and CBD are metabolized by and are inhibitors of cytochrome P450 enzymes, primarily CYP3A4 and CYP2C9. Clinicians must be cautious when co-administering cannabis with drugs metabolized by these pathways, such as warfarin (increased INR), certain antiepileptics (e.g., clobazam), and immunosuppressants like tacrolimus. There is also an additive CNS depressant effect with opioids, benzodiazepines, and alcohol.
Reference: Balachandran, P., Elsohly, M., & Hill, K. P. (2021). Cannabidiol Interactions with Medications, Illicit Substances, and Alcohol: a Comprehensive Review. Journal of general internal medicine, 36(7), 2074–2084.
When THC is ingested orally, it undergoes extensive first-pass metabolism in the liver. The enzyme CYP2C9 converts Δ⁹-THC into 11-hydroxy-THC (11-OH-THC), a metabolite that is significantly more potent and psychoactive than the parent compound. This explains the delayed onset, increased intensity, and prolonged duration of edibles compared to inhaled products.
Reference: Huestis, M. A. (2007). Human cannabinoid pharmacokinetics. Chemistry & biodiversity, 4(8), 1770–1804.
Advise the patient that abstaining for as little as 48 hours can begin to upregulate CB1 receptor density. Upon re-initiation, their previous therapeutic dose may produce exaggerated psychoactive effects. The patient should restart at approximately 50% of their previous dose and re-titrate slowly to re-establish the minimum effective dose.
Reference: Hirvonen, J., et al. (2012). Reversible and regionally selective downregulation of brain cannabinoid CB1 receptors in chronic daily cannabis smokers. Biological psychiatry, 71(7), 622–629.
CHS is a paradoxical condition characterized by cyclical episodes of severe nausea, vomiting, and abdominal pain in chronic, high-dose cannabis users. A pathognomonic feature is the temporary relief of symptoms with hot showers or baths (compulsive bathing). The only definitive treatment is complete cessation of cannabis use.
Reference: Perisetti, A., et al. (2020). Cannabinoid Hyperemesis Syndrome: An Update on the Clinical and Therapeutic Aspects. Curēus, 12(7), e9323.
The ECS is a primary homeostatic regulatory system in the body, like a "master thermostat." It's composed of receptors (CB1 and CB2), endogenous cannabinoids your body makes (like anandamide), and enzymes that build and break them down. Medical cannabis works by interacting with this system to help restore balance when it's dysregulated by illness or injury.
Reference: Alger, B. E. (2013). Getting high on the endocannabinoid system. Cerebrum: the Dana forum on brain science, 2013, 14.
While research is preliminary, minor cannabinoids show distinct therapeutic potential. Cannabigerol (CBG) is non-psychoactive and is being investigated for anti-inflammatory (e.g., in IBD) and neuroprotective properties. Cannabinol (CBN), a degradation product of THC, is being explored for its potential sedative effects and may be useful for sleep disorders.
Reference: Cather, J. C., & Cather, J. C. (2021). Cannabigerol: A Novel Cannabinoid for the Treatment of Various Skin Conditions. Journal of the American Academy of Dermatology, 85(3), AB134.
A clinician or patient should verify:
Cannabinoid Potency: Confirms the mg/g or percentage of THC, CBD, and other cannabinoids matches the label.
Terpene Profile: Identifies the dominant terpenes, which may help predict therapeutic effects.
Safety Testing: Ensures the product has passed tests for contaminants, including pesticides, heavy metals, microbial life, and residual solvents.
Reference: U.S. Food and Drug Administration (FDA). (2025). What You Need to Know (And What We’re Working to Find Out) About Products Containing Cannabis or Cannabis-derived Compounds, Including CBD. Retrieved from fda.gov
In Florida, a qualified physician must complete a state-mandated 2-hour course, conduct an in-person exam, obtain written informed consent, and enter the patient's order into the MMUR. They are responsible for setting the dosage and routes, with certifications for non-smokable forms lasting up to 210 days and smokable flower orders limited to 35-day intervals.
Reference: Florida Statutes, Chapter 381, Section 381.986 - Medical use of marijuana.
Cannabinoids exhibit polypharmacology. CBD, for instance, acts as a negative allosteric modulator of CB1 receptors, an agonist at TRPV1 channels and 5-HT1A receptors, and an inhibitor of fatty acid amide hydrolase (FAAH). THC and other phytocannabinoids also interact with GPR55, GPR18, and various TRP channels, creating a complex signaling cascade that is still being elucidated.
Reference: Pertwee, R. G. (2008). The diverse CB1 and CB2 receptor pharmacology of three plant cannabinoids: Δ9-tetrahydrocannabinol, cannabidiol and Δ9-tetrahydrocannabivarin. British journal of pharmacology, 153(2), 199–215.
Key challenges include: 1) Ineffective Blinding: The psychoactive effects of THC make it difficult to blind participants and investigators to the treatment arm. 2) Product Standardization: Lack of standardized cannabis "drug" products (chemovars) with consistent cannabinoid and terpene profiles makes replicating studies difficult. 3) Placebo Selection: Choosing an appropriate placebo that mimics the sensory aspects of cannabis (smell, taste) without active compounds is problematic. 4) Regulatory Hurdles: The Schedule I status of cannabis creates significant administrative and logistical barriers to research in the U.S.
Reference: Vandrey, R., et al. (2020). Methodological Challenges and Opportunities in Cannabis Clinical Science. Annals of internal medicine, 172(2_Supplement), S49–S54.
Chronic exposure to exogenous CB1 agonists like THC leads to profound neuroadaptations, including homologous desensitization, internalization, and downregulation of CB1 receptors, particularly in the hippocampus, cerebellum, and prefrontal cortex. This receptor downregulation is a key neurobiological substrate of tolerance and is largely reversible upon cessation of use. The impact on endogenous ligand (anandamide, 2-AG) levels is less clear but appears to be regionally specific.
Reference: D'Souza, D. C. (2016). The Endocannabinoid System in Psychosis: A Critical Review of the Literature and Future Vistas. Biological psychiatry, 79(7), 548–557.
Inhibiting the enzymes that degrade endocannabinoids offers a novel therapeutic strategy. FAAH inhibitors prevent the breakdown of anandamide, leading to enhanced endocannabinoid signaling at postsynaptic neurons without the psychoactivity of direct CB1 agonists. They are being investigated for anxiety, PTSD, and pain. MAGL inhibitors increase levels of 2-AG, a potent CB1/CB2 agonist, but have shown a more complex safety profile, including physical dependence in preclinical models.
Reference: Ahn, K., McKinney, M. K., & Cravatt, B. F. (2008). Enzymatic pathways that regulate endocannabinoid signaling in the nervous system. Chemical reviews, 108(5), 1687–1707.
Major unanswered questions include: 1) To what extent do THC and CBD induce lasting epigenetic modifications (e.g., DNA methylation, histone acetylation) in somatic and germline cells? 2) Are there specific epigenetic signatures associated with the development of Cannabis Use Disorder or cannabis-induced psychosis? 3) Can prenatal cannabis exposure lead to heritable, transgenerational epigenetic changes that affect neurodevelopment and disease risk in subsequent generations?
Reference: Szutorisz, H., & Hurd, Y. L. (2016). Epigenetic effects of cannabis on the brain. Trends in neurosciences, 39(1), 25–36.
Genetic variability significantly impacts cannabis effects. A common single nucleotide polymorphism (SNP) in the FAAH gene (C385A) leads to reduced enzyme activity and higher baseline anandamide levels, which has been associated with decreased anxiety and altered responses to THC. Polymorphisms in CNR1, the gene encoding the CB1 receptor, have been linked to susceptibility to dependency and cognitive effects.
Reference: Haughey, H. M., et al. (2008). A common genetic variant of fatty acid amide hydrolase (FAAH) affects fronto-amygdala connectivity in humans. Neuropsychopharmacology, 33(9), 2275–2284.
Emerging evidence indicates a bidirectional relationship. The gut microbiome can influence ECS tone by modulating levels of endocannabinoids and receptor expression in the colon. Conversely, activating CB1/CB2 receptors can alter gut microbial composition and improve intestinal barrier integrity. This interplay is a promising area of research for inflammatory bowel diseases like Crohn's.
Reference: Cani, P. D., et al. (2007). The endocannabinoid system controls gut permeability and inflammation in obese mice by modulating dysbiosis. Gut, 56(4), 541-551.
Standard blood/urine tests for THC and its metabolites (THC-COOH) indicate past exposure but do not correlate well with the timing or degree of psychoactive impairment. Current research is focused on identifying more reliable biomarkers in alternative matrices like oral fluid and exhaled breath. Promising approaches include measuring parent THC concentrations in oral fluid, developing sensitive roadside breathalyzers, and exploring cognitive or psychomotor performance tests.
Reference: Lee, D., & Huestis, M. A. (2014). Current knowledge on cannabinoids in oral fluid. Drug testing and analysis, 6(1-2), 88–111.
NIDA's strategic plan emphasizes several key areas: 1) Elucidating the long-term neurodevelopmental consequences of adolescent cannabis use, especially from high-potency products. 2) Understanding the therapeutic potential and risks of minor cannabinoids and terpenes. 3) Developing novel medications for the treatment of Cannabis Use Disorder. 4) Clarifying the health impacts (both positive and negative) of different cannabis administration routes.
Reference: National Institute on Drug Abuse (NIDA). (2025). Marijuana Research Report. Retrieved from nida.nih.gov
Dr. Terel Newton welcomes engagement with researchers, clinicians, and industry professionals who are advancing the understanding and application of cannabinoid science. For direct inquiries, please use the appropriate contact information below to ensure your message is routed effectively:
For Dispensary & Industry Inquiries: For questions related to dispensary operations, industry collaborations, or product-specific information, please contact: Terel.Newton@Trulieve.com
For General & Scientific Inquiries: For academic discussions, questions about cannabinoid research, or other general inquiries, please contact: DrTerelNewton@gmail.com
