The generation that smoked marijuana through the '60s and '70s, and who now might be returning to it for medical reasons, could be surprised at just how much the weed has changed over the decades.
Years of underground plant science have wildly increased its potency. The level of the active ingredient tetrahydrocannabinol, or THC, found in pot can range from 4 percent -- the average for the popular Mexican weed of the '70s -- to a whopping 35 percent.
"Because of the cross-straining and doing different things with cultivation, the native cannabis of 30 years ago is becoming a blur," said Kari L. Franson, a doctor of pharmacy and associate dean at the University of Colorado School of Pharmacy and Pharmaceutical Sciences.
With the heightened THC levels, Franson said, the marijuana high feeling has changed drastically as well. It has gone from an experience in which "euphoria and brilliant storms of laughter; ecstatic reveries and extension of one's personality on several simultaneous planes are to be complacently expected," as Alice B. Toklas described it in her famous cookbook of 1954, to one that packs a much-stronger punch.
When Connecticut's new medical marijuana program takes off next spring, patients will choose from a dizzying variety of strains, concentrations and products. They can purchase a low- or high-THC strain, smoke it in a traditional cigarette or pipe, ingest the vapors through a machine, put a few drops of a liquid tincture under their tongue or eat a cannabis-laden cookie or brownie.
An emerging science
All those and more will be offered at dispensaries for patients who have been certified by their doctors and registered with the state Department of Consumer Protection, which runs the medical marijuana program.
But for 59-year-old Robert Specht, of Hamden, who has a variety of debilitating ailments and has been certified as a patient since last November, any kind of legal marijuana will be better than his stressful, monthly search in the state's underground cannabis market.
"It's a stereotype to think that everyone has access to cannabis," Specht said in an interview. "I never know where my next batch comes from. I've never had any regular source. I want to be able to choose different strains."
Medicinal cannabis is an emerging science that has long been thwarted by federal drug laws against its use, with massive restrictions on research.
But as more states approve medical marijuana -- not to mention Colorado and Washington state, where it is now legal for adult recreational use -- more information is emerging on the effects of various strains and the role of THC and other cannabidiol compounds (CDB) in making patients feel better.
There are now websites like Leafly.com, Webmd.com and Nuggetry.com that rate hundreds of strains. Each has been branded with a clever marketing name and an enticing back story.
"Space Queen," for instance, "has a very fruity taste, with a hint of pineapple," Leafly says, listing its medical benefits as a treatment for anxiety. "A definite head high."
Another strain for anxiety, one of the symptoms of post traumatic stress syndrome, is the '60s classic "Acapulco Gold."
"It has been argued as one of the best strains of cannabis ever created," Leafly reports. "With gold, green and brown colors of resin collecting on the bud of this plant, it has been likened to dinner at a five-star restaurant."
A race to the dispensary
Deputy DCP Commissioner Michelle Seagull, who has been closely involved in drafting Connecticut's regulations, said recently that she anticipates the state's medical marijuana industry to react to market needs.
"We expect that producers will respond to patient demands in determining which strains, and how many, will be available," Seagull said.
Erik Williams is executive director of the state chapter of the National Organization for the Reform of Marijuana Laws and chief operating officer of Biltin Advanced Propagation, which hopes to secure one of three state permits to grow marijuana. Williams is planning a secure, 73,000-square-foot grow facility and kitchen in New Britain, and said that, initially, patients will choose from the types of marijuana that mature the fastest.
"We intend to grow between 50 and 60 strains at any given time, but there may be fewer to begin with," he said, adding that once the Department of Consumer Protection approves growing and dispensary proposals early next year, the race will be on to have a crop to sell.
A mid-November deadline has been set for the proposals, which require some of the most restrictive regulations in the nation. So far, 100 physicians and 1,118 patients have been registered.
Identification cards will allow patients and their caregivers to enter dispensaries and buy up to two-and-a-half ounces of marijuana per month.
Growers have hybridized the two major strains of marijuana -- cannabis sativa and cannabis indica -- over the decades to increase the concentration of THC.
Various parts of the plant have different uses, but males are culled out in order to make sure female plants are not fertilized. Mature female flowers -- some are ready in 60 days -- are where most of the active ingredients concentrate. The harvested buds are trimmed off larger leaves, dried and prepared for sale. Trimmed leaves and other larger leaves of the plant are used for salves, tinctures and edibles.
While other states have allowed marijuana to be used in sodas and candies, Connecticut drew the line. Growers may only offer raw material; cigarettes, extracts, sprays, tinctures and oils; transdermal patches; baked goods; and capsules and pills.
There is a strict ban on the use of alcohol above one half of one percent in marijuana-based products.
Patients are eligible for the program if their physicians certify that they suffer from one of 11 diseases, including cancer, glaucoma, HIV/AIDS, Parkinson's disease, multiple sclerosis, damage to the nervous tissue of the spinal cord, epilepsy, cachexia, wasting syndrome, Crohn's disease, or post-traumatic stress disorder.
Specht, like many patients, inhales cannabis through a vaporizer, which runs air through the marijuana without burning it.
"I consider it an exit drug, not a `gateway' drug," said Specht, who suffers from complex regional pain syndrome, peripheral neuralgia, reflexive dystrophy and other ailments, including post traumatic stress syndrome, which qualified him for the medical marijuana program. "I was able to reduce my meds from 23 a day, down to four, just by using cannabis."
A former entrepreneur, artist, weaver, commercial photographer and teacher, Specht has been living off disability checks for the last nine years and has become an advocate for medicinal marijuana, which has helped him stay off opiates for the last three years, while losing 80 pounds.
"It's one of the safest substances on the planet," said Specht, a NORML board member who is also a member of the Connecticut Cannabis Business Alliance, an advocacy group for prospective growers and dispensers.
Specht is worried that the licensed pharmacists who will run the dispensaries might not have the necessary experience to advise patients.
Williams said if selected, his company will either train Connecticut pharmacists in Colorado, where the firm has been operating, or hire pharmacists from that state.
In addition to dried marijuana flowers for smoking, vaporizing and home cooking, Williams' company would provide a half dozen edible products -- so-called medibles -- including infused olive oil, brownies, baklava, other baked goods, teas, topical salves and tinctures, liquid made from marijuana resin applied as drops under the tongue.
Since patients vary in size and reaction to THC and CDB, there will eventually be a range from which to choose.
"Most people are comfortable with a brownie or cookie," Williams said.
Patients such as Specht find that smoking or vaporizing provides faster relief for pain, with the smoke and vapor going through the lining of the lungs into the blood stream toward the brain. Edibles -- once they take effect through the stomach lining -- have longer-lasting effects.
"It's not always fun to be impaired, but sometimes it's good to distract me from my pain," he said. "My body dictates how I medicate."
Franson, the Colorado pharmacist, said in a recent interview that the study of the drug is really in its infancy in the U.S.
While THC is the primary ingredient and provides the subjective psychoactive effects that generations of pot users have come to know, she said CBD levels have been found to block some of the THC effects. But since research has been opposed in the states, the science is being conducted in Canada and Europe, particularly in the Netherlands, where Franson lived and studied for years.
"What THC does do clinically is, it increases appetite and the subjective feeling of being high causes an immediate elevation of the heart rate by 16 beats per minute," she said of the typical reaction to smoking or vaporizing.
Franson said at this point, no one can really predict that one strain of marijuana will help more than others, because research has been controlled, and stymied, by the National Institute for Drug Abuse. She believes the institute has been performing a "disservice" to the medical community.
"If someone walks into a dispensary with back pain, at the same counter they'll be asked what they need," Franson said. "Based on their experience, the pharmacist will pick one out that they think is the best and make a recommendation. The unknowns and the ways the drug is being given, it's just unscientific to me. It's disappointing to me."
Chris Walsh, editor of the Rhode Island-based Medical Marijuana Business Daily, said that initially, Connecticut growers may encounter inventory problems.
"In general you'll find new dispensaries will have trouble matching demands," Walsh said in a phone interview. "Getting the patient the right medicine is really up to the dispensary. Those who excel in customer service with a knowledgeable staff of pharmacists, who can walk people through with the best information, those will be the most-successful businesses."
Part of the challenge that will face dispensaries will be guiding patients to the right strains and forms of ingestion.
"A lot of people might not want to smoke marijuana, so they should have varying types of products with different potency and tastes," Walsh said, stressing that dispensaries are going to want to make their patients comfortable.
The biggest leap of faith might be among the patients who may confront the stigma of buying something that's been illegal for 75 years.
"Patients are going to be really nervous," Walsh said. "In a sense, you're doing something that's federally illegal and possibly looked down upon in this day and age."