Healthier Alternatives to Smoking Medical Marijuana

The medicinal use of marijuana is legal in a growing number of U.S. states, and other states might eventually join this list.1 Some patients, however, might be unable to smoke medical marijuana because of their illness, disease, symptoms, treatments and/or other factors. This article explores the alternatives to smoking marijuana that might prove healthier or more viable for patients who’ve received a prescription for medical marijuana.

Marijuana Use for Medicinal Purposes

Requiring a doctor’s “recommendation” or referral and secured from legal vendors, medical marijuana can help relieve numerous symptoms, such as pain, glaucoma, migraine headaches,2 nausea, and weight loss.

While there are various pros and cons of using medical marijuana, it’s important to understand that the use of marijuana is not without potential side effects. For example, conventional or “street” marijuana might contain harmful fungus and/or pesticides,3 which can prove especially dangerous for patients with a compromised immune system.

Moreover, the fact that marijuana is usually smoked—either in cigarette form or through the use of tobacco or water pipes—introduces additional concerns. Patients who have never smoked before, or those receiving other treatments that can interfere with their ability to smoke, might find smoking marijuana difficult or simply impossible.

I found that to be a case with a patient with lung cancer and COPD. He suffered from chronic bone pain, nausea, and severe weight loss. He asked his doctor about medical marijuana and received the necessary prescription. When I came to see him, he held a joint but didn’t know how to use it. It was immediately clear that because of his inexperience and because he was using oxygen and was already suffering from a forceful cough, smoking a marijuana cigarette would not be the best method for him.

Alternative Options

It’s important to again stress that medical marijuana is a physician-referred treatment and should only be used according to a doctor’s instructions. If you or someone you care for receives a prescription for medical marijuana use but cannot smoke marijuana, non-smoking options might include:

Edible Marijuana: Medical cannabis can be heated and made into oils, butters, and tinctures. Many “cannabis clubs” sell pre-made cookies, brownies, lollipops, and teas. Savvy patients—those willing to take the time to empower themselves through research and knowledge—can also find recipes to make their own marijuana tincture, oil, or butter.

Eating or drinking marijuana’s main or active ingredient tetrahydrocannabinol (THC) is certainly preferable for many patients rather than smoking it, but these alternative methods can also create problems. When consumed via food or drink, THC does not absorb into the bloodstream as quickly as when it is smoked.4 This can make it more difficult to control the effectiveness of the drug or how much is consumed. In addition, patients who suffer from decreased appetite or nausea might not tolerate eating or drinking marijuana.

Vaporizers: Another option is to inhale marijuana using a vaporizer. This method involves heating the marijuana to a high enough temperature to vaporize the THC but not burn the plant. Patients can then breathe in the vapor from a bag without inhaling the harsh and potentially toxic smoke.

Vaping as it is commonly known, can cause serious lung injury. In 2019, a series of outbreaks across the country of what is called product use associated lung injury (EVALI), have resulted in over 2,291 hospitalizations and caused a reported 48 deaths (as of December 3, 2019).5 The Centers for Disease Control and Prevention are conducting studies to analyze the components of the TCH from the vaping products. They recommend that people do not use THC vaporizers and to watch carefully for any symptoms if they continue to vape.5

Finding the Solution That Works for You

Ultimately, it is possible to find healthier or more suitable alternatives to smoking marijuana, as my aforementioned patient did. He experimented with edible marijuana and found that he enjoyed the marijuana brownies he was able to get at a cannabis club, but as his appetite waned, he found it difficult to stomach the rich chocolate taste. He didn’t want to invest in a vaporizer because his life expectancy was short. However, through the people he met at the cannabis club, he was able to strike a deal with another medical marijuana patient and split the cost of a vaporizer—with the agreement that the other patient would inherit the device after his death. It was an unusual arrangement, to be sure, but it allowed him to continue using medical marijuana for several more weeks.

How to Get the Best Version of Your Strain

Ever wonder why the same strain of cannabis can be slightly different, depending on which store you get it at? A gram of OG Kush from one grower who sells to a particular dispensary will be slightly different from another grower’s OG Kush at the dispensary across town. Although they are the same strain, these are different phenotypes (or “phenos”)—different expressions of the same genetic material.

If two cats—one an orange tabby and the other a black and white calico—have a litter of kittens, some of the kittens will be orange tabbies and some black and white calicos. Some may even be black and white tabbies. So too, do different cannabis phenotypes have different traits from one or both of their parent strains.

When a grower decides to produce a particular strain, they typically get a packet of seeds from a breeder, each one a different phenotype of that strain. After growing each seed, the grower will pick the best one because of its characteristics, picking for yield, bud density, smell, flavor, potency, color, and many more attributes, and discard the others.

This narrowing process usually takes a few generations of selection, and months, sometimes years, but in the end, the best pick will be mass produced for sale, and that’s the cannabis you buy off the shelf at the dispensary.

The Importance of Labeling

An example of the phenotype selection process. Growers typically mark and number each phenotype for tracking purposes. In this case, a grower is selecting OG Kush (OGK) phenotypes. Click to enlarge. (Elysse Feigenblatt/Leafly)

Selecting phenos is a meticulous process. Organization and keeping track of things through the long growing process is imperative. You’ll be taking clones of each phenotype and keeping some while discarding others, so it’s important to label clones according to their originals phenos and to not mix up any.

To start, plant all of your seeds and label each one with a separate tag. So if you’re growing 10 phenos of OG Kush, you would assign them “OGK 1,” “OGK 2,” etc., up to “OGK 10.” The order of the numbering doesn’t matter, but make sure that a number always stays with the pheno you assign it to.


How to germinate cannabis seeds

Grow out each seed until they are 6-12” tall, or big enough to clone. This will probably take about 3-6 weeks.

Take a clone of each phenotype and number each clone to its corresponding original: the clone of “OGK 1” would also be named “OGK 1” and so on.

If you’re starting out with ten seeds, you should now have 20 plants: 10 seedlings and 10 clones.

Clone, Flower, Discard

After you have taken clones, grow them separately in a vegetative state. When the original phenos are big enough, after at least 2 months in the vegetative state, put them on a flowering light cycle (12 hours of dark, 12 of light).

After about 8-10 weeks of flowering, these original phenos will be ready to harvest for buds. Some phenotypes might finish sooner than others and each will probably be slightly different. Now you will discard some of the phenos based on their poor quality and keep the ones that have good qualities.

A lot of seeds come pre-feminized, but if you are starting out with male and female seeds, you will need to determine the sex of the plants first and discard all of the males, because only females produce buds. Reproductive organs appear a couple weeks into the flowering cycle, and if you have any males, discard them and their corresponding clones and keep flowering the females.


Cannabis anatomy: The parts of the plant

When harvesting each phenotype, take meticulous notes of each pheno’s bud structure, yield, smell, density, and overall appearance. Some phenos can be discarded right away, as it will be easy to tell that they won’t produce quality buds. Whenever you discard a pheno, discard its corresponding clone that’s in the vegetative state.

You can still use the harvested buds from discarded phenos. This product may not be as desirable because it’s from the phenos that didn’t make the cut, but a lot of growers will sell this for pre-rolls or extracts, just usually not quality flower.

Repeat the Process

The process is repeated. If you started with 10 phenos and discarded six after the first round of flowering, you’ll be left with four. Take a set of clones off of these four—a second generation of clones, or clones from clones. Keep this new second generation in the vegetative phase separately, and flip the first generation of clones into flower.


Stages of the cannabis plant growth cycle

This first generation should be big enough to flip into flower now because they were growing vegetatively while the original phenos were flowering. But you can always grow these out more vegetatively if you want bigger plants.

After flowering these four remaining phenos, harvest them and take more notes. Discard the ones with poor qualities and their corresponding clones and keep the ones with good qualities.

Continue this process until you’re down to one pheno. That is your winner!

You don’t want to discard a pheno with possible good qualities, but keep in mind that the less you discard, the more rounds of cloning, flowering, and discarding you’ll have to do.


Often, commercial growers will go through at least three rounds of generations of this selection process to get the final pheno, sometimes even more.

You can see how this is a time-consuming process. Three generations of flowering phenotypes, if each round takes about 8-10 weeks, is 24-30 weeks alone. Add on top of that another month or so for the seeds to germinate and get to an initial size in which to clone off of at the beginning of the process, plus time to harvest, dry, and cure buds at the end.

So before that OG Kush from your favorite grower hits the shelves for the first time, they have been growing and narrowing it down for 7-9 months at least, to get you the best version of that OG Kush. That phenotype is now their “cut” of that strain.

How to turn a THC strain into a CBD strain

As the CBD industry continues to surge, that market becomes more independent from the traditional (THC) cannabis industry. Companies are constantly looking for ways to bridge the gap between the classic consumer and the future way of weed.

One way is by putting a new age spin on a classic product. Lately, growers have been turning THC-dominant strains into a CBD-dominant or balanced strain.

Industry evolution

When the legal cannabis industry was first born in 2014, the market was all about THC products and seeking the most powerful high possible. That’s why there was so much emphasis on THC percentage, because consumers believed the higher that number, the better the high, though that is not necessarily true. Cannabis producers placed little-to-no focus on breeding, growing, or even researching CBD strains and genetics.

This has changed over time as the industry expands. Nowadays, the CBD market is such an unstoppable force that companies who reigned supreme in the THC game are looking for ways to convert.

Enter: THC-turned-CBD strains.


By now you should know the difference between THC and CBD: THC will get you high, CBD will not. THC is viewed as the recreational weed and CBD is viewed as the medical weed, though both compounds certainly provide their own respective wellness benefits. With CBD, many people believe it to be the best treatment for various psychological and physical ailments.

Types of CBD cannabis strains

CBD cannabis comes in two forms: CBD-dominant and balanced. CBD-dominant strains contain CBD:THC ratios of 5:1 or more. With these, out of all the plant’s cannabinoids, CBD is the most pronounced, meaning effects will be more influenced by CBD than the other cannabinoids. ACDC, with its 14:1 CBD:THC ratio, is an example of a CBD-dominant cannabis strain.

Balanced cannabis strains hold a CBD:THC ratio between 1:1 and 5:1. This means you may still feel some degree of high as effects will be intensified by THC’s influence, but it should be wayyy less of a powerful high than a THC-dominant strain. Harlequin, with an average CBD:THC ratio of 2:1, is an example of a balanced cannabis strain.

How to grow marijuana in Michigan and Illinois

Welcome to the world of legal recreational cultivation, Michigan and Illinois! While all closets might be created the same, outdoor conditions vary greatly by region. Knowing the specifics of your climate will go a long way in your success as a grower.

Here are some specific considerations to keep in mind in the Great Lakes region.

Know your local homegrow laws


Michigan went legal on December 1, 2019. Michiganders 21 and up can grow 12 plants at their residence—if multiple people live in a house, there can still only be 12 total. Plants have to be out of sight from the public and in an enclosed area that can be locked, even if it’s outside.


Frustrated, Michigan? Here’s why there’s no cannabis store near you


On January 1, 2020, cannabis goes legal in Illinois. As the law currently stands, only medical cannabis patients will be allowed to grow at home—and only five plants at a time—so you’ll still need a medical marijuana card to homegrow, even though pot’s legal to buy for folks 21 and up. There will be a civil penalty of $200 for anyone growing up to five plants without a medical card.


Illinois cannabis dispensaries open New Year’s Day for adult-use sales

Check your frost dates

Weed is a warm-season annual. Frost kills it, making your region’s frost dates—first and last—of utmost importance. You’ll want to pop seeds indoors while it’s still too cold outside and have the seedlings ready to go into the ground once all danger of frost has passed and the soil has warmed some.

If this sounds daunting, don’t sweat it: The crop that weed most closely lines up with in terms of planting time is tomatoes. When in doubt, consult the Farmer’s Almanac guidelines for sowing tomatoes in your region and use those dates as a guide. In the Midwest, you’re looking at starting seeds indoors sometime in March and getting them into the ground sometime early to mid-May.

Want to learn more about growing marijuana? Check out Leafly’s Growing resource!

Choose seeds and clones suited to a northern climate

Certain cannabis varieties evolved in equatorial climates—typically sativas—meaning they can take an extra long time to finish (before their flowers are ready for harvest). Other varieties hail from harsher, northern climates, and finish before the frost arrives, typically indicas.

While pretty much every cultivar you get your hands on these days is a hybrid of these two, look for any clues in the description that points to “early finishing.” This helps in a climate where eventual frost will happen without a doubt.

Understand the impact of humidity

The Great Lakes and Midwest regions are known for hot, muggy summers. While this is less of an issue during the early part of the growing season, it can be troublesome come flowering time because buds are susceptible to mold.

A few things you can do to mitigate problems include making very certain your plants are sown in a spot in your garden where they’ll get the fullest amount of sun—at least six hours of direct sunlight a day, with plenty of breathing room in between them to allow for air circulation. Also, use drip irrigation instead of overhead watering.

Brace for thunderstorms and wind

Wild storms are a part of life in the Great Lakes and Midwest. To help see your plants through, consider the following tips.

Cage or trellis your plants at planting time. While they seem itty bitty when they go in the ground, those ladies will grow to be large and in charge, not to mention heavy, as they begin to flower. Strong winds have a lot less of a chance to knock them over or break branches if a plant is supported properly.

Also, consider placing a few tall stakes around the perimeter of each plant, so you’re ready to drape a tarp or canvas over them should hail be in the forecast. This security blanket will help prevent damage.


How to protect your cannabis crop from rain

Keep pests—big and small—at bay

While we’re massive fans of gardening outdoors, it’s true that cultivating outside puts you in close contact with other of Mother Nature’s glorious creatures.

If deer are an issue in your locale, grow your crop behind a deer fence. Cats go a long way in deterring gophers and other rodents. If you’ve not got one on hand, consider sinking cannabis plants into gopher cages at planting time.

Handpicking slugs and snails in their shady daytime hideouts is your best bet for squashing them.

Use blasts of water to rid plants of aphids, and be diligent—you might have to do this several times.

Lastly, applications of neem oil help with infestations of spider mites, white flies, and fungus gnats. It’s a great organic option for the garden. But we definitely advocate a less-is-more approach to pest control.

Give your plants optimal conditions from the start—full sun, healthy soil, the right amount of water—and you will be less likely to battle bugs. Remember that anything you put on your plant might make it into your eventual crop, so be careful with any chemicals.


Predators Over Pesticides: An Introduction to Chemical-Free Pest Control

Harvest time

Most cultivars are ready to harvest between September and October. While weed can survive a light freeze (28-32°F for up to three hours) with no trouble, a hard freeze, any lower temps or longer hours, will kill it.

If a hard freeze in the forecast, cut your losses and harvest your crop even if it’s not fully finished. If humidity is nuts when it’s time to harvest, you could get a little crazy and haul box fans powered by extension cords out to your garden and dry things out a bit before you chop. It’s certainly not pretty, but we’ve absolutely seen it done.

CDC “Breakthrough” Focuses on Vitamin E Acetate in Vape Illnesses

Vitamin E acetate, which is sometimes used as a thickening agent in vape products, is emerging as a potential “culprit” of vape-related lung illnesses that have hit every state but one, according to the latest federal and state investigations. And the data examined so far, according to the Centers for Disease Control and Prevention (CDC), “point to a much greater risk associated with the THC-containing products that are acquired from informal sources as opposed to licensed.”

The CDC released these “breakthrough” findings and a number of updates Friday. As of November 5, 2,051 people living in 49 states have fallen ill, and 39 deaths have been reported in 24 states, according to the CDC. The CDC is also reporting that as of October 15, 86% of people with vape-related lung illnesses said they used a THC vape in the three months before they got sick.

Some early investigation findings were released that showed that of 29 patient lung fluid samples tested, Vitamin E acetate was detected in every single one. Of these patients, 21 were male, and the average age was 23, “which is consistent with the sex and age patterns of EVALI patients reported to CDC to date.” (EVALI stands for “e-cigarette, or vaping, product use associated lung injury.) Two of these patients died, a CDC Morbidity and Mortality Weekly Report released Friday noted.

“These findings provide direct evidence of vitamin E acetate at the primary state of injury within the lungs, and the samples reflect patients from states across the country,” CDC Principal Deputy Director Anne Schuchat said during a telebriefing with reporters Friday morning.

While Vitamin E acetate isn’t known to be harmful when swallowed as a supplement, or rubbed onto the skin as a topical, “previous non-CDC research suggests that when vitamin E acetate is inhaled, it may interfere with normal lung function,” Schuchat said.

The early CDC results “relied” on collaboration and input from CDC scientists working closely with epidemiologists, clinicians and public health officials nationwide.

“It’s important to note that these findings do not rule out other possible compounds or ingredients that may be causing these lung injuries. There may be more than one cause of the outbreak. However, they help us better understand the potential compounds or ingredients that may contribute to the cause of EVALI,” Schuchat said.

As the early results still show a majority of vapes contain THC, the findings “reinforce” previous CDC recommendations that people refrain from using THC vape products, “particularly from informal sources like friends or family, online dealers, or the illicit market,” Schuchat said, emphasizing that until the relationship between vitamin E acetate and lung health is better understood, no Vitamin E acetate should be added to any vape products.

And, while Vitamin E acetate was “universally detected” in these 29 lung samples, “additional studies are needed to establish whether a causal link exists between the exposure and EVALI, and it may be that there is more than one cause of the outbreak,” Schuchat said.

Cannabis Wire asked the CDC whether autopsies had been conducted on any of the 39 people who have died.

The “CDC does not currently have any information to release regarding autopsies, however we will be doing an upcoming report looking at the autopsy tissue findings,” Karen Hunter, a senior press officer with the CDC told Cannabis Wire. The CDC does not yet have an estimated publication date of those findings.

During a question and answer period, a Boston Globe reporter asked if cannabis products containing Vitamin E acetate were being sold by state-licensed dispensaries.

Schuchat responded by characterizing the patchwork of state laws, saying that state regulators “set their own regulatory measures in terms of what needs to be done, what ingredients are allowable or what documentation on the quality of production, distribution and handling has been made.”

“It is possible that Vitamin E acetate may be included in dispensary-sold products in one state or another. And it is possible it’s there intentionally, possible it’s there unintentionally. I believe that state regulators are taking a look at their regulations right now in light of the ongoing outbreak,” Schuchat said.

Still, reports could be confirmed that some lung illness cases could be linked to state-licensed shops. “There is some anecdotal information right now about individuals who only report getting products from licensed dispensaries. And exactly what those products are, and whether they were as labeled, or as expected to be produced, is unclear,” Schuchat said. “Might there be some infiltration of the licensed product distribution system in terms of some of the suppliers intentionally or inadvertently having problematic ingredients? I think that’s possible. But the majority of what we’re seeing right now is pointing to the informal sources.”

Jennifer Layden, chief medical officer and state epidemiologist from the Illinois Department of Public Health added, “In Illinois we have not had cases associated with our medical marijuana program.”

Layden shared results of an online public survey of 4,631 Illinois adults that found that 94% used nicotine containing products, compared to 21% THC products. IDPH took the group of survey participants who said that they used THC products but did not have EVALI, and compared them to EVALI patients of the same age group. Key findings emerged.

EVALI patients were roughly two times more likely to report the exclusive use of THC-containing products compared to survey respondents, and a “higher proportion” of EVALI patients than survey participants said they used THC products more than 5 times daily.

“EVALI patient cases were roughly 9 times more likely to obtain the THC containing products from informal sources such as a dealer off the street or from a friend compared to survey respondents,” Layden said.

Study finds more teens vaping marijuana even as mysterious lung illness claims young lives

More teens are regularly using marijuana by vaping rather than smoking, even as mysterious lung illness claims young lives across the United States, according to a study released Wednesday.

Fourteen percent of high school seniors said they vaped marijuana in the previous month, according to the National Institutes of Health’s annual Monitoring the Future survey. That’s nearly double the rate from 2018, the second-largest annual increase recorded in the survey’s 45-year history. It’s also up dramatically from 4.9% in 2017.

The survey, conducted earlier this year, also found that 22% of high school seniors — about the same percentage as in 2018 — say they use marijuana, which can be smoked, vaped or eaten through an edible.

“It appears that kids are switching how they are using marijuana, not how much they are using marijuana,” said Ken Warner, an emeritus professor of health policy at the University of Michigan, who was not affiliated with the study.

About 26% of high school seniors said they vaped nicotine within the previous month, mirroring results from a separate survey published by the Centers for Disease Control and Prevention earlier this year. Meantime, less than 6% of 12th graders said they smoked conventional cigarettes, according to the new survey, which was funded by the NIH’s National Institute on Drug Abuse.

The survey of more than 42,000 students in grades 8, 10 and 12 was conducted by Richard Miech and colleagues at the University of Michigan.

“We’ve seen [increases] in the past among the three grades, never at this size that we’re observing with vaping,” said Dr. Nora Volkow, director of the National Institute on Drug Abuse. “Never.”

The study shows how popular vaping is becoming, especially among young people. Newer products have transformed centuries-old methods of consuming nicotine and THC, the compound that products a high in marijuana. They can be used discreetly and are often available in sweet flavors that make vaping more palatable and critics say helps attract teens.

A surge in teen vaping during the past few years has sent lawmakers and regulators scrambling. President Donald Trump and top U.S. health officials have been weighing for months whether to ban flavored e-cigarettes in a bid to make the products less appealing to kids.

An outbreak of a deadly lung disease among people who vape revealed another critical health risk: People are vaping unregulated and sometimes deadly THC oils. The illness has hospitalized 2,409 people across the country and killed 52, the CDC said last week. Health officials have tallied 152 different THC products that patients reported using. A majority of the patients are young men.

“Teenagers are believing less and less there’s any harm in marijuana, and then on top of that you have sleek, cool devices that actually have become very, very popular among teenagers,” Volkow said. She also noted that vaping allows people to consume potent doses of THC without the pungent smell that smoking marijuana produces.

Volkow anticipates the lung illness outbreak may deter some teens from vaping THC. She thinks stories of otherwise healthy teenagers ending up in intensive care may cause teens to “think twice.”

While the study shows increases in vaping, it also identifies a significant decrease in teen cigarette smoking. In 2019, less than 6% of high school students reported smoking in the past month, down from 20% in 2009, according to the survey.

“The data are just tremendously encouraging on cigarettes,” Warner said. “That’s the most deadly use we’re talking about.”

Illinois Lieutenant Governor Buys Marijuana On State’s First Day Of Legal Sales

The lieutenant governor of Illinois was among the first customers to purchase marijuana on the state’s first day of legal sales on Wednesday.

Shortly after the Sunnyside Lakeview dispensary opened its doors, Lt. Gov. Juliana Stratton (D) bought clementine-flavored edible gummies and paid with cash. The event marks the beginning of Illinois’s adult-use program, which went into effect with the new year, months after Gov. J. B. Pritzker (D) signed legalization legislation into law.

.⁦@LtGovStratton⁩ buys Mindy’s edibles at the 6 am opening of cannabis store in Wrigleyville. She pays with a $100 bill.

View image on Twitter

The reform move has been widely welcomed by top lawmakers in the state. But while there’s enthusiasm about the economic and industry potential of the nascent cannabis market, much of the focus has concentrated on social equity and ensuring that communities most impacted by prohibition reap the benefits of legalization.

Video via CBS Chicago.

To that end, Prtizker announced on Tuesday that he had issued more than 11,000 pardons for people previously convicted of low-level marijuana possession.

“We believe the social equity aspects of this legislation should be a model for the entire country,” Stratton said outside of the cannabis shop. “Yesterday, Governor Pritzker pardoned 11,017 low-level cannabis arrests and convictions. That’s just the beginning.”

“We have hundreds of thousands more who will be eligible for having their records expunged. That’s a big deal,” she said.

For too long, IL residents, particularly those that are black & brown, have been targeted and criminalized for possession.

It’s not just a new year, it’s a new day. Thank you, @GovPritzker, for ending prohibition and building a more equitable Illinois. 



Illinois Lieutenant Governor Juliana Stratton joined hundreds of patrons at a Chicago marijuana dispensary on the first day of legal recreational sales. She touted related policy changes, such as expungement of some convictions for weed possession. 

View image on Twitter
98 people are talking about this

This appears to be the first time a lieutenant governor has publicly purchased marijuana from a state-legal shop. But while there were smiles all around at the Sunnyside shop, not everyone is celebrating.

Kevin Sabet of the prohibitionist group Smart Approaches To Marijuana had a few choice words for Stratton.

“What a wonderful example for the children of Illinois,” he sarcastically wrote in a tweet about the lieutenant governor’s cannabis purchase.

.⁦@LtGovStratton⁩ buys Mindy’s edibles at the 6 am opening of cannabis store in Wrigleyville. She pays with a $100 bill.

View image on Twitter