Patient Education and Support Materials
Locations
Chandler - 318 S Bracken Lane, Chandler AZ, 85224: Open Daily 8am - 10pm
Flagstaff – 1250 S Plaza Way, Flagstaff, AZ 86001: Open Daily 9am - 9pm
Glendale – 9240 W Northern Ave #103 B, Glendale, AZ 85305: Open Daily 8am - 10pm
Mesa – 5550 E McDowell Rd, Ste. 103 Mesa, AZ: Open Daily 8am – 10pm
Phoenix - 21035 N Cave Creek Rd Ste. 3 & 4, Phoenix, AZ 85024: Open Daily 8am - 9pm
Tucson - 3008 N. Stone Ave, Tucson, AZ 85705: Open Daily 8am - 10pm
Queen Creek - 7343 S 89th Pl, Mesa, AZ 85212: Open Daily 8am – 9pm
Contents
I. Introduction
Arizona Medical Marijuana Act (AMMA)
Law Overview and Qualifying Patients’ Rights
Qualifying Medical Conditions
II. How Marijuana Works
What is Marijuana?
The Endocannabinoid System (ECS)
Cannabinoids Details
Terpenes
Methods of Consumption
Cannabis Species, Effects, Health Benefits, and Strains
III. Cannabis Use - Contraindications, Drug Interactions, Side Effects, and Addiction
Contraindications
Known Interactions
Possible Side Effects
Addiction – Signs of Abuse
IV. Patient Record Keeping
Patient Symptom Tracking Log
V. Regulatory Compliance Testing
Tests Required by Product Type
How to Read and Understand the Results Report
Appendices
Appendix A – Flower Strains, Purported Effected, and Health Benefits
Appendix B – Patient Symptom Tracking Log
I. Introduction
Ponderosa Dispensary is committed to providing Qualifying Patients and Designated Caregivers with the most current and accurate information regarding the use of medicinal marijuana (cannabis). We believe that patient education and support are essential components to meeting all our Qualifying Patients’ wellness and medicinal needs. This in-depth Patient Education and Support Materials ensures that Patients and Caregivers have access to important information regarding the use of medicinal marijuana and marijuana products, while meeting and exceeding the requirements set forth in the Arizona Department of Health (ADHS) Rules Section R9-17-310(A)(2)(h).
Arizona Medical Marijuana Act (AMMA)
The AMMA went into effect on April 14, 2011, making Arizona the fourteenth state to adopt a medical marijuana law. The AMMA designates ADHS as the licensing and issuing authority for the Arizona Medical Marijuana Program. AMMA allows a “qualifying patient” with a “debilitating medical condition” to obtain up to 2.5 ounces of marijuana in 14 days from a registered non-profit medical marijuana dispensary.
Law Overview and Qualifying Patients’ Rights
In November 2010, voters passed the Act. In 2011, pursuant to the requirements of the Act, ADHS implemented the rules. Below is a brief overview of the AMMA. All our Qualifying Patients and Designated Caregivers need to understand that the use of medicinal marijuana, even in complete compliance with the AMMA, does not shield them from federal prosecution. The Department of Justice continues to view the use, sale, or dissemination of medical marijuana as a federal crime.
What the Act Really Does
Provides Qualifying Patients and Designated Caregivers Certain Protections. The Act prohibits certain discriminatory practices against Qualifying Patients and Designated Caregivers, including:
A school or landlord may not refuse to enroll or lease to a Qualifying Patient of Designated Caregiver unless failing to do so would cause the school or landlord to lose benefits under federal law.
An employer may not discriminate against Qualifying Patient of Designated Caregiver regarding hiring, terminating, or imposing employment conditions unless failing to do so would cause the employer to lose benefits under federal law.
An employer may not penalize a Qualifying Patient for a positive drug test for marijuana, unless the patient used, possessed, or was impaired by marijuana on the employment premises or during hours of employment.
Requires Written Certification
The AMMA requires all Qualifying Patients to be physically examined and diagnosed by a licensed physician. Upon the appropriate diagnosis, or confirmation of a diagnosis, of one of the following debilitating medical conditions, a physician may provide written certification of a medical marijuana card.
What the Act Does NOT Do
The Act:
does not authorize an individual to undertake any task under the influence of marijuana that constitutes negligence or professional malpractice.
does not authorize possessing or using medical marijuana on a school bus, on the grounds of a preschool, primary school, or high school, or in a correctional facility.
does not authorize smoking marijuana on public transportation or in a public place.
does not authorize the operation, navigation, or physical control of any motor vehicle, aircraft, or motorboat while under the influence of marijuana.
does not require a government medical assistance program or private health insurer to reimburse for costs associated with the use of medical marijuana.
does not require the owner of private property to allow the use of marijuana on such property.
Does not require an employer to allow the ingestion of marijuana in the workplace.
Does not prevent nursing care or other residential or inpatient healthcare facilities from adopting reasonable restrictions on the provision, storage, and use of marijuana by residents or Qualifying Patients.
What Doctors can NOT Do:
Provide additional assistance to patients in obtaining cannabis beyond what is required by the Act.
Recommend cannabis without a justifiable medical cause.
Qualifying Medical Conditions
Cancer
Glaucoma
Human immunodeficiency virus
Acquired immune deficiency syndrome
Hepatitis C
Amyotrophic lateral sclerosis
Crohn’s disease
Agitation of Alzheimer’s disease
A chronic or debilitating disease or medical condition or the treatment for a chronic or debilitating disease or medical condition that produces cachexia or wasting syndrome
A chronic or debilitating disease or medical condition or the treatment for a chronic or debilitating disease or medical condition that produces severe and chronic pain
A chronic or debilitating disease or medical condition or the treatment for a chronic or debilitating disease or medical condition that produces severe nausea
A chronic or debilitating disease or medical condition or the treatment for a chronic or debilitating disease or medical condition that produces seizures, including those characteristic of epilepsy
A chronic or debilitating disease or medical condition or the treatment for a chronic or debilitating disease or medical condition that produces severe or persistent muscle spasms, including those characteristic of multiple sclerosis
Post-traumatic stress disorder for which the individual is receiving treatment
A debilitating medical condition approved by the Department under A.R.S. § 36-2801.01 and R9- 17-106.
II. How Marijuana Works
What is Marijuana?
Marijuana refers to the flowering parts of the Cannabis Sativa or Cannabis Indica plant that contains over 500 chemical substances called cannabinoids. The main cannabinoids, tetrahydrocannabinol (THC), and cannabidiol (CBD) are the substances primarily responsible for the effects and benefits of medical marijuana.
The Endocannabinoid System (ECS)
The human brain and body have a transmitter system called the endocannabinoid system (ECS), a network of receptors that regulates and controls many of our essential bodily functions. The receptors in the brain, CB1 receptors, control levels of many of our neurotransmitters responsible for a range of functions including mood, sleep, appetite, and memory. These receptors cause the high commonly associated with marijuana consumption.
CB2 receptors, primarily located in immune cells, do not produce the high associated with cannabis. Instead, they play a crucial role in immune function and in modulating pain and inflammation.
Cannabinoids Details
At least 85 cannabinoids have been isolated from the cannabis plant. Common testing methods provide profiling for the six most prevalent cannabinoids – THC, THCV, CBG, CBC, CBN, and CBD. Since the 1980’s, lots of research has been done on the different effects and workings of cannabinoids. Today, there are literally hundreds of cannabis strains, each with their own unique balance of cannabinoids and potency. These differences result from the plant’s genetics, breeding, and growing conditions. Each strain has its own cannabinoid profile resulting in unique effects on individuals. The graphic below shows the most prevalent cannabinoids and their health benefits:
Terpenes
Numerous references in popular cannabis literature and culture claim that cannabis strains can smell like tropical fruit, citrus, gas, pine, earth, or other familiar scents. These aromas come from over 120 terpenes (a.k.a. terpenoid fragrance molecules) that are made by the plant. Terpenes have some interesting effects on humans, including modulating the effects of THC. Refer to the graphic below to review common terpenes and their purported effects:
Methods of Consumption
Smoking – Smoking marijuana produces the most immediate effects and permits the most refined control of your dosage. The flower or ‘bud’ portion of the plant is harvested, dried, cured, and smoked. It is not recommended to smoke leaves or stems. Medical marijuana is most commonly smoked in the form of a joint (like a cigarette), although pipes (bowls), or water pipes (bongs or bubblers) are also quite common. Note that while inhaling combusted material is harmful to your lungs, the amount of marijuana needed to achieve the desired effects is small and therefore less concerning.
Vaporizing – Vaporizers or “Vapes” are said to be a less harmful way of consuming marijuana via inhalation because they heat the marijuana or marijuana oil to a temperature just below the point of combustion, reducing the carcinogenic carbon and tars produced.
Eating, drinking – Marijuana can be ingested through infused edible products such as candy, baked goods, teas/drinks, butters, oils, and tinctures. The most common edible forms of marijuana products on the market today are in the form of candy gummies and baked goods.
Topicals – The cannabis plant has an incredible amount of healing properties and can be used topically in the form of a cream or salve. This application does not induce psychoactive effects, yet works as a muscle and joint pain reliever and can soothe skin irritations.
Suppositories – A highly effective approach to addressing serious health issues—such as cancer, tumors, gastrointestinal diseases, severe pain, and end-of-life comfort—is the use of suppositories. Because they typically have minimal psychoactive effects, patients can take higher doses of THC, which may help alleviate intense symptoms and potentially slow or reverse cancer and tumor growth.
Cannabis Species, Effects, Health Benefits, and Strains
Cannabis Species
There are two predominant species of the cannabis plant:
Cannabis Sativa
Cannabis Indica
While there is a wide variety of marijuana strains available, the vast majority can be classified into one or more of the following groups:
Sativa
Sativa Dominant
Hybrid
Indica Dominant
Indica
The majority of patients report that the effects from these two species (Indica and Sativa) of cannabis have distinct and unique characteristics.
Effects
Indica - Most patients feel that Indica and Indica Dominant strains provide relief for the body and generally provide the following medicinal effects:
Pain relief
Muscle relaxation
Appetite stimulant
Reduction of inflammation
Reduces
Reduces nausea
Sleep aid
Intraocular pressure relief from Glaucoma
Sativa - The majority of patients find the effects of Sativa and Sativa Dominant strains to be mostly cerebral, feeling energetic and uplifting effects while providing help with focus and concentration. Sativa strains are most commonly used as daytime medication and may provide the following medicinal effects:
Relief from depression
Headache or migraine relief
Stimulating and energizing
Increased focus and creativity
Reduces nausea
Health Benefits
Patients using medical marijuana for the following medical conditions may experience symptomatic relief and a higher quality of life:
ADD/ADHD
Alzheimer’s Disease
Anorexia
Asthma
Anxiety
Arthritis
Cancer
Chronic Pain
Crohn’s Disease
Epilepsy
Glaucoma
HIV/AIDS
Hepatitis C
Inflammation
Leukemia
Lymphoma
Multiple Sclerosis
Nausea
Osteoporosis
Psychiatric Symptoms
Sleep Apnea
Spinal Cord Injury
Tourette’s Syndrome
Strains
There are hundreds of cannabis strains, each with its own distinct cannabinoid and terpene profile that contributes to its unique characteristics. Please refer to Appendix A for a comprehensive list of the strains we cultivate, categorized by their dominance (Hybrid, Indica, Sativa), along with details on their commonly reported effects and potential health benefits.
III. Cannabis Use - Contraindications, Drug Interactions, Side Effects, and Addiction
Contraindications
While marijuana is remarkable safe to use, patients should first consult with your certifying physician regarding any health conditions that may be exacerbated by cannabis use, such as:
Respiratory disorders
Heart Conditions
Mental Illness
Pregnancy
Known Interactions
Polydrug use is mixing drugs or using a drug when already under the influence of another. Mixing may result in undesirable or even dangerous effects.
Possible interactions include:
Alcohol - Marijuana use might increase the effects of alcohol.
Anticoagulants and anti-platelet drugs, herbs, and supplements - These types of drugs, herbs, and supplements reduce blood clotting. Marijuana might change how the body processes them, possibly increasing the risk of bleeding.
Central Nervous System (CNS) Depressants - Marijuana use in combination with CNS depressants (sedatives, tranquilizers, and hypnotics) might increase the sedative effect of these drugs.
Protease inhibitors - When used with these antiviral drugs, marijuana might reduce its effectiveness.
Selective serotonin reuptake inhibitors - Mixing marijuana with this type of antidepressant might increase the risk of mania.
Side Effects
Given the high level of safety as a medicine, it is unlikely marijuana consumption will produce any toxic effects; however, there are some side effects to be aware of to use it effectively. If you experience any undesirable side effects, notify your certifying physician. Side effects may include:
Increased appetite
Short-term memory challenges
Redness in the eyes
Drowsiness
Tachycardia (increased heart rate)
Lung irritation (when smoked)
Giddiness
Sleeplessness
Addiction – Signs of Abuse
Personal responsibility is critical when using altering substances, including medical marijuana. If you feel you are demonstrating signs of dependence or addiction, please seek help. Here are a few signs of possible marijuana addiction/dependence:
Withdrawal from family and friends
Neglecting responsibilities
Unable to cut back or stop if necessary
Irritability when not using
Anger when not using
Anxiety when not using
Mood changes when not using
Cannabis Hyperemesis Syndrome (severe vomiting)
IV. Patient Record Keeping
No one understands your body better than you do. Conducting a self-assessment of your symptoms, and monitoring how your medication impacts your symptoms can provide valuable insights for both you and your healthcare team.
A Patient Symptom Tracking Log (Appendix B) can be a convenient tool for monitoring and tracking your symptoms, medication, and outcomes to assess what works best for your condition and discomforts. Once you’ve completed your symptom tracking log, consult with your certifying physician to develop a personalized treatment plan. Our knowledgeable dispensary staff is available to guide you toward the strains and products that best support your recommended treatment plan.
V. Regulatory Compliance Testing
All marijuana products sold at Arizona-licensed dispensaries must undergo testing for specific analytes by a state-licensed laboratory. Analytes are substances whose chemical components are identified and measured. Depending on the type of product (as shown in the chart below), required tests include potency, pesticides, microbial contaminants, heavy metals, residual solvents, and mycotoxins. Products can only be sold at Arizona-licensed dispensaries once they have passed these state-mandated tests.
You have the right to request and receive a copy of the final report for any marijuana products you wish to purchase. Additionally, all marijuana products in Arizona are required to feature a quick response (QR) code on the packaging, linking to the test results report and other relevant product information.
Tests Required by Product Type
How to Read and Understand the Results Report
Laboratory test results are presented in a detailed report. Each analyzed compound includes a limit of quantification (LOQ) alongside its test result. For contaminants, the report specifies an acceptable limit for a passing result. The LOQ indicates the minimum amount that the testing instrument can reliably detect. Results may show a value above this threshold or indicate ND (not detected), meaning the sample was tested for that compound but did not exceed the detectable limit. We’ve provide an overview of the report's sections and guidance on how to read and interpret the information.
The top of the report, as shown in the screenshot below, provides the following information:
The name, contact information, and license number of the state certified laboratory.
The name and license number of the state licensed dispensary, or the brand operating under a state licensed dispensary.
Sample information including the strain, matrix (e.g. flower, concentrate), Batch #, and relevant dates for collection, receipt, and completion.
A photo of the sample.
A summary of the tests conducted, the date tested, and whether the result was passing or not.
Analyte Tests
Cannabinoids (Potency)
The required cannabinoid tests include THC-A, Delta-9 THC, CBD-A, and CBD. However, Arizona state labs enhance their testing by examining additional cannabinoids present in the sample. Cannabinoid potencies are reported as a percentage (%) and/or milligrams per gram (mg/g). In this example, the concentrate sample contains 73.62% or 733.62 mg of THC per gram, and 90.41% or 904.17 mg/g, total cannabinoids, reflecting the combined levels of all cannabinoids tested.
Microbials
A microbial is a microscopic organism, including bacteria, fungi, mold, algae, and protozoa. While some microbes can be beneficial, harmful microbial contaminants, particularly bacteria, can pose health risks. It’s essential to ensure that harmful levels of living organisms are absent from marijuana and its products. The figure below outlines the required microbial tests, indicating that the tested product passed all assessments with undetectable levels of microbes
Pesticides
Pesticides, fungicides, and herbicides are essential for promoting plant health and achieving optimal results in marijuana cultivation. However, they can pose risks to human health if present in excessive amounts, so it's crucial to flush them out before harvesting. The figure below displays all the required pesticides to be tested. In this instance, all tested pesticides were found to be not-detectable.
Mycotoxins
Mycotoxins are naturally occurring substances produced by certain fungi. They can cause a range of adverse health issues, from acute poisoning to long-term effects such as cancer and immune deficiency. It is only required to test for mycotoxins in concentrates and concentrate inclusive products. The image below displays the required mycotoxins to be tested and show that they are reported as parts per billion (ppb).
Heavy Metals
Heavy metals, which naturally occur in soil, can sometimes be present in marijuana plants. The metals that require testing include arsenic, cadmium, lead, and mercury. While these metals may be found in soil-grown marijuana, their levels must remain within safe limits. The example below shows that the tested product is free of heavy metals, indicated as ND (not detected). Heavy metals are measured in parts per million (PPM).
Residual Solvents
To produce concentrates like badder or shatter from marijuana flower, a solvent extraction process is necessary. Common solvents used in this process include butane, propane, and ethanol. The extraction culminates in a final purging step to eliminate any remaining solvents, ensuring a clean and potent product. If purging is not done thoroughly, residual solvents may persist in the final product and appear in testing results. Fortunately, products that test above acceptable levels of residual solvents can often undergo additional purging to remove the excess. The example below lists the required solvent compounds for testing, which, like heavy metals, are reported in parts per million (PPM).
Terpenes
Although terpene testing isn't mandated by state regulations, many companies opt to test for them. As mentioned earlier, terpenes not only give marijuana and its products their distinctive aromas, but also play a role in their effects. The figure below lists various terpenes that can be tested, organized by their quantities. When selecting products based on terpene content, focus on the top four terpenes to guide
