WellesleyWeston Magazine

FALL 2017

Launched in 2005, WellesleyWeston Magazine is a quarterly publication tailored to Wellesley and Weston residents and edited to enrich the experience of living in two of Massachusetts' most desirable communities.

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How the Locals Do It Dr. Robyn Riseberg, Wellesley resident and chief of pediatrics at South End Community Health Center in Boston, starts talking to her patients about drug and alcohol use in middle school. She gives kids the oppor- tunity to have a private discussion with her; parents are asked to leave the room. "I ask them if any of their friends have started smoking weed, and move on to ask them about their own choices." The discussions are strictly confidential between Riseberg and her patients; her goal is to establish a relationship in which each child feels comfortable talking to her. For kids who are using marijuana (or other drugs) she asks why. "Getting to the root of why kids are using is really important." When discussing marijuana, she also emphasizes the risk of cross con- tamination — in other words, pot can contain chemicals and substances that they don't know about. She does feel that once sales of marijuana start in Massachusetts (in July 2018), the landscape — and therefore her approach — will change. For instance, she might introduce the topic at an earlier age. Even now she supports parents initiating the discussion at younger ages than she does. Parents in the Wellesley and Weston are taking note, talking to their kids and anticipating what may come next. F E D O R O V A C Z / D R E A M S T I M E . C O M There are four main methods of ingesting marijuana: inhalation, oral, sublingual, and topical. Inhalation: This is the fastest method of ingestion; the effects are almost instantaneous. The majority of cannabinoids enter the body through the lungs and then into the blood stream. Peak effects tend to occur after about an hour and total duration of effect is around two hours. There can be significant variation in these times due to factors including THC content, depth and length of inhalation, and previous marijuana use (tolerance). There are two ways to inhale: smoking and vaporizing (or "vaping"). Smoking involves burning the flowers and inhaling active components of the plant. Vaporization involves heating the plant to a temperature (up to 350-400 degrees F) at which the active ingredients are released as a vapor that is inhaled. Some vaporizers are oil based; concen- trated oils can contain high concentrations of THC, up to 80 percent by some reports. Vaporizers are available in a wide array of shapes and sizes, from fancy home units to pocketsize pens. THC also can be extracted using various solvents including butane and ethanol to create highly concen- trated products including oils and tinctures called "wax," "dabs," "budder," and "shatters." These can be smoked or "vaped." ("Dabbing," another commonly used term, is similar to vaping.) Oral: This can be in the form of edibles, capsules, oils, or tinctures. (Tinctures are liquids extracted from the canna- bis plant using alcohol.) During digestion, the cannabinoids are metabolized by the liver to a more active, stronger form, which can result in a more intense high. The onset of effect for oral ingestion is slower (often 30 to 60 minutes) and the duration of effect is longer (for as long as six hours). It can be difficult to titrate dosage when marijuana is ingested orally. Additionally, an edible might contain multiple doses of drug, but this might be unclear in labeling, leading to consumers to inadver- tently ingest higher doses than intended. Cannabis can also be infused into tea, alcoholic drinks, and other beverages. Sublingual: Marijuana enters the bloodstream when placed under the tongue, allowing absorption through oral mucosa. These products include dissolvable strips, sublingual sprays, medicated lozenges, or tinctures. Sublingual absorption typically has onset of effect in five to thirty minutes and effects can last two to four hours. Hybrid absorption might occur when a food item like a lollipop is held in the mouth, but swallowed as it melts. Topical: These come in form of lotion, salves, bath salts, and oils applied to the skin. This means of use does not allow a significant amount of cannabinoids to reach the brain and is unlikely to produce intoxication. Marijuana, It's Not Just for Smokers 96 Cannabis and Our Kids W e l l e s l e y W e s t o n M a g a z i n e | f a l l 2 0 1 7

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