We Need to Chill Out About Categorizing ‘Medical’ Versus ‘Recreational’

I used to wake up in the middle of the night, every night, with a nightmare. In it, my body was frozen, and trigger warning: In the nightmare, I was fading in and out of unconscious, but someone was raping me. They were textbook PTSD nightmares, and I had no idea what to do about them.

I was raised in the Caribbean, in the U.S. Virgin Islands, surrounded by ganja culture. While millennial “statesiders” my age I’d meet later when I moved to the South for school and then New York for my forever home, I realized that my childhood was different. Far from the “Just Say No” and D.A.R.E rhetoric my contemporaries experienced, many of my friend’s parents were Rastafarians. I grew up understanding that cannabis was a sacrament. So I spent high school, during the Bush era, on the debate team arguing for its legalization, and college majoring in journalism, reporting on cannabis. I’ve always been vehemently pro-legalization. But the reason cannabis didn’t become a big part of my personal life until a decade ago, in 2013, was because I was a total boozehound. 

But alcohol made my PTSD stemming from my assault worse. Sometimes, back in the day, to be perfectly honest, it made me downright nasty or even suicidal. So my ambition kicked in, having seen what alcoholism can do to others (it runs in my family), and I quit. I haven’t had a drink in 10 years. I’ve been Cali Sober since before the term existed, baby. 

So, a few years into sobriety, when a stoner close to my heart told me that people used cannabis to treat anxiety, PTSD and that THC could even suppress nightmares, at first, I was skeptical. Sure, it should be legal, just like alcohol, and the government is full of shit, but would it affect me like liquor did? Personally, 12-Step programs did more harm than good. I’m a big believer that a one-size-fits-all model is not suitable for recovery, something society finally seems ready to talk about.

Especially in the first few years after my assault, I needed to be shaken and reminded of my power — which had been robbed from me — instead of admitting I was powerless, which is, in so many words, the first step of AA. I’m glad the program works for many, including people I love, and I won’t even get into the fact that its founder, Bill W., fully embraced psychedelics at the end of his life, adamant that they could treat alcoholism. Because this story is about why recreational use and medical use have more overlap than the establishment makes them out to.

When I first quit drinking shortly after my assault, I was a shell of my former self. I’d accept invitations to parties only to turn around at the door, back to the safety of my apartment, as my social anxiety was so bad even small talk was terrifying. I should add that I was prescribed a very high level of benzodiazepines, which I’m not against on principle, they have their time and place, but as anyone who’s weaned off them knows, they also have their downfalls (quite serious, benzo withdrawal can cause seizure or even death). So after doing my research and realizing that cannabis could not only quell nightmares, help me better inhabit my body, and treat social anxiety, but had a lower side effect profile than benzos, and was less physically addicting, I decided (after talking with my psychiatrist and therapist) to give cannabis a shot. It worked. It stopped my nightmares. My dissociation got better. I could socialize again; I could even goddamn do karaoke without a sip of booze or flutter of nerves. I didn’t need all that Klonopin. I was sold, even if those I knew in recovery circles at the time were not. 

So when New York legalized medical marijuana for PTSD in 2017, even though I was already using it under doctor supervision, I jumped at the opportunity and got a medical card, hitting up a dispensary right away. I was a little bummed to learn that they sold lower-dose products for much more than my dealer (I prefer the term “florist”) could offer, so like so many others in this economy, I returned to the black market and honestly eventually just let my medical card expire. 

But something else had happened by 2017. I healed. Sure, I still had anxiety, some trust issues, and enough reasons to have a therapist, but I no longer woke up every night with flashbacks. I was my outgoing, extroverted, optimistic self again. Cannabis still helped me be present, dial down any social anxiety, and only need a Klonopin if having one of those panic attacks that feel like a heart attack. Still, I started to wonder: Was I “bad” for continuing to use cannabis, not primarily for PTSD, but simply because it felt good and made life easier? And, no, to this day, it’s never made me blackout, it’s never made me say something nasty to a friend I don’t remember the next day, it’s never given me a hangover with a side of suicidal thoughts. My friends, doctors, and partner actually sometimes need to remind me to take it when I get a little bitchy now and then. 

Then I realized something even more horrifying — I was thinking like a Reagan supporter. Is it wrong to enjoy the euphoric side effects of a substance? Taking this a step further, is it morally worse to enjoy the euphoric side effects of a substance such as cannabis that’s federally illegal instead of many FDA-approved anxiety or pain treatments that also make you feel high? What was this hypocritical bullshit? I’m a Virgin Islander, goddamnit, not some regressive conservative clinging onto the bullshit the Moral Majority spent so many years spewing. 

Of course, legalization has upsides, such as fewer people in prison and more research on the plant’s benefits. But by 2017, and absolutely by the present day, I don’t just fit the bill for a medical patient; I’m a recreational (make that adult-use, a term I greatly appreciate) user. Yes, it helps my anxiety and PTSD. Yes, it plays a role in harm reduction, just like dear old Bill W. eventually supported, and it makes it easier not to drink. I never even think about alcohol. But cannabis is also just fun. Plenty of people who use cannabis recreationally also receive medical benefits as a nice side effect, such as lowered social anxiety or better sleep. Conversely, people with medical cards who use it for an ailment enjoy the pleasant side effect of euphoria. Is either team wrong? I think not. Does one need a stamp of government approval (since when do we trust them on this subject?) to use cannabis guilt-free? Dear god, I hope not. 

We live in a culture that moralizes euphoria. From a government-approved recovery program POV, if it makes you feel good, it’s bad. Any substance use should involve honesty about its effects. For instance, while I used to use cannabis to help with nightmares, as I got older, THC started giving me insomnia. So now, unless I’m at a concert or late-night dance party, I don’t take any after a certain hour, sticking with a low dose during the day. But that’s just me. We’re all different, and everyone’s reaction to substances is different and will likely change throughout their lifetime. But in this beautiful life on this wicked world, filled with violent crimes, people in prison for non-violent crimes, pandemics, homophobes, hurricanes, cancer drug shortages, but also love, community, science, the spiritual experience of playing with a dog — I’ll take all the euphoria I can get as long as it continues to offer a positive impact on my life. Binary thinking is so Bush-era and so over. May the adult-use cannabis consumers also enjoy lowered anxiety or pain, and may the medical patients guilt-free pop an edible before a concert and dance up a sweat while enjoying a heightened sensory experience. 

Euphorically yours, 
Sophie Saint Thomas

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5 Medications You Should Avoid Using With Cannabis

While cannabis undoubtedly has a wide range of potential benefits, including pain and anxiety relief, there are some prescription medications you should avoid using with weed, even if you are a medical marijuana patient. Cannabis may interact negatively with your medication or dull the medication’s impact, potentially creating a range of health risks.

If you’re currently prescribed any of the following medications, you should consider refraining from cannabis use until you have had an opportunity to discuss the potential outcomes and best options with your doctor.

Prescription Opioids

Although both prescription opioids and medical cannabis can be used to treat long-term or chronic pain, the two should not be used together.

One opioid medication worth mentioning is oxycodone. An opioid like oxycodone can be incredibly addictive on its own. Some doctors may be able to help moderate oxycodone use and ensure its use is as safe as possible. When you mix oxycodone with other drugs, like cannabis, the risks only increase. One study found that combining oxycodone and cannabis leads to an increased risk of depression and anxiety and unintentionally subdues a patient’s central nervous system to a dangerous degree.

However, there is a plus side: Medical cannabis can potentially be used to reduce prescription opioid intake, which ultimately reduces the chances of negative side effects such as dependence and overdose. Those who intend to utilize medical cannabis to reduce their opioid intake should speak to a qualified healthcare professional to get the appropriate support and tapering programs, which improves the chances of overcoming dependence.

Blood Thinners

Blood thinners, which regulate the ease of blood flow throughout the body, require incredibly careful dosages in the first place, and adding cannabis to the mix can be risky. Some blood thinners are drastically affected by cannabis use. One study found that using blood thinners and cannabis simultaneously can lead to the increased potency of certain blood-thinning medications.

Doctors prescribe people medicines at certain dosages for a reason. With some blood thinners, the potential exists, in practice, for people to essentially be taking a significantly higher amount of medication than their doctor intended. If you are on blood thinners and actively use cannabis, your doctor might recommend lowering the prescribed dose of your medicine or suggest you reduce or cease cannabis use.


SSRIs, or selective serotonin reuptake inhibitors, have a lot of potential uses but are most commonly used as antidepressants to treat conditions such as depression, anxiety or obsessive-compulsive disorder. More research is needed to determine whether patients need to avoid cannabis entirely when taking a prescribed SSRI. Still, until then, patients should be aware of potential issues, be careful, and seek their physician’s advice.

Some initial warning signs suggest that antidepressants’ effectiveness may be dulled by co-use with cannabis. Some studies also suggest that cannabinoids like CBD can prevent your body from eliminating antidepressants such as escitalopram and sertraline, which can lead to an increase of antidepressants in the body. This, in turn, can lead to an increased risk of side effects such as panic attacks.

On the other hand, some patients on SSRIs may benefit from the medical use of some marijuana products, as cannabis can have antidepressant qualities when dosed appropriately. Moreover, cannabis may be useful in reducing antidepressant intake. As always, open and honest communication with your healthcare provider is the best course of action when combining SSRIs and cannabis.


Some studies suggest that there could be potential benefits to using cannabis to aid in the withdrawal from benzodiazepines, though further research is needed. Those with forms of epilepsy like Dravet syndrome or Lennox-Gastaut syndrome may also find that CBD reduces their need for antiseizure medications, many of which are sedative and benzodiazepine-based (e.g., lorazepam, midazolam, diazepam, and clonazepam).

Combining cannabis use with active benzodiazepine use, however, could be a different story. Benzodiazepines are depressant, sedative-like drugs known for general potency. Like blood thinners, cannabis use can effectively increase the amount of benzodiazepines in the body. In other words, cannabis use can ramp up the potency of a drug like Xanax, which is already quite powerful on its own.

Those who wish to utilize cannabis to reduce their benzodiazepine intake should do so under medical supervision, especially as benzodiazepine withdrawal can be dangerous and even life-threatening.


Ritalin is a stimulant often used to treat conditions like ADHD. While CBD or low-dose THC may help manage some of Ritalin’s side effects, some studies have found that cannabis use can result in minimized effectiveness of Ritalin.

Due to its ability to potentially dull Ritalin’s effectiveness, those prescribed Ritalin should work with their doctors to determine whether they should continue using cannabis.

The Bottom Line

Several prescription drugs should not be combined with cannabis use, or at the very least, should be done so under medical supervision. With that said, it is important to remember that cannabis is not the sole, potentially problematic factor for adverse medical reactions. All potentially negative drug interactions should be taken seriously, whether cannabis is involved in any way or not.

Even grapefruit has been shown to negatively interact with some forms of medication, leading to the term ‘The Grapefruit Effect.’ This is because grapefruit can inhibit the liver enzyme, cytochrome P450 (CYP 450), which metabolizes many drugs and medications. CBD has a similar effect.

As always, you should be open and honest with your doctor so that, together, you can make informed, responsible decisions about what medications are best for your health. Medical cannabis can be an amazing tool for managing chronic pain, multiple sclerosis, and many other conditions but, like everything, it requires careful consideration and is not for everyone.

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Research Chemicals Provide Dangerous, Experimental Highs to Desperate Users

Research chemicals are newly-synthesized drugs that have not yet been scheduled by the FDA, making them very easy to order online under the guise of “not for human consumption.” Every year, teams of shadowy scientists from all around the globe create oodles of new chemical compounds that are relatively similar to drugs people already take recreationally, but completely different chemically speaking. This is super dangerous because minute differences in chemical composition could mean the difference between a killer high and a high that kills you, as Cal Poly Humboldt Chemistry professor Joshua Smith reminded me.

“The most infamous drug you should learn about is thalidomide,” Smith said. “One version of it was an anti-nausea drug for pregnant women. One very small change to it created horrible birth defects.”

That’s a very succinct way of saying just because a drug is similar to another drug in terms of chemical composition, it should not be considered safe to take by any stretch of the imagination. 25i is a well-known example of this. It gained popularity as a cheap replacement to LSD for a while until people started overdosing and dying because it was much more toxic than LSD and very poorly understood. Many of the thousands of different novel compounds available for purchase online have never been tested on humans but are still sold under catchy names like “Dr Buzz pellets” or “Mitsubishi capsules,” leading one to assume that there are people taking gross advantage of this legal loophole to lure addicts and dealers into buying knockoff drugs.

A screenshot taken from a website that sells research chemicals. The name of the website has been omitted to prevent anyone from seeking out the website in question, though it is admittedly very easy to find.

I posted something on my personal social media accounts asking if anyone I knew had tried these drugs, I received no less than 30 firsthand accounts of awful terrible no good very bad experiences with “liquid Xanax” or “fake acid” and the like. I received a fair amount of feedback from a handful of people who knew all about research chemicals and had personally ordered several, sometimes with mild or nonexistent consequences but more often to the tune of a very bad trip. There are also Reddit threads dedicated to the research chemical lifestyle with thousands of members. Out of all those people, two agreed to speak with me on the record.

A screenshot taken from the research chemicals subreddit. Usernames have been omitted out of an abundance of respect for the privacy of drug users.

Alexis Pritchard is a 27-year-old from Eureka, California. She works for a drug and alcohol rehabilitation program, the same program she recently attended for three months.

“I guess it started with that synthetic weed, that fucking kryptonite stuff,” Pritchard said, referring to any one of dozens of synthetic cannabinoids that have come out since the 1990s. “I had a heart attack, I think. I almost died, I thought it was all a dream I was like out of my body and my eyes were in the back of my head.”

Pritchard tried other research chemicals later on in life, including drugs meant to resemble benzodiazepines like Xanax, Valium, and MXE, a common substitute for ketamine users.

“At the time I was just like well, it’s getting me high, I’m alive and I like the feeling,” Pritchard said. “Obviously now that I’m in recovery and looking back on it it’s pretty wild to think that I would do that and some nights end up doing coke and God knows what else, and drinking a shit-ton on top of it. My heart could have stopped so easily.”

Kane Seal is the head chef at an Italian restaurant in Redding, California. He has been clean from drugs for three years. Before he got sober, Seal experimented heavily with research chemicals, particularly benzodiazepines.

“Some of those [pills] you’d take two and be high for like two days and forget everything that you did,” Seal said. “I took two or three of one batch we got and I missed two days of work and didn’t know I missed work.”

Seal said at a certain point, the research chemicals were difficult to stay away from because they were so cheap and replicated the drugs he was already addicted to.

“I think they made me almost feel more comfortable because some of them were so easy to take,” Seal said. “When I got a batch of 500, I took 150 in two days.”

Now I want to be clear, this is an issue that is very hard to pin down or accurately quantify because it’s a very fluid situation. Laws change, new drugs are banned and synthesized every year. Scary “new” drugs make the local news months after the problem has already come and gone. Maybe my scope on the matter is skewed because I tend to associate with the downtrodden. That said, I witnessed an ex girlfriend of mine pass out, unable to speak or move for almost a week straight from one drop of the wrong research chemical; I’ve seen my friends very close to death from combining the wrong pills, and I’ve heard story after story about awful experiences not to mention my own, which are as follows:

Etizolam turned me into a zombie with no memory. Flubromazepam almost killed me and a dozen or so of my friends. 2CB was a fever dream from hell, at the end of which my roommate found me hiding behind our couch and I don’t remember much of the rest of that day. Dimethocaine was basically 10 energy drinks plus the worst anxiety you’ve ever experienced (I swear to God I walked right past Daniel Radcliffe walking down to Patrick’s Point to shoot a commercial right after snorting a bunch of Dimethocaine on a sea cliff and I was too busy having a panic attack to realize it was him).

When I asked the FDA to shed some light on this issue, they referred me to the DEA, who finally told me they didn’t want to comment either and they referred me to the National Institute on Drug Abuse. The NIDA media rep told me that for all questions about policy she’d have to refer me back to the DEA/FDA, but she did tell me the following:

“The surge of new or novel psychoactive substance (NPS) use during the last eight to ten years is a major public health concern and necessitates a broad research agenda to guide prevention and treatment strategies. NPS are unregulated mind-altering substances with no legitimate medical use and are made to copy the effects of controlled substances. They are introduced and reintroduced into the market in quick succession to dodge or hinder law enforcement efforts to address their manufacture and sale. Some of these substances may have been around for years but have reentered the market in altered chemical forms, or due to renewed popularity.”

Maybe it’s not that big of an issue in the grand scheme of things, but it seems odd to me that every branch of law enforcement in America is spending God-knows how much money to make flashy arrests for the small handful of drugs most people know about when extremely dangerous loopholes exist making all that effort seem completely redundant. There’s probably another side to this. Maybe it would hamper scientific progress if the laws were any different, maybe one of these research chemicals will cure cancer, or maybe a bunch of bad people are shamelessly making money at the expense of drug addicts.

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