Dr. Michelle Weiner, DO, MPH

Dr. Michelle Weiner, DO, MPH

Dr. Michelle Weiner, is an Interventional Pain Management Physician board certified in Physical Medicine and Rehabilitation. She completed her residency and fellowship training at the University of Miami. Her specialty is focused on prevention, treatment, reversal of health deterioration, increasing function and managing pain. Dr. Weiner focuses on diagnosing and treating spine and musculoskeletal pain as well as chronic migraines at the Spine and Wellness Centers of America


Can You Pass a Drug Test While Consuming CBD Products?

Although CBD hemp oil continues to grow into a more widely accepted, plant-derived treatment for patients across the U.S., some consumers pose the question, “Can I pass a drug test with pure CBD oil in my system?” Whether you are on the hunt for a job that requires a drug screening, or you are dealing with a life event that requires government-enforced urinalysis (UA) checks, consuming cannabis-derived cannabidiol can be a cause for concern. 

To obtain more insight on the topic of drug tests and CBD hemp products – where there is still so much gray area – we chatted with Dr. Michelle Weiner, a Miami, Florida-based interventional pain and physical medicine and rehabilitation physician and chair of the Florida Medical Marijuana Advisory Committee. Below, Dr. Weiner helps us break down the different varietals of CBD and the importance of doing your research when selecting your CBD products of choice – especially if you will be subject to drug tests looking for tetrahydrocannabinol, or THC, in the near future.

The Different Varietals of Cannabidiol CBD 

For potential consumers wondering, “Is CBD legal?” the answer is yes. As of 2018, CBD oil is legal to sell, purchase and consume throughout the U.S., so long as the CBD extract contains no more than 0.3 percent THC. Within the CBD hemp space, there are three varietals you can consume, ranked from lowest to highest THC content:

  1. CBD isolate: This is a format where cannabidiol is completely isolated from the remainder of the hemp plant, including all other cannabinoids (like THC), as well as terpenes and waxes
  2. Broad spectrum CBD oilThis type of CBD is completely stripped of its THC content, but still contains beneficial plant matter and compounds
  3. Full spectrum hemp oil: This form of cannabidiol CBD includes the hemp plant in its total capacity, including THC, and all other compounds and cannabinoids

Click here to learn more about CBD benefits, dosage information and more.  

Can I pass a drug test with CBD oil in my system? 

“THC-free CBD oil or CBD isolate should not show THC on a UDS, or Urine Drug Screen,” says Dr. Weiner. So, if you know you have a drug screening coming up in the near future, you must consume broad spectrum CBD products or CBD isolate in order for the test results to yield zero percent THC. Although many doctors and scientists recommend full spectrum CBD oil, due to its Entourage Effect (where all cannabinoids and compounds of the plant work synergistically for optimum results), broad spectrum hemp CBD also contains the same profile of cannabinoids – minus the THC. 

How long will pure CBD oil stay in my system? 

“It will take between five to 10 days for CBD to be removed from the bloodstream. However, for a chronic user, it may take up to two weeks to one month,” shares Dr. Weiner. “The half-life of THC, on the other hand, is about 30 hours for a standard user; this means that the THC should be eliminated from your body in 6.25 days.” When it comes to full spectrum hemp oil, even at less than 0.3 percent THC, the THC can accumulate and turn up positive on a drug screening, according to Dr. Weiner. 

Click here to learn more about the CBD effects on your body and endocannabinoid system.

If I have a medical marijuana card and use CBD products, can I pass my drug test?

Although CBD oil that is derived from the hemp plant is federally legal to consume, you may also come across cannabidiol oil with high levels of THC. This type of CBD tincture is typically found at dispensaries in states where marijuana is legal to consume medicinally, recreationally or both.

However, if you are a CBD tincture consumer and have a drug test scheduled, despite your legal right to consume all types of cannabis products in your state, you may not pass, even with trace levels of THC. “Your employer’s policy on THC supersedes your medical card, despite your medical condition that qualifies you for a cannabis recommendation,” offers Dr. Weiner. “Cannabis is still federally illegal, so your employer may fire you, despite your issued med card.” 

Additionally, you cannot expect to consume CBD oil with THC as a recreational user in a legal state, and receive an exemption on a court-mandated drug test. However, some U.S. states are lenient regarding hemp oil with THC when it comes to government-appointed drug tests – if you hold a valid medical marijuana card. When choosing your CBD products leading up to a drug test, keep the following pointers in mind: 

  • If you take a drug test for work purposes, the company has the right to enforce its own drug policy, no matter where you live (if you test positive for ingesting CBD hemp with THC in a legal state, it may cost you a job)
  • If you take a court-mandated drug test, you may be able to consume THC-heavy CBD oil as a medical user, depending on the laws in your state of residence – and with the court’s permission (make sure to address this component prior to any UA testing date to avoid further legal altercations)

The Importance of Researching Your CBD Products  

Now that you are able to differentiate the types of CBD, along with understanding the CBD effects on a drug test, it’s important to dig a bit deeper into the current inner workings of the cannabidiol oil marketplace. 

As the CBD hemp oil industry continues its upward trajectory, there are more players entering the space. However, as a consumer, you must do your due diligence as you look into buying the best CBD oil available online. “We are in a ‘Goldilocks and the Three Bears’ moment when it comes to CBD and the CBD market,” says Dr. Weiner. “Some products have way too little CBD; some are delivering way too much.” For example, this experiment conducted by NBC 6 in South Florida, which tested 35 samples, found that 20 CBD tinctures had less than half the amount of CBD advertised – some containing no cannabidiol CBD at all. 

Additionally, Dr. Weiner warns about the mislabeling of CBD oil with THC. “The University of Pennsylvania published a JAMA study showing that 21 percent of CBD hemp products sold on the internet contain THC, even though their labels didn’t properly disclose it.” In fact, Dr. Weiner notes that an estimated 70 percent of hemp extracts currently for sale on the CBD marketplace are mislabeled. And, while hemp plants should contain no more than 0.3 percent THC, this is based on the dry weight of the plant. “Dry weight doesn’t necessarily equate to what’s in the finished product,” Dr. Weiner explains. 

So, what can you do to ensure your hemp oil tincture is free of THC when preparing for a drug test for work or legal reasons? “Get a Certificate of Analysis, or COA,” Dr. Weiner suggests. The best CBD companies include COAs from certified, third-party labs that will reveal information on: 

  • The THC and CBD percentages within the product.
  • The minor cannabinoids present in the product (including CBC, THCA, CBDA, CBG and CBN).
  • Any terpenes, or aromatic oils, present.
  • Undesirable elements present, like mold and mildew, yeast, E. coli, mycotoxins and salmonella.
  • Whether or not the hemp was grown organically, in a pesticide-free environment.
  • The presence of any heavy metals absorbed through the soil.
  • Any residual solvents left behind from the extraction process.

The Final Word: CBD Drug Test Tips

If you are a CBD hemp consumer with a drug test approaching, prepare accordingly. When attempting to pass your drug test with CBD in your system, make sure you:

  1. Consume only broad spectrum hemp oil or CBD isolate.
  2. Confirm there is no THC in your CBD products via COAs.
  3. Ensure you allow time for trace THC to pass through your system, if consuming full spectrum hemp oil.
  4. Understand your potential employer’s policy regarding THC.
  5. Receive permission from the court to consume cannabidiol with THC – if you are a medical card holder taking a government-appointed UA test.

Review our comprehensive online CBD shopping guide, so you can buy CBD oil that is properly tested – and ethically grown – prior to your next drug screening.

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Virtual Reality Effects on Pain Perception: Implications for Pain Management

Current Status: Pending

Literature suggests that the use of virtual reality distraction for adjunctive pain control has been successful. In clinical settings and experimental studies, participants immersed in a virtual reality experienced reduced levels of pain, general distress/unpleasantness and reported a desire to use virtual reality again during painful medical procedures.

There has been research into the use of virtual reality distraction for adjunctive pain control with significant success. There has been growing evidence for the use of EEG for the measurement of pain. It has also been suggested that virtual reality could be used an alternative to marijuana and opioids for pain management. Further implications have been seen specifically among chronic pain sufferers. This is especially interesting since there is a reduced risk of addiction as is seen associated with marijuana and opioid use. This study aims to investigate the effect of virtual reality distraction on pain perception.

Additionally, we intend to create a body of open source content for potential use by other investigators utilizing similar tools. 

The intervention has the potential to relieve chronic pain sufferers of their pain with a non-invasive mechanism and minimal risk. The participants may experience a temporary decrease in the perception of pain during the course of the experiment or a distraction from said pain.

Pending IRB approval at UM

Seniors Over 60 With Chronic Pain Using Medical Marijuana

Current Status: Active

 

The purpose of this study is to identify what is effective and safe for older adults with chronic pain to develop an understanding of what educational materials are required for facilitate access to appropriate products at medical marijuana treatment centers (MMTC). 

Survey older adults (> 50 years) with chronic pain who have MM access cards and receive their product from state-approved dispensaries to document: demographic/health data; patterns of use; product specifics; pain effects on daily life; pain-related medical conditions; education prior to MM purchase; helpful and problematic effects of MM use. 

The proportion of Florida’s population that is 60 and older is growing more rapidly than other components of the population. Musculoskeletal disorders with associated chronic pain are a common problem in later life. Symptom management in older adults, including chronic pain management can be challenging (Briscoe, 2018). Medications, especially opioids, can increase the risk of confusion, constipation, falls and injury (Briscoe,2018). Medical marijuana (MM) is often recommended by doctors in the treatment of these medical conditions, guided by state law that defines qualifying conditions.

Medical marijuana use among older adults is growing at a rate more rapid than younger age groups (Lum, et al, 2019). The 2016 National Survey on Drug Use and Health estimated a 2.9% prevalence of marijuana use among this older population. However, the survey did not ascertain if use was for medical or recreational purposes (Han et al., 2016). Older adults may have important differences in pathophysiology, pharmacological interaction of medications, comorbid conditions, and toxicological responses to cannabis.

There is little evidence to evaluate the differences associated with medical marijuana use among older adults, such as individual reasons for use and problems arising with use (Haug et al., 2017).

Chronic pain is a major public health problem. Approximately 178 million (41%) adults in the U.S. age 18 and older suffer from at least one painful health condition (Nahin, et al, 2019).

In Florida, there are 327,492 medical marijuana card holders and chronic non-malignant pain was the No. 1 diagnosis for which patients are registered (The Florida Department of Health, Office of Medical Marijuana Use, 2020). Yet, it is not a qualifying condition, creating challenges for physicians wishing to support patient use of MM for chronic pain.

Chronic pain accounted for nearly 34 percent of diagnoses at certified dispensaries (The Florida Department of Health, Office of Medical Marijuana Use, 2019).