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The First Puff Doesn’t Always Work

When Emily Earlenbaugh was diagnosed with anxiety and chronic pain from fibromyalgia, her doctors put her on prescription medications — and they worked. A few years later, however, those same medications were causing severe side effects. So she tried cannabis.

“I would try some type of cannabis that wouldn’t work for me. I would try it out and I get much more anxious or I would feel sicker,” Earlenbaugh recalled on The Cannabis Enigma Podcast. “But then other types of cannabis were life changing. I would just take a little puff and instantly my anxiety would melt away. My pain would be gone.” 


It took her over a year before she found the regimen — of strains, timing, dosing, and delivery methods — that has effectively managed her anxiety and pain for the past decade.

Dr. Emily Earlenbaugh, PhD

Today, she puts that experience to work in order to help patients who are new to cannabis find their own personalized regimen and navigate their way through the rapidly expanding world of medical cannabis.

“There’s a lot of information out there but there’s also a lot of incorrect information out there,” said Earlenbaugh, who is also a writer in the field of medical cannabis.

Earlenbaugh also talked about how her meditation and mindfulness practice became intertwined with cannabis, and an integral part of her treatment. [Read her recent article about meditation and cannabis.]

“I was able to pay more attention to my emotions and with cannabis it wasn’t so scary,” she explained. “It was something that I was then actually able to dive into.”

You can learn more about Emily Earlenbaugh’s cannabis consulting at her website, mindfulcannabis.com, and her meditation program at karunatraining.com. Follow her on Instagram — @emilyearlenbaugh.

Produced, edited, and mixed by Michael Schaeffer Omer-Man. Music by Desca.

Full transcript:

Michael Schaffer Omer-Man: Hi, Emily, thanks for joining us. We have been corresponding for many months about the topics we’re going to be speaking about today, medical cannabis and various aspects of its use and research, and how people, the issues and questions that people have about it. But I wanted to ask you about your story first. How did you first encounter cannabis in a medicinal capacity or realm? 

Emily Earlenbaugh: Sure. For me, cannabis use started as a patient. I have been diagnosed with a generalized anxiety disorder and fibromyalgia, chronic pain condition. So really for my entire life — as long as I can remember, I’ve had a lot of pain, a lot of anxiety on just a daily basis.

And it wasn’t until undergrad that I was actually diagnosed with the condition. And I went on some pharmaceutical medications at the time. That helped me for a few years and then started to actually really diminish my health. I started to have a much weaker immune system. I was getting sick from things like strep throat, whooping cough, like basically every other week I would get some new virus or bacteria that my system wasn’t able to fight off.

So I realized that I was really gonna need a different solution for my anxiety and the pharmaceuticals that I had been on. And I started to talk to people about cannabis.  I was in California at that time so it was a legal option for me, and I decided to try it out and I was kind of shocked at how much it helped with my anxiety and my pain just right away.

Um, so I pretty quickly became a daily cannabis user and you know, I was really working on figuring out. What types of cannabis would work for my particular symptoms? And you know, my own unique biochemistry because, well, what’s happened for me a lot of the time is I would try some type of cannabis that wouldn’t work for me. Maybe it was something that a friend said, “oh, this is really relaxing. This will help you.” And I would try it out and I would actually get much more anxious, or I would feel sicker. But then other types of cannabis were like life changing. I would just take a little puff and instantly my anxiety would melt away. my pain would be gone. So it was really a process of over a year working with figuring out exactly, you know, what was working for me and what wasn’t. You know, through that process I was able to figure out a regimen that I’ve been using for the last decade and able to really effectively manage my anxiety and my chronic pain.

So I went from being, you know, filling out disability forms, thinking I would never be able to live a functional life to really having a full, rich life — career family. So it’s been, it’s been pretty powerful. 

Michael: Did you have any guidance? Somebody or any resources to help you through that initial process of figuring out what worked for you and what didn’t?

Emily: Yeah, I would say I had a lot of guidance from different places. You know, there was a lot of helpful advice that came from friends that came from people, you know, working at dispensaries. Also, of course, working with medical doctors and getting those recommendations and then getting advice from them about what would be helpful.

But what I found at that time was that there was a real lack of information at the source of going to the doctor. There were a lot of doctors that were giving out recommendations but weren’t able to really suggest what type of product to use or even where to go get the products because of legal restrictions around that in California.

So I ended up doing a lot of research on my own. One half of that was doing scientific  research. M, my background academically is in the philosophy of science. And when I started using cannabis, I was midway through my PhD program and I was researching a lot of different tools for how to study subjective experiences — how to look at things like pain, anxiety, happiness, things that people are really reporting subjectively themselves. 

Michael: So you were qualified to, to help yourself figure it out. 

Emily: Yeah. So what I actually did was adapt a lot of those tools to really work with testing out different strains, testing out different products, and you figuring out how those worked well for me.

And a big part of that process was also actually bringing in mindfulness techniques that I had been learning through meditation, which has also been a really helpful part of my recovery. So combining this way of tracking my experience with these data-based methods and then also really tuning into my experience through mindfulness methods, of really noticing how each strain was impacting my body.

Through that process, I was able to really hone in on very specific strains and options that worked well for me. 

Michael: I have a lot of questions about everything you just said, but let’s start with, what strains did work for you? What products? What did you find? 

Emily: Yeah, so I found that it was actually a pretty small range of products that would work for me.

There were specific strains that worked really well. Asku you is my absolute favorite strains. It’s been 10 years and I’m still, I’ll get that whenever I see it. What I found in general was, there was a certain sort of subclass of Indica strains that had an Afghani lineage. So they all had some Afghani landrace cannabis as part of the mix.

And then they also would all usually have a little bit of some type of Haze. So these kinds of Indica hybrids that would have those two elements are usually the ones that. You know, will help me out. So I started looking really specifically for those. I’ve been later, um, I started bringing in more CBD as well.

And so I’ve found that for me, what works really well is just a combination of that particular lineage of strains and then balancing that out with some CBD. Because for me, I need a little bit lower THC than what’s available on the market in general. You usually see the very, very high THC strains or the very high CBD strains, and there’s not a huge amount in the middle.

What I’ve learned to do is just combine those two elements to get that ideal blend for me, and…

Michael: Have you been able to deduce or see any connection in the other cannabinoid or terpene profiles of those strains that you think are the common denominator of what’s working  for you? 

Emily: There are certain terpenes that I find work well.

Myrcene, Limonene are two terpenes that are usually high in the strains that I enjoy, but I’ve also found that, you know, the chemistry between all of these different elements can be complicated to track. There might be two strains that have the same amount of these primary intervenes that we test for the same amount of THC, but they still might have different effects for me.

So on a personal level, I’ve found that tracking the strain lineage has actually been more effective for me in finding what works. Then, looking at those terpene profiles.  

Michael: You said that you get it whenever you can find it. Is finding what works for you an issue consistently? 

Emily: Yeah, it has definitely been an issue.

That I think is the biggest challenge to using cannabis medicinally is that there is such a huge variety of different strains, and so to find the ones that work for you in your area on a consistent basis isn’t always easy.  In the area that I’m living right now — I’m near Sacramento in California — for some reason, this geographic area, I find a lot of the strains that I’m looking for. I think to have consistent tastes with the market. In other areas, like when I lived in the Bay area, you know, I thought, “oh, I’m in the Bay area. There’ll be tons of cannabis. I’ll definitely find what I need.” But I found that there, the strain preferences in the market sort of veered more towards OGs, um, which gives me headaches.

So it was often challenging to actually find the strains that would be helpful for me. 

Michael: Okay. Well, I’m glad that you found a better, a more consistent way to get it. I’m assuming that smoking is your primary delivery method of how you use it?

Emily: Yeah. I use a mix of different methods. I do smoke regularly. One of my primary symptoms is nausea and smoking is just a very effective way to treat that. When you’re feeling very nauseous, eating something isn’t always the best option. And I find that there are different effects that you get from each different way of metabolizing cannabis, and it’s different way of using it.

So for me, smoking has been the most effective for symptoms like nausea and anxiety. But I’ll also use edibles and find those very helpful for pain relief. I’ll use a sort of a mix. I try to, you know, keep the smoking as low as possible just because of allergies. And, you know, I’m drying out my throat and symptoms like that, but I do smoke on a regular basis, and when I don’t, I definitely feel the difference.

Michael: That’s interesting. I was going to ask if the same strain treats the fibro and the anxiety. But it sounds like it’s the delivery method that’s more… 

Emily: Yeah. Yep. I would definitely say that. I find that the strains, the strains, I will usually shift those more based on the energy level that I want to have. So I have certain strains that I’m more likely to use earlier in the day. That gives me a little bit more energy and focus. And then I have strains that I use in the evening that are a little bit more relaxing and sedated. But I find all of those strains are helpful for controlling my anxiety and my pain level.

Although, the caveat of that is that there are plenty of strains that won’t help either, but the ones that I use tend to help those both for me. 

Michael: You said it was about a year that it took you to figure everything out? 

Emily: Yeah. That was about it until I got a consistent regimen that was helping me consistently.

I would say that that regimen has developed and shifted over the last decade. And you know, able to be even more and more fine tuned. But I definitely had a very effective regimen after a year. 

Michael: So you mentioned that some are more sedative, and you also said that you were in grad school when this started.  Did you find any difficulties with keeping a clear head or any cognitive effects in that time? Or today? 

Emily: That’s a great question. No, that’s something people ask me a lot because you know, there’s, cannabis has such a reputation as a mind altering drug that’ll make it very difficult to think clearly or remember things.

And, you know, there’s certainly some truth to that. And when I first got started using cannabis, I was really worried about using it during the day. When I was studying, when I was doing schoolwork. 

And a friend at the time, he’s actually now my husband, recommended just trying it. He was like, you know, “I know that you feel a little bit out of it at night when you use cannabis but you use it kind of sporadically. He’s like, I use it every day and I’m fine. Maybe you should just try it.” 

So, I was like, all right, well, let me just test this out. You know, I’m, I’m home studying today. Not a big deal. So I would start to experiment using this while I was studying, while I was doing my writing work at home on my dissertation.

And what I found was that for the first couple of days I did have I did feel a little bit slowed down by it. Even in those first couple of days as I was having kind of cognitive effects from it, I still honestly was doing better than when I was dealing with anxiety and team because those symptoms really can impact your cognitive functioning and make it very difficult to think clearly.

So cannabis was more helpful for me than the anxiety pain in terms of that. But I was still getting some sort of like, you know, mental confusion. But after a couple of days of this, you know, my body just adjusted. What I found was that I was still getting the anxiety and the pain relief. But it was no longer really having much of an impact on my cognitive functioning.

So I was able to, you know, go through my program, get my dissertation, finished successfully, defend it. I, you know, using a lot of cannabis the day that I defended my dissertation in front of a panel of professors and had to make arguments on the fly and at this  high academic standard.

Michael: It doesn’t sound like an anxiety free situation to begin with… 

Emily: No, no. It was a very anxiety provoking situation. Um, and the cannabis really helped me get through it, um, without making a negative impact on my mind. So that’s what I always tell people. You know, if you’re using cannabis medicinally, and you know, it’s helping me with something that, weighing you down during the day, that’s slowing you down. Try it, try it out during the day, try it out while you’re doing a little bit of cognitive work in a safe kind of space, and you might find that you’re actually able to function a lot better on it than you might think. 

Michael: So today, a decade later, you are a professional writer and educator on  cannabis.Yyou consult and help people go through the kind of processes that you went through. How did, how did this become a career for you? 

Emily: Yeah, so I started in the cannabis industry a few years after I became a patient. And at that time.,The cannabis space in California was very open. Everything was based around being a patient. So if you were a patient and you could kind of provide products to dispensary, you could be a part of that.

And so I first really got started by creating products for the local dispensaries that were niches, that  one thingfilledd. Um, so I have like a small line of pre-rolls and these infused sugar cubes. So it was, you know, it was kind of a beautiful time in the industry  in a certain respect.

And then from there, you know, I ended up going into a lot of different areas in the industry. I started, I managed a delivery service in my local area. And through that work, I started to do a lot of talking with patients about what was working for them, what wasn’t working for them. And I realized there was just this huge lack of information for people on the process of using cannabis and how to really get started with it.

How to really, you know, find what works well for you. So, you know, I decided to start this consultancy and offer, from a patient’s perspective, um, how to go through that process, and offer a lot of the tools that I had used and developed for myself in terms of, you know, tracking your experience, um, bringing in mindfulness to be able to really, um, notice what’s happening with different products and, um, and yeah, I started to consult with patients and  offer these kinds of resources to them.

Michael: What’s the thing, if there is one thing, what’s the thing that people tend to have the most trouble approaching or getting through when they start using cannabis as a medicine? 

Emily: I think the hardest sort of block to finding an effective regimen is, is just the huge amount of products available.

In some ways it’s helpful to have so many products available because you have so many options for people, but it’s very confusing for people that are starting. Right. So the majority of people that I work with come to me saying. “Okay, I got a recommendation for cannabis.  I’ve tried a few things that have helped me but I’m having all these bad experiences where I’m getting these negative side effects and you know, I don’t want to give up, but you know, I’m about to, because I go into the dispensary every time, you know, the bud tender will tell me what’s the new hot  strain to try and then I’ll end up home feeling paranoid and my pain not relieved.”

So I think that is the big difficulty for people as they come into this space, there’s a huge amount of products. A lot of products are geared towards recreational users. And they ended up having these experiences that really were not what they were looking for. So a lot of what I will do is help them understand how to navigate the system that’s already in place in the cannabis industry — help them understand what the different terms mean,  that they can start to be able to look for themselves. And then how to sort through that in terms of trying the different things out and saying, “okay, you know, maybe I’m a person who does really well with this particular kind of Sativa even though my friends told me that Indica was the thing that was going to help me.” 

And people just vary to such an extreme degree in terms of what strains will do what for them, so it’s such an important part of the process to really track how different products are affecting you so that you can go back and find similar products the next time.

And not just have it be this sort of gamble every time. This roll of the dice where you try something out and you just have no idea how it’s going to impact you. 

Michael: Medical cannabis is such a nascent field and there’s a lot we still don’t know. You and I are both involved in various and similar ways in helping to educate people and, and create those resources so that people can learn how to use it for themselves, can learn what the research is behind it.

Do you think that those resources are scarce or that people just don’t know they’re there or how to find them?

Emily: I think that they used to be a lot scarcer. We’ve had a big, you know, content boon in cannabis. So there, there’s a lot of information out there. But there’s, you know, there’s also a lot of incorrect information out there. Unfortunately, you know, there’s a lot of information that is, you know based on hearsay around the industry.

You know, there’s a lot of misinformation that’s been put out there by sources that are anti-cannabis. And so what I think is really important is for people to have science-based resources available where people are really explaining this is the science. You know, here is a link to the study of where we’re pulling this information from and acknowledging that we don’t know everything about cannabis yet. There are a lot of research restrictions and issues that have prevented good cannabis research from being done.and there’s also a lot of amazing cannabis research out there. 

So we have both a huge amount of studies but we also have a sort of lack of the particular study that we often want to be able to make claims. So it’s, you know, it’s an interesting space where, you know, people really are in the position of having to make these decisions for themselves about, you know, whether they’re going to move forward using cannabis for their medical condition without the kind of clinical studies often that we would see for a pharmaceutical option. 

You know, so we both have this like, you know, conversation going in the industry of how there’s so much cannabis research, you know, we know that it’s helpful. We know that it’s safe, but then on the other hand, you know, there’s this big lack of the kind of information, the kind of research that  would really convince the mainstream for any particular condition that cannabis is gonna help you with it. 

Michael: You mentioned that mindfulness and meditation has been a part of your own wellness and treatment for your conditions. You actually just wrote an article about cannabis and meditation for us, for The Cannigma, and we’ll put a link to that in the show notes. Can you tell us about what it’s meant for you and how cannabis fits into that?

Emily: Yeah, absolutely. It’s been really interesting to me using cannabis with meditation together has really been the path that I’ve taken in my recovery from anxiety and chronic pain. I think back to when I first got diagnosed with these conditions, and one of the first pieces of advice that the doctor gave me was to try meditating.

You know, in these conditions, there aren’t many treatments from conventional medicine. You know, doctors are pretty much like, “Oh, you’ve got anxiety, you’ve got chronic pain, good luck.” So meditation was one thing, but they said, you know, exercise, try meditation. So, and this was in the middle of undergrad before I had started using cannabis.

And I, I remember going to a meditation event and sitting down to meditate and, wow. It was like the most traumatizing anxiety provoking experience I have ever had. I felt like I was just totally trapped in my own mind with all of these, you know, terrifying anxiety thoughts that I had been suppressing for a long time.

And suddenly I’m sitting there and meditation and you know, there’s really no hiding from your own emotions. So. It was a really intense experience. And you know, I, I remember just like running out of the room at the end of it, like, “I am never going to do that again. That was terrible.” 

So it was years before I tried meditating again and when I did, it was after I had started using cannabis and it almost happened just sort of naturally that as I was using the cannabis, I would start to go into these kind of meditative states where I would start to notice more things that were happening, um, physically for me in my body.

I was able to, you know, pay more attention to my emotions and with cannabis, you know, it, it wasn’t so scary. It was something that I was then actually able to dive into. So at that point I, I started, you know, more formal meditation practice and started really learning about meditation techniques and you know, how to work with your own mind.

Michael: Do you think that you were able to get there —was it because the pain and the anxiety were dialed down or because of a mental place that the cannabis brought you, irrespective of those other things? 

Emily: No, I think it was a combination. I think it was both. And you know, what we see from the cannabis science is that both CBD and THC have the ability to blunt our stress reaction.

So they tested this out in contexts like people giving speeches that have people who have social anxiety, having to give a speech in front of people. And they find that, you know, if you have cannabis in your system and you know, the right dosing of cannabis, that people are actually able to have stressful experiences and not have the same kind of stress response come up.

So I think that for me, that was a big part of it. On the other side of the science of meditation, they also find that people who have very high levels of anxiety, people who have been through traumatic experiences or have PTSD often find that meditation can actually retraumatize them.

It can be a very stressful thing, you know, despite its ultimate ability to reduce stress, starting that can be very traumatic for people. So I think for me… 

Michael: Like therapy, you know, you have to dive through the hard stuff to get to a better place. 

Emily: Exactly, exactly. So I think unfortunately, so many people will  start meditation the way that I did, have just a very traumatic experience with it and then never want to go back to it. So for me, what cannabis allowed was to actually go there, you know, to actually be able to look at what was happening for me at an emotional level and be with that, which is really the kind of core teaching of meditation.

And so being able to work with both, you know, now, it’s been 10 years of meditating. I, you know, don’t need to necessarily use cannabis in order to do that. Now, meditation is actually a huge resource for me in terms of reducing my anxiety because, you know, I developed this sense of safety with my own internal experience that I didn’t have before.

So I think cannabis really opened the door to medication for me and then I’ve been able to, you know, use both the meditative practices and the cannabis to really, you know, increase my level of functionality, decrease my level of anxiety. And so, you know, for me it’s always hard to disambiguate between the two because it’s really been a joint practice for me throughout using both. 

Michael: Thank you, Emily. This has been great. We’ll  put a link to your website in the show notes if anybody wants to reach out to you for help exploring many of the things we’ve been talking about today.  It has been great talking to you. 

Emily: Great talking to you too. Thanks for having me on the podcast.

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