BEGINNER’S GUIDE TO SUNDAY, SEPT. 18, 2022
CANNABIS AND MEDICAL MARIJUANA
was a hotbed of hemp pro duction in the 1700s, with two townships, East and West Hempfield, named after the crop. Industrial hemp was banned nationwide in 1937 because of its similarity to marijuana.
The 2014 Farm Bill, under President Barack Obama, allowed research institutions and state departments of agriculture to issue research permits for growing hemp, within limits.The2018
Farm Bill removed hemp — and products such as the CBD oil which can be derived from hemp — from the Controlled Substance Act list of illegal drugs.
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Hemp is a variety of the Cannabis sativa plant grown specifically for industrial use. Hemp’s seeds, stalks, oil and leaves are used in clothing, rope, paper, biodegradable plastics, paint, insulation, biofuel, food, mulch, animal
MARIJUANA AND HEMP: THE BASICS
feed and more. Hemp also contains higher levels of CBD, found mostly in the plant’s flower. And that’s the compound that CBD oil advocates tout as being helpful for condi tions ranging from anxiety and depression to chronicLancasterpain.County
Marijuana and hemp are both from the same species of plant, Cannabis sativa, and they share many of the same chemical compounds, including THC and CBD, but to different degrees.Despite their similarities, hemp and mari juana are very different in their chemical and genetic compositions, how they are defined under law, and how they are produced and used.Hemp contains a low level of THC — less than 0.3% — a level that’s set by federal and state law. As such, it does not have the psycho active properties of marijuana. Marijuana’s THC levels are much higher.
A glossary of terms you should know
Cannabidiol, also known as CBD, is a cannabinoid like THC made by the cannabis plant. Unlike THC, however, CBD does not have psychoac tive properties.
Tetrahydrocannabinol, or THC, is found in the resin produced on the cannabis plant’s leaves and buds. It is the substance primarily respon sible for the mind-altering “high” of marijuana.
The cannabis plant contains over 400 chemical substances, including a group known as cannabinoids, which are similar to the endocannabi noids that humans and other mammals naturally create in their bodies. The cannabis plant contains more than 100 cannabinoids, but the main ones are THC and CBD.
Discovered in the 1990s, the human endocannabinoid system or ECS is a system of endocannabinoids, cell receptors and enzymes that is be lieved to help regulate many bodily functions, from sleep, mood and memory to appetite, reproduction and pain sensation.
Terpenes are oils secreted from the resin glands of flowers. They are found not just in cannabis but in other plants as well. Terpenes give various strains of cannabis their distinct aromas and flavors. Like can nabinoids, terpenes also interact with the human body, and research indicates they may play a role in enhancing the effects of cannabinoids.
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An analysis of the concentration of various cannabinoids and terpenes in a product.
UNDERSTANDING CANNABIS
CANNABIS
PROFILE
Sources for pages 2 and 3: Food and Drug Administration, National Institutes of Health, LNP Archives, New York
Though CBD and THC are both found in marijuana and interact with the endocannabinoid system, there are some important differences.
In Pennsylvania, CBD products bought over the counter that don’t re quire a prescription must be derived from hemp plants. They also must contain 0.3% or less of THC, which at much higher levels gives mari juana users that “pot high.” Only medical marijuana dispensaries can offer CBD products made from marijuana. CBD products are touted for relieving everything from anxiety to chronic pain, but they are not regulated by the FDA like drugs.
Cannabis is part of a family of flowering plants known as Cannabace ae. Parts of the plant, such as dried leaves and flowers, have been used for medicinal and recreational purposes throughout history.
Despite both being cannabinoids, CBD and THC interact with slightly different receptors in a person’s brain. As a result, CBD is unlikely to get an individual high. Medical marijuana that is CBD dominant has minimal THC, which means that someone taking medical marijuana will not feel high when taking the medication.
CBD
THC
Times, Congressional Research Center
Many people associate marijuana with getting high. Indeed, THC may cause a person to experience a high. Often, THC produces the high people associate with using marijuana recreationally.
ENDOCANNABINOID SYSTEM
CANNABINOIDS
TERPENE
Both CBD and THC are present in marijuana. When a person takes a CBDdominant version of medical marijuana, they are using CBD from hemp, which is closely related to marijuana. THC originates in the marijuana plant, and people extract it from that source.
CBD VS. THC
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Heather and Nathan’s latest venture expands on that mission through the creation of an open and airy public space on the corner of Prince and Walnut, right behind Our Town Brewery. Hempfield Apothecary welcomes Lancaster Countians who want to learn more about natural wellness. The Apothecary is a source of cannabis knowledge and education, and offers adjunct therapies like restorative yoga, sound immersion meditation, cooking with cannabis, and non-pharmacological pain relief.
Together, Dr Folgueras and Heather embrace a holistic approach to care with an emphasis on science-backed research to help patients with conditions that benefit from medical marijuana. Conditions that may benefit from medical marijuana include PTSD, anxiety, depression, and chronic pain
Hempfield Apothecary is the latest venture from local hemp startup, Hempfield Botanicals The original business was started in 2017 by Heather and Nathan Kreider Hempfield Botanicals’ mission was to provide tested, trusted hemp-based CBD products for issues such as skin care, sleep aid, anxiety relief, and pain reduction.
Hempfield Apothecary offers Lancaster Countians an all-inclusive learning space, free of shame or social stigma. At the Apothecary, people can be free to ask questions and learn how to improve their health in a science-backed way that is healthy for both humans and the environment.
What makes Hempfield Apothecary unique among local wellness organizations is their focus on the natural healing properties of cannabis products. In particular, the Apothecary will help ensure that Pennsylvania Medical Marijuana Card patients are using their medication appropriately and effectively based on their individual needs.
Hempfield Apothecary is open Monday through Wednesday, 9:00 AM to 5:00 PM, Thursday and Friday 9:00 AM to 7:00 PM (First Fridays until 9:00 PM), and Saturday 10:00 AM to 3:00 PM.
Cutting Edge Healing, Naturally
Hempfield Apothecary | Hempfield Botanicals
On staff at the Apothecary are Dr Annette G. Folgueras, M.D., who is fluent in Spanish, and founder Heather Kreider, R.N who is certified in Advanced Cannabis Training and is Pennsylvania Dispensary Agent Certified.
Learn more at HempfieldApothecary.com https://www.facebook.com/HempfieldApothecary
The Apothecary also is a place to try hemp products under the Hempfield Botanicals and Makes Scents Natural Spa lines These products are vegan and eco-friendly and come in a range of applications such as oral oils, topicals, teas, flower extracts, body products and pet products. All products are third-party tested by Green Scientific Labs to ensure that every batch meets rigorous standards of quality and accuracy.
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When Kristen Sullivan of Lancaster was undergo ing chemotherapy for cancer, she dealt with near constant nausea and pain.
Getting medical marijuana
So, how do you get medical marijuana, if you have a medical condition that might be improved with medical marijuana? The first step is to determine if youMedicalqualify.marijuana can be used by patients who are 21 or older, as well as some minors who qualify with a serious medical condition. Minors need to have a caregiver who is 21 or older.
If you have any of these conditions, you may quali fy for medical marijuana in Pennsylvania.
While it is called medical cannabis in some states,
After trying several medications that made her feel “out if it,” her doctor suggested medical marijuana. Now in remission, Sullivan found the relief she needed to deal with her treatments and carry on in her daily life.
In spring 2016, the Pennsylvania Department of Health began the process of implementing the state’s Medical Marijuana Program. Medical mari juana has been legalized in Pennsylvania, as well as other states, but has a different set of regulations than other medications. It has not yet been approved by the FDA and is still considered to be a Schedule I controlled substance by the Drug Enforcement Agency (DEA).
MEDICAL MARIJUANA
Medical conditions that qualify for medical mari juana include everything from cancer, epilepsy and glaucoma to inflammatory bowel disease, Parkin son’s disease and Tourette syndrome. For a com plete list, see page 8.
Can it help you, how do you get it and what to expect
like New Jersey, in Pennsylvania it is known as med icalNotmarijuana.allexperts agree on promoting marijuana for medical use. However, many experts agree that mar ijuana may offer relief when other medications don’t work or produce uncomfortable side effects. Its ef fectiveness in reducing painful and adverse side ef fects in cancer patients and those with multiple scle rosis has been shown to improve the quality of their lives, according to Harvard Health.
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“I never thought I would be using marijuana,” said the 70-plus grandmother. “But it was a lifesaver for me.”Many people still associate marijuana or cannabis with the hippie era of peace and love. However, med ical marijuana does not get anyone “high.” It can be valuable in helping those suffering from a number of medical conditions, especially relating to pain.
LAURA KNOWLES FOR LNP | LANCASTERONLINE
When completing your application in the Medi cal Marijuana Registry, you can designate up to two caregivers to assist you in obtaining medical mari juana. Caregivers can be a spouse, a parent, or even a friend. Patients under the age of 18 are required to have a caregiver. Caregivers also have to register for the medical marijuana program. All caregivers must complete a background check before being ap proved.Yournext
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n The FDA has not approved the cannabis plant for any medical use. However, the FDA has approved several drugs that contain Epidiolex,cannabinoids,individualincludingwhichcontains a purified form of CBD and is approved to treat two rare forms of epilepsy. Three other drugs, two containing synthetic THC and another a synthetic substance similar to THC, have been approved for therapeutic uses.
step is to get a medical marijuana ID card, which is required to purchase medical mari juana. Once you have been certified by an approved physician, you need to return to the Medical Mari juana Registry and complete your application for a medical marijuana ID card. The cost of the card is $50. Patients who participate in assistance pro grams including Medicaid, PACE/PACENET, CHIP, SNAP, and WIC may be eligible for fee reductions. You will need to renew your registration annually. You will receive an email with directions on how to pay 30 days before your annual payment is due. This email includes a due date that is usually about a week before the expiration date on the ID card. If the payment is not received by that date, the ID card will automatically be deactivated. When you log in and pay the annual payment, the card is immedi ately
n Products containing THC or CBD cannot be sold as dietary supplements.
MARIJUANA, page 12
Getting medical marijuana through Pennsylva nia’s medical marijuana program involves four basic steps: registering for the program through the Medi cal Marijuana Registry, having a physician certify that you suffer from one of the medical conditions that qualify for medical marijuana, paying for a medical marijuana ID card, and then getting medi cal marijuana from an approved dispensary in Penn sylvania.InLancaster County, there are several approved dispensaries, including Vital Options Medical Mari juana Dispensary, Restore Medical Marijuana Dis pensary, Trulieve Medical Marijuana Dispensary, Verilife Medical Marijuana Dispensary, Sunnyside Medical Cannabis Dispensary and The Apothecari umToDispensary.register,you
will need to create a profile in the Medical Marijuana Registry. Your profile will in clude basic information, such as your legal name, current address, and contact information. To reg ister for the medical marijuana program, you must have a Pennsylvania driver’s license or an ID card is sued by the Pennsylvania Department of Transpor tation.Once you have registered in the Medical Mari juana Registry, the next step is to have an approved physician certify that you have a qualifying medical condition.Approved physicians also have access to the Medi cal Marijuana Registry and will submit their certifi cations directly to the system. You can find a list of approved physicians who recommend medical mar ijuana at health.pa.gov, under “medical marijuana.” These physicians are required to register with the
A view inside The Apothecarium Dispensary.
Department of Health. If your current physician is not registered with the Department of Health, you can find an approved list at the website.
DID YOU KNOW?
Oncereactivated.youhave your medical marijuana ID card, you are ready to visit the dispensary of your choice.
— Anxiety disorders
— Huntington’s disease
— Damage to the nervous tissue of the central nervous system (brain-spinal cord) with objective neurological indication of intractable spasticity, and other associated neuropathies
Medical marijuana is available in the following forms:—Pills, oil, topical forms such as patches or oint ments.—Forms medically appropriate for administration by vaporization or nebulization, including dry leaf or plant form for administration by vaporization. — Tinctures and liquids.
— Autism
— Intractable seizures
— Cancer, including remission therapy
— Opioid use disorder for which conventional ther apeutic interventions are contraindicated or ineffec tive, or for which adjunctive therapy is indicated in combination with primary therapeutic interventions
— Severe chronic or intractable pain of neuropathic origin or severe chronic or intractable pain
MEDICAL MARIJUANA IN PA
WHAT ARE THE APPROVED CONDITIONS?
— Neurodegenerative diseases
— Post-traumatic stress disorder
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— Dyskinetic and spastic movement disorders
— Terminal illness
— Neuropathies
— Crohn’s disease
HOW DO YOU USE MEDICAL MARIJUANA?
Gov. Tom Wolf signed a bill in 2016 legalizing the use of medical marijuana in Pennsylvania. The term “medical marijuana” refers to using the whole unprocessed marijuana plant or its basic extracts to treat a disease or symptom. Studies have shown that medical marijuana can assist patients suffering from serious medical conditions by alleviating pain and improving their quality of life.
Anyone with an approved serious medical condi tion who is a Pennsylvania resident and is certified by a doctor participating in the program can receive medical marijuana.
— Glaucoma
— HIV / AIDS
— Inflammatory bowel disease
WHO CAN USE MEDICAL MARIJUANA?
Only patients suffering from one of the following medical conditions can participate in Pennsylvania’s medical marijuana program:
— Parkinson’s disease
— Tourette syndrome
— Epilepsy
PENNSYLVANIA LAW
— Amyotrophic lateral sclerosis
— Multiple sclerosis
— Sickle cell anemia
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To register for the Pennsylvania medical marijuana program, create a patient profile in the medical marijuana registry at pa dohmmp.custhelp.com. You can register as an adult or as a caregiver of someone who needs in-home support, someone with a disability or a minor. You will need a valid Pennsylvania driver’s license or state-is sued
2 341 We offer a wide range of Hemp and CBD products, locally made glass and art, and the largest selection of incense in the area! We are family owned and operated and been in business since 1969. ROCKVALE LOCATION • 35 S Willowdale Dr STE 505 • Lancaster, PA 17602 717-390-4830 • puf fnstuf flanc.com COMING SOON! DOWNTOWN STORE RELOCATION 121 E Chestnut St. • Lancaster, PA 17602
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HOW DO I GET A MEDICAL MARIJUANA CARD?
registered, schedule an ap pointment with an approved physician who can certify that you have a qualifying medical condition. Approved physicians are also certified through the registry. A complete list of approved physicians by county is available at pa.gov. See page 8 for a complete list of approved conditions.
Once the physician submits your certifica tion, you can return to the registry to apply and pay for your medical marijuana card. Cost is $50. Patients who participate in assistance programs including Medicaid, PACE/PACENET, CHIP, SNAP, and WIC may be eligible for fee reductions.
Once you receive your card, you can pur chase medical marijuana through any dis pensary in Pennsylvania. For a complete list of medical marijuana dispensaries, including those in Lancaster County, visit pa.gov. You will have to renew your regis tration for the medical marijuana program each year.
CBD Gummies
This is a dietary supplement tincture usually taken orally, under the tongue Uncomplicated and convenient, this tincture supplements your diet with CBD (cannabidiol). This tincture may also be added to food and to other liquids, as well as, under your tongue
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“Meeting with the consultant will help patients de termine what products will be best for their condi tion and needs,” Moleski says.
Going to a dispensary
“The Apothecarium is a full-service medical mari juana dispensary focused on patient experience,” Moleski says. “Our dispensaries are known for em phasizing education and customer service for se niors and first-time dispensary visitors.”
Among the products are a variety of concentrated resins, oils, edibles, pills, tinctures, creams, oint ments and forms administered through vaporiza tion or nebulization, excluding dry leaf or plant form. Most recently, cannabis flowers are now avail able at some of these shops.
I never I would be using marijuana, but it was a lifesaver for me.
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are often pleased to get relief from pain,” Moleski says.
You have the option of getting your medical mari juana products online, at the dispensary or via curb side pickup.
Kristen Sullivan
It is usually best to contact the dispensary of your choice first. You will need to set up an appointment for a consultation with a medical marijuana phar macist. There are many products to choose from, and the pharmacist can help determine which prod uct might be best for your needs and preferences.
It can be a little overwhelming to decide without that help, because there are so many choices and brands. The consulting pharmacist can explain ex actly what the products are and how they are admin istered.Marijuana
is a drug from the hemp plant Cannabis sativa. Even though many people use the word mari juana when referring to cannabis, the term marijua na specifically refers to the dried flowers and leaves of the cannabis plant.
One product not allowed in Pennsylvania are gum mies, notes Michelle Moleski, director of physician and community outreach for The Apothecarium. The reasoning, she says, is that they might be mis taken for candy by children.
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That has been the experience for Sullivan, who says medical marijuana has helped her feel more relaxed and get relief from the pain and nausea of chemotherapy.“Itmadeaworld of difference in dealing with my illness,” she says.
Many patients are senior citizens who might have a perception of marijuana from the 1970s. But medical marijuana is designed to provide effective treatment through different strains and delivery methods that do not cause the “high” associated with recreational marijuana use. There are still restrictions on driving and other activities, because medical marijuana can cause“Seniorsleepiness.patients
Medical marijuana, which is often known as medi cal cannabis, can be used to treat a variety of symp toms, including nausea, pain, muscle stiffness, mus cle spasticity and loss of appetite.
CBD’S effect on sleep?
When it comes to CBD helping with sleep, though, the research is sparse.
CBD, page 14
While it’s not entirely clear how CBD works in the body, it’s thought to re duce inflammation, which may help al leviate pain, and it can calm the central nervous system, which may ease anxi ety, said Mitch Earleywine, a professor of psychology at the University at Alba ny in New York, and an advisory board member of the nonprofit National Or
“To this day, there’s no study that has used CBD on its own in any trial of in somnia,” says Anastasia Suraev, a doc toral candidate and research fellow at the Lambert Initiative for Cannabi noid Therapeutics at the University of Sydney. There are studies that have found that CBD used in combination with THC holds promise as a treat
ganization for the Reform of Marijuana Laws.(CBD’s calming effects have also been shown to treat certain types of seizures; an anti-epileptic medication called Epidiolex is the first and only CBD pre scription approved by the Food and Drug Administration.)
Suraev, along with the other experts, noted that CBD itself does not have se dating effects. While some studies on CBD for seizures found that a side ef fect of the treatment was drowsiness, that may have been because of “CBD interacting with other medications” like anti-epileptic drugs, Suraev says.
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RACHEL RABKIN PEACHMAN NEW YORK TIMES
CAN CBD INSOMNIA?HELP
If you’re like many adults around the world who have found themselves tossing and turning during the pan demic, you may have been tempted to try a sleep aid, like CBD, to get a better night’s rest. Unlike the cannabis plant’s other famous — and psychoactive — compound THC, CBD does not get us ers high and is touted for relieving a range of conditions, including pain, anxiety and, yes, sleep problems.
ment for sleep disorders like insomnia, sleep apnea, restless legs syndrome and nightmares related to post-traumatic stress disorder. But there are no large placebo-controlled clinical trials (the gold standard for scientific research) that have investigated how CBD alone might help with sleep problems.
Still, CBD may indirectly help you sleep by alleviating other conditions, says Ryan Vandrey, professor of psy chiatry and behavioral sciences at the Johns Hopkins University School of
or what brands to purchase for anxiety or any other condition. Epidiolex is the only CBD product regulated by the FDA, so there is a lot of variety (includ ing a range in formulations, purity and labeling practices) in products like oils, gummies, creams, patches and vape pens. “There’s state-level regulation, but it’s different from one state to the next,” Vandrey says. “And none of those states have the right infrastructure, resources or level of enforcement that the FDA does.”
from
you can order CBD oil, but CBD oil is not CBD oil is not CBD oil,” Van drey says.
If you can’t easily find a certificate of analysis on the website, choose another brand. Some companies may also indi cate that they use good manufacturing practices (GMP), meaning their prod ucts have been manufactured in ways that are in line with FDA standards.
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In one case series, researchers looked back at the medical charts of 72 people with anxiety or sleep problems who were treated in the same clinic with 25 to 175 milligrams of CBD per day for three months. Based on the patients’ self-reports at follow-up appoint ments, the researchers found that CBD was most helpful for anxiety, not sleep. But “ultimately, even if they weren’t sleeping better, they were less anxious about it and felt maybe more rested,” says Dr. Scott Shannon, a psychiatrist in Fort Collins, Colo., who led the study.
— Discuss it with your doc tor first. “CBD as a chemical entity is a very safe molecule with very low toxicity,” Van drey says. But it can interact with some medications, like warfarin (a blood thin ner), tamoxifen (a breast cancer medication), some anti-seizure medica tions and certain anti
— Make sure the brand is credible. The best way to find a high-quality CBD product is to buy it from a state-regulat ed cannabis dispensary, Vandrey says. “If you can’t do that,” he adds, “look for national brands that have a good reputation.” Credible brands should have websites that offer a certificate of analysis for each individual product batch. This document — which can be found on the company’s home page un der “FAQ,” “Questions,” “Lab Results” or simply “Certificate of Analysis” — shows that their product was tested by an independent laboratory for its levels of CBD, THC and other cannabis com pounds, as well as for possible contami nants like pesticides or heavy metals.
— Start with a low dose and increase slowly. Because there is no con sensus on how many milligrams of CBD a person should take, or in what form (except for with Epidiolex), the experts suggest that you start with a low dose to make sure you tolerate it well. Then, gradually increase the amount you take until you begin to feel an effect. While many of the clinical studies on CBD involve doses of 200 to 800 milligrams daily, Shannon recommended starting closer to 15 to 20 milligrams each day, and using trial and error to figure out what works for you.
Vandrey cautioned that the available studies, like this one, are limited and there isn’t enough data to determine what dose to take, what form to choose
— Don’t forget about good sleep hygiene. Earleywine says that if you’re finding that your sleep is improved with low doses of CBD, that may actu ally be a result of the placebo effect, not the CBD itself. Though that’s not neces sarily a bad thing, you might find it just as effective — and less expensive — to tackle your insomnia with behavioral modifications, like reducing your caf feine intake and avoiding screens too close to bedtime.
depressants, so make sure your doctor is aware of the drugs and supplements you’re currently taking.
Continued 13
CBD: Insomnia
Medicine and principal investigator at the university’s Cannabis Science Lab oratory. For example, he says, if pain is keeping you awake at night and CBD helps lessen your discomfort, you may be able to sleep better. Similarly, if you can’t sleep because you’re anxious, he adds, “CBD may reduce anxiety,” which in turn may promote sleep.
In a study published in 2017 in JAMA, for example, Vandrey and his col leagues analyzed the contents of 84 dif ferent CBD products purchased from 31 companies online — including oils, tinctures and vape liquids — to see if their labels were accurate. They found that just 26 of the products were ac curately labeled in terms of their CBD content — 36 products had more CBD than advertised, and 22 had less. They also found that 18 of the products con tained undisclosed THC, in some cases at high enough doses to cause intoxica tion.“So
How to take CBD safely
Despite the lack of clarity, the experts say that it’s not unreasonable to try CBD if you’re having trouble sleep ing. But keep these tips in mind.
LANCASTER, PA | LNP 15SEPTEMBER 18, 2022 1,830414,446773,307 23.3 million 66.3 million $5.7 billion MEDICAL MARIJUANA IN PENNSYLVANIA: PROGRAM TO DATE Patients and caregivers registered in the program Active patient certifications as of July 2022 Approved practitioners Patient dispensing events Products dispensed Total sales Source: Pennsylvania Department of Health Check out Lancaster County’s Best Kept Secret Concession Trailer Menu Opening this Fall! HIGH PROTEIN SOFT PRETZELS Ac ro ss fr om Jilly’ s Bakery - 130 Hellam St , Wr ightsville (back alley way ) lancas te rtradinghouse .c om | Hemp ze ls.co m | 1-800-USE(8 73 )-HEMP(436 7) Fo ants Limited delivery in the Lancaster & surrounding areas or pick up in Wrightsville. Soft Pretzel Shop Menu od Service Ready for Bar & Restaurants or
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