The Seat Belt, the Open Eyes, and the Speed Limit
At the Portsmouth Cannabis Expo last month, I heard a speaker on a harm-reduction panel compare harm reduction to driving a car and putting on a seat belt. That comparison stayed with me because a seat belt is only one part of driving responsibly. You also keep your eyes open. You pay attention to the road. You respect the speed limit. None of those choices makes driving completely risk-free, but they help you understand the risk and prepare for it. When we use cannabis, why would we want to approach it with our eyes closed, without limits, and without useful information?
Most people already practice harm reduction without calling it that. We wash our hands, read medication labels, wear protective equipment, maintain machinery, lock up dangerous items, and avoid driving when we are impaired or exhausted. Harm reduction is not a permission slip and it is not a declaration that something is harmless. It is the practice of seeing risk honestly, reducing preventable consequences where we can, and treating the person involved with dignity.
Humans do more than react to danger. We learn from experience, share knowledge, build routines, and adapt. A single decision may help someone get through a difficult moment, but repeated habits can shape whether a person remains stuck in damage control or begins moving toward greater stability. Education, preparation, limits, maintenance, and care are all parts of what I think of as a safety culture.
Cannabis Needs an Honest Safety Culture
We build safety cultures around cars, medicines, tools, firearms, machinery, and workplaces. I am not saying those activities have the same risk profile as cannabis. I am saying that people understand the need for information, training, boundaries, and protective habits when something can affect health or safety.
Cannabis has often been given two inadequate messages. The first is that cannabis is bad, so people should not discuss it honestly. The second is that cannabis is legal and available, so people should simply buy it. Fear and salesmanship are both poor substitutes for education. Neither one teaches a person how to understand a product, consider their own circumstances, recognize impairment, or decide whether cannabis is appropriate for them at all.
When many people hear the word cannabis, they immediately think of getting high. Intoxication and impairment are real parts of the subject, and pretending otherwise would not be harm reduction. But that picture is incomplete. Cannabis also involves medicine, agriculture, science, history, nutrition, industry, caregiving, and public health. Harm reduction begins before consumption. It begins with the story a person has been taught and whether they have access to honest information.
Adults deserve accurate information and room to make informed choices about their own lives. That does not erase responsibility for impairment, storage, caregiving, or the effect our decisions can have on other people. It means people should not have to choose between shame and misinformation.
Two conversations helped make that idea more concrete. Travis Vought’s work with veterans, older adults, and caregivers points to one kind of honesty: being able to say what a person is using, why they are using it, and what they are worried about without being punished or dismissed. Nick Shifflett of EndoCulture describes another: the private honesty of noticing whether cannabis, a product, a dose, or a routine is actually helping. Both forms of honesty matter.
Shifflett put the education problem plainly during our interview: “I want people to learn about it, not just do it.” That does not mean every person needs the same lesson or the same cannabis plan. It means consumer education should include product information, impairment, timing, storage, personal limits, and permission to say, “This is not working for me.”
The Human Side: The Cost of Silence
Harm reduction is not only a product question. It is also a question of whether a person has somewhere safe to ask for help. Vought, founder of Veteran Home Guardians, works to support veterans, older adults, and caregivers with cannabis education and resources. Veteran Home Guardians is an active cannabis education source and proponent for veterans. “People need to feel safe talking about cannabis use,” he said. “Stigma and misinformation get in the way.” He said people are already using cannabis or considering it. They need practical information that can help them reduce avoidable risks and recognize when something is not working.
Vought said many older adults, veterans, and caregivers do not feel safe asking honest questions. They may worry about being judged, dismissed, losing access to medication, or creating problems with a healthcare provider. “Silence creates more risk than an honest conversation,” he said.
That matters because the people who need the clearest information are not always the people most comfortable walking into a dispensary, searching a menu, or sorting through conflicting advice online. A safety culture has to make room for the patient, the caregiver, the veteran, the first-time consumer, the longtime consumer, and the person who may ultimately decide cannabis is not right for them.
Vought’s perspective changed the Onion Model for me (which I describe in detail below). The Onion model showed that harm reduction can begin before someone changes a product, dose, or route. For some people, the first layer is simply moving from silence to an honest question and from fear to a safer conversation with a caregiver or healthcare professional.
“This is a human-to-human interaction,” Vought said. “We treat it like it has to be clinical because of the environment we’re in, but it’s simple. It works when two people can just talk.”
At Home and at Work: How I Found the Question
When I started a Hocking College, I knew I was taking on a challenge. As a Cannabis Laboratory Sciences student, I felt a responsibility to eventually help explain cannabis to the public through a scientific lens.
After my wife and I moved into our apartment in Nelsonville, a simple question began to take shape: What is the smartest way to consume cannabis?
That question had already been forming through conversations with people around me. People asked how cannabis might fit into different situations: how to avoid becoming more intoxicated than intended, how to avoid smoking, what products were stronger, which products made sense for a particular person, and how personal habits could affect the experience.
At home, the work looked like reading research, organizing information, and thinking through different cannabis situations. At work in a dispensary, it meant navigating menus with real customers and seeing those questions appear in front of me. The goal was never to push one product or method. It was to understand what a person was looking for, what they could afford, what ingredients or materials mattered to them, and whether there was a better-fitting option based on the information available.
The questions kept expanding: research articles, scientific data, lived experiences that had not necessarily been formally studied, and the gap between what was documented, what people believed, and what people were already attempting in real life.
The Onion Model did not begin as an attempt to invent a universal theory. It began as a way to turn scattered questions into a better process: meet people where they are, understand the starting point, improve the habit that exists, consider another route when appropriate, and leave room for using less, taking a break, or stopping.
Nick Shifflett and EndoCulture: Start Within
I met Nick Shifflett at the Ohio Cannabis Expo in Hilliard on May 22. Shifflett is a graduate of Hocking College’s Cannabis Laboratory Sciences program and the creator of EndoCulture. After the expo, I started seeing his short videos online and reached out for an interview. Our conversation became less about promoting a product than about how people learn to pay closer attention to themselves.
EndoCulture describes itself as a lifestyle brand built around five principles: sleep, movement, nutrition, stress management, and responsible cannabis use or non-use. Its message is simple: Start Within. The framework is not meant to give everyone the same routine or the same cannabis answer. Shifflett compares it to a fingerprint: every person has a different body, history, set of needs, and daily life, so what works for one person may not work for another.
The five principles are meant to make self-awareness practical. Sleep means noticing what helps a person feel rested. Movement can start with one manageable action rather than an unrealistic workout plan. Nutrition asks people to notice how foods affect them. Stress management can look like hiking, meditation, reading, music, or slowing down. The cannabis principle leaves room for responsible use, less use, a tolerance break, or non-use.
That approach broadened the model in a different direction. The early Onion Model focused heavily on the outside of a cannabis decision: a different route, formulation, dose, piece of hardware, or routine around use. Shifflett kept turning the question inward: what if the next harm-reduction move is not another product?
Cannabis as Part of the Framework
For Shifflett, cannabis is one part of the framework, not its center. He does not treat it as a universal answer. In his view, responsible use can include using less, taking a break, changing a routine, or deciding that cannabis is not the right fit at that moment.
During the interview, Shifflett pushed back against an all-or-nothing view of changing a habit. If someone believes cannabis is disrupting sleep or daily function, he said, the choice is not always to keep using in the same way or quit instantly. A person might change the time of day, reduce the amount, take a break, or change one part of the wind-down routine.
His larger point was that small, realistic steps count. He also described the difference between using cannabis intentionally and using it automatically. Before increasing THC, dose, or frequency, a person can pause and ask what feels off in their own routine: sleep, food, hydration, movement, stress, finances, or responsibilities. If something does not feel right and people close to them are noticing changes too, that can be a signal to become more aware and take small steps toward habits that feel healthier and happier. It is not a reason for shame. It is an invitation to look more closely at the pattern.
This is not a clinical prescription, and it should not be treated as settled medical science. It is a community perspective with an important harm-reduction lesson: a person may need help choosing a better product, but they may also need to consider whether sleep, stress, routine, or another source of support needs attention first. As Shiflett put it, “Supporting them is the only thing you can do.” Support is not about controlling someone or waiting for other people to tell them what is wrong. It is about creating room for a person to recognize their own patterns, make small changes, and choose the next step with support around them.
The Onion Model: Four Questions Before One Answer
The Onion Model is not one cannabis ladder. It is a shared harm-reduction map that changes based on what a person needs. The center is not “use more cannabis” or “quit everything.” It is: What is the next honest, safer, more supported step for this person?
The model can begin in different places. For a person changing a higher-risk substance pattern, the first layer may be immediate safety and support. For a veteran, older adult, caregiver, or patient, as Vought’s work shows, the first layer may be having permission to ask a healthcare question. For an everyday cannabis consumer, as Shifflett’s framework shows, the first layer may be noticing an automatic habit and asking how cannabis is affecting sleep, stress, money, relationships, or responsibilities.
The question remains: safer compared with what? Harm reduction starts with a person’s actual baseline, not an imaginary average consumer. A cleaner vaporizing device may be an improvement over a dirty one, but it does not erase the risks associated with combustion. A different route may reduce one concern while creating another. For some people, the best next step may be using less, taking a break, never starting, or stopping altogether.
A useful model has to leave room for all of those outcomes.
The Onion Model asks four questions:
- Compared with what starting point?
- Which product or route is involved?
- What is true about this individual?
- What can improve within the method or routine currently being used?
The layers move from broad context toward specific decisions. The person matters. The product matters. The route matters. The surrounding habit matters. The model does not promise a risk-free answer, and it does not rank one product as universally best. It gives people a way to ask better questions before making their next decision.
The original Onion Model was strongest at examining the outside of the decision: product, route, dose, setting, and habit. Vought added a communication layer: whether a person can safely disclose, ask questions, and receive care without shame. Shiflett added the inward layer: the person’s routines, stress, sleep, movement, nutrition, relationships, and whether cannabis is truly helping. Together, those perspectives make the model broader and more human.
A reader can begin with one current habit or assumption. Learn what is in the product and how much is intended. Keep hands, equipment, and preparation areas clean. Store cannabis away from children and pets. Plan around impairment and never drive impaired. Reduce dose, frequency, or unnecessary exposure. Take a tolerance break. Stop when harm reduction is no longer enough.
These actions do not create a perfect answer. Cleaning equipment may reduce contamination, but it does not make smoke healthy. Changing one habit does not erase every other risk. The purpose is not to perform perfection. It is to make one honest improvement and then keep learning.
From Harm Reduction Toward Health Promotion
The reporting behind this article changed the Onion Model for me from a product-and-route framework into a broader set of harm-reduction paths. Vought’s path moves from silence to an honest healthcare conversation. Shifflett’s path moves from automatic external cannabis use toward self-awareness, supportive habits, and the possibility that less cannabis, a break, or no cannabis may be the better answer. The original path remains important too: people still need practical help understanding products, routes, doses, materials, and impairment.
The larger progression is from damage control to harm reduction and, when the evidence and circumstances support it, toward health promotion. That last step requires humility. If cannabis itself is claimed to produce measurable health improvements, that claim needs research. Lived experience can identify worthwhile questions, but it does not automatically settle them. Some of these ideas deserve to be defined, measured, tested, revised, or rejected.
This work has become personal for me because I think about cannabis across an entire lifetime. As people age, become ill, provide care, or face serious health decisions, they deserve comfort, dignity, and informed choices. Cannabis may be part of that conversation for some people, but better education and better research are needed to understand when, how, and for whom it is appropriate.
That is the work this column can do: separate established evidence from lived experience, uncertainty, and ideas that still need to be tested. The cannabis community does not need to pretend every theory is proven, and it does not need to ignore real experiences simply because research has not caught up with every question yet.
Harm reduction is not perfection. It is learning to keep your eyes open, respect the limits, use the protection available to you, and take the next honest step.
After writing this article, I realized that one of the best ways to reduce harm may simply be to make connections, ask questions, learn from others, and find what works best for you with the right support. The Ohio Cannabis Column can be a home for those conversations.
Join the Ohio Cannabis Harm-Reduction Conversation
This article introduces the Onion Model and the way I am beginning to think about cannabis harm reduction. Now I want to hear from the people who live with these questions every day. If you have a question about cannabis, a personal experience, a product problem, a caregiving situation, or a topic you believe deserves more honest attention, I want to hear it.
You can send a harm-reduction question, a consumer confusion, a patient or caregiver perspective, a question about smoking, vaping, edibles, or other routes, a research idea, an Ohio cannabis memory, or a workforce question. The next article will apply the Onion Model more directly to products, routes, individual needs, and everyday habits.
You can contribute:
- A harm-reduction question
- A cannabis experience that has not been well studied
- A consumer confusion or product concern
- A question about smoking, vaping, edibles, or other routes
- A patient or caregiver perspective
- A “What I Wish I Knew” story
- A harm-reduction practice that has helped you
- A question for the next article
- An Ohio cannabis memory or community lesson
- A scientific source or research topic
- A workforce or dispensary question
Take this month’s MedicateOH community consumer survey: The Consumer Voice
Subscribe to the MedicateOH Ohio Cannabis Column: Subscribe
Connect with Dawson on LinkedIn: Linkedin.com/in/dawson-holtzclaw-138530406
Submit a question, experience, story, resource, or research idea: dawson@medicateoh.com
If we publish your response, you may remain anonymous. The MedicateOH Ohio Cannabis Column is being built through research, honest conversation, and community participation. If you have a question, experience, or idea that could help Ohioans think more clearly about cannabis, I want to hear from you.
