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CANNABIS DOSING GUIDE

Cannabis therapeutics is personalized medicine. The right treatment regimen depends on the person and condition being treated. For maximum therapeutic benefit, choose cannabis products that include both cannabidiol (CBD), a non-intoxicating compound, and tetrahydrocannabinol (THC), the psychoactive component of cannabis. CBD and THC interact to enhance each other’s therapeutic effects. They work best together. A patient’s sensitivity to THC is a key factor to determining the ratio and dosage of CBD-rich medicine. Many people enjoy the cannabis high and can consume reasonable doses of any cannabis product without feeling too high or dysphoric. Others find THC unpleasant. CBD can lessen or neutralize the intoxicating effects of THC. So a greater ratio of CBD-to-THC means less of a “high.” Finding your ratio is the first step to effective treatment. 

DOSAGE GUIDELINES

FAQ

Decide how you want to take cannabis. Cannabis oil is available in sprays, capsules, edibles and other products.

Find your ratio. Cannabis products have varying amounts of CBD and THC. A high CBD or high THC product is not necessarily superior to a strain with a balanced ratio. Find the proper combination to optimize your therapeutic use of cannabis.

Begin with a low dose especially if you have little or no experience with cannabis.

Take a few small doses over the course of the day rather than one big dose.

Use the same dose and ratio for several days. Observe the effects and if necessary adjust the ratio or amount.

Don’t overdo it. “Less is more” is often the case with cannabis therapeutics.

Be aware of possible side effects. Cannabis is a safe and forgiving medicine. But depending upon delivery method and individual tolerance, it can amplify anxiety and mood disorders. Other possible side effects are dry mouth, dizziness, and faintness.

Consult your health counselor. Proceed cautiously, especially if you have a history of alcohol or drug abuse, mental illness, or are pregnant or breastfeeding.

CBD Pain Relief

FIND YOUR RATIO!

FAQ

For anxiety, depression, spasms, and pediatric seizure disorders, many patients initially find they do best with a moderate dose of a CBD dominant remedy (a CBD: THC ratio of more than 14:1).

But a low THC remedy, while not intoxicating, is not necessarily the best therapeutic option.

A combination of CBD and THC will likely have a greater therapeutic effect for a wider range of conditions than CBD or THC alone.

For cancer, neurological disease, and many other ailments, patients may benefit from a balanced ratio of CBD and THC. Extensive clinical research has shown that a 1:1 CBD: THC ratio is effective for neuropathic pain.

Optimizing one’s therapeutic use of cannabis may entail a careful, step-by-step process, whereby a patient starts with small doses of a non-intoxicating CBD-rich remedy, observes the results, and gradually increases the amount of THC.

In essence, the goal is to self-administer consistent, measurable doses of a CBD-rich remedy that includes as much THC as a person is comfortable with.

THE BIPHASIC EFFECT

FAQ

Cannabis compounds have biphasic properties, which means that low and high doses of the same substance can produce opposite effects.

Small doses of cannabis tend to stimulate; large doses sedate.

Too much THC, while not lethal, can amplify anxiety and mood disorders.

CBD has no known adverse side effects at any dose. But an excessive amount of CBD could be less effective therapeutically than a moderate dose.

“Less is more” is often the case with respect to cannabis therapy.

“Dosage is everything”—Paracelsus

PERSONALIZED MEDICINE

FAQ

Cannabis Therapeutics is personalized medicine. The right treatment regimen depends on the person and the condition being treated.

For the maximum therapeutic benefit, choose cannabis products that include both cannabidiol (CBD), a non-intoxicating compound, and tetrahydrocannabinol (THC), the psychoactive component of cannabis.

CBD and THC interact to enhance each other’s therapeutic effects. They work best together.

A patient’s sensitivity to THC is a key factor in determining the ratio and dosage of CBD-rich medicine.

Many people enjoy cannabis high and can consume reasonable doses of any cannabis product without feeling too high or dysphoric. Others find THC unpleasant.

CBD can lessen or neutralize the intoxicating effects of THC. So a greater ratio of CBD-to-THC means less of a “high.”

Finding your ratio is the first step to effective treatment

Sources

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Blake DR, Robson P, Ho M, Jubb RW, McCabe CSPreliminary assessment of the efficacy, tolerability and safety of a cannabis-based medicine (Sativex) in the treatment of pain caused by rheumatoid arthritis. Rheumatology (Oxford). 2006 Jan;45(1):50-2. Epub 2005 Nov 9. PubMed PMID: 16282192.

Boggs DL, Surti T, Gupta A, Gupta S, Niciu M, Pittman B, Schnakenberg Martin AM, Thurnauer H, Davies A, D’Souza DC, Ranganathan M. The effects of cannabidiol (CBD) on cognition and symptoms in outpatients with chronic schizophrenia a randomized placebo controlled trial. Psychopharmacology (Berl). 2018 Apr 5. doi: 10.1007/s00213-018-4885-9. [Epub ahead of print] PubMed PMID: 29619533.

Evanoff AB, Quan T, Dufault C, Awad M, Bierut LJPhysicians-in-training are not prepared to prescribe medical marijuana. Drug Alcohol Depend. 2017 Nov 1;180:151-155. doi: 10.1016/j.drugalcdep.2017.08.010. Epub 2017 Sep 4. PubMed PMID: 28892720; PubMed Central PMCIDPMC5648595.

Gallily R, et al. Overcoming the Bell-Shaped Dose-Response of Cannabidiol by Using Cannabis Extract Enriched in Cannabidiol.Overcoming the Bell-Shaped Dose-Response of Cannabidiol by Using Cannabis Extract Enriched in Cannabidiol. Pharmacology &Pharmacy, 2015, 6, 75‐85.

Goldstein B. Cannabis Revealed. 2016.

Johnson JR, et al. “Multicenter, double-blind, randomized, placebo-controlled, parallel-group study of the efficacy, safety, and tolerability of THCCBDextract and THC extract in patients with intractable cancer-related pain.” Journal of Pain and Symptom Management. 2010;39(2): 167-179.

Leweke FM, Piomelli D, Pahlisch F, Muhl D, Gerth CW, Hoyer C, Klosterkötter J, Hellmich M, Koethe D. Cannabidiol enhances anandamide signaling and alleviates psychotic symptoms of schizophrenia. Transl Psychiatry. 2012 Mar 20;2:e94. doi: 10.1038/tp.2012.15. PubMed PMID: 22832859; PubMed Central PMCIDPMC3316151.

MacCallum CA, Russo EBPractical considerations in medical cannabis administration and dosing. Eur J Intern Med. 2018 Mar;49:12-19. doi: 10.1016/j.ejim.2018.01.004. Epub 2018 Jan 4. Review. PubMed PMID: 29307505.

Perez J. Combined cannabinoid therapy via an oromucosal spray. Drugs Today (Barc). 2006 Aug;42(8):495-503. Review. PubMed PMID: 16969427.

Portenoy RK, et al. Nabiximols for opioid-treated cancer patients with poorly-controlled chronic pain: A randomized, placebo-controlled, graded-dose trial. The Journal of Pain. 2012;13(5):438-449.

Russo EBCannabinoids in the management of difficult to treat pain. Ther Clin Risk Manag. 2008 Feb;4(1):245-59. PubMed PMID: 18728714; PubMed Central PMCIDPMC2503660.

Steffens S, Veillard NR, Arnaud C, Pelli G, Burger F, Staub C, Karsak M, Zimmer A, Frossard JL, Mach F. Low dose oral cannabinoid therapy reduces progression of atherosclerosis in mice. Nature. 2005 Apr 7;434(7034):782-6. Erratum in: Nature. 2005 May 26;435(7041):528. Karsak, Meliha [added]. PubMed PMID: 15815632.

Sulak, Dustin. A physician’s perspective on optimal cannabis dosing. Leafly. 2018 Feb 26.

Wade DT, Makela PM, House H, Bateman C, Robson P. Long-term use of a cannabis-based medicine in the treatment of spasticity and other symptoms in multiple sclerosis. Mult Scler. 2006 Oct;12(5):639-45. PubMed PMID: 17086911.

Waldman M, et al. An ultra-low dose of tetrahydrocannabinol provides cardioprotection. Biochemical Pharmacology. 2013;85(11):1626-1633.

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