Phytologie Promotes the Sensible Use of Cannabis

Here are some general guidelines and best practices when medicating.

Dosage

Establishing the right dose of medical cannabis can be challenging since absorption and availability of cannabis’ active ingredients depends on whether the medical cannabis is being smoked, vaporized, eaten, or taken sublingually.

Calculating the proper dose of cannabis begins with speaking with your physician. Your doctor can suggest the amount of cannabis’ active ingredients that are recommended per dose for your medical condition. It’s unlikely that your physician will be familiar with how to dose herbal cannabis, so ask your doctor what dosage of THC, the primary active ingredient in most cannabis they would recommend if they were writing you a prescription for Marinol, the capsule form of THC dispensed by pharmacies. Marinol capsules are available in 2.5, 5 and 10 milligram doses of THC. From this dosage recommendation of Marinol, it is possible to estimate a dose of herbal cannabis, based on CBCB’s lab testing results.

At CBCB, the general rule of thumb for cannabis dosage is always: “Take the smallest amount of cannabis required to produce the intended medicinal effect.” Because of its low toxicity, doses of cannabis are often higher than actually needed, since a mild overdose of cannabis doesn’t produce the uncomfortable side effects associated with overdoses of more toxic medicines.
Portrayals of cannabis use on film and television often depict cannabis over-dosage. From Cheech and Chong movies of the 1970’s to the recent film, “Pineapple Express”, media depictions of cannabis emphasize the character’s ability to withstand enormous doses of cannabis. Most medical cannabis patients are influenced by these media depictions and tend to over-medicate.
For example, if a particular Phytologie cannabis strain contains 15% THC, then one gram of that cannabis would contain approximately 150 milligrams of THC. When smoked in a cannabis cigarette, much of this THC will be destroyed by combustion or lost in side-stream smoke. One study indicated that almost 75% of the available THC was lost when smoked in a cannabis cigarette.

If your physician recommends 5 milligrams of THC to reduce nausea before chemotherapy, then to smoke the medicine, divide a gram of 15% THC cannabis into eight equal portions and use one. If you were planning on using a vaporizer, you could divide that single portion in half, since vaporizers are more efficient in delivering THC than smoking. However, if you were going to ingest the dose by eating an edible, your body would absorb more of the THC, therefore you would only eat a quarter of that single portion. One rule of thumb is that eating properly cooked cannabis is twice as efficient as vaporizing and vaporizing is twice as efficient as smoking in delivering THC.

Cannabis Dispensary

In a 1992 study, individuals that used cannabis daily over several months were shown to have a 1 in 3 chance of developing some level of drug dependency on cannabis. Other studies have asserted that up to 9% of cannabis users will exhibit symptoms of dependency at some point in their course of using the drug. While only a portion of cannabis users seem to develop dependency, caution should be exercised to monitor the possibility while using cannabis medicinally.

The following are some signs of possible cannabis dependency:

Tolerance – as defined by either of the following: the need for markedly increased amounts of cannabis to achieve the desired effect and/or markedly diminished effect with continued use of the same amount of cannabis.

Withdrawal – as manifested by any of the following: withdrawal symptoms, such as irritability, restlessness, or insomnia when cannabis dosage is withheld, or cannabis is taken in larger amounts or over a longer period than was medicinally intended; or there is a persistent desire or unsuccessful efforts to cut down or control cannabis use.

Other signs of cannabis dependency include:

  • A great deal of time is spent in activities necessary to obtain cannabis (e.g., visiting multiple dispensaries, driving long distances)
  • A great deal of time is spent either using cannabis(e.g. chain smoking) recovering from the effects
  • Important social, occupational, or recreational activities are given up or reduced because of the effects of cannabis use
  • Cannabis use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by cannabis.

If you or your patient exhibits these symptoms discuss treatment options with a physician.

Adverse Effects of Cannabis

The respected British medical journal, “The Lancet” published an overview of the adverse effects that may be caused by cannabis. Even though cannabis is less toxic that some drugs, cannabis is still a drug and can produce adverse effects.

Acute adverse effects of cannabis use include anxiety and panic in naive users, and a probable increased risk of accidents if users drive while under the influence of cannabis.

Use during pregnancy could reduce birth weight, but does not seem to cause birth defects. Whether cannabis contributes to behavioral disorders in the offspring of women who smoked cannabis during pregnancy remains uncertain.

Chronic cannabis use can produce a dependence syndrome (addiction) in as many as one in ten users. Regular users of cannabis have a higher risk of chronic bronchitis and impaired respiratory function. Dependent users of cannabis may also experience psychotic symptoms and disorders, most probably if they have a history of psychotic symptoms or a family history of these disorders. The most probable adverse psychosocial adverse effect in adolescents who become regular users is impaired educational attainment. Adolescent regular cannabis users are more likely to use other illicit drugs, although the explanation of any association remains controversial. Regular cannabis use in adolescence might also adversely affect mental health in young adults, with the strongest evidence for an increased risk of psychotic symptoms and disorders.

Some other adverse effects are associated with regular cannabis use, but whether they are actually caused by cannabis alone or from the effects of other drugs is not known (tobacco for respiratory cancers; tobacco, alcohol, and other drugs for behavioral disorders in children whose mothers smoked cannabis during pregnancy). Studies where cannabis and other drugs were used have shown increased incidence of depression and suicide, plus impaired cognitive function. In the case of depressive disorders and suicide, any association with cannabis remains uncertain. For cognitive performance, the size and reversibility of the impairment caused by cannabis remain unclear. The focus of epidemiological and clinical research should be on clarifying any causative role of cannabis for these adverse health effects.

Some of the adverse effects from cannabis may be due to the exclusive use of high-THC cannabis strains. Strains with more CBD in ratio to THC may reduce the incidence of adverse effects, though more research must be conducted to confirm this assertion.