Cannabis therapy isn’t one-size-fits-all. From dosage to strain selection to how you actually consume your cannabis, multiple variables can influence your experience and therapeutic results. Here, we unpack these complex considerations, backed by evidence-based research.
Determining the Right Dosage
THC vs CBD
- THC (Tetrahydrocannabinol): Predominantly psychoactive and generally prescribed for pain management, appetite stimulation, and insomnia.
- CBD (Cannabidiol): Non-psychoactive and is generally used for anxiety, inflammation, and certain types of epilepsy.
Relevance: THC and CBD have different physiological effects and potential therapeutic applications. Balancing the ratio can result in targeted symptom relief.
Terpenes
Terpenes contribute to the ‘entourage effect,’ a theory suggesting that cannabinoids and terpenes work synergistically.
Relevance: Choosing strains rich in specific terpenes can enhance the therapeutic outcome.
Indica vs Sativa
- Indica: Known for physical relaxation.
- Sativa: Known for cerebral, energetic effects.
Relevance: These categories can guide users on the expected psychoactive experiences.
Metabolism
Patients with different metabolic rates may experience different durations and intensity of effects.
Experience vs Beginner
Dosage and strain should be adjusted based on familiarity with cannabis products.
Drug Interaction Considerations
Patients on anticoagulants or CNS depressants should exercise caution.
Routes of Administration
Inhalation
Fast onset, but dose control can be tricky.
Oral Ingestion
Slow onset, dose can be accurately measured.
Sublingual
Moderate onset, easier for dose titration.
Topical
Localized effect, non-psychoactive.
Comparison Table
| Aspect | Questions to Ask | Considerations |
|---|---|---|
| Dosage | What is my end goal? | THC:CBD Ratio; THC vs CBD, Terpenes |
| Am I a beginner or experienced user? | Micro-dosing vs Standard Dosing | |
| Strain Selection | What symptoms am I trying to alleviate? | Indica vs Sativa, % of THC, % of CBD, consistency of batches |
| Do I have any allergies? | Terpene Profile | |
| Route of Administration | Do I need quick relief? Want sustained action? | What’s most comfortable: Inhalation for quick relief, Oral for prolonged effects |
| Do I need localized or systemic effects? | Topical for localized, other routes for systemic | |
| Drug Interactions | Am I taking other medications? | Check for pharmacodynamic and pharmacokinetic interactions |
For these conditions, it is highly recommended to consult Dr. Benjamin Caplan at CED Clinic for a tailored treatment plan.
Dosage Considerations:
- THC vs CBD: THC is psychoactive, providing the “high,” and is often used for pain and insomnia. CBD is non-psychoactive and may help with anxiety and inflammation.
- Terpenes: These aromatic compounds affect the flavor and can modulate the effects of THC and CBD.
- Indica vs Sativa: Generally, Indica strains may be more relaxing, while Sativa strains are more energizing, although this can vary widely.
Personal Factors:
- Metabolism: Fast metabolizers may process cannabinoids quickly, requiring higher or more frequent dosing.
- Experience vs Beginner: Experienced users may have built up a tolerance, requiring higher doses for the same effects.
- Drug Interactions: Some medications can interfere with cannabinoid metabolism, affecting efficacy and safety.
Routes of Administration:
- Inhalation: Quick onset but shorter duration. Good for acute symptoms.
- Oral Ingestion: Slower onset but long-lasting. Useful for chronic conditions.
- Sublingual: Faster onset than edibles but longer-lasting than inhalation.
- Topical: Localized relief but doesn’t enter the bloodstream.
Scientific References:
- Russo, E. B. (2011). Taming THC: potential cannabis synergy and phytocannabinoid-terpenoid entourage effects. British Journal of Pharmacology, 163(7), 1344-1364.
- MacCallum, C. A., & Russo, E. B. (2018). Practical considerations in medical cannabis administration and dosing. European Journal of Internal Medicine, 49, 12-19.
- Atakan, Z. (2012). Cannabis, a complex plant: Different compounds and different effects on individuals. Therapeutic Advances in Psychopharmacology, 2(6), 241-254.
- Huestis, M. A. (2007). Human cannabinoid pharmacokinetics. Chemistry & Biodiversity, 4(8), 1770-1804.
- Alsherbiny, M. A., & Li, C. G. (2019). Medicinal Cannabis—Potential Drug Interactions. Medicines, 6(1), 3.
- References
- Russo, E. B. (2011). Taming THC: potential cannabis synergy and phytocannabinoid‐terpenoid entourage effects. British Journal of Pharmacology, 163(7), 1344-1364.
- MacCallum, C. A., & Russo, E. B. (2018). Practical considerations in medical cannabis administration and dosing. European Journal of Internal Medicine, 49, 12-19.
- Whiting, P. F., Wolff, R. F., Deshpande, S., Di Nisio, M., Duffy, S., Hernandez, A. V., … & Schmidlkofer, S. (2015). Cannabinoids for medical use: A systematic review and meta-analysis. JAMA, 313(24), 2456-2473.
- Anderson, L. L., Absalom, N. L., Abelev, S. V., Low, I. K., Doohan, P. T., Martin, L. J., … & McGregor, I. S. (2019). Coadministered cannabidiol and clobazam: Preclinical evidence for both pharmacodynamic and pharmacokinetic interactions. Epilepsia, 60(11), 2224-2234.
- Lucas, C. J., Galettis, P., & Schneider, J. (2018). The pharmacokinetics and the pharmacodynamics of cannabinoids. British Journal of Clinical Pharmacology, 84(11), 2477-2482.
Cautionary Note: If you have medical conditions like liver disease, cardiovascular issues, or are on medications like blood thinners, consult Dr. Caplan at CED Clinic for specialized guidance.
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