Marketplace News News

CBDs, THC & other initials: A physician’s approach to medicinal cannabis

This is part 3 in a series of three.

After consideration of what strain(s) to try, the next question is one of dosing and how to administer each dose. If someone is not a regular user of cannabis (or has never tried it), the mantra is “start low and go slow.”

One can always take an additional dose if the desired effect is not achieved, but one cannot go backwards. If too much is ingested, this will produce unfavorable, not to mention unpleasant and/or dangerous, results.

For one trying cannabis for the first time, the initial dose should never exceed 5 mg. of THC.   This is not likely to produce a high, but it can provide some pain relief and relaxation.

It is much easier, for obvious reasons, to quantify a dosage when cannabis is ingested in edible form as opposed to through smoking, as the manufacturer can control exactly the amount of active ingredients.   

Inhalation of cannabis, on the other hand, has variables that do not exist in edible compounds.  For example, some people inhale stronger and larger amounts, some can hold their breath longer, etc. These can affect the absorption of THC into the body.  It takes about seven seconds for inhaled THC to reach the brain, which is the same as with tobacco cigarettes), so its efficacy should be demonstrated within a few minutes. If a patient feels as though he or she has not achieved the desired effect, they can then take another “hit” and re-evaluate a few minutes later, repeating as needed.

Edibles, however, do take longer to achieve their desired effects because they must be absorbed by the gastrointestinal system and processed through the liver. Hence, one must wait 1-2 hours in order to fully evaluate the results. The good news is that the effects of edibles often last longer.

“Edibles” may be sold in many forms: “gummies,” cookies, brownies, etc. For patients with chronic disorders ranging from anxiety to pain, low dose edibles (e.g. containing 3-5 mg THC) taken once or twice a day can do the trick for them. Patients with sleep issues might take a little bit stronger dose about two hours prior to bedtime.

Tolerance can develop for some, requiring increase in dosage, but many do fine on low doses. [Note: Legitimate cannabis dispensaries sell products that are labeled with its THC content so that patients can gauge the proper amount to consume for their particular conditions.]

Clearly, a patient needs to consult with a physician to determine if medical cannabis is a viable option in his or her particular situation. Certainly there are persons who may not be comfortable with this form of treatment, or who have sensitivities and/or allergies to any of the ingredients. 

Others who have a personal or family history of addiction may likewise not be good candidates for medical cannabis.  It is also worth noting that persons below the age of 25 should avoid any kind of prolonged exposure to cannabis as it can affect brain development.

Also, many kids (as well as some adults) figure that “if a little is good, then more is a lot better.” It is possible to ingest too much cannabis and develop conditions such as hyperemesis (a vomiting condition).

Growing males who ingest chronically can develop gynecomastia (excessive breast tissue). Be aware, also, that patients with schizophrenia can have psychotic reactions. Finally, cannabis can interact with opiates and benzodiazepines, leading to overdose, so care must be taken to examine the dosages being employed for each.

The above list, of course, is not intended to be inclusive, but points to the fact that cannabis used for medicinal purposes should not be taken without first obtaining medical clearance. 

Fortunately, most patients who take low dose cannabis for legitimate medicinal purposes rarely experience any significant problems, unlike their recreational counterparts who are dosing at much higher levels. 

If you have further questions about whether or not you may benefit from medicinal cannabis, you should seek out a physician who is knowledgeable in this area to discuss whether or not this may be a viable treatment option.     

Dr. Pearson is a board-certified Family and Sports Medicine physician who has been practicing in North County since 1988. His office is located in Carlsbad Village.

Feel free to contact him with any questions at www.medicine-in-motion.com.

Leave a Comment