Taking the time to find your “just right” Medical Marijuana dose will make your experience with the cannabis plant more enjoyable and help it work better for you, regardless of your condition. Medical Marijuana is plant-based medicine at its most sophisticated. It isn’t like a typical prescription medication that’s given to reverse a particular symptom or illness. Medical Marijuana dosing is unique.
Marijuana, like any strong medication, has risks. Just because your neighbor can take a 200 mg THC edible does not mean you should, or that you could even handle that amount. Though nobody has ever died from an overdose of marijuana, it’s still a very intoxicating substance at moderate to high doses and should be treated with respect.
The most commonly reported side effect of marijuana is dizziness. Other common side effects can include sleepiness, anxiousness (from too high a dose of THC), dry mouth, dry eyes, poor balance and coordination, decreased short term memory function, and reduced motor skills. Safe marijuana use starts with learning your tolerance to the plant, the method you wish to take it (oral, sublingual, or vaping), and the duration of its effect with that delivery method and dose. All of these things take some planning.
New marijuana users may get absolutely no effect from the first one or two times they use it. Recreational users know this and often cite personal experience of not getting “high” the first time they tried marijuana.
The endocannabinoid system needs to be primed first to be able to react to the medication. Sometimes this takes one or two days of micro-doses before trying to find a dose to treat a patient's condition.
To keep things simple, I usually recommend planning a 3-5 day sensitization period no matter the delivery method the patient chooses. Typically, a sublingual or oral product will give them the ability to keep the dosing low or even take it drop-by-drop if needed. I also always recommend taking a quality CBD product once or twice daily. I recommend 10-25 mg CBD in any form, like a capsule, liquid, or vape. Look for a full-spectrum CBD product with 0.3% or less THC.
The patient should plan to take a dose of 1-2.5 mg THC orally in the evening when they are in a safe and comfortable location. It’s always a good idea to have someone they trust available and nearby. Keeping a mindful approach with each experience will make the relationship with marijuana all the better. Write down your plan in a journal with the dose of CBD along with the planned dose and time for the THC.
Finding a therapeutic dose of marijuana is the next step. The process follows a similar path to sensitization, but at higher doses more regularly during the day or evening.
The delivery method starts to make a considerable difference depending on whether you vape flower, take a sublingual preparation, or take a capsule by mouth. The onset of action for vaping might be 2 minutes, while the capsule may take 2+ hours to take effect. Also, the duration of the vape might be 1 hour and the capsule may linger for the whole day (10+ hours). This article discusses a sublingual tincture, which typically has effects beginning as early as 45 minutes to one hour after ingestion.
I offer specific dosing protocols for each new patient individually because each person is different and has different goals and tolerances. Check with your provider or contact me for detailed information. Utahmarijuana.org is building comprehensive dosing protocols for all products based on my experience with patients, current research, and known best practices.
On the morning of Day 1 of finding a therapeutic dose, the patient takes a small dose 1-2.5 mg of THC when they're ready to begin. I suggest the afternoon or early evening to allow for the onset of action and enough time before sleeping. For this example, let’s use 2pm as our starting time.
At 5pm, if the patient doesn’t feel the effects of the marijuana plant in their body, they can try to take an additional dose of 1-2.5 mg of THC. This is it for today. Wait a few hours and take an assessment of how you feel. Awareness of the effects of marijuana is the key to establishing a good relationship with the plant as medicine.
If the patient finds that around 7-8 pm they feel more relaxed and separated from their pain, that's a good sign. They're close to finding their "just right" dose. If they found themselves feeling anxious or uncomfortable, they may have taken too much and need to find a middle ground on Day 2. If the patient felt nothing or felt only mild effects, but didn’t feel improvement in their symptoms, move on to Day 2.
Day 2 of finding a therapeutic dose starts with the dose you left off with from Day 1. If you’ve already noticed that 2.5mg of THC allows you to feel better and you’re tolerating the side effects without any trouble, congratulations! You've found your “just right” dose.
If the patient is tolerating the side effects well and isn't quite getting beneficial results, they'll start this day with the dose they left off from Day 1, 2-5 mg of THC. Three hours later, it's best to take a mental inventory of how they feel. Are they starting to feel relief from pain? Are they able to relax into their pain and notice that it’s still there, but not as bothersome? If the answer is no, and the side effects aren't noticeable or are tolerable, try a different dose.
At this point, the patient can add 1-2.5 mg of THC and record the effects in their journal. This will help them remember the dosing and the impact on their body that they felt. It's important to list the side effects and the level of pain the patient is feeling as well.
Day 3 follows the same plan. The patient takes the dose they did the day before to start, whether that was 1, 2, or 3 doses of 1-2.5 mg. It’s important to make each dose the same. If they’re taking 1mg doses and don’t feel the effects after 3 mg, it's important they don’t jump to 6mg out of frustration. It’s a commitment to find the right dose for you. Trust me, it’s worth building a solid knowledge of how this plant affects you, and the more care you take in the early stages, the better your long-term relationship with marijuana.
The patient can take another dose about three hours later if they still feel that the side effects are small and the therapy isn't working. They'll continue this daily practice until they find that the pain is improved and the side effects are tolerable.
Two things may happen when a patient follows this type of protocol. On the positive side, they’ll find a dose that helps their pain level decrease with tolerable side effects. Alternatively, they may find that the side effects become the dominant force, making them uncomfortable. Nobody wants that.
If you find that the side effects are strong enough to outweigh any benefit from the medicine, you’re not alone. Many of my patients report that the psychoactivity of THC bothers them during this first phase, or that some other effect bothers them. Try not to lose hope.
It’s well known that humans develop tolerance to marijuana through studies of recreational users. Medical patients, mine included, typically report that the adverse side effects lessen over time, but the therapeutic benefits remain. All the while using the same dose of THC!
This is excellent news for Medical Marijuana patients. They'll simply lower the dose they’re taking until they find the side effects are tolerable, maintain that dose for 3-4 days in a row to build up a tolerance to the undesirable side effects, and return to finding that dose that works for them.
Remember the CBD they take daily? CBD acts as a buffer to some of the psychoactivity of THC and can lessen the adverse side effects at higher ratios. You may also increase the amount of CBD during this exploration phase of treatment to help blunt some of the side effects if you’re feeling them.
Therapeutic dosing with marijuana follows a bell curve distribution. Too low a dose may not give you enough benefit to make sense and too much may cause bothersome side effects and negative impacts. Consistently overdosing THC levels makes it so that you may need to keep increasing the dose of THC for the same effect. If 10 mg of THC is an ideal dose to help you decrease your medication or sleep better and avoid pain meds altogether, and you consistently take 20 mg in order to get that “high” effect, you will eventually need to take 20 mg of THC in order to treat your condition. The cost of your medicine per month will continue to increase. You can typically avoid this by using the correct dose found by following the above protocol. Evidence suggests that the endocannabinoid system will maintain balance long-term with the right dosing strategies.
Sensitizing your body to marijuana and finding the perfect dosing strategy for you can be an exciting journey. Check your mind and your body, keep a journal, and talk to your medical provider about questions and concerns. You can never have enough good advice from trusted sources.
As always, if you have comments or questions about any of my articles, or want more information on individualized dosing strategies for any condition, don’t hesitate to reach out to me.