One of the most common questions we receive at KIP is how to dose cannabis, especially from new patients. By explaining the following concepts, I hope to offer new patients some clarity on how to dose their cannabis. If you’re an experienced user, I’ll teach you how to reset your tolerance to save product AND money!
First, let me say that cannabis is unlike any other medicine. In my last article I mentioned that cannabis has hundreds of active compounds versus just one or two that you find in any pharmaceutical or over-the-counter medicine. So, slight variations in the active compounds between cannabis varieties can produce different experiences, and therefore I recommend all my patients keep a journal of their products and experiences.
The first concept we’ll cover is the difference between “whole plant” and “isolate”. Whole plant (also called broad spectrum or full spectrum) is a term used to describe cannabis products that contain a variety of cannabinoids and/or terpenes. Isolate is used to describe a product that contains a single cannabinoid. We see a common example of this with CBD – many stores sell either whole plant CBD or CBD isolate. So, which is better?
What we see from scientific research is that cannabinoids are synergistic, meaning they are more effective when working together. This is called the “entourage effect”. For example, a patient may require 20 mg of CBD isolate to treat an acute anxiety attack, whereas that same patient may require only 10 mg of a whole plant CBD to achieve similar results because of the entourage effect. There may be some instances where a single cannabinoid is desired, but generally whole plant preparations (or the whole plant itself) are more effective. More efficacy means lower doses, lower doses means less out-of-pocket costs.
Next, we must realize everyone’s endocannabinoid system is different. What may work for you may or may not work for someone else, so its important to realize that dosing cannabis is entirely personal (use your journal!). It’s also important to understand that if you’re new to cannabis, or its been a long time since you used it, your body’s sensitivity to it is low. This is why many people report not feeling anything the first couple times they use cannabis. Dr. Dustin Sulak of Healer (healer.com) has a brilliant method for sensitizing your body to cannabis. I encourage all new cannabis users to visit his site and follow the 6-day protocol to finding your “optimal dose”, or for experienced users you can follow the sensitization protocol to reset your tolerance.
Dr. Sulak’s optimal dose is an important concept for minimizing cost and driving efficacy. We can think of the optimal dose as the lowest dose that provides the most relief WHILE producing the least amount of side effects (a balancing act that each of you will have to discover for yourself). In maintaining the optimal dose when consuming cannabis, you avoid building a tolerance! Dr. Sulak’s method for reversing tolerance is quite simple as well: abstain from cannabis for 48-72 hours, then your body’s endocannabinoid system will be far more sensitive. When ready to consume again, remember the saying “start low, go slow”, meaning start with low doses and slowly work your way up if necessary. He also has a variety of other dosage protocols and educational materials on his site for sensing how effective your medicine is.
Lastly, cannabis comes in a variety of dosage forms, each of which have different onsets and durations of time. Cannabis is processed and turned into concentrates, edibles, tinctures, and topicals that are easier to dose because the dosages are listed right on the products. The dosages you should familiarize yourself with are listed in milligrams (mg) of CBD and/or THC. Most new cannabis users (once sensitized) can feel the effects from a dose between 1-5 mg THC. Inhaled cannabis is a bit trickier to dose because of the variety of inhalation techniques. For example, one patient may inhale quickly, hold the dose in their lungs for under a second, and exhale quickly – giving the patient a small dose. Another patient may extend the inhale, hold the dose in their lungs longer, and exhale slower – giving that patient a larger dose. Over enough time you will eventually develop your own technique and get a sense for your optimal dose. Inhaled cannabis (flower and concentrates) are listed as a percent THC or CBD, rather than milligram content.
An important point about edibles is that they take much longer for the effects to be felt and those effects last much longer than when using inhaled cannabis. A common mistake amongst new users is not waiting long enough to feel the effects of edibles, and they consume more thinking they need a higher dose. Ultimately these stories lead to patients over medicating to the point where the experience is unpleasant. So, if using edibles allow yourself about 2 hours for the effects to be felt after consuming to determine whether you need more or not.
To sum up what we’ve learned, dosing cannabis is an exploratory adventure for each of you to discover your optimal dose, remember to start with low doses until you understand how the medicine affects you, then you can work your way up if necessary. Be sure to check out Healer.com to learn even more about dosing!