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Dosage and Administration of your Medical Cannabis

Starting with cannabidiol, or CBD, it is important to note that the effects of CBD might take up to 2 weeks to begin. I encourage my patients to journal observations, this is an important part of the process. The specific complaints of each person are related to imbalances in our endocannabinoid system, and require the addition of plant based cannabinoids, or phytocannabinoids, to restore the balance of the system.

Whichever form of ingestion you choose for your CBD, I recommend a starting dose of 10 mg.  If a patient finds that 10 mg is not sufficient after three days, they can begin increasing the dose in 5 mg increments every third day until they get the desired results or reach a total of 25 mg.  At the limit of 25 mg if benefits are not obtained, I suggest once again seeking consultation with a qualified clinician to determine your specific needs.  Depending on the severity of the specific problem, the dose needed to achieve benefit could be significantly higher, and should be guided by working with this clinician.

The goal here is to start low and titrate up to an effective dosing range, achieving the lowest necessary dose to alleviate the problem. This approach minimizes tolerance issues, and conserves medicine for patients. My strategy with cannabis patients focuses on microdosing, specifically when using THC products.

It is important to simplify things for the Cannabis naive patients, specifically when using THC. I recommend for these patients the Healer sensitization protocol from the Healer.Com website. In this approach the endocannabinoid system is primed with very low doses of THC for several days, and then the body is able to work efficiently in a medicinal sense with lower doses of THC. Keep in mind that my goal with medical patients is to avoid the psychoactive effects of THC, and minimize the need for adding high amounts of CBD to counteract the psychoactivity. 

THC can be effective at very low doses, and by adding CBD we trigger the Entourage effect which further enhances the synergy. The acidic form of THC, or THCA, is a remarkably medicinal part of this plant. It provides the medicinal benefits without the psychoactivity, and these properties are seen at very low doses. Some local dispensaries are now offering THCA products, and I frequently recommend this to patients who are elderly, younger patients, and those who want to minimize any psychoactivity issues. It is important to caution anyone thinking of smoking this and point out that if this compound is decarboxylated, or heated, it turns into a very potent form of THC, which is approximately equivalent to an 80% THC concentrate.

When consulting with patients I recommend starting with tinctures because we have much more specific control over the dosing. Once a person graduates from Cannabis naive to being more educated, they can then begin using a wider range of products. It is important to know your tolerances.  The differences between the effects from flower, tinctures, and edibles vary greatly in terms of both intensity and duration.  When using THC, I recommend 1 to 2 mg a day for 3 days, and after that the patient can begin using 5mg increments to the point where they achieve the benefits that they desire. 

I like to recommend that my patients purchase separate CBD and THC tinctures. This gives them much more specific control over the dosing and ratio of their CBD and THC.  In this way my patients can then adjust and personalize their CBD to THC ratios to the milligram, and it is a more cost-effective strategy for my medical cannabis patients in general. I minimize the use of flower and vaping for my medical patients, as the effects tend to be more intense and shorter in duration. They are very useful however when a patient needs a fast-acting and strong dose of medication (as needed use). I should also note the difference in effects between smoking flower and vaping concentrates. By nature of the word concentrate, the THC level is 4 to 6 times stronger in a vape cartridge Typically (80-92%) than it is in the flower form (typically 15-25%).

The last point to consider is what is referred to as a dose layering strategy. As with pharmaceutical medications, we need medication to be administered in a similar fashion when using cannabis. Understanding the forms of ingestion, and the resulting properties of each method leads us to creating these strategies. Time of day for each dose is based on the length of effectiveness of that particular method of ingestion, and the severity of the problem being addressed. In my cannabis consultations, patient treatment plans are devised to address each complaint and include CBD and THC products in smokable forms, tinctures, topicals, and edibles, with specific dosing and frequency instructions.

To continue reading more by Dr. Lonny Weiss Psy.D. please visit www.drlonnycbd.com!


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