Confronted by the myriad choices available when entering a cannabis dispensary, patients, especially new patients, can wonder how they could ever figure out the important question — how much will I need? The goal is optimal dosing, where the patient receives the most benefits from the cannabis combined with the fewest adverse side effects.
Generally, the people working at the dispensary have extensive knowledge of different strains and their potency, but there are general rules of thumb with medical cannabis.
When you think of medications, there is a simple rule — a higher dose will result in stronger therapeutic effect and a higher likelihood of adverse effects. Doctors refer to this as a monophasic dose-response relationship.
This isn’t true with cannabis. There isn’t a standard weight to dosage relationship. Some patients receive optimal benefit from very low dosages, while others seem to require, and are fine with, very high doses. This points to the fact that in the human body, our endocannabinoid system varies with how our cannabinoid receptors respond to stimulation. When these receptors become overstimulated, the cells pull the receptors inside, possibly to protect them. Now there are fewer receptors available, so more cannabis is needed to achieve the same effects. This is also known as tolerance building.
The goal is to find the window between lowest effective dosage and the dosage that produces unwanted side effects. For new patients, this window is likely to be narrow, but for regular users the window is wider because of the tolerance building described above.
A good rule of thumb is to start low and increase your dosages slowly, but only as needed. This can even be achieved with THC-dominant cannabis, where low dosages can deliver therapeutic effects at levels below those required to produce euphoria or impairment.
There is also research showing that combining CBD and THC can enhance the benefits of each, all the while reducing unwanted effects. This includes the psychoactive effects of the THC. What has been shown, however, is that while the combination of CBD and THC can further enhance the therapeutic benefits without the negative effects, the patient will have to use a higher amount of total dosage to receive these extra benefits.
Also unlike pharmaceuticals, cannabis can produce opposite effects in different people. You’ve surely heard colloquial tales of this from recreational use. In people using the same marijuana, one person becomes relaxed and mellow, while the other becomes anxious and nervous. This can also be true of the same person, but with different strains/varieties.
This means you’ll have to try different strains to see how your individual system reacts.
New users of medical cannabis will need to be prepared for some trial and error when finding the correct strain and dosage that works best for them. As mentioned above, there are no rules based on body weight/height/etc. Every person’s body has variation in the receptors that respond to cannabinoids in cannabis. There are even thresholds with THC strains that can be effective under the level of delivering unwanted psychoactive effects.
Trust the expertise of the budtenders at the dispensary, and do some research on your own, and then follow one rule…
Start low and go slow.