DOSING WITH MEDICAL CANNABIS

DOSING WITH MEDICAL CANNABIS

The procedure of any treatment is best when guided by a licensed medical marijuana doctor or health professional with the the ability to make good judgments and quick decisions, proper training and experience.  Today, medical marijuana is highly recommended and often is a replacement for prescription drugs that have multiple side-effects and addictive elements.  Such condition as epilepsy, no other drugs provide  a good quality solution.

Medical marijuana are now commonly recommended together with other drugs to control pain,  inflammation, stress and other symptoms.

Patients and many licensed medical doctors still  don’t have enough experience in cannabis based medicines (CBM)which can effectively be delivered to patients in every way.  Asthmatics,  can now inhale cannabis medicine with a vaporizer.  In fact, smoking pot may soon be the least common delivery method of medical cannabis.

Consumption routes for Cannabis based medicines are:

  • Oral

  • Inhalation

  • Topical

  • Injection

  • Sublingual

RATIONAL GUIDELINES FOR DOSING MEDICAL CANNABIS 

 How to maximize medicating effects and minimize side effects. – D. Abrams, MD, Professor of Clinical Medicine at UCLA.- 2004.

This medicine dosing construct is not unique to marijuana.  A patient self-dosing determined model is highly recommended. This self-medicating model is acceptable given the variables affecting administration as well as the low toxicity of medical cannabis. Other medication have relatively low toxicity and high dosing ceilings and are commonly balanced effectively.

Inhalation; an experienced cannabis user can regulate dose to obtain the desired medicating effects and minimize side effects. Each inhalation delivers a discrete dose of MMJ components to the body. Inhalation volume changes with phase of smoking. Highest at the beginning and lowest at the end of smoking.

Comment: A vape is recommended to all medical marijuana patients who prefer the inhalation method.
Oral consumption of THC has quite different effect than inhalation. The effect is delayed and controling is more difficult.

“In a 2 day study, she was given a mixture of intravenous THC + CBD and on the other day a female patient was given pure THC. With this mix she was , coherent, happy and euphoric. She was paranoid, couldn’t form thoughts,  and was extremely uncomfortable with how she was feeling – in contrast with the pure THC” – The Beckley Foundation

 

Medical Marijuana Doctor Notes: Today THC is not recommended for most patients alone.  Rather CBD:THC in a 1:1 ratio for THC tolerant patients appears to provide far superior medical effects to most patients while psychoactivity responses tend to be overwhelmingly better at reducing stress, enhancing the feeling of well being with minimal feelings of psychosis.  Non psychoactive medications containing CBD and little or no THC are becoming more popular in the treatment of elderly, children, epileptics and hard-to-treat individuals.

 

INHALATION METHOD

Some examples are: flame, joints, inhaler, vapes, dabb, pipes.

Traditionally dried marijuana buds or leaves are smoked.  Oily concentrated marijuana Hash and kief are also used throughout this days. Inhaled medicine are generally absorbed very quickly, and act locally and systemically in a few minutes.  Correct method using inhalation tools is necessary to control the dose. Some medications can cause irritation in the mouth and have an unpleasant taste.

Inhalation method delivers the medicine to the nervous system and brain with little dilution by the circulatory system.  Inhalation of psychoactive substance may cause addiction in certain individuals, even so, cannabis ranks lowest in addictive properties. Much lower than alcohol, heroin, cocaine, caffeine or even nicotine.

  • Inhalation advantages: fast and easy.

  • Inhalation disadvantages: after-taste with some medicines and odor on breath.

  • Dosing range: THC and/CBD – 2-100  mg/day.

  • Recommended: Using vapes with the right medicine will afford superior benefits without appreciable aftertaste or odor.

  • Therapeutic effects: Begins in a few minutes and lasts about two hours.

Right dosage: Start with 2 mg, Inhale fully;  don’t hold the smoke in your lungs for long …and exhale relaxed. Than wait a few minutes and take another 2mg if your symptoms are still present. As you learn about your response, more medicine can be used right away.

You need to preheat your vaporizer to the temperature recommended by the manufacturer. Put a measured amount of  medical cannabis flower or oil extract into a vaporizer.  Press the button and then inhale. The cannabis should be heated to a temperature below combustion but still hot high enough to release the active medical elements: the terpenes and cannabinoids.  Vaporizers are now available in a wide variety of sizes and shapes.  Note that Vapes are more efficient than just smoking a joint, you’ll  be saving a lot of money in the long run and they’re safer.  Vapor can be so clean that the patient sometimes thinks they never got anything.  You can be easily fooled into overdosing and should wait before dosing again, about 10 minutes.

 The effects of smoking dried cannabis are felt almost immediately, for most patients, but soon begin to diminish. Depending on the cannabinoid content and potency of the cannabis, effects disappear almost completely within 2 to 4 hours.

DON’T WANT TO SMELL LIKE A POTHEAD

Will I smell like a pothead after smoking or vaping?  Yes, BUT only if you smoke a lot of joints.   Most patients use a vape with good cannabis product this days. It produces negligible odors.  Weed smoke may be harmful to lungs but only in large amounts.  In moderate use(1-2 per day) the effects on the lungs appears to be negligible or even therapeutic.

“After exercise-induced bronchospasm, placebo cannabis and saline were followed by gradual recovery during 30 to 60 min, whereas 2.0 per cent marijuana and isoproterenol caused an immediate reversal of exercise-induced asthma and hyperinflation.” – PubMed

CAFFEINE MORE ADDICTIVE THAN CANNABIS

“The difference between caffeine and Cannabis is that caffeine more reliably produces abuse-related effects in preclinical rodent models.” – Dr. Lazenka,THC Researcher

SAFETY! LAB TESTED CANNABIS IS THE BEST WAY TO GO

There is a point in medicating and poisoning at the same time.  Pesticides, mold and residual solvents are serious contaminants too often found in random testing. When using any kind of cannabis products should be free of residual solvents, pesticides, herbicides, heavy metals, mold, fungus and other toxic elements.

The cannabinoid profile should be measured using liquid chromatography (LC) to see that cannabinoids are present in the appropriate quantity.

Overdosing is possible with both THC and CBD but are low-risk as compared to most other drugs.  The benefits of cannabis is that their toxicity and side effects are much lower than your standard pharmaceutical drugs.  THC overdose can result in temporary anxiety and scares the living hell out of the patient.  CBD overdose is very uncommon.   Side-effects are limited.

“Several studies suggest that CBD is non-toxic in non-transformed cells and does not induce changes on food intake, does not induce catalepsy, does not affect physiological parameters (heart rate, blood pressure and body temperature), does not affect gastrointestinal transit and does not alter psychomotor or psychological functions. Also, chronic use and high doses up to 1,500 mg/day of CBD are reportedly well tolerated in humans.”  PubMed

RECOMMENDED! ORAL AND EDIBLE MEDICAL MARIJUANA

Examples: Edibles using cooking oils and butter, alcoholic beverages, capsules.

Advantages:  long lasting, soothing and smooth, easy to take. Raw cannabis contains THC-A,a non-psychoactive but therapeutic form of THC.

Baking cannabis converts THC-A into psychoactive THC (d9).  So raw and baked can deliver non-psychoactive or psychoactive effects.

Disadvantages: unpleasant taste for some patients, bitter. THC overdose is possible so start small when using THC high medication.

Dose range: 2 – 100 mg

Side Effects: Eating too much high THC products can cause extreme dizziness, inability to concentrate, diminished ability to focus, drowsiness, rapid heartbeat, blood pressure jumps, feelings of euphoria and need for sleep. Balanced forms of THC:CBD or CBD alone are recommended for THC intolerant patients.

“Dr. William Courtney, a juicing guru of fame, recommends ingesting 15 leaves and a couple of big buds on daily basis.”

The oral way is generally the most cheapest and convenient of drug delivery. In most cases, medical cannabis tends to sooth and balance the intestinal tract were inflammation can be dramatically reduced as seen in many documented cases of Crohn’s disease.  However, medications, including medical marijuana can cause gastrointestinal tract irritation in some patients.  Medication that comes in pills or capsules tends to be delivered more rapidly than edibles – where absorption is time-released.

“Juicing raw cannabis is the Crohn’s Disease health cure that Kristen claims saved her life. Diagnosed at 16 with juvenile rheumatoid arthritis, the illness quickly turned into an auto immune disorder that left her bedridden for four years. Finally, the teen and her mother began to look for alternative treatments. Kristen began juicing raw cannabis, and after a month she claims her pain stopped and her recovery began. She is now an advocate for medical marijuana treatment for fellow sufferers.”   –  Kristen Courtney

Cannabis is usually infused into butter and oil that is substituted into a great variety of recipes . Edibles take 30 minutes to 2 hours to take effect while inhalation takes only a few minutes. Doses can be difficult to rate because absorption rates vary depending on the patients and products.

The easiest way to control an edible dose is to take a known amount of THC/CBD on almost empty stomach. Another way is to munch a little bit, and then wait an hour and gauge the effect before eating more.  Through effect and trial , the correct dosage can be determined.

Many cancer patients, chronic pain, AIDS, nervous system disorders often find that oral consumption provides greater relaxation and calming effects than any other delivery method. Oral marijuana medication are particularly popular for those with medical conditions that interfere with a good night’s sleep.

Patients new to medical cannabis are looking for a right solution for conditions.  They were often taking several types of different medications and not getting the results they wanted. The reason they came to medical cannabis in the first place was because the meds cocktail was not as effective as they’d like and the side effects became too much to handle.

Tinctures allow medication without any psychoactive effects. Marijuana tinctures have been around forever.  Before prohibition in the 1930’s US Pharmacopeia listed tinctures as a preferred form of application.  Cannabis infused liquor was also a popular choice. These days, low-dose ethanol cannabis tinctures are readily available in states with legalized medical cannabis program.

ORAL DOSES MANAGEMENT

  • Start with ¼ of the recommended “dose”of the herbal drug.
  • Wait an hour and analyze the effects – with a licensed medical marijuana doctor if possible.
  • Consume another ¼ dose if required, wait another hour, analyze effects.
  • Consume the remainder of the dose, if needed.
  • The next day analyze results and discuss dosage with your medical marijuana doctor.

Types of edibles:  juice, baked food, smoothies, sauces, teas, soda, whiskey, tinctures, energy bars, yummy bears, nut mixes, popcorn, the list is endless.

RECOMMENDED! TOPICAL APPLICATION

Examples: lotions, oils, patches and creams.

Advantages: Topical products act mostly at the site of harm, high levels of patient satisfaction. Are easy to use. Slow but long lasting effect,non-psychoactive, non-invasive.

 The risk of systemic side effects is minimized when delivering drugs almost directly to the site of action. However, skin irritation can result in a minority of patients.

Disadvantages: The dose of some forms such as creams or lotions, the dosage is difficult to control. Slow absorption.

Dose range: 10 to 200 mg.

“CBD oil helps with the healing process and inflammation. So you want to get these for before and after the fights, training. It’ll make your life a better place.” – Mixed Martial Artist – Nate Diaz

Topical medicines are applied directly to the skin or muscles. Topicals include salves, balms, sprays, oils, creams and lotions.  Patient testimonials suggest that they are tremendously effective for skin conditions like psoriasis. Joint diseases like rheumatoid arthritis, migraines, restless leg syndrome, spasms, common muscle stress and soreness. Unlike inhalation and oral routes , topicals are 100% non-psychoactive. You could bathe in them and never get high.

TRANSDERMAL APPLICATION – PATCHES 

THC and CBD are fat and can be dissolved in alcohol.  THC and CBD or other cannabinoids pass from the patch through the skin into the blood.

Patches are relatively rare today, but this route of administration might become the most popular and effective choice of all soon.  Just slap on a patch and go to do your things.  Some medication tends to be relaxing and other types energizing.  Patients with chronic conditions that require constant medication to maintain their quality of life can start their day with a “day patch” and finish off with a “night patch”.

How to use: Just apply the patch to a your skin.  Popular places to apply a patch are the inner-wrist area, top of foot or ankle. This method is widely used by patients that do not want to inhale cannabis.

MEDICAL MARIJUANA HEAVY DUTY THERAPY

Cannabis medicines delivered via suppositories is uncommon but it may become an especially effective way to treat certain difficult to treat conditions, like organ insults and cancer.

Advantages: fast and long lasting, efficient, may be particularly effective for liver, pancreas and internal organ injury resulting from cancer and other conditions.
Cons: Difficult to take “on the road”.  Refrigeration is required.
Dosage: Suppositories come in different sizes, 1 or 2 grams usually with varying amounts of active ingredient.  Bum pills can be cut in half to reduce dosage.

“There is a “watershed” of veins in the rectum.  Collectively they are called the rectal or hemorrhoidal plexus.  The majority of the venous flow ( after absorbing cannabinoids ) goes by way of the superior rectal vein into the portal vein, while the inferior veins flow into the vena cava.  The portal vein collects most all venous return from the pancreas to the rectum with all the nutrients and enzymes for digestion) where the blood goes on to the liver for what is called first-pass metabolism.  The majority of the THC is converted to 11-OH-THC, a similarly psychoactive molecule.  The vena cava on the other hand goes back to the heart and general circulation before it more slowly reaches the liver for metabolism. ”  –  Jeff Hergenrather MD

 

HOW TO USE

Patients insert a small ball of marijuana meds into their rectum, where it is absorbed into the blood . This method is perhaps controversial and less used than other ways to medicate, but some patients have no choice.  It is not difficult, lie on your side, and insert the suppository about 2 inches into the anus. Squeeze sphincter muscles and don’t move for a few minutes. Then you’re done. There are also syringe deliverable suppository drugs too.  Whatever helps.

 

SUBLINGUAL

Examples: Tinctures and Essential Oils.

Advantages: prefered route for children, easy, fast, effective. easy to control the dose.

Disadvantages: Hard to get, often expensive.

Dose range: 1 to 100 mg.

Sublingual means drug administration through the tissue under the tongue.  Many patients find that either oral or sublingual delivery is the best choice for their conditions. Many medicines are designed for sublingual administration, including cardiovascular drugs, steroids, barbiturates, opioids with poor gastrointestinal bioavailability, enzymes, vitamins and minerals.

A marijuana tincture is a highly concentrated form of cannabis dissolved in ethanol, glycerin or MCT oil. Dosage must be carefully monitored, it takes only a few drops to achieve a medicinal effect. Patients start with a few drops sprayed or squirted under the tongue.  Patients track the effect and take another few drops, if required.  In the beginning stages, the process, of course, should be done at home and be directed by a licensed medical marijuana doctor.  Tinctures can also be mixed with beverages. The potency and effect is more unpredictable than simple under the tongue administration.

INJECTIONs – NOT RECOMMENDED

Examples: Hypodermic needle, IV drip.

Advantages: potent medication for extreme cases, fast.

Disadvantages: expensive, can require assistance, pain, inconvenient.

Dose range:2 to 100 mg.

Injections can be intravenous (IV), intramuscular (IM), and subcutaneous (SC).  Injections take effect rapidly – in 10–20 seconds for IV, 10–20 minutes for IM, and 15–30 minutes for SC. Medication is more or less 100% bioavailable.  Marijuana is used for Cancer, AIDS/HIV, chronic pain sufferers and anti-inflammatory conditions to improve feelings of well being. To overcome anxiety,reduce inflammation, improve appetite and manage  chronic pain.  Patients already on IV can conveniently use Marijuana based medicines by simplifying the appropriate concentrate to their drip.  Of course this procedure must be approved and done by a licensed medical marijuana doctors.

“After being diagnosed with cancer, Beverly Hills celebrity Cheryl Shuman began taking a cocktail of medications and up to 27 morphine tablets a day in a bid to overcome the disease. However, after learning about cannabis oil, Cheryl started to treat herself. She says the treatment cured her in 90 days and remains in remission to this day.”  –  Cheryl Shuman

DABBING.  NOT RECOMMENDED

Dabbing is a rude but somewhat effective way to medicate with cannabis concentrates such as budder, shatter, wax, hash oil, etc. Dabbing devices vary but basically the pot is placed on metal and heated to a very high temperature, perhaps with a butane torch and the vapor is inhaled.  This method is not recommended by medical marijuana doctors because elements created at a high temperature can be carcinogenic and expensive medicine can be wasted.

MEDICAL CANNABIS OVERDOSE SYMPTOMS

Although medical cannabis overdose symptoms are rare, it is possible to overdose.

Some signs of a cannabis overdose may include:

  • Hallucinations.
  • Rapid heart rate, increasing the risk of heart attack.
  • Mental confusion.
  • Panic attacks.
  • Extreme paranoia.
  • Anxiety
  • Stress

If the cannabis is mixed with other drugs, some common side effects can include strokes, or irregular heartbeats, seizures.

Medical Marijuana Doctor:  To access and medicate with the right form of medical cannabis, patients in California need to have a medical marijuana recommendation from a licensed medical marijuana doctor.  Fortunately, the California Board of Medicine allows patients to conveniently get a medical marijuana card by visiting one of our locations in San Jose or San Francisco.  MmjDoctor.com specialize in quick and affordable 420 evaluations online- the process is 100% confidential.  we are helping patients from 11 am to 7 pm every day to process your request.  Click here to get a medical marijuana card online NOW.

 

DISCLAIMER: The information provided here is for informational purposes only.  Before taking any action, patients should consult with a licensed medical marijuana doctor with experience in therapy using medical cannabis. Schedule your appointment with our doctors now.

Labels: oral, vap,vape,joint,suppository,tincture,drug administration, dose,edible,side-effect,toxicity,injection, iv,sublingual,mmj, medical marijuana, mmj doctor, cannabis doctor, medical cannabis doctor, 420 evaluations.

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