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Metabolizing Medical Cannabis

May 11, 2020

Metabolizing Medical Cannabis

The form of cannabis and the method of its consumption profoundly affect how it works as a medicine. Different forms will have different chemistries and the body metabolizes them differently. Various delivery methods impact the speed and efficiency with which a cannabis medicine works – and how long its effects will last.

As a natural product, cannabis is perishable. Knowing how to store it well extends its shelf-life. Occasionally, there is more in a medical cannabis product than should rightfully be there. Learning how to spot contaminants and spoilage in cannabis products, and knowing which contaminants require laboratory detection, is a key skill for consumers. Above all, learning how to master cannabis delivery methods and dosage can be of significant help in finding the best way to treat your specific medical condition.

Many patients, and even a few physicians, have little idea as to how to dose and administer herbal cannabis medicines. Media stereotypes of cannabis users reinforce the absurd notion that cannabis use only results in befuddled intoxication. Reality TV and YouTube have done little to counter this, portraying big bongs of Kush and fat dabs of 80 percent THC oil as connoisseurship. A 2016 study on the cognitive impact of cannabis on both infrequent and daily users, indicated that the neurocognitive deficits caused by THC are not reduced by frequency of use. In other words, frequent heavy users may claim they’ve earned a tolerance to the cognitive impacts of their doses of THC, but tests measuring those deficits prove otherwise.

There is a more rational approach to medical cannabis dosage of THC. This approach minimizes cognitive and motor impairment by employing the smallest amount of THC cannabis that delivers the desired effective outcome. This is supported by the observation from pharmacologists that THC exhibits biphasic effects; their studies show how a small dose may activate a receptor, whereas a high dose may inhibit the same receptor. A minimum effective cannabinoid dose is summarized by the phrase, “just a little bit,” emphasizing a small, controlled, and measured dosage approach. It can be challenging for new patients to avoid overmedication since many of the common cannabis consumption tools – bongs or dab rigs – don’t come with detailed instructions (if any) encouraging controlled and restrained dosage. Consistent overmedication with high-THC herbal cannabis or extractions may lead to tolerance to some of cannabis’s medicinal effects as indicated by decreased CB₁ receptor density, but not its actual intoxicating effects. This tolerance would demand increased dosage to relieve symptoms previously relieved at smaller doses.

Dose guidance is especially useful with THC-dominant cannabis medicines, which can be highly intoxicating when taken excessively. But what’s a dose? The best-studied cannabis medicines are dronabinol (Marinol), the prescription form of pure THC, and nabiximols (Sativex), a cannabinoid-based oromucosal spray containing nearly equal amounts of THC and CBD. Clear dose guidelines are well understood for these two products, since each has been subjected to a full suite of clinical trials and dose-ranging studies. Extrapolating from these studies can provide help in ascertaining approximate ranges of effective doses for other cannabis medicines.

The following information is presented for educational purposes only. Summit Releaf distributes this information to provide an understanding of the potential benefits of medical marijuana for patients living with one of the approved Ohio Medical Marijuana Control Program qualifying conditions for an Ohio marijuana card. Links to third party websites do not constitute an endorsement of these organizations by Summit Releaf and none should be inferred.

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