As the demand for cannabis soars, so too does the need for clear guidelines governing its use. Cannabis is potent medicine, and as a medicine, requires a framework that minimizes harm. Standardized dosing may be the cornerstone of such a framework.
For a long time, the recommended adage for those experimenting with cannabis medicine has been to “start low, go slow.” A shift is afoot, however, with calls for standardized THC units for both research and clinical purposes.
Different people have different experiences. One individual may feel stress releaf, while another feels over-stimulated and stressed, while another feels energized and on-task. There are many factors that impact the effect:
- Amount used (dosage)
- Strain of cannabis used and method of consumption
- Experience and history of cannabis use
- Mindset or mood
- Nutrition or diet
- Type of cannabis used
Though cannabis is biologically classified as the single species Cannabis Sativa, there are at least three distinct plant varieties: Cannabis Sativa, Cannabis Indica, and Cannabis Ruderalis, though the last is rare. There are also hybrids, which are crosses between sativa and indica varieties. Cannabis used for fiber is typically referred to as hemp and has only small amounts of the psychoactive cannabinoid THC, usually less than 1%.
Genetic “breeders” of the cannabis seed have developed thousands of different strains of cannabis from these three varieties. There are marked differences between sativa, indica, and hybrid. Today, we mostly find hybrids. It can be difficult to find pure indica or sativa.
A standard dose for cannabis
Standardizing dosage promotes safer patterns of use. It’s not a novel proposal. Motions to standardize cannabis dosing have been floated before: measuring cannabis in grams, for example, or having standard joints. Problematically, neither accurately captures the differing concentrations of THC that may be present in products—a joint, blunt, dab, and edible all have different amounts of THC, as do different strains of flower.
To overcome this shortfall, the above study’s authors proposed a 5 mg standard THC unit for all cannabis products, across all methods of administration. Such an approach echoes the way consumers have been taught to understand alcohol.
A 5 mg dose can deliver meaningful effects regardless of the route of administration while minimizing the risk of unpleasant or excessive effects for newbie consumers. Standard dosing guidelines will also help consumers to determine the number of standard doses in each product.
Standardizing THC units may offer greater clarity into understanding current inconsistencies in cannabis research, especially regarding its influence on brain development, cannabis use disorders, addiction, and psychoses.
While some research points to adverse events after a single exposure to cannabis, other studies show no differences with regular exposure. A lack of information about THC content may contribute to discrepancies in research outcomes. Case in point: Many meta-analyses or systematic reviews of cannabis medicine often report conflicting findings.
Getting the Dose Right
Unlike a typical pharmacy, every dispensary will carry different products with varying percentages of THC and CBD. Trying to get a consistent dose like with pharmaceutical medications can be a challenge.
No matter how complicated it may seem, it’s important to try to be consistent. Not only is it cost effective to use as little medicine as needed, it also helps avoid building up a tolerance to the medication.
Cannabis can also have a biphasic effect, where at lower doses it can have one effect, but provide the opposite effect at a higher dose. For example, some people may find a low dose of sativa energizes and focuses them, but at too high of a dose, it can make you feel lethargic.
All types of medical cannabis produce effects that are more similar than not, including pain and nausea control, appetite stimulation, reduced muscle spasm, improved sleep, and others. But individual strains will have differing cannabinoid and terpene content, producing noticeably different effects. Many people report finding some strains more beneficial than others. For instance, strains with more CBD tend to produce better pain and spasticity relief. As noted above, effects will also vary for an individual based on the setting in which it is used and the person’s physiological state when using it.
Many patients prefer to smoke or vape cannabis either for the flavor or for the entourage effect from getting all the cannabinoids and terpenes in the plant. Unfortunately, it can be difficult to calculate the exact amount of THC when using the inhaled route of administration.
Whereas vape concentrates often show the percentage of THC, it can be difficult to know the exact amount of THC you’re getting if you’re smoking flower.
Even if you do know the exact amount of THC in your inhalable medicine, it’s still hard to calculate exactly how much you are getting into your lungs. The amount of THC that is lost to smoke or side-steam varies based on what kind of instrument you are using and how experienced you are. Up to half (but sometimes even less than one quarter) of the cannabinoids in the product will actually make it into your bloodstream and be available for use by your body.
some people metabolize THC faster than others and may require much higher doses to get the same effect as other patients. This can be an expensive source of frustration.
Other patients metabolize THC poorly and may find that even low doses (around 5 mg) are too much. They need to use smaller amounts compared to others. It’s important to keep these possibilities in mind if you are finding it difficult to get your intended effect when using medical cannabis.
Ultimately, patients should start small and feel things out. This is especially true if you are new to marijuana or you are trying a new route of administration.
If you are smoking or vaping, take a draw for a few seconds, inhale deeply for around 2-3 seconds. Then wait 10 minutes to see if that dose is sufficient for your symptoms. If there is not noticeable effect, repeat the process and keep working your way up until you find your baseline dose. The same principle applies to tinctures, sprays, pills, homemade edibles and any other route of administration.
You may be surprised at how well cannabis works at low doses. Researchers have found that microdosing cannabis—using very small doses of marijuana—can be highly effective at treating certain conditions and symptoms. For some folks, cannabis actually becomes less effective if too much is used.
While titrating your dosing, notice how you feel with the very small doses. You may not need to increase your dose much at all if you’re able to microdose and achieve relief. It’s important to know, however, that not all conditions respond well to microdosing. For example, research shows that patients often need more than 100 mg of cannabinoids to ease their migraine symptoms. Titrating is the best way to find out if microdosing works for you.
As you increase your dose or the frequency of your cannabis use, you’ll likely notice your tolerance shifting. Patients tend to be less affected by cannabis the more they use and the longer they use it. What this means is that you may need to increase your dose to get the same effects. This may frustrate some folks, but the upside is that patients report fewer negative or overwhelming side effects from their medicine as their tolerance rises. This allows you to become more functional when using your medicine.
It’s important to note that tolerance can be tied to the particular product you’re using. If you use the same product or strain regularly, and feel like your tolerance has gotten too high, try switching to another product. You may find that your tolerance is much lower to a cannabis you aren’t used to. Remember to titrate with your new product, instead of going with the same dose you’re accustomed to taking with your other products, as your tolerance to it may be much lower.
Your tolerance to cannabis may also shift depending on your set and setting. If you’re used to using cannabis at home alone, you may feel quite functional on a certain dose. But if you try that same dose in another context—say, at work around coworkers or out shopping at a store—you may find yourself feeling overwhelmed or simply too high.
- Zenpype.com is an educational website dedicated to shedding the light on many sides of medical and recreational cannabis. Aside from informing people about cannabis, we also provide cannabis seeds and CBD products. Readers who show their support with purchasing, help us keep doing this. Thank you for your support and for helping us improve!