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Meds Micro-Dosing Cannabis

Chicken Charlie

MicroDose Cognoscente
As an M.D. (Child and Adolescent Psychiatry) I target medication to a minimum dosage to effectuate adequate symptom relief for my patients. I follow the same protocol when I ingest cannabis. Individualistically that correlates to 0.0320 grams p/day. I have been maintaining this standard for many years; and would be curious if any in this forum subscribe to similar patterns.
Thank-you
 

momofthegoons

Vapor Accessory Addict
Staff member
@Chicken Charlie thank you for starting this thread. It's an interesting subject and something that I think needs to be discussed. :smile:

First I think a definition of 'micro dosing' should be established. According to Wikipedia, "Microdosing (or micro-dosing) is a technique for studying the behaviour of drugs in humans through the administration of doses so low ("sub-therapeutic") they are unlikely to produce whole-body effects, but high enough to allow the cellular response to be studied." In the scenario we are discussing, I take this to mean an amount of cannabis small enough to feel some medicinal effect, but not a 'full body' or 'stoned' effect.

The amount would be subjective since each person has their own tolerance levels.

I do not weigh out my doses. But I can say without hesitation that they are much smaller than what I would use if I was sitting down to recreationally 'get high.' I will usually use one small dab in the morning as my first meds of the day. This is usually around 8:00 am. I wont medicate again until around noon (again; as a rule). This med session may use a bit more product and is usually flower. I will use 1 bowl from the SSV, or 1 - 2 stems full with the WoodScents; again much less than I would use for a recreational high. I'll repeat this around 4:00 pm. After that point, however, I'm no longer concerned with having to drive or be as productive so I will medicate until I feel like stopping. I would consider this more of a recreational usage.

The thing that I have found is that you do not need to use a ton of cannabis to alleviate symptoms. A small amount can do the trick and any more than that just contributes to getting high. It's up to the individual to figure out what that threshold is if they don't want to over medicate.
 

Squiby

Cool Kitty
Staff member
I am a microdoser.

Yes, I admit it freely. I vape throughout the day starting somewhere between 10am and noon. If I have business in town, like collecting the mail, groceries etc. I take care of it in the morning. If I have no need to drive into town, I start earlier.

I like to begin with a high octane sativa, usually in concentrate form, the tiniest amount possible. This starts me off with a clear headed, energetic high. In love my Durban Poison, Super Lemon Haze or anything Jack. I'm not stoned but I am high and this gives me the energy I need to do the chores, like hauling hay, gardening, mucking out the barn etc.

Then a few hours later, I move on to flowers, like a nice Thai or Pineapple Express. After that come the indicas to relax with and get ready for bed.

My flower sessions are usually 0.015 grams. This is just a tiny nug off a flower. It took me awhile to get my doses down this low and it still astonished me that my consumption is so low. Every day a bit less, every session a tiny bit less. I have found that my highs are much more enjoyable now and I still get the effects I need for pain relief and nausea.

High CBD stains are sprinkled throughout depending on how I feel. I have a wonderful strain called Remedy and it absolutely obliterates pain and nausea in tiny amounts. It is fantastic medicine!

I consume cannabis every day. The only exceptions are when I'm using power tools, which I prefer to operate straight as an arrow or when circumstances don't allow.

When nausea or pain is more severe, I dial it up a bit then back down when the crisis is over to my microdose levels.
 

Killick

Well-Known Member
I've had some great success with pain and other things recently. I have been using 10 grams per day, and now I'm cutting back dramatically. I'm not sure how much 'dramatically' actually means as I'm not documenting. If I document I get twitchy, so I'm letting things stabliize a bit before actually doing numbers and such.

I've been suggesting to those new to cannabis is small amounts of cannabis frequently through the day. And now I'm kinda following the same methodology, although I tend to ingest via multiple methods - coffee with cocobudder and 'Holy Moley (TM) tincture (homemade, at around 90 mg per drop-ish), C02 vape oil, the occasional herb vape (but surprisingly little of late). I also have access to CBD-infused sunflower oil, which I take sublingally every few days.

So from my own perspective I'm starting to think of the body as being somewhat self-regulating when it comes to cannabinoid intake. When I needed *a lot*, which I now ascribe to homeostasis... an attempt to balance cannabis trying to fix something and pills also trying to fix something, if that makes any sense? And now that there is no longer an imbalance my reliance on large amounts of predominantly high THC indica strains is relaxed, and I can start to find what the new 'normal' looks like for daily dosing.

I've read of 'the synergistic effect' which suggests that multiple methods of intake are better, holistically, then any one method. So, when it comes to microdosing, I'd be interested in learning what and how others identify their own 'right' amount. Are any methods preferred over any other methods? Does the addition of CBD contribute to amount micro-dosed per day?

Lots of Q's, to be sure. Hopefully they make a bit of sense? I've also recently discovered that my communication skills can be a little shoddy at times, so hopefully this isn't a rambling collection of soup :)

PS - Alphabet soup, dangit, cause none can read chicken noodle...
 

Baron23

Well-Known Member
Microdosing marijuana: Doctors say it’s the best way to consume pot
This piece originally appeared on The Fresh Toast.
There are those cannabis connoisseurs who enjoy getting super stoned at the end of a long day at the office, while others are now embracing an emerging trend called microdosing, a procedure that allows the user to moderate their mind by taking small doses throughout the day.

The concept of microdosing is simple: instead of consuming enough THC to join the land of catatonia, the user leans on somewhere between 3 to 10 milligrams to feel some effect without entering into a realm of laughing fits, paranoia and ravenous hunger. It is increasingly popular practice that Rolling Stone calls “Marijuana 2.0,” an idea that less is actually more when it comes to using cannabis for its therapeutic and creativity-inducing benefits.


However, there are some challenges involved. What is considered a low dose for some may not cut it for others. It is similar to how it would be if measuring the effectiveness of Ibuprofen on a large group of people. Some of them would find relief with 200 milligrams, while it might take others near pharmaceutical levels to cut through the pain. So, the core of this dosing principle is really just about the individual finding the perfect “micro-buzz” that allows them to feel comfortable and productive.

Dr. Duston Sulak, who has been working with medical marijuana patients in Maine for the past eight years, told Rolling Stone that he has developed a system to help people find their optimal microdose.

“Abstain from cannabis for two days. On day three, consume one milligram of THC and one milligram of CBD, preferably in a tincture or oil where they can be measured precisely,” he said. “Before consuming, ask yourself three questions, and answer on a scale of one to 10: How easy is it to breathe, how comfortable and calm does your body feel and how easy is it for you to smile authentically, to feel content and grateful?”

Feel nothing? Increase your dose by one milligram, the doctor says.

“You repeat this process over the next few days, increasing the dose by small increments,” he explained. “When you reach a point where you feel a difference after consuming, you’ve found your minimal effective dose.”

No matter how high of a tolerance a person has, the doctor says 48 hours of abstinence is all that is needed to hit the rest button.

Although microdosing may go against the grain of the old time stoner philosophy, medical experts say that finding the “minimum effective dose” is the key when treating a patient with any medication. After all, it is not advised to take other medications at intoxicating levels, so why should marijuana be treated any differently?
 

momofthegoons

Vapor Accessory Addict
Staff member
Microdosing cannabis: 5 reasons why less is more

by Bethany Rae on August 21st, 2017 at 1:15 PM
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Flower & Freedom’s Bethany Rae says microdosing cannabis enhances her mood and helps support her active lifestyle.


Call it conscious consuming or mindful marijuana, microdosing cannabis could play an important role in the future of healthy consumption as part of the legalization of adult use cannabis in Canada.

Microdosing certainly changed my approach to cannabis. Instead of consuming any old joint passed around in a social setting, I make careful choices based on my cannabis knowledge in order to achieve the goal, or intention, I have set for that day.

Microdosing cannabis is effectively looking for the minimum effective dose. In other words, what’s the smallest amount of THC you need to consume to achieve the results you desire?

I’ll explain this further by sharing the five reasons I microdose cannabis.

1. Microdosing complements and enhances my active lifestyle
Stoner stereotypes need not apply. Cannabis is part of my healthy lifestyle that focuses on optimizing my mind and body through clean diet, self care and regular exercise.

By microdosing carefully chosen cannabis strains and products, such as indica oil drops, I am able to achieve muscle relaxation and recovery and a deeper night’s sleep without feeling lethargic in the morning.

For daytime activities or in a social setting, I mindfully select cannabis products and strains that are known to be more energetic, my go to being sativa oil drops or a sativa-dominant vape pen. By consuming the smallest amount possible, usually for a pick me up in the afternoon, I am able to get a boost in energy, creativity and focus while avoiding feeling high or anxious.

This type of cannabis consumption is complimentary to my exercise routine. It has required some experimentation, but for me, cannabis has become a reliable pre- and post-workout supplement.

2. Microdosing allows me to experiment with symptom relief
Microdosing the ideal strain of cannabis can help to boost my mood when I’m feeling down, melt away stress and bring calm to my racing mind.

I’ve also been experimenting with microdosing cannabis for mild pain relief throughout the day. When I start to feel the onset of cramps or a headache, I try microdosing THC, in combination with CBD (the non-psychoactive compound) to find relief without the high. I have found success with this technique and have dramatically reduced the need to take over the counter painkillers monthly.

I did consult with a cannabinoid educated doctor before self-medicating with cannabis. They made suggestions on dosages and wisely suggested to start low and going slow to find that the sweet spot unique to my tolerance and desired effect.

3. Microdosing delivers more consistent results
By being mindful and aware of how many milligrams of THC or CBD I am consuming, at any given time, I am able to adjust and/or repeat these result with much more success than if I just consumed cannabis at random.

Besides the active compounds (cannabinoids and terpenes) and other ingredients that might be present in each cannabis strain or product, other factors at play might affect your cannabis experience. This could include your tolerance level, your mood and intention, the method of consumption, any alcohol consumption, what you’ve eaten and so on.

When starting out, I found it useful to keep a journal or digital diary of the different cannabis strains and products that I tried. This was to remind myself of the different effects each session induced and in what environment I had sampled them.

4. Microdosing reduces my likelihood of over consuming
Ever regretted getting a little bit too high? Microdosing cannabis allows me to find that sweet spot where I’m not overwhelmed with the euphoria from THC but I’m able to enjoy the therapeutic benefits of the active compound.

Finding this sweet spot, also known as self-titration, has taken some personal experimentation. Part of the challenge, is that it’s difficult to measure exactly how many milligrams are consumed during some of the more traditional methods of consumption such as smoking and vapourizing. I favour oil drops and capsules where the consumed amount is clearly identified and measurable on the packaging.

This ideal dosage is very personal, so what is effective for me may provide no results for someone with a much higher tolerance. It’s possible microdosing may actually prevent the buildup of a cannabis tolerance. With any new product I always start low and go slow to carefully measure the results.

5. Microdosing is easier on the wallet
This doesn’t require much explaining! By consuming small amounts of cannabis, my cannabis supply lasts longer and I’m spending less. (I am no longer spending money on pharmaceutical painkillers so that is an added bonus.)

The only challenge I have to this is my fascination to try all the innovative cannabis products coming onto the market, some of which I’ll be highlighting over the coming weeks in partnership with Georgia Straight! Stay tuned.
 

momofthegoons

Vapor Accessory Addict
Staff member
CANNABIS DOSING CONUNDRUM
High dose? Low dose? CBD? THC? Optimizing one’s therapeutic use of cannabis may entail some experimentation. In essence, the goal is to administer consistent, measurable doses of a CBD-rich cannabis remedy with as much THC as a person is comfortable with.

Highlights:
Cannabis can be effective therapeutically at a wide range of doses. There’s no standard dosage that’s right for everyone. Here are some do’s and don’ts for dosing cannabis:

  • The successful use of cannabis as a medicine depends on managing its psychoactive properties. Many people enjoy the cannabis high; others do not. A person’s sensitivity to THC (“The High Causer”) is key to implementing an effective treatment regimen.
  • One does not need to smoke marijuana or get high to benefit from medical cannabis.
  • CBD is not psychoactive like THC. High doses of CBD-rich formulations are safe, well tolerated, and sometimes necessary.
  • But high doses of CBD are not always more effective than lower doses. As little as 2.5 mg CBDcombined with a small amount of THC can have a therapeutic effect.
  • Preclinical studies have shown that full-spectrum CBD-rich cannabis oil (with a small amount of THC) is efficacious at much lower doses and has a much wider therapeutic window than pure, pharmaceutical-grade CBD.
  • Less is more: Cancer patients who received 21 mg/day of Sativex (a cannabis sublingual spray with roughly equal amounts of CBD and THC) experienced significant reductions in pain, more so than cancer patients who received 52 mg of Sativex, while those who were given 83 mg of Sativex reduced their pain no better than a placebo.
  • Cautious titration is recommended when ingesting THC-rich cannabis products (with little CBD). Microdosing as little as 2.5 mg THC can provide symptom relief without making a person feel high. If well tolerated, consider increasing the amount of THC to a total of 15 mg divided equally throughout the day.
  • Cumulative doses of THC exceeding 20-30 mg per day – or a single dose of 10 mg or more – may cause unwanted side effects.
  • For cannabis-naïve patients, it may be best to start with low doses of a CBD-rich remedy with little THC and slowly increase the dosage – and, if necessary, the amount of THC – one step at a time. Take a few small doses over the course of the day, rather than one big dose.
Figuring out the optimal dose of cannabis may involve some trial and error. A balanced ratio of CBDand THC could have a greater therapeutic impact than either CBD or THC alone. Adjust the amount of CBD and THC until you find the sweet spot with the right combination of both compounds. In essence, the goal is to administer consistent, measurable doses of a CBD-rich cannabis remedy with as much THC as a person is comfortable with.

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It’s relatively easy to experience medical benefits from cannabis. A puff or two of a resin-rich reefer can do the trick for a lot of people.

But smoking marijuana is not the be-all and end-all of cannabis therapeutics. One doesn’t have to smoke marijuana or get high to experience the medical benefits of cannabis.

In recent years, the advent of potent cannabis oil concentrates, non-psychotropic CBD product options, and innovative, smokeless delivery systems have transformed the therapeutic landscape and changed the national conversation about cannabis.

It’s no longer a question whether marijuana has medical value. Now it’s about figuring out how to optimize one’s therapeutic use of cannabis.

That can be a challenge – for doctors as well as patients. Most physicians never learned about cannabis in medical school and, according to a 2017 survey, few feel they are qualified to counsel patients about dosage, CBD:THC ratios, different modes of administration, and potential side effects.

“Dosing cannabis is unlike any therapeutic agent to which I was exposed in my medical training,” says Dustin Sulak, D.O., the director of Integr8 Health, which serves patients at offices in Maine and Massachusetts. “Some patients effectively use tiny amounts of cannabis, while others use incredibly high doses. I’ve seen adult patients achieve therapeutic effects at 1 mg of total cannabinoids daily, while others consume over 2000 mgs daily without adverse effects.”

Cannabis comes in many different forms with a wide range of potencies, and its production and distribution have yet to be standardized in states where cannabis is legal for therapeutic use. So what’s the best way to proceed when it seems like cannabis dosing is all over the map?

Managing psychoactivity
The successful use of cannabis as a medicine depends to a great extent on managing its psychoactive properties. Many people enjoy the cannabis high; for others it’s unpleasant. A person’s sensitivity to tetrahydrocannabinol (THC), the main psychoactive component of cannabis, is key to implementing an effective treatment regimen.

Cannabidiol (CBD) does not cause a psychoactive high like THC. CBD can actually lessen or neutralize the THChigh, depending on how much of each compound is present in a particular product. A greater ratio of CBD-to-THC means less of high. Today cannabis patients have the option of healing without the high.

Broadly speaking, there are three types of resin-rich cannabis (and cannabis products):

  • Type 1 (THC-dominant) – High THC, low CBD (ubiquitous psychoactive marijuana varietals that millions like to smoke)
  • Type 2 (THC & CBD) – Mixed THC and CBD cultivars (psychoactive, but not as edgy as THC-dominant varietals)
  • Type 3 (CBD-dominant) – High CBD, low THC (non-euphoric marijuana or hemp)
There’s also a fourth type – those rare cannabis cultivars that prominently express a so-called minor cannabinoid (like CBG or THCV). But in terms of what’s currently available for patients, the THC:CBD ratio is paramount and must be considered when formulating dosage strategies.

What’s the appropriate dosage for each of the three main types of cannabis?

Microdosing for beginners
One of the common misconceptions about cannabis therapy is that one has to get high to attain symptom relief.

“Most people are surprised to learn that the therapeutic effects of cannabis can be achieved at dosages lower than those required to produce euphoria or impairment,” says Dr. Sulak, who asserts that “ultra-low doses can be extremely effective, sometimes even more so than the other [high-dose] extreme.”

Preclinical science lends credence to the notion that a small amount of THC can confer health benefits. Oral administration of a low dose of THC (1 mg/day) resulted in “significant inhibition of disease progression” in an animal model of atherosclerosis (hardening of the arteries), according to a 2005 report in Nature, which noted: “This effective dose is lower than the dose usually associated with psychotropic effects of THC.”

Because of federal cannabis prohibition and consequent research restrictions, clinical data is lacking to determine if low dose THC therapy can protect against atherosclerosis in humans. But this much is certain: The practice of micro-dosing – which entails the consumption of a sub-psychoactive or slightly psychoactive dose of cannabis – is gaining popularity among those who want the medical benefits of cannabis without the buzz.

Although banned by federal law, measurable doses of cannabis medicine are currently accessible in the form of concentrated oil extracts, infused sublingual sprays, tinctures, edibles, gel caps, topical salves and other products.

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“Start low, go slow”

The adage “start low and go slow” is apropos for cannabis therapy, in general, and THC titration, in particular, as discussed by Caroline MacCallum and Ethan Russo in a January 2018 article in the European Journal of Internal Medicine. The authors, who are both physicians, provide sensible guidelines for health professionals and patients regarding the judicious administration of (Type 1) THC-dominant medicinal preparations.

If a new patient is going to smoke or vape THC-rich cannabis, Russo and MacCallum suggest they start with a single inhalation and wait 15 minutes before inhaling again. The effects of inhaled cannabis usually can be felt within a few minutes, thereby providing quick relief of acute distress. If need be, one can inhale an additional puff every 15 to 30 minutes “until desired symptom control is achieved.”

As for oral administration, one should keep in mind that it can take 60 to 90 minutes before the effects of a single dose are felt.

MacCallum and Russo suggest a carefully titrated regimen for consumption of ingestible THC-rich cannabis products. They recommend that patients with little or no experience using cannabis should start by ingesting the equivalent of 1.25 to 2.5 mg of THC shortly before bedtime for two days. If there are no unwanted side effects, increase the bedtime dose of THC by another 1.25 to 2.5 mg for the next two days. Continue to increase the dose of THC by an additional 1.25 to 2.5 mg every other day until the desired effects are achieved.

If there are adverse side effects, reduce the dose of THC to the prior amount that was well tolerated.

Type 1 – Titrating THC
For adequate symptom relief, some patients may need to ingest a cannabis preparation two or three times during daylight hours in addition to their night-time regimen. Again, cautious titration is urged: On days 1 and 2, start with one dose of the equivalent of 2.5 mg THC; on days 3 and 4, increase to 2.5 mg THC twice a day; and, if well tolerated, up the dose incrementally to a total of 15 mg THC (divided equally throughout the day).

“Doses exceeding 20-30 mg/day [of THC] may increase adverse events or induce tolerance without improving efficacy,” the authors warn.

Adverse events mainly pertain to THC and are dose-dependent. Very high doses are more likely to cause unwanted side effects.

For most medications, a higher dose will pack a stronger therapeutic punch. With cannabis, however, it’s not so simple. THC and other cannabis components have biphasic properties, meaning that low and high doses generate opposite effects. Small doses of cannabis tend to stimulate; large doses sedate.

In practical terms, this means that starting low and gradually upping the dose of cannabis will produce stronger effects at first. But, after a certain point, which differs for each person, “dosage increases can result in weaker therapeutic effects,” according to Dr. Sulak, “and an increase in side effects.”

Sulak observes that “symptoms of cannabis overdose closely mirror the symptoms one would expect cannabis to relieve at appropriate doses: nausea, vomiting, diarrhea, sweating, spasms, tremors, anxiety, panic attacks, paranoia, dis-coordination, and disturbed sleep. Extreme overdoses can lead to hallucinations and even acute psychosis.”

Type 2 - THC and CBD: Power couple


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Although many patients do well at the lowest effective dose, some benefit more from a high dose cannabis oil regimen, preferably one that includes a substantial amount of CBD as well as THC. By lowering the ceiling on THC’s psychoactivity, CBDmakes high potency cannabis oil treatment easier to manage. If high doses are necessary, steady titration over several weeks will help build tolerance to THC’s tricky psychoactive effects.

CBD and THC are the power couple of cannabis therapeutics. Both compounds have remarkable medicinal attributes, and they work better in combination than as isolates. CBD can synergistically enhance THC’s anti-inflammatory and painkilling properties, for example, while reducing unwanted side effects.

A clinical study published in the Journal of Pain examined the efficacy of different dosage levels of Sativex, a cannabis-derived sublingual spray with 1:1 CBD:THC ratio, which is an approved medication in two dozen countries (but not in the United States). Of 263 cancer patients who were not finding pain relief with opiates, the group that received 21 mg of Sativex each day experienced significant improvements in pain levels, more so than the group that received 52 mg Sativex daily. And those given even higher doses (83 mg daily) reduced their pain no better than a placebo, but they experienced more adverse effects.

Cannabis therapeutics is personalized medicine. There is no single CBD:THC ratio or dosage that’s optimal for everyone. As little as 2.5 mg of CBD combined with a small amount of THC can have a therapeutic effect. If necessary, much higher doses of good quality CBD-rich formulations are safe and well tolerated.

For cannabis-naïve patients, it may be best to start with low doses of a CBD-rich remedy (with little THC) and increase the dosage (and, if necessary, the amount of THC) step-by-step. Take a few small doses over the course of the day, rather than one big dose.

But a low-THC product is not always the best treatment option. A more balanced combination of CBD and THC could have a greater impact than CBD or THC alone.

In essence, the goal is to administer consistent, measurable doses of a CBD-rich remedy with as much THCas a person is comfortable with. Experiment, observe the effects, and adjust the amount of CBD and THCuntil one finds the sweet spot with the right combination of both compounds.

Type 3 – Full-spectrum CBD-rich extracts
Microdosing cannabis is a feasible option for those who prefer not to leap over the psychoactive threshold. High dose CBD therapy is another way of healing without the high.

As a general rule, Type 3 CBD-dominant cannabis (with little THC) won’t make a person feel stoned. Nor will a pure CBD isolate (with no THC). But CBD isolates lack critical aromatic terpenes and other cannabinoids, which interact synergistically to enhance CBD’s therapeutic benefits. Single molecule cannabinoids are simply not as versatile or as efficacious as whole plant formulations.

Preclinical research indicates that full spectrum CBD-rich cannabis oil is effective at much lower doses and has a wider therapeutic window than a CBD isolate. “The therapeutic synergy observed with plant extracts results in the requirement for a lower amount of active components, with consequent reduced adverse side effects,” a 2015 Israeli study concluded.

In animal studies, CBD isolates require very high – and precise – doses to be effective. Problematic drug interactions are also more likely with a high-dose CBD isolate than with whole plant cannabis.

Hemp-derived CBD isolates and distillates are already available via numerous internet storefronts. Drug companies are also eyeing single molecule CBD as a treatment for intractable epilepsy, psychosis, and other diseases.

In a 2012 clinical trial involving 39 schizophrenics at a German hospital, 800 mg of pure pharmaceutical-grade CBD proved to be as effective as standard pharmaceutical treatments without causing the harsh side effects typically associated with antipsychotic drugs. But a follow-up study at Yale University found little cognitive improvement in schizophrenics who were given a CBD isolate.

Pharmaceutical CBD


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Bereft of the THC stigma (and its therapeutic moxy), single-molecule CBD will soon become a FDA-approved pharmaceutical for pediatric seizure disorders. This is good news for families with epileptic children that have health insurance. Anyone without health insurance won’t be able to afford Epidiolex, a nearly pure CBD remedy developed by GW Pharmaceuticals as an anti-seizure medication.

Consider the dosage range utilized in clinical trials of epidiolex. Children with catastrophic seizure disorders were given up to 50 mg of epidiolex per kg of body weight. Such high doses caused interactions with other anticonvulsant medications, requiring adjustments of the latter to avoid a toxic overdose.

By comparison, Dr. Bonni Goldstein, author of Cannabis Revealed, typically starts with a much lower dose of full spectrum CBD-rich oil (1 mg CBD/kg of body weight) for epileptic children – with the understanding that the dose may have to be lowered or raised depending on the initial response. If necessary, Goldstein will increase the dose of CBD by increments of 0.5 mg/kg until a threshold of 5 mg/kg of body weight is reached. And that amount also may need to be adjusted.

Kids and adults metabolize drugs differently. It may seem counterintuitive, but young children can tolerate high doses of cannabis oil concentrates, including THC-rich formulations, which might be daunting for an adult. Thus, it’s not a good idea to calculate dosage for an adult based on what works for a child.

If 1 mg/kg of CBD is an appropriate starting dose for a child, and an adult weighs 15 times more than the child, one should not assume that the correct CBD starting dose for the grown-up is 15mg/kg of body weight. That could be way too high a dose. While CBD has no known adverse effects at any dose, an excessive amount of CBD may be less effective therapeutically than a moderate dose.

Similarly, it’s not a good idea to devise a dosage regimen based on data from preclinical animal studies, which usually involve high doses of single-molecule cannabinoids. Human metabolism differs from mice and rats, and data from animal models doesn’t always translate to human experience.

Personalized medicine
For people as well as pets, cannabis dosing must be individually determined. Several factors come into play, including one’s overall health and endocannabinoid tone, which are influenced by diet, exercise, sleep patterns, day-to-day stress, and genetics. Cannabis is best used as part of a healthy lifestyle.

Here are some dosing variables to consider:

  • Cannabis experience. Is the patient cannabis-naïve? Or a stoner who already uses cannabis every day but isn’t getting the best results? A veteran user may need a higher dose than a new user. Or a chronic user might need a break from getting high to reboot his or her sensitivity to cannabis (see Dr. Dustin Sulak’s cannabis “desensitization protocol” on Healer.com).
  • Time of day. Optimizing one’s therapeutic use of cannabis may entail using products with different CBD:THC ratios at different times of the day – more CBD for daylight hours, more THC at night.
  • Preventive dosing. Prolonged low dose therapy may be advantageous for managing chronic symptoms or to prevent disease recurrence. Preclinical studies indicate that cannabinoids have neuroprotective and cardioprotective properties that could limit the damage of a traumatic brain injury or a heart attack.
  • Cannabinoid acids. Raw, unheated cannabis contains CBD and THC in their “acid” form, CBDA and THCA, which are not intoxicating. Consumed orally over several months, cannabinoid acids can be effective in very small amounts, but precise dosing is difficult when juicing raw cannabis. Other delivery systems are becoming available for CBDA-rich and THCA-rich products.
Cannabis is a safe and forgiving medicine. Figuring out how to make the most of its health-enhancing properties may involve some trial and error. No worries! At least cannabis isn’t harmful like so many FDA-approved pharmaceuticals.

So if you’re new to cannabis medicine or if you’re seeking to improve your therapeutic routine, remember this advice from Dr. Sulak: “Start low, go slow, and don’t be afraid to go all the way!”

Project CBD director Martin A. Lee is the author of Smoke Signals: A Social History of Marijuana – Medical, Recreational and Scientific.

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momofthegoons

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Ultra-low cannabis dosing: When microdosing is still too much

If you’re open to taking your coffee decaf or drinking low-alcohol beer, the idea of lightening your cannabis dose is probably welcome. Unsurprisingly, today’s cannabis consumer generally isn’t looking to get stoned to the point of paralysis. But pot has never been as potent as it is today. According to a 2019 study, mean Δ9-THC concentration in cannabis has increased almost twofold in the past decade or so, from 8.9% in 2008 to 17.1% in 2017.

Rather than resign themselves to disorientating head highs, consumers are experimenting with novel ways to get the most out of their hit, with less … of a hit. As growing research confirms that a little weed goes a long way, both cannasseurs and researchers alike are looking to enhance the beneficial outcomes of cannabis while minimizing detrimental ones with very small doses.

Variations on the microdosing theme
The concept of lightening the load isn’t a new one. Microdosing, a process used in drug development to assess the effects of a minute dose of a substance on the body, first became popular and absorbed into cannabis culture several years back. Savvy consumers grew aware of the benefits of small doses that served therapeutic benefits without the side of anxiety or paranoia. Microdosing also enables the canna-curious to dip their toes into the water.

While microdosing represents one method of facilitating a more grounded cannabis experience, other variations have also sprung forth—“lite” products, which allow novice consumers to experience the joys of weed without its potential pitfalls. For example, the Rookie Cookie, with 10mg of CBD and 10mg of THC, allows you to demolish an entire cookie, enjoy the buzz, and remain lucid enough to function.

Similar to CBD oil, marijuana lite products promote the feeling of relaxation, or a body high without the head high. Most critically, they take the guesswork out of dosing edibles, so there’s no longer a need to carve an infused chocolate bar into twenty pieces.

Italy has even seen the meteoric rise of a “cannabis light” movement. Cannabis light, which became legal in December 2019, refers to cannabis sativa plant derivatives with levels of 0.6% THC or less, facilitating a super mild, barely-there buzz. Italian consumers can enjoy cannabis light in the form of infused pasta, olive oil, and gelato, along with buds.

Ultra-low doses: When dosing gets really low
While microdosing and cannabis lite are pitched at consumers, researchers have also been exploring the therapeutic potential of very low doses in the laboratory. Enter ultra-low dosing.

According to Dr. Stacia Woodcock, clinical pharmacist and Director of Education at The International Research Center on Cannabis and Health, ultra-low dosing has its roots in hormesis, the concept that a compound can have directly opposite effects at high versus low doses—also known as biphasic dose-dependency.

“Homeopathic medicine is based on this concept. Compounds which can be toxic or cause undesirable effects at standard doses are diluted down by several levels of magnitude, at which point the highly diluted form is then used to prevent those same symptoms,” explained Woodcock.

“A simpler way of explaining this is to consider allergy shots. A large ‘dose’ of pollen from the environment introduced into the body causes horrible allergy symptoms, but a highly diluted form of that same pollen injected into the body can actually help the body build an immune response to prevent those allergy symptoms from occurring,” she said.

In the case of cannabis, ultra-low dosing is several orders of magnitude smaller than what is considered a microdose. “For example, if a microdose is considered to be 2mg of THC, an ultra-low dose would be 0.02-0.2mg of THC,” said Woodcock. “These are not hard numbers, however, because we do not have any clinical studies in humans that clearly delineate the lines between ‘dosing,’ ‘microdosing,’ or ‘ultra-low dosing.’”

While it may sound like semantics, there’s ample evidence to suggest it’s not. More often than not, the key to optimizing one’s experience with weed is experimenting with doses incrementally and noting nuance until the perfect balance is struck.

Studies on ultra-low dosing
In the past ten years, a range of studies have emerged exploring the effects of ultra-low doses of THC. Findings to date indicate that ultra-low doses can modify brain plasticity and induce long-term behavioral and developmental effects.

Several early studies suggested that ultra-low doses of THC may cause mild cognitive impairment. In a 2007 study, a single injection of an ultra-low dose of THC (0.001mg/kg) in mice had a detrimental effect on memory and learning that lasted up to four months. Similar results were reported in a 2010 study where a single ultra-low dose caused behavioral deficits in mice that lasted up to five months.

According to the above 2010 study’s lead author, Dr. Haitham Amal, principal investigator at The Laboratory of Neuromics, Cell Signaling and Translational Medicine of The Institute for Drug Research at The Hebrew University of Jerusalem, the potential for ultra-low doses to issue protective benefits outweighs the mild impairment.

“We found significant differences between the control dose and the treated group which indicated the ultra-low dose can affect memory and spatial learning, but this effect is not severe, it doesn’t pose severe damage,” explained Amal. “In our follow-up work, we used this ultra-low dose, which has a specific molecular mechanism different to a high dose, to see whether it could protect mice from epileptic seizures and mechanical head injuries. We carried out these experiments and found that the ultra-low dose conferred a protective value in mice models.”

According to Amal, the ultra-low dose has two phases. The advantages that can be gained from the ultra-low dose in the treatment of diseases overcome the disadvantages or delicate damage that the ultra-low dose may inflict.

Additionally, a subsequent animal study from 2014 revealed that ultra-low doses of THC can shield the brain from cognitive damage caused by neuroinflammation. The authors report that ultra-low doses could potentially be used to address neuroinflammatory conditions, including neurodegenerative diseases.

For Dr. Amal, long-term, ultra-low dosing may support individuals experiencing neurological assaults from disorders such as Alzheimer’s, multiple sclerosis, autism spectrum disorder, and Parkinson’s. “My work was on a single administration of ultra-low doses, so I’m hypothesizing here,” stated Amal. “While chronic ultra-low doses will negatively affect memory, spatial learning, and biochemical changes, I think using low doses long-term for the treatment of these neurological disorders could be beneficial.”

Amal’s hypothesis has been echoed in a 2019 review conducted by expert Dr. Yosef Sarne. Sarne reports that ultra-low doses of THC have been shown to rescue cognitive function in models of brain injury in mice, including seizures, hypoxia, anesthesia, neurotoxicity, and neuroinflammation. THC’s anti-inflammatory properties also help combat cognitive deterioration in neurodegenerative disorders and slow down age-related decline.

Compellingly, the protective effects conferred by ultra-low doses of THC were not confined to the brain, but also noted in the kidneys, liver, and heart.

Ultra-low dosing for beginners
If you’re curious to try ultra-low dosing yourself, Sarne, in the above study, recommends a dose of 0.0002 mg/kg in humans, which works out to about 0.014mg (or 14 micrograms) for an individual of 150 lbs (70 kg). This dose is 100 times lower than the standard threshold (1-2mg of THC), which is when the intoxicating effects of THC would begin to kick in.

Woodcock recommends tinctures and oral solutions when it comes to experimenting with ultra-low dosing. “They’re easy to dilute down and measure to accurately administer the dose. As a clinician, I would only recommend utilizing cannabis products from a legal source that is regulated and tested in a way that ensures the accuracy of the dose being utilized.”
 

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