Start Low and Go Slow
The basic principal for dosing medical marijuana is to start with a low dose and to go slow in taking more until the effect of the first dose is fully realized, because the effects of cannabis are not always immediately felt. Starting low and going slow allows patients to accommodate for the different experiences they may have.
Cannabis has a wide margin of safety and there is limited risk of overdose. However, caution is warranted until a patient fully understands the effect that the cannabis may have. Dosage varies greatly among patients, even when treating the same condition.
There are many factors that impact the effect, including:
Amount used (dosage)
Strain used and method of consumption
Experience and history of cannabis use
Mindset or mood
Nutrition or diet
Inhalation has the primary advantage of allowing a patient to adjust the dosage easily for maximum benefit because the onset of action is almost immediate. The medical marijuana is taken into the lungs and quickly absorbed through the capillaries into the bloodstream.
Hand or machine rolled cigarette (joint)
Pipe or water pipe (bong)
Length of Effect
Effects from inhaling cannabis products are felt within minutes and reach their peak in 10–30 minutes. Typical inhalers experience an effect that tapers off after approximately 2–4 hours, and lasts about 4–12 hours. As cannabis affects your cognitive abilities, you should not operate a motor vehicle, operate heavy machinery, or engage in any activity that requires full cognitive abilities until after the effect of the cannabis has completely dissipated, no less than 24 hours after use.
Smoking versus Vaporization
Smoking involves combusting the cannabis using an open flame. Vaporization steadily heats the cannabis to a temperature high enough to extract THC, CBD, and other cannabinoids into an inhalable mist, without burning.
Differences between smoking and vaporization:
- With smoking, up to 40% of the available cannabinoids may be completely combusted or lost in side-stream smoke and thus are biologically unavailable.
- A vaporizer steadily heats dried cannabis to a temperature that is high enough to extract THC, CBD, and other cannabinoids but too low to release the potentially harmful toxins that occur during combustion.
Vaporization is claimed to reduce some of the health risks associated with smoking.
- There may be differing vaporization points for the individual cannabinoids and vaporized cannabis may have differing concentrations and ratios of cannabinoids compared with smoked cannabis
Many patients are more comfortable with oral administration of medical marijuana. Patients should consider, however, that absorption is slower when medical marijuana is taken orally, with lower, more delayed peak THC levels and reduced bioavailability of THC and CBD due to extensive metabolism in the digestive tract. While some studies have suggested that 3–5 times the quantity of medical marijuana is required to be taken orally to achieve the same effect as smoking, PharmaCannis recommends each patient start low and goes slow.
Effects of Medical Marijuana
Short-Term Cognitive Effects
Patients should be aware that cannabis use causes short-term impairments in the following brain functions:
Sense of time
Cannabis users may “pull themselves together” to concentrate on simple tasks for brief periods of time. That said, performance impairments may be observed for at least one to two hours following cannabis use, and residual effects have been reported up to 24 hours depending on potency of the cannabis, the method of administration, and the tolerance of the user.
Long-Term Cognitive Effects
Consult the advice of your physician if you are a long-term user of medical cannabis and intend to stop using it, or if you are concerned about dependence on or addiction to cannabis. Your physician can help you manage any withdrawal effects that you may experience. Always seek the advice of your physician or other qualified healthcare provider before starting any new treatment or discontinuing an existing treatment with medical cannabis.
Talk with your healthcare provider about any questions you may have regarding your cannabis use. The information and materials provided to you by PharmaCannis should not be used as a substitute for the care and knowledge that your physician can provide to you.