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Know your dose: How to decide how much to take

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Contents

  1. Important factors to consider
  2. The therapeutic window
  3. Incremental dosing
  4. Dosing considerations for different product types

Medical cannabis is a highly personal affair. When it comes to finding the perfect dose, dozens of variables factor into the equation. Differences in product types, potencies, individual genetics, weight, age, and so on produce unique experiences every time an individual chooses to consume cannabis.

With so little research available, it requires an ongoing effort to determine the best cannabis dose for each person’s specific medical needs. Doctors are a good starting point. However, it’s helpful to know how different factors play into your cannabis experience. This knowledge can empower you to make informed, safe decisions about your medical cannabis use.

In this article, we take a deep dive into finding the optimal dose, how to incrementally adjust the dose, and what to keep in mind when using different forms of medical cannabis.

Important factors to consider

Every person has a unique endocannabinoid system (ECS) and, as such, a different response when they consume cannabis. It’s essential to know what type of product at what potency produces what kind of response. Determine your medical cannabis goals and slowly work to find what allows you to reach those goals.

Every person has a unique endocannabinoid system (ECS) and, as such, a different response when they consume cannabis. Photo by: Gina Coleman/Weedmaps

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Some patients find success with 1 milligram of cannabis, while others require much more potent doses. However, while higher doses will have more potent effects for a time, subsequent dose increases will result in weaker effects accompanied by more adverse reactions. And the highest dose is hardly the most cost-effective. Medical marijuana is expensive, and consuming more doesn’t necessarily equate to more relief.

The optimal dose, then, is the lowest amount that provides adequate therapeutic relief without adverse effects.

The therapeutic window

A therapeutic window is a period in which one can observe measurable therapeutic effects, while adverse side effects are avoided.

The therapeutic window for novice cannabis users is much narrower than for seasoned consumers. The ECS is a highly tuned instrument that responds to overstimulation by diminishing cannabinoid receptors, meaning higher doses will be required to achieve the same therapeutic effect. With higher doses come higher chances of adverse effects. .

“Start low, go slow,” is advice provided by many dispensaries, with clinical research to back it up. A 2012 study showed that patients with advanced cancer experienced more effective pain relief with fewer side effects by using lower doses of cannabis spray. Another study found that low doses of vaporized cannabis were equally effective in relieving nerve pain as higher doses and the smaller doses were less likely to have a significant impact on daily cognitive function.

Clearly, there’s an upper limit to cannabis’ effectiveness. While to date, there is no known lethal dose to cannabis, it’s possible to experience unwanted anxiety or paranoia by consuming too much.

This is where incremental dosing comes into play.

Incremental dosing

Except in some states, physicians aren’t allowed to provide patients with a specific medical marijuana dose, as they would for other prescription drugs. Therefore these patients must gradually increase doing to figure out what works best for their physiology, symptoms, and cannabis goals.

Check for cannabinoids

It’s essential to know precisely what’s in a medical cannabis product before purchase. Check the label for cannabinoid percentages (potency) and terpene content, which plays an important role in cultivar-associated experiences via the entourage effect.

The cannabinoid makeup of a medical marijuana product can dramatically affect the users’ experience. Photo by: Gina Coleman/Weedmaps

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The cannabinoid makeup of a medical marijuana product can dramatically affect the users’ experience. THC, the most well-known cannabinoid, is responsible for the psychoactive intoxication of cannabis and may provide a host of medicinal properties. CBD, the plant’s second-most abundant cannabinoid, has its own list of reputed therapeutic benefits, as well as overlapping qualities while acting on different physiological mechanisms than THC.

Many studies show that CBD may protect against cognitive impairment caused by THC. THC and CBD used together, depending on the dosage and consumption method, could offer a patient higher therapeutic value.

Determine your cannabis baseline

By starting with lower levels of potency, patients allow the ECS to self-correct and achieve equilibrium. Less potency will be needed for maintenance, reducing tolerance build-up, unwanted side-effects, and financial expenditure in the long run.

A clean slate allows you to establish a tolerance baseline from which you can determine your optimal cannabis dose. In an interview with Marijuana.com, Dr. Chris Emerson recommended regular users start with a 48-hour break to reset the system. More seasoned cannabis users might require a more extended tolerance break.

After the break, try a three-milligram dose of THC. Observe and write down how it feels. The next day, try three milligrams of CBD and observe those effects. Take the next week to try different combinations of THC and CBD while keeping the total less than 3 mg.

As you establish a baseline, you can begin to experiment with more precise doses. Keep your medical cannabis goals in mind as you mix different ratios, try dosing at various times during the day, timing meals with your dose, etc. From here, you can steadily increase your dosage in small increments as needed until you reach the lowest amount that delivers your desired results.

Microdosing is also increasing in popularity as people seek the therapeutic benefits of cannabis without diminishing cognitive capacity. Some users start with 1 to 2.5 mg, just enough to mitigate symptoms that would otherwise affect their ability to work.

Dosing considerations for different product types

Optimum dosing depends on the type of cannabis product. Some offer more consistent and precise options than others. Edibles, for example, can be broken into smaller serving sizes, whereas flower potency ranges based on cultivar type, its growing conditions, bioavailability, and cannabinoid makeup. Other products offer an innately more potent experience, such as dabbing concentrates, while others have longer onsets and durations.

Flower

Smoking cannabis flower provides a quick onset of effects within seconds of inhalation, hitting a peak at around 30 minutes, after which it lasts anywhere from one to three hours.

Smoking cannabis flower provides a quick onset of effects within seconds of inhalation. Photo by: Gina Coleman/Weedmaps

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Each strain, or cultivar of marijuana flower varies in potency and cannabinoid content, and differences often exist in strains with the same name. A cannabis plant’s compounds can change based on it’s growing conditions and how it’s cured and dried. Purchasing a product from the same cultivator or brand help ensure a similar experience every time.

However, it’s difficult to accurately dose cannabis flower, even when it’s purchased from the same breeder and crop. Say a lab result reports that a strain has 10% THC, and you are buying one gram. This means that there are 100 milligrams of THC in the amount you purchased. When smoked, only approximately 50% of the THC in flower enters the bloodstream while the remainder burns off, leaving behind 50 mg of cannabis in our example. At this point, it’s hard to separate a single gram into several doses without guessing.

A good starting point is taking one or two hits off a small bowl and waiting up to an hour to see how you feel. You can always smoke more if you don’t achieve the desired result.

Vaporizers heat cannabis flower or extracts to their vaporization point, at which consumers inhale the vaporized trichomes and terpenes. Effects appear within seconds, peak within 15 minutes, and last anywhere between one and three hours.

Vaping flower presents similar challenges to smoking it, namely how to measure doses precisely. Vape cartridges, alternatively, typically show THC percentages on the box, and some manufacturers give a rough estimate of how many hits are in a single cartridge.

Cannabis oil, another vaping choice, is also more potent than flower. Photo by: Gina Coleman/Weedmaps

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Cannabis oil, another vaping choice, is also more potent than flower, so fewer hits introduce more cannabinoids to your system.

Concentrates and dabs

Cannabis concentrates are considered a more advanced method of consumption not recommended for novice medical users. Concentrates, or dabs, are highly potent cannabis extracts that contain an average of 60% to 99% THC, up to five times the amount in cannabis flower. Fast-acting dabs hit your system immediately and last up to three hours.

Dabs are usually sold in half-gram or full gram amounts. If a dab has 60% potency, there are 600mg of THC in a gram of the concentrate.

Some types of concentrates are easier to break into smaller portions than others. Shatter, for instance, can be cut into even pieces and weighed on a small scale. Wax or resin, on the other hand, don’t lend themselves to easy measuring. Most consumers recommend starting with a single dab no bigger than the tip of a nail or ballpoint pen.

Using the right tool also makes it easier to portion a precise dab dose. A sharp, flat tool will more easily slice shatter, while a spoon scoops up more precise servings of gooey rosin.

Dabs are recommended for seasoned users or those who require more substantial doses. Photo by: Gina Coleman/Weedmaps

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Remember, start low and go slow. Dabs aren’t for the faint of heart. They are recommended for seasoned users or those who require more substantial doses.

Edibles

The body processes THC in edibles differently than other cannabis products. After digestion, the liver transforms THC into 11-hydroxy-THC, a compound that’s more potent than THC, lasts longer, and has more sedating properties. It takes 45 to 60 minutes for edibles to kick in and effects last for up to six hours, depending on the dose and an individual’s metabolism.

Edibles’ packaging will list cannabinoid potency in milligrams per product. Many professional edible producers will evenly mix cannabinoids throughout the food, which allows consumers to divide it into smaller serving sizes. For example, an infused chocolate bar may contain 50 mg of THC total and be easily broken into 10 pieces of five milligrams each.

Edibles’ packaging will list cannabinoid potency in milligrams per product. This precise division makes consuming smaller doses easier and produces more consistent effects. Photo by: Gina Coleman/Weedmaps

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This precise division makes consuming smaller doses easier and produces more consistent effects. With edibles, it’s advisable to start with a low dose, such as one to five milligrams. Wait 24 hours to evaluate the dose’s efficacy and slowly increase by 1 mg every 24 hours until you reach the desired relief.

Tinctures

Cannabis tinctures are made by dissolving cannabis in an alcohol or oil solution. Tinctures are crafted with specific amounts of ingredients and packaged in dropper bottles, allowing patients to precisely and discreetly self-dose by dropping the liquid under the tongue or mixing it into a beverage. Effects occur within 20 to 30 minutes and last two to three hours. Start with a small amount, such as 0.5 or 1mg THC, and wait at least an hour before increasing the dose.

Tinctures are crafted with specific amounts of ingredients and packaged in dropper bottles, allowing patients to precisely and discreetly self-dose. Photo by: Gina Coleman/Weedmaps

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Tinctures are meant to be absorbed in the mouth. This requires a person to use their tongue to rub the product in, under the tongue and inside of the cheeks, allowing the product to remain in the mouth for 2-3 minutes. If a tincture is swallowed before it is fully absorbed, it acts more like an edible, and the effects can last up to 6 hours. Many patients use tinctures this way before bed, as a sleep aid.

Topicals

Topicals are lotions, ointments, or transdermal patches that are usually non-intoxicating and provide relief for a host of benefits. Because they don’t present adverse side effects, topicals are an excellent choice for novice cannabis users or those with a low-THC tolerance.

Topicals are lotions, ointments, or transdermal patches that are usually non-intoxicating and provide relief for a host of benefits. Photo by: Gina Coleman/Weedmaps

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In order to reap the benefits of topicals, they must be fully absorbed into the skin. This requires rubbing the product (such as a lotion) all the way in, until the skin is essentially dry. Many patients report the best results when they apply topicals frequently, up to every two hours.

Know your dose: How to decide how much to take Copy article link to clipboard. Link copied to clipboard. Contents Important factors to consider The therapeutic window

Medical marijuana dosage

THC SINGLE DOSE AND DAILY DOSING IN MEDICAL MARIJUANA Updated January 2020

What is the amount of a single dose of THC and what is an average daily dose of THC as used in medical marijuana—What is the average dose of medical marijuana needed to treat a patient and what are the standards, if any, as pertains to THC Single Dose and Daily Dose?

Although there are no exact standards, there are some guidelines offered by respected industry leaders and patterns set by current pharmaceutical companies that have distributed THC products. This page is for informational purposes only and MEDCAN did not develop or research these doses. These numbers and dose figures are from relatively reputable sources.

A typical single dose of THC may be considered to be 5mg to 10mg. [1] An average daily dose of all cannabinoids totaled may be considered to be 30 mg to 90 mg per day, and would include both THC and CBD. (30 to 90 mg per day total cannabinoids means a range of “15mg THC plus 15mg CBD” to “45mg THC plus 45mg CBD”). Thus, the average daily dose of only THC might be 15mg to 45mg per patient per day. [2] Doses of over 45 mg per day are not recommended according to the source data. Doses of THC greater than 54 mg per day were noted to cause signs and symptoms of overdose/poisoning. These consisted of acute intoxication produced CB1 agonism-type reactions including dizziness, hallucinations, delusions, paranoia, tachycardia or bradycardia with hypotension. [3]

It is estimated that a dose of THC 10 mg has a similar effect as 60 mg of Codeine and equivalent to two tablets of Tylenol #3 with Codeine. [4]

It is estimated that the average street joint 0.35g (equals 350mg) has about 35mg of THC (in a common 10% THC product). Larger street joints of 0.5g to 0.7g and higher percent THC will give higher results. In the 1990’s THC percent was as low as 2 to 4 %, now it can go as high as 25% to 28%.

An “eighth”, is 1/8th of an ounce and is equal to 3.5g. An “eighth” will make 10 joints of 0.35g each, or 7 joints of 0.5g. Thus an “eighth” will make one ‘big’ joint per day for a week, and 4 eighths will supply a person with one ‘big’ joint a day for a month. At that rate, they would be using ½ ounce per month (4/8ths of an ounce), which contains 50mg THC in a 10% strain. This would be 100mg per day if the strain was 20% and would be almost 150mg per day if the strain was 28%.

Daily Dosing of THC Vaping translated to smokeables:

Conversely, a patient that is Vaping 50 mg per day of THC is potentially receiving the effective dose of ONE OUNCE of “whole plant/smokeables/flower” per month. This may vary, but, as 50mg Vape x 30days equals 1500mg THC Vaped. Vaping delivers more THC to the patient per mg compared to smokeables as in smokeables, there is combustion of the THC which can destroy up to half the amount of mg of THC.

When a patient smokes ONE OUNCE of Smokeables (approx 30g) in a month, which is 30,000 mg whole leaf–and if it was 10% THC (a popular strain) this would contain 3000mg THC, but remember half of the THC in smokeables is lost to combustion (whereas it is not destroyed by vaping to the same extent as in smokeables), so using Smokeables, a person would receive closer to 1500mg THC. Thus it can be surmised that 50mg Vaping per day is appoximately equivalent in the THC dose delivered as using ONE OUNCE of Smokeables per month. Of course, if the %THC were higher, the total THC per ounce smokeables would be higher as would be the patient daily intake.

—————————————————————————–
What does an ounce of smokeable medical marijuana equal in THC Mg.?

Laypersons recognize the term “joint” as a common unit of use. A regular sized “joint” of 0.35 grams often contains approximately 35 mg of THC, (this is based on 10% strain and can vary) and 10mg of THC is considered by many to be ‘one dose’. Light users: 1 joint/day. Medium to Heavy users: 3 or more joints per day. If the joint was a 0.35 grams of 20% THC, the joint would contain 70 mg of THC.

Daily Dose For Cannabinoids (CBD plus THC): 2.5 mg to 90 mg — the average amount being 45mg (which would be 22 mg CBD and 22mg of THC per patient per day).

Do not confuse the “grams of whole leaf” with the “milligram dose of THC”. The conversion factor is that THC mg. is 10-15% of the whole leaf weight (in grams).

An eighth of “leaf/smokeables” is 3.5 grams, which is 3500 milligrams, which would contain 350 milligrams of THC (10% THC strain) and 700 milligrams of THC (20% THC strain)

Daily Dose for THC from 2 different Florida Dispensaries websites:
Trulieve: 5mg two times a day. (for a total of 10mg per day)
Surterra: Up to 20mg per day

Dosing and equivalent dose to Codeine pills. Clinical studies use a wide range of preparations and usually allow dosage titration for effect, making standard dosage recommendations difficult. A large, multicenter trial used initial doses of 5 mg of oral delta-9-tetrahydrocannabinol (THC) daily, self-titrated up to 25 mg THC daily for up to 52 weeks in multiple sclerosis. Estimates of relative efficacy for THC compared with codeine for pain are 10 mg THC to 60 mg codeine—the equivalent of two tablets of Tylenol No.3 [5]

Pharmaceutical Manufactured THC Dose: The pharmaceutical company, AbbVie Inc. manufactures THC and packages this drug as Marinol™. The company makes their THC available in 5mg and 10mg capsule dose sizes. [6]

From “Medical Jane”:

Generally speaking, 30-100mg of active cannabinoids (THC, CBD, etc) is considered a daily dose by most patients who consume cannabis regularly, although it will vary per individual and the health condition you are looking to treat. Having said that, 10-15mg of active cannabinoids (THC, CBD, etc.) is typically a good starting point for medical marijuana patients that are ingesting cannabis for the very first time. It is recommended that you start with micro (very small) doses and work your way up to larger dosages as you become more and more familiar with the effects of eating infused edibles or oils. The 30 mg to 100 mg total includes both THC and CBD mg combined. [7]

Lower Dose of THC may be more effective and better tolerated by patient: 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. Cumulative doses of THC exceeding 20-30 mg per day – or a single dose of 10 mg or more – may cause unwanted side effects. [8]

The Average Recommended Dose of Edibles: 5 to 10mg of THC
The Cutting Edge Thinking on Edibles: 2 ½ mg THC may be the preferred single dose amount
“10mg of THC has been established as a single dose amount” [9]

Disclaimer: MEDCAN specifically does not intend to give medical advice nor expect anything on this page to be used as medical advice. Please consult your physician.

[1] 5 mg to 10 mg dose figure is based on several sources including Florida MMTC dispensary websites.

[2] GW Pharmaceuticals package insert of medical marijuana medication. See more here https://www.medicines.org.uk/emc/product/602

[3] GW Pharmaceuticals package insert of medical marijuana medication. See more here https://www.medicines.org.uk/emc/product/602

[4] https://www.drugs.com/npp/marijuana.html and based on the Karst study Karst M, Wippermann S. Cannabinoids against pain. Efficacy and strategies to reduce psychoactivity: a clinical perspective. Expert Opin Investig Drugs. 2009;18(2):125-133.19236260

[5] https://www.drugs.com/npp/marijuana.html and based on the Karst study Karst M, Wippermann S. Cannabinoids against pain. Efficacy and strategies to reduce psychoactivity: a clinical perspective. Expert Opin Investig Drugs. 2009;18(2):125-133.19236260

[1] This figure is based on several sources including Florida MMTC dispensary websites.

[2] GW Pharmaceuticals package insert of medical marijuana medication.

[3] GW Pharmaceuticals package insert of medical marijuana medication.

Medical marijuana dosage THC SINGLE DOSE AND DAILY DOSING IN MEDICAL MARIJUANA Updated January 2020 What is the amount of a single dose of THC and what is an average daily dose of THC as