Understanding Dosing


When it comes to cannabis, the most successful patient is an educated one! Unlike traditional medications, cannabis dosing is very individualized; it is not based on age, weight or condition, but rather the needs of our own body. Cannabis interacts with our endocannabinoid system to elicit a response; because our endocannabinoid systems all operate differently, each individual will experience a variance in how their body absorbs and processes cannabis. The complex interactions of the chemicals in the cannabis plant produce varying effects which can make dosing medical cannabis somewhat challenging. The average patient will undergo 20 dosage adjustments before finding their sweet spot.

The most rational approach is to use the lowest effective dose that delivers adequate symptom relief with the least amount of unpleasant effects. Cannabis is one drug that can be tailored specifically to meet a patient’s needs and patients play an important role in their dose optimization. The rule of thumb is to start low and go slow. At high doses, THC can cause anxiety and paranoia; however, these effects can be mitigated with CBD. Be sure to discuss your treatment goals with a patient consultant at each visit to optimize your CBD:THC ratio and overall dosage. With inhaled dosage forms, start with one 3-5 second inhale, hold your breath for 5-10 seconds and exhale. Wait 15-30 minutes before inhaling another dose until you are familiar with your comfort zone. For sublingual dosage forms, hold product under the tongue for 30-60 seconds before swallowing and allow 20-30 minutes before using another dose. For oral dosing (anything swallowed), wait 45-60 minutes before consuming another dose as the oral route has the longest onset time.

Increases in dose should be done slowly and as comfortable. When switching strains or dosage forms of cannabis, give your body time to adjust to something new and start slowly even if you are an experienced consumer. Until you are familiar with any new product, take it slow.

Cannabis, like any medication, may produce unwanted effects which can be frightening to those unaccustomed to its psychoactive effects. Dosing should always be approached with caution to minimize discomfort. Most side effects are associated with THC content; by choosing a strain or product also containing CBD, some of the THC related side effects can be reduced or eliminated. When addressing uncomfortable psychoactive side effects, the best approach is to remain calm, stay hydrated, breathe slowly, relax and take comfort in knowing that the feeling is temporary. A higher than necessary dose of cannabis is not associated with any damaging, permanent or long-term effects.

The goal of treatment is always to maintain an acceptable comfort level with the smallest effective dose in order to maximize therapeutic outcomes while minimizing side effects. With record keeping, diligence and awareness, we at PAH can help you establish a beneficial cannabis regimen to alleviate symptoms and improve overall quality of life.