You are about to start your basic Canna 101 online training. This lesson, the subsequent test and the zoom trainings is an abbreviated, yet comprehensive training in lieu of the full day live trainings.
You will be asked to schedule an oral exam after your have studied the following material. There are 25 questions that you will need to answer/explain. You will be allotted 2 minutes for each question, but you should be able to explain your answer in 30-45 seconds.
You will need to successfully answer at least 20 questions to earn your Master Cannabinologist® Certificate.
You should also plan to participate in at least 4 on-line zoom classes or sign up to view the recorded classes, each year.
Introduction to CBD
Cannabidiol (CBD) is a naturally occurring compound found in the flower of the cannabis plant, which has a rich history of medicinal use going back millennia. More recently, scientists and doctors worldwide have been testing and confirming the medicinal properties of CBD, deeming it safe and non-addictive.
CBD is a phytocannabinoid (“phyto” meaning 'derived from plants' and “cannabinoid” meaning it is one of over 100 compounds found in cannabis, which interact with cannabinoid receptors in the body and brain and alter neurotransmitter release), and it is closely related to its fellow phytocannabinoid, tetrahydrocannabinol (THC). THC is the compound that causes the high cannabis is famous for. CBD and THC are the most-studied compounds by far, though they are not the only beneficial cannabinoids.
CBD is non-intoxicating, unlike THC, because these compounds act differently and on different receptors in the brain and body. Depending on the ratio of CBD:TCH consumed, CBD can lessen or even neutralize the psychoactive effects of THC (which are what make a person feel “high”). This is great news for anyone who wants the therapeutic benefits of cannabis without the high, or just with a lesser high. CBD is therapeutically potent and easy to administer, making it an excellent option for first-time cannabis users.
Recent years have brought the advent of a much larger market for cannabis products, especially non-intoxicating CBD products. The increase in demand led to new innovations, which have changed the national conversation around cannabis as well as the therapeutic world itself. The question has moved from “Does cannabis have medical value?” to “How can we optimize the medical value of cannabis for different people?”
The Endocannabinoid System (ECS)
One of the primary ways that CBD and THC interact with the body is by mimicking and augmenting the effects of “endogenous cannabinoids”—naturally-occurring compounds in the body that are named for their similarity to compounds found in the cannabis plant. “Endocannabinoids” are part of the body's greater “endocannabinoid system”.
The Endocannibinoid System (ECS) is the communication system in the brain comprising cannabinoid receptors that induce a response in the body when activated, endocannabinoids that target these receptors (also known as signaling molecules), and the enzymes that break down the endocannabinoids.
There are two main types of cannabinoid receptors: CB1 and CB2. CB1 is highly expressed in the brain and regulates the release of neurotransmitters. It is also the primary psychoactive receptor. There are no CB1 receptors in the brainstem, which is why people can't overdose on cannabis the way they can overdose on other drugs. CB2, on the other hand, is expressed most in the body, and deals more with the immune system and anti-inflammatory properties.
The discovery of this system furthered our understanding of health and disease, resulted in major implications for nearly all areas of medical science, and explained how and why CBD and THC are such versatile compounds.
The ECS helps the body maintain homeostasis, which means it helps keep a person's internal environment stable and optimal regardless of that person's external environment. It regulates the everyday physiological processes that keep people alive—mood, energy level, memory, appetite, intestinal fortitude, immune activity, blood pressure, bone density, glucose metabolism, how people experience pain, stress, hunger, and more. It even protects nerves and cells. When something isn't quite right, the body activates the ECS to correct whatever is amiss.
When the ECS isn't functioning properly, whether it is deficient or overactive, the result is disease. The ECS is irregular in many pathological conditions. Using cannabis to regulate and improve the state of the ECS has potential therapeutic benefits in many diseases that affect humans. CBD and THC can slow or even stop disease progression in some cases.
Many people seek out alternatives to pharmaceuticals, whether it is out of a concern of experiencing side effects from pharmaceuticals or a wish to find a naturally-occurring therapeutic solution to their ills. Considering the low-risk profile of CBD, many people feel comfortable using it to supplement existing treatment plans.
Extensive scientific research–much of it sponsored by the U.S. government–and steady growth in anecdotal accounts from patients and physicians highlight CBD's potential as a treatment for a wide range of maladies and conditions, including (but not limited to):
· Autoimmune diseases (inflammation, rheumatoid arthritis)
· Neurological conditions (Alzheimer’s, dementia, Parkinson’s, multiple sclerosis, epilepsy,
Huntington’s chorea, stroke, traumatic brain injury)
· Metabolic syndrome (diabetes, obesity)
· Neuropsychiatric illness (autism, ADHD, PTSD, alcoholism, depression, anxiety)
· Gut disorders (colitis, Crohn’s)
· Cardiovascular dysfunction (atherosclerosis, arrhythmia)
· Skin disease (acne, dermatitis, psoriasis)
· Chronic pain, inflammation, and many other conditions
CBD has even been shown to stimulate neurogenesis, or the growth of new brain cells.
It is not just low-THC or no-THC products that hold health benefits, however. Many studies show that CBD works best in conjunction with THC and the full spectrum of cannabinoids found in the cannabis plant. THC has properties that are associated with easing nausea and pain, as well as serving as a muscle relaxant and a potent anti-inflammatory agent.
An example of how cannabinoids actually work can be found in how they treat pain. Pain is not actually pain until it reaches the brain—it starts out as cells communicating that something is wrong. When a patient has chronic pain, however, they don't really need the constant reminder that something in their body is not quite right—or, their body is misfiring and perceives pain where there shouldn't be any. Cannabinoids can block pain pathways that send information to the brain, which are used for telling the brain that it should be experiencing pain. They do this by slowing down the communication between nerve cells. This is accomplished by cannabinoids like THC and CBD inhibiting the release of glutamate, an excitatory neurotransmitter.
Another example of how cannabinoids work in the body is found in how they treat inflammation. Inflammation is a reaction on the body where skin reddens, warms, and swells, often as a result of injury, infection, or irritation. Inflammation is necessary for recovery and healing, but too much of it can damage tissue and cause much pain. Cannabinoids are excellent at decreasing inflammation. They bind to human immune cells by blocking enzymes that break down endocannabinoids, decreasing the release of chemical messengers (which leads to the decreased swelling and inflammation), and inhibiting tissue damage by decreasing the production of certain compounds.
It's important to understand that most health professionals are not educated about cannabis therapeutics and lack the expertise to adequately counsel patients regarding dosage, modes of administration, CBD/THC synergies, and risk factors, such as interactions with other drugs.
The U.S. Food and Drug Administration (FDA) first recognized CBD as medicine in 2018, when they approved Epidiolex, a nearly-pure pharmaceutical form of CBD. Epidiolex was approved as a treatment for two pediatric seizure disorders, Lennox-Gastaut syndrome and Dravet syndrome.
One might imagine that the common practice of “off label” prescribing (a practice where physicians prescribe pharmaceuticals “off label” to treat conditions that were not the focus of the clinical trials of the drug) might put Epidiolex in high demand. However, the hefty, $30,000+ annual price tag prevents tens of millions of Americans without health insurance from even being able to consider this drug for such “off label” prescribing.
Following the FDA's historic decision, the Drug Enforcement Administration (DEA) removed Epidiolex from Schedule I classification, meaning it was no longer considered a dangerous drug with no medical value. It was then considered Schedule V, meaning it was classified as one of the least dangerous controlled substances regulated by the DEA. It was later descheduled altogether and removed from the federal government's list of controlled substances.
However, cannabis and CBD (when derived from a plant with more than 0.3% THC) were left on Schedule I as illegal narcotic substances.
It is also important to consider the reason it took so long for the federal government to approve a cannabis-derived product as a medicine. This has largely to do with the “reefer madness” era 90 years ago, when anti-marijuana propaganda took the United States by storm. This had huge consequences for the public and governmental perception of the plant, and those consequences still affect us today.
While pharmaceutical CBD may be difficult to obtain, that doesn't mean CBD in general is hard to get. What do gas stations, coffee shops, internet storefronts, upscale boutiques, and health clubs have in common? Many of them sell hemp-derived CBD oil. Some even sell pure CBD isolates comparable in chemical make-up to Epidiolex. In states that have legalized cannabis for therapeutic use, there are also CBD oil products and flower available at dispensaries.
A massive consumer demand prompted a huge market for CBD oil products, and CBD oil became trendy and newsworthy, garnering praise from celebrities and average citizens alike.
CBD oil has been portrayed as a panacea for the sick, a preventive for the healthy, and a palliative for humans and other animals of all ages. Unfortunately, the growing awareness of cannabidiol as a potential health aide has led to widespread misinformation about CBD and cannabis therapeutics in general, and it doesn't help that the market is largely unregulated.
CBD Oil and hemp
CBD also catalyzed the revival of the U.S. hemp industry, which had gained an impressive layer of dust after decades of dormancy due to drug war politics. The 2018 Farm Bill includes a provision that legalizes the cultivation of hemp, largely because of the economic force that is CBD.
But what is hemp? Hemp is, legally speaking, all parts of the Cannabis Sativa plant with no more than 0.3% THC by dry weight, including derivatives, extracts, and cannabinoids, as redefined by the 2018 Farm Bill. This percentage is an arbitrary one, drawn up for a general distinction, not intended for any legal determination by those who came up with it. But the percentage was latched onto and has been clung to tightly by lawmakers ever since.
The revival of the hemp industry allows for easier access to CBD oil than ever before. However, a large problem with hemp-derived CBD oil products is that they are manufactured with minimal regulatory oversight, leading to inconsistent quality, poorly processed CBD oil tainted with contaminants, and chronic mislabeling. The CBD content in almost 70% of CBD products available online could be mislabeled, with 43% of products being underlabled and 26% overlabeled for CBD content.
The conscientious consumer who does their research, however, will find plenty of high-quality CBD oil products with correctly labeled CBD/THC content and no such contaminants. All it takes is a little vigilance, and that vigilance goes a long way.
What's the best source of CBD oil?
In terms of growing cannabis or hemp plants for CBD oil, the best source is organically grown, high-resin, CBD-rich cannabis—not low-resin industrial hemp. That's because the more resin there is in a plant, the more CBD there is to extract.
Industrial hemp contains less resin and thus less CBD, so one would need to grow a lot of it to get a small amount of CBD. Hemp is usually grown for fiber or seed oil, so CBD hasn't been high on the priority list for hemp development. Hemp also naturally draws toxins from the soil, which is great for the soil, but not great for people who want to make ingestible medicinal products.
The terpenes (organic compounds produced by plants associated with odor and enhancing the effects of cannabinoids) in resin repel predators, attract beneficial insects, and protect plants from blight—meaning that low-resin hemp is more vulnerable to pests and mold.
There are over 200 terpene compounds found naturally in cannabis. The signature terpene compounds in cannabis plants can actually be replicated with terpenes derived from other plants. Terpenes are also responsible for the entourage effect, or how the different parts of the cannabis plant work best together to enhance each other's effects—terpenes improve the effect of cannabinoids in a person's body.
Cannabis also has a wide array of flavanoids, which are phenolic compounds that contribute to color, taste, and aroma. These have their own medicinal benefits that are enhanced by the entourage effect.
Industrial hemp is less chemically diverse than high-resin cannabis, resulting in a lack of the terpenes and other cannabinoids that interact synergistically with CBD and THC to amplify therapeutic benefits.
However, farmers have been able to develop high-resin cannabis (also known as “marijuana”) with less than 0.3% THC, meeting the arbitrary threshold for legality. Since the source of CBD is critical to determining its legal status, these high-resin plants rich with CBD qualify for legally manufacturing CBD oil for medicinal and personal use. This could very well be a big boon to the industry, assuming it is cultivated and processed properly.
It is worthwhile to note that hemp-derived CBD products are widely available for purchase online and over the counter throughout the country, whereas marijuana-derived CBD products are only available in states with qualifying medical marijuana laws or in states with adult-use/recreational laws.
Types of Cannabis, Dosing, and Methods of Consumption
When exploring cannabis therapeutics, it is useful to understand many things, but especially the following: the three main types of cannabis; dosing; and methods of consumption. Knowing these three things can help a person to understand the wide variety of options awaiting exploration in the wide world of medicinal cannabis.
Different types of cannabis products
There are three main types of resin-rich cannabis and cannabis products:
· Type 1 (THC-dominant) – High THC, low CBD (famously intoxicating cannabis varietals)
· Type 2 (THC & CBD) – Mixed THC and CBD
(intoxicating, but not as intense as THC-dominant varietals)
· Type 3 (CBD-dominant) – High CBD, low THC (non-euphoric marijuana or hemp)
There are other types of cannabis cultivars that primarily express other cannabinoids like CBG or THCV, but those are quite rare and not particularly available for patients, so it's most important to examine the THC:CBD ratio for coming up with dosage strategies. Each of the above three types requires different dosage considerations.
The advice that applies to all of them, however, is “start low and go slow,” especially with THC titration (adjustment).
Some doctors advise new patients to ingest 1.25-2.5 mg THC before bedtime for two days, as a sort of starting block for the patient to build off of, allowing plenty of space for noting any unwanted side effects. If there are no unwanted effects, then the patient can increase the dose of THC by an additional 1.25-2.5 mg for another two days. Then, barring adverse effects, an increase may take place every other day until the patient achieves the desired effects.
TYPE 1 – TITRATING THC
When titrating Type 1, it's important to understand that adverse effects are mainly dependent upon THC and are dose-dependent. High doses are more likely to cause unwanted side effects, such as doses exceeding 20-30 mg of THC per day. Those doses can also make the patient more tolerant of the drug, making it less effective at that higher dose.
It's also good to know that THC and other cannabinoids have biphasic properties, meaning that low doses and high doses have opposite effects on the patient. A larger dose will sedate where a smaller dose will stimulate, making cannabis quite different from many other medications.
For patients who might need to ingest cannabis more than just at nighttime for adequate symptom relief, careful titration is urged. For the first two days of cannabis therapeutics, taking one small daytime dose of 2.5 mg THC is encouraged. Then, for days 3 and 4, increase to two doses of 2.5 mg each. Patients can continue to increase incrementally for up to 15 mg of THC per day. Eventually, dosage increases can end up producing weaker therapeutic benefits with more side effects. So, while increasing the dosage, patients should make sure to check in with themselves and note effects, side effects, and rate of tolerance buildup.
It's not too difficult to tell if someone is taking too much cannabis: the symptoms are mirrors of what the cannabis could be expected to relieve at healthier doses—nausea, anxiety, paranoia, disturbed sleep, and related maladies are common. For extreme overdoses, patients should be wary of hallucinations or even acute psychosis.
Introducing THC slowly and increasing the dosage gradually will minimize a patient's risk of adverse side effects and help them find their sweet spot effectively.
TYPE 2 – THC AND CBD: THE POWER COUPLE
CBD and THC work well as isolates, but they work even better together. They complement each other synergistically—CBD can enhance THC's anti-inflammatory and painkilling properties while reducing unwanted side effects. CBD can even make an ineffective dose of THC become an effective dose in some cases, magnifying the medical impact of a small amount of THC to allow people to experience the therapeutic benefits of THC without the high.
Since cannabis therapeutics is such a personalized field of medicine, there isn't any magic CBD:THC ratio that will work for everyone. A study published in the British Journal of Pain showed that when cancer patients who were not finding relief from opiates took a sublingual spray with a 1:1 CBD:THC ratio, the group that received the lowest dose of the spray experienced the most relief. The middle group experienced less relief, and the group with the highest dosage had the equivalent relief of a placebo but with more negative side effects. Navigating the world of CBD:THC medicine can be tricky, as some patients do benefit from a high dose regimen.
For patients who are new to cannabis therapeutics, starting with a low dose with more CBD than THC is common. Gradual increase of the CBD content, and if desired, the THC content, is the way to go. A few smaller doses throughout the day are more effective than one large dose. The patient needs to experiment and find the comfortable ratio of CBD:THC that works best for them.
TYPE 3 – FULL-SPECTRUM CBD-RICH EXTRACTS
If a patient wants to avoid THC entirely, high-dose CBD therapy is an excellent option to consider. The benefits of Type 3 CBD-dominant cannabis over CBD isolates are that Type 3 still includes terpenes and other cannabinoids, which enhance CBD's therapeutic benefits. Whole plant formulations are more effective and versatile than single-molecule cannabinoids.
Whole plant Type 3 cannabis also requires a lower dosage to be effective than a CBD isolate, resulting in fewer side effects and a lesser chance of problematic drug interactions. Full-spectrum products also have a wider therapeutic window, meaning that it's easier to find the right dose.
Dosing and methods of consumption
Cannabis comes in a plethora of different forms with an abundant range of potencies. But when production and distribution have yet to be standardized, it can be difficult to know where to begin. Luckily, there are many ways to try cannabis products, several of which are non-intoxicating, for those who want the healing without the high. Most methods of cannabis consumption fall into a handful of general categories, each with advantages, disadvantages, and unique effects.
There are four important factors to consider when determining what form of cannabis is right for a patient:
1. Onset: How quickly will the cannabinoids begin to work?
2. Dose: What does a reasonable starting dose* look like?
3. Distribution: Which parts of the body will be most affected?
4. Duration: How long will the effects last?
*Note: Dosage depends on quality of product and reason for use. Doses described below are based on managing the psychoactivity of THC.
EDIBLES & CAPSULES
· Onset: 1-2 hours.
· Dose: The threshold for mild psychoactive effects is 3 mg THC in most new users. Doses of CBD-rich products range from 5 mg to hundreds of milligrams. New users should become comfortable with being high before using edibles containing more than 5 mg of THC.
· Distribution: Absorbed through the gut and modified in the liver, then spreads fairly evenly throughout the body.
· Duration: Psychoactive effects subside after about 6 hours in most people. Other effects may last up to 12 hours.
Ingested cannabinoids are absorbed through the intestines and sent to the liver. It takes about an hour to feel effects when taken on an empty stomach, or up to three hours with food. People should not re-dose THC edibles for at least three hours after ingestion. Otherwise, people can get much more intoxicated than they intended (or are comfortable with), simply because they didn't wait long enough for the edible to “kick in”.
On the way to the liver, cannabinoids will interact with receptors in the gut, so the effect on conditions like irritable bowel syndrome will be more pronounced. The longer-lasting effect of edibles and capsules make them suitable for many chronic conditions.
TINCTURES & SUBLINGUAL
· Onset: 15 minutes to an hour.
· Dose: 2.5-5 mg of THC and CBD is a common starting dose. This could cause a slight high in new users.
· Distribution: Absorbed into the bloodstream in the mouth, then distributes evenly.
· Duration: After 6-8 hours, most of the THC and CBD has been metabolized or eliminated from the body.
Oral-mucosal drugs are absorbed directly into the blood vessels in the mouth and under the tongue. If sprayed under the tongue, the patient should try to wait at least one minute before swallowing (see Accidental Ingestion below.) Effects peak around an hour and a half after administration. For consistency, it is best to avoid eating immediately before or after using a tincture.
Oral mucosal tinctures usually come in one of two forms: an under-the-tongue spray or a dropper with a marking at a specific volume (usually 0.5 ml or 1.0 ml). This allows for consistent, measurable dosing. Pay close attention to the labels on these products. Products should be labeled with the dose of cannabinoids per spray or per ml.
Interestingly, some of the adverse side effects attributed to cannabis extracts may actually be due to ingesting large amounts of the carrier oil.
One must be careful when using sublingual sprays, because although they provide rapid and precise dosing, an accidental immediate swallow leads to the body processing most of the spray like an edible. This essentially means getting a lower dose over a longer period of time. If the product is just CBD, this might just make for a weaker effect. With accidental ingestion of a THC-rich tincture, however, people may take another dose after half an hour, thinking they haven't taken enough, which can lead to accidental THC intoxication.
INHALATION: SMOKING AND VAPING
· Onset: Seconds to minutes.
· Dose: As little as a puff may be necessary. A typical joint is 0.3 - 1.0 grams of cannabis.
· Distribution: Affects the lungs immediately, then the heart and brain, and then is distributed fairly evenly throughout the body.
· Duration: Most effects, including psychoactivity, subside after 2-3 hours.
When drugs are inhaled through the lungs, they are sent to the brain before getting metabolized by the liver. This makes inhalation the fastest method for administering cannabis.
The short onset and duration make inhalation appropriate for acute problems (e.g. nausea or acute pain). The fast onset also allows patients to titrate and quickly find a desired dose. Overdosing (getting too high) is short-lived when inhaling as compared to other methods, which can be of comfort to those new to THC.
There are a wide variety of different ways to inhale cannabis products: smoke pipes, water pipes, cannabis cigarettes (“joints”), and more.
SMOKING VS. VAPING, BUD VS. OIL
To inhale cannabinoids, one needs to smoke or vaporize the flower. You can also vaporize or dab (vaporizing a concentrated form of cannabis extract on a hot surface and then inhaling the produced vapors) cannabis oil.
The problem with smoking is that it is harmful to the lungs. Smoking cannabis isn't associated with lung cancer or chronic obstructive pulmonary disease (COPD), but there are issues associated with breathing in any kind of smoke (chronic cough, congestion, asthma). Additionally, not all cannabinoids react the same way to being smoked or vaped; some work better with different methods of consumption than others.
Vaporizing has a slightly slower onset than smoking, but absorbs much better into the body, and it's generally better for the lungs. The problem with vaping is that certain additives in oil extracts and cartridges can break down into carcinogens when heated in a low-quality vaporizer. However, this isn't an issue when vaporizing flower instead of oil. Vaping also has less carbon monoxide, toxic gases, and tar, making it healthier than smoking. The lower temperatures required for vaping also results in less thermal damage to the patient's airways.
There isn't much research on the effects of vaporizing oil concentrates. Oil extracts have different terpene and cannabinoid profiles than the original plants they came from. However, the problem with flower is that it's very inconsistent—one can't always access the same plants to get the same flower. It's also difficult to dose consistently when inhaling in general, as the concentration of cannabinoids varies in flower and in oil, and the length of the patient's each inhalation will also vary.
When a new patient is going to smoke or vape THC-rich cannabis, they should start with one inhalation and wait for 15 minutes before dosing again, considering the swift effect of inhaled cannabis. Smoking and vaping are often used for acute distress, so if needed, one can inhale another puff every 15 to 30 minutes for symptom management until the desired effect is achieved.
Another benefit of cannabinoid therapeutics is that low doses of cannabinoids have not been shown to cause harmful interactions with other drugs. Low doses are all most people need to get the therapeutic benefits of cannabis. It's when people use hundreds or thousands of milligrams that their bodies might have a hard time breaking down other pharmaceuticals they are taking. However, people with certain conditions or who can only obtain CBD isolates should speak with their doctors if they wish or need to take high doses of CBD, so their doctors can help manage potential CBD-drug interactions.
However, to err on the side of caution, patients who are on blood thinners, seizure medications, or antibiotics should use caution, as well as those with cancer and/or seizures.
THC SENSITIVITY AND GENETICS
How psychoactive THC is depends on a person's metabolism of it. Around 20-25% of people with European descent have genetic mutations that slow the metabolism of THC, meaning that they may experience double or triple the dose they consumed. This effect is heightened further in edibles, so it is wise to understand one's sensitivity to THC before trying edibles. People of Asian and African descent can experience this mutation as well, though it is less common.
Topicals, such as balms, salves, lotions, and rubs are substances that a person puts on their skin, often used for skin or joint issues. These do not get absorbed into the bloodstream. Skin permeation seems to increase when there are terpenes and non-intoxicating acid cannabinoids (such as THCA and CBDA) present, but the topicals still do not enter the blood, and large concentrations of terpenes can irritate skin.
Topicals can be used to treat arthritis, pain, and inflammation. Some use them to supplement skincare routines and with other sun protection.
Transdermal products, like topical products, are applied to the skin, but their effects are wholly different. A transdermal patch is designed to release cannabinoids into the bloodstream at a constant rate. Some patches can have THC and those can lead people to experience psychoactivity.
The experiences of transdermal administration are similar to that of sublingual administration, though patches can be designed to last much longer. It is worthwhile to note, however, that a transdermal CBD isolate failed to treat epilepsy in a clinical trial where a sublingual CBD isolate was successful, so there are differences in how they affect the body.
Cannabinoids are not fond of dissolving in water due to chemical structure, but it is possible, allowing for the production of CBD and THC-infused beverages. The process of making CBD and TCH water soluble might also make them easier for one's body to absorb CBD and TCH, meaning they have a quicker onset than a typical edible and may have stronger doses over shorter periods of time.
Epidiolex, the pediatric seizure drug discussed earlier, is a good example of how children and adults metabolize drugs differently. Young children can actually tolerate high doses of cannabis oil concentrates, including THC-rich formulations that would affect an adult very differently. Dosage should not be calculated for children or adults based on what is good and effective for the other.
Other dosage variables:
· Cannabis experience: Is the patient new to cannabis, or are they a frequent user who just isn't getting good results? An experienced user might need a higher dose than a newcomer. Someone who uses cannabis multiple times daily might need a break from cannabis in order to “reboot” their sensitivity to cannabis.
· Time of day: Some patients benefit from using different CBD:THC ratios at different times of day—more CBD during the day and more THC at night.
· Preventive dosing: Extended low dose therapy can help manage chronic symptoms and may even help prevent disease recurrence. Cannabinoids have neuro- and cardioprotective properties that could limit the damage of traumatic brain injury or heart attack.
· Cannabinoid acids: Raw, unheated cannabis contains CBD and THC in their acid form, CBDA and THCA. These are non-intoxicating, and can be effective when consumed orally over several months in small quantity.
· Micro-dosing, or consuming sub-psychoactive to slightly-psychoactive doses of cannabis, is gaining popularity among individuals who want the medical benefits of cannabis without the high.
Part of the beauty of cannabis is how differently we all process it. The diversity of human experience means that discovering one's ideal form of cannabis consumption requires experimentation, just start slow and titrate up to find your body’s optimum comfort level.