For medical cannabis patients, finding the right dosage can be a journey. Age, genetics, other medications and health conditions, all play factors in how patients may respond to medical cannabis, making dosing an individualized process.

To help patients safely administer medical cannabis, we’ve developed the following educational information, which includes dosing guidelines.

About Cannabis

Believed to have originated in Asia, cannabis refers to the plant Cannabis sativa L.

Today, cannabis is cultivated globally. Its fast-growing nature, versatility, and ability to produce unique molecules have made it a rich source of food, fibre, and medicine.

While cannabis is known to produce more than 120 unique cannabinoids, many of these compounds have unknown or undefined pharmacological profiles.1

With the legalization of cannabis for recreational and medical purposes in Canada, however, a number of regulatory barriers have been lifted, allowing for further investigation into cannabinoid therapy.

THC vs. CBD

Delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) are among the most studied, primary active cannabinoids found in cannabis.

While THC has intoxicating effects, CBD is non-intoxicating, and has been shown to counteract the intoxicating effects of THC.2

Early research has pointed towards the utility of THC and CBD for managing chronic pain and other common comorbidities.3

 

The Endocannabinoid System

Humans have a wide-ranging endocannabinoid system (ECS). The ECS is a major neurotransmitter system believed to regulate homeostasis in many physiological processes, including those related to pain, inflammation, metabolism, and mood.4

The ECS produces two natural endocannabinoids – anandamide and 2-arachidonyl glycerol. These bind with, and influence the activity of, cannabinoid receptors (CB1 and CB2) in the brain, central nervous system, and immune cells.5

Plant-derived cannabinoids, such as THC and CBD in cannabis, also interact with the ECS. Both cannabinoids have been studied for their therapeutic value, including pain-relieving and anti-inflammatory properties.6

Cannabis Consumption & Effects

Cannabis dried flower can be inhaled through vapourization as an alternative to smoking. When inhaled, reaction times are fast (seconds to minutes), with acute effects lasting two to four hours, or longer.

When taking cannabis orally (through an oil, spray, infused food or beverage, or capsule), initial effects take longer to set in (between 30 minutes and as late as three or four hours after administration), and can last up to eight hours, or more, based on dosage.7

Lotions and balms infused with cannabis extracts can be applied topically for localized treatment. 8

Starting Low & Going Slow

To avoid over-consumption, it is advised patients start with a low dose and wait for the active ingredients to come into full effect before slowly increasing the dose over time.

Also referred to as titration, the low-and-slow method of determining dosage aims for maximum benefit without adverse effects.

Below is a sample dosing schedule for the titration of cannabis oils, which offer patients a consistent and accurate means of dosing that can easily be adjusted.9

Vapourization as a route of administration is subject to more variables, including the type of vapourizer used, size of chamber containing the input material, and depth and duration of inhalation.8

Although this can make titration more challenging, it’s generally advised to inhale once and wait for about 15-30 minutes before assessing effects and consuming any more dried cannabis. Speak to your healthcare practitioner about what is right for you.


Please note: Should any problematic effects occur, stop titration and consult with your prescribing healthcare practitioner.

Learn more

For questions or assistance, call us toll-free at 1-855-841-2009 ext. 4056, or email clientcare@greenrelief.ca.

 

*Owing to limited evidence on dosage and interval for vapourized cannabis and cannabis oils, there are no validated dosage recommendations for medical cannabis. As such, the information in this post is based upon best-available evidence.

 


Sources:

1. Turner SE, Williams CM, Iversen L, Whalley BJ. (2017). Molecular Pharmacology of Phytocannabinoids. In Phytocannabinoids, Unraveling the Complex Chemistry and Pharmacology of Cannabis sativa, Kinghorn AD, Falk H, Bissons S, Kobayashi J (eds). 2017; Springer International Publishing: Basel, pp. 61–101

2. Government of Canada. About Cannabis. https://www.canada.ca/en/health-canada/services/drugs-medication/cannabis/about.html. Accessed June 27, 2019.

3. Urits, I., Borchart, M., Hasegawa, M., Kochanski, J., Orhurhu, V., & Viswanath, O. (2019). An
Update of Current Cannabis-Based Pharmaceuticals in Pain Medicine. Pain and Therapy, 8 (1), 41–51. doi:10.1007/s40122-019-0114-4

4. Pacher, P. The Endocannabinoid System as an Emerging Target of Pharmacotherapy. Pharmacological Reviews 58, 389–462 (2006).

5. Galiegue, S. et al. Expression of Central and Peripheral Cannabinoid Receptors in Human Immune Tissues and Leukocyte Subpopulations. Eur. J. Biochem. 232, 54–61 (1995).

6. Di Marzo, V. & Piscitelli, F. The Endocannabinoid System and its Modulation by Phytocannabinoids. Neurotherapeutics 12, 692–698 (2015).

7. Government of Canada. Access to Cannabis for Medical Purposes Regulations – Daily Amount Fact Sheet (Dosage). https://www.canada.ca/en/health-canada/services/drugs-medication/cannabis/information-medical-practitioners/cannabis-medical-purposes-regulations-daily-amount-fact-sheet-dosage.html. Accessed August 9, 2019.

8. MacCallum, C.B. & Russo, E.B. Practical considerations in medical cannabis and administration and dosing. European Journal of Internal Medicine. 49, 12-19 (2018).