Cannabis dosing and tolerance
Things would be a lot easier if there were just one
kind of Cannabis plant and doctors would have an easier task of recommending a
certain Cannabis dose. But the truth is that there are thousands of different
strains some very potent and others which don’t have much effect on the body or
mind. Different delivery routes also complicate the matter further because
different routes have different effects. Despite all these mysteries
surrounding Cannabis medicine dosage can be measured in order to achieve the
desired healing effect each patient is looking for. At the end of the day
dosing is relative to the potency of the THC content of the plant material. Dr
Donald Abrams MD is a Professor of Clinical
Medicine at the University of California
in San Francisco. He is one of the few medical doctors who have written
about Cannabis dosing. He offers final dosing recommendations which ii use in
my own medicine as a guideline. Plants which tests result in around 10% THC he
suggests a daily dose of between .15 to 5.55 grams which is a suitable dose for
most illnesses but certain cancers will need a much higher dose. As THC levels
increase dosage should decrease in grams. Cannabis testing at 20% THC for
example would reduce to a daily dosage of around .08 to 2.79 grams while 30%
THC would reduce to .01 to 1.86 grams and so on but the important thing to
consider is that dosage is an deeply individual issue and often ii will treat
two patients with the exact same medical diagnoses with different dosages and
again this is because of individual Cannabinoid receptor expression.
It really is true that less is more and ii am a huge
fan of micro dosing or miniscule dosing in my healing work and especially with
Cannabis medicine. Research is now starting to prove that just tiny amounts of
Cannabinoids can stimulate the body to make more Endocannabinoids and build
more receptors. This is exactly why so many first-time Cannabis users do not
feel any effects the first few times they consume but by the third or fourth
time, their bodies would have built more THC receptors and will be ready to
respond. More receptors increase a person's sensitivity to Cannabinoids; which
means that smaller doses have larger effects, and the individual has an
improved foundation for optimum Endocannabinoid activity by consuming just a
tiny dose of Cannabis on a regular basis. Some of my oldest patients in their
90’s already are literally consuming six raw Cannabis leaves a day as part of a
miniscule maintenance dosing plan. Other patients maintain their health with
daily doses Cannabis seeds while others might have established their personal tolerance
at say 10 ml of coconut infused Cannabis oil per day. Dosage consideration
requires a deep understanding of individual receptor expression in patients.
When
it comes to man-made drugs, it can be difficult to control the dose of synthetic
medicines and often the patient doesn’t really have a choice but to commit to
the medicine at the prescribed dose and endure whatever side effects come their
way. It starts becoming obvious that the whole herbal version of Cannabis can
offer many positive side effects which are not present in synthetic versions. The important thing to bear in mind is that synthetic
man-made Cannabis medicines are definitely not as effective as when working
with whole herbal plant extracts. Here
is a quote by Dr Ware of Health Canada, he says:
“By virtue of purifying
those resins, isolating them, and putting them into pharmaceutical products,
you sort of give rise to a more standardized and clean product…the challenge is
that even though we have these existing prescription cannabinoids that these
prescription medicines don’t seem to work the same way that the herbal product
does.”
This is the truth and ii really don’t mean to bash the
pharmaceutical industry because they do have a lot of excellent products which
are also helping many patients but it seems obvious that doctors will have to
educate themselves about whole herbal Cannabis healing and not only the synthetics
they will be allowed to sell. A lot of the doctors ii have worked with have
shown enough enthusiasm to learn about this complex and highly evolved plant by
realising that Cannabis medicine doesn’t really fit into any of the
conventional medical boxes and so it needs to be handled in its own right and
with individual treatment programs to be fully appreciated. The reason why the
actual plant cures more effectively than synthetics is because of The Entourage Effect. This is the
understanding that all of the plants chemical components must be present in the
recipe. All of the different Cannabinoids and terpene
profiles are involved in the healing process and they actually all have to work
together to achieve the magical healing properties we are seeing with whole
herbal Cannabis. We must all realize that THC and CBD are only a
part of the equation.
The concept of the Entourage Effect comes from the Hebrew
University in Israel from the laboratory of Professor Raphael Mechoulam and
describes how all of the chemical compounds of Cannabis must work together in
symphony to create the total of all the plant parts which then transcend to the
magic powers of this plant of renown. The entourage effect is the natural
combination of an array of the over 140 known Cannabinoids as well as hundreds
of other chemical components which together produce the specific natural
effects of whole herbal Cannabis. There are even terpenes and terpenoids of
which over 200 have already been identified and which also mimic the actions of
Cannabinoids and also have their own special healing powers so no-one really
knows the true number of chemical components within the Cannabis plant.
Potency as with other medical drugs is not only concerned
with how strong the effect of a medicine is but rather at what concentration or
dose these effects are achieved in different individuals. For instance THC and
CBD have different potencies at different targets because of the different ways
in which they interact with the different receptors and of course everyone’s
receptors work completely differently. This is important because at higher
doses THC and CBD are able to engage more targets. Estimating which doses are
needed to engage different targets is the secret to healing with this medicine.
The research involving my own recipe The
Cannabis Coconut Connection took 12 years of field study to bring to the
public after almost 20 years of growing and researching the human companion
plant. Over the years the challenge has always been to try to produce a quasi-standard
recipe for the most common ailments like insomnia, nausea, pain, inflammation,
menstrual problems, lack of appetite, obesity, constipation, headaches, high
blood pressure, depression, and anxiety. In general when working with a
Cannabis strain which records around 6 to 8% THC and a 1:1 ratio of THC to CBD
meaning that the CBD ratio would also be between 6 and 8% an effective formula
has proven to be 10 grams of pure Cannabis flowers to 100 ml of virgin organic
coconut oil to make small amounts of medicine.
One of the biggest differences between Cannabis medicine
and pharmaceutical drugs is that the pharmaceuticals generally only have high
potency at one specific target, meaning a specific receptor which they are
engineered to target. Cannabis targets all of our receptors and this is why
this medicine works so fast and so effectively for such a wide range of health
issues. This is also why Cannabis works so well with other pharmaceutical drugs
and this has been a blessing over the years as many doctors were not even aware
that their patients were taking Cannabis as part of their treatment. The truth is that Cannabis will never really be a medicine
which can be standardized and this is because our Cannabis receptor system is
as unique to each of us as our fingerprints so factors like receptor
expression, tolerance, dual purpose, retrograde transmission and the
chakra system also need to be understood. This is not only
because everyone is different it is also because no two Cannabis plants are the
same and even on the same plant no two buds or branches contain the exact same
chemical makeup. Nothing about the EC system is constant or predictable because
it is an everchanging system unlike any other system we have ever studied.
Establishing Cannabinoid tolerance also varies from
person to person especially in respect of the main psychoactive compound THC.
Scientists are actively studying the mechanisms which underlie the development
of this tolerance. And it is interesting to note that the extent to which any
one of these mechanisms is involved in the establishment of this tolerance
seems to be brain-area based and ii really believe that this is because the
brain is the main target of THC. In chapter 8 we will take a closer look at the
psychedelic properties of the plant.
Many medical practitioners and paediatricians and even
veterinarians continue to be amazed at the virtually miraculous healing
abilities of the Cannabis plant and truly this plant has shown us many miracles
which people continue to experience even when doctors say there is no hope.
Many people have seen me at their death bed and then weeks later we are
drinking tea together. A lot of doctors must be wondering if Cannabis medicine
will work for their patients but they don’t really know anything about how the
medicine works or even if it is a real medicine. Some doctors feel that once
Cannabis is legal for everyone there doesn’t seem to be any point in doctors
prescribing it. Doctors can expect obvious questions from patients such as “How much to take? When to take it? And what type of effects will be felt?” These are
the type of things you should be able to discuss with your doctor or health
care provider. And there will always be a need for whole herbal Cannabis
dispensing because not everyone likes gardening and most people are either too
busy or too ill to tend plants. So doctors will still need to assist in making
this medicine available to their patients where they can be sure that it
contains what the label says it contains and possibly has been tested for
toxins and heavy metals.
The truth is that there are
many people producing various Cannabis medicines and often ii think there are
more producers than patients but the fact is that you really do not know what
is in these products and the only way to be totally sure of what you are
consuming is to grow the plants yourself and produce your own medication
otherwise you will need to put your trust in another human being who really is
no more qualified than yourself. Many doctors today are in fact aware of the
medicinal healing properties of Cannabis and everyone should be urged to
discuss this very serious matter with their health care practitioners to find
the best solution for their personal medical disorders. It is quite possible
for conventional and natural medical practitioners to work together for the
overall healing of the people. We can see how more and more doctors are beginning
to realise the truth about Cannabis however they lack the scientific research
to adequately administer this medication in its natural form.
Going forward more and more people will need information
from their doctors about Cannabis medicine because it is helpful for so many
day to day complaints. Doctors must not feel awkward when discussing Cannabis
with their patients even though the patient might be far more informed. It is important to rather focus on the
evidence of the healing abilities of the plant and realise that this is a
barrier which needs to be broken down for the benefit of everyone especially
sick children and their suffering parents.
While most doctors are approachable and are accustomed to
discussing alternative treatments if your doctor is unfamiliar or hesitant to
prescribe it you should take it upon yourself to explain the science and medical
support for your specific experiences because the best way to approach your
doctor is from a position of knowledge and this is exactly how a lot of doctors
will learn about Cannabis medicine from their patients. My limited medical
training was most helpful because a healer can be very gifted but at times it
does become necessary to confer with doctors on various patients when a medical
treatment becomes the more appropriate intervention. Without this training it
is not easy to communicate with the medical professionals so healers with
training and practice in western medicine automatically bring something extra
to their work and can act as a bridge between the traditional world and the
medical world. The biggest difference between doctors and traditional healers
is that we are shown through our connection to the ancestors the exact nature
of a patient’s problem. It is different from listening through a stethoscope to
find clues to form an opinion. This is how we are able to tell the patient
exactly what they are feeling and what symptoms they are experiencing before
they even begin to speak. No one can do this no matter how many medical degrees
they might have or how successful their medical practise is. And if you as a
patient have to tell a traditional healer what is wrong with you then you can
be sure that this is not a genuine healer. As a healer ii really value
cooperation with medical professionals and ii have tried to cultivate
relationships where we each respect one another and many doctors have told that
ii have wonderful medicine. They want to know more about it and they refer
patients to me because ii specialise in some areas and they specialise in other
areas and we should refer to each other for our own specialities as we do
amongst ourselves as well.
Medical professionals must try to understand the myths,
the facts, the fears, the challenges as well as the rewards of working with
this medicine in order to become a dependable doctor who can confidently treat
patients with Cannabis medicine. They need to understand the different delivery
routes of this medicine and why it is so important to choose the appropriate
method for each individual patient. Individual personalised treatment is one of
the core principals of prescribing Cannabis medicine. It is my hope that
doctors might see this as an opportunity to provide an excellent healing
service to their patients and to actually cure them so we need doctors and
patients to have an open mind about Cannabis medicine. Personally ii feel that
the doctors who will benefit the most are the paediatric neurologists
especially when treating epilepsy for instance. No one can say that there is
not enough research or evidence to prove that Cannabis is helping thousands of
epileptic children and their families to live relatively normal lives.
Acknowledging the sacred relationship between Cannabis
and humans is what will determine whether doctors and healers will comprehend
the intricate network of the true natural healing powers of the Cannabis plant
and its receptors in our bodies. In the future ii would like to see Cannabis
being the first port of call for preventative and curative treatment through
the focus on receptor expression rather than a last resort.
We really do need more cooperation between doctors and healers
throughout the world. We all have our specialities, our strengths and
weaknesses. We must refer to other healers and doctors who are best able to
assist the patient. Some diseases are better treated with traditional herbs
while others respond best to western medicine. For example western procedures
are seen as best for emergency and critical care and most healers will have an
ambulance on standby for such cases. Hospitals are able to replace patient’s
fluids if they become dehydrated and can offer blood transfusions where
necessary. Millions of people especially in Africa have placed their faith in
traditional healing for generations, yet they hear about the miracles of modern
science. As health care providers we must all try to offer patients the best of
both worlds. Not so long ago it was unacceptable for the medical community to
work with traditional healers but now we are reaching out to the doctors and
visiting their clinics. Today we can see that this cooperation will only grow
stronger and stronger and have great benefits for everyone.
