{"id":4384,"date":"2020-07-16T01:09:08","date_gmt":"2020-07-16T06:09:08","guid":{"rendered":"http:\/\/anandamidagardens.com\/the-optimal-dose-of-cannabis-from-a-doctors-perspective\/"},"modified":"2020-07-25T16:08:08","modified_gmt":"2020-07-25T21:08:08","slug":"the-optimal-dose-of-cannabis-from-a-doctors-perspective","status":"publish","type":"post","link":"https:\/\/anandamidagardens.com\/en\/the-optimal-dose-of-cannabis-from-a-doctors-perspective\/","title":{"rendered":"The optimal dose of cannabis from a doctor’s perspective."},"content":{"rendered":"\n

Dr.\nDustin Sulak<\/strong><\/h2>\n\n\n\n

The\ndosage is the key factor to achieve the greatest benefits and the least\nadverse effects of cannabis. After following thousands of patients who\nused medicinal cannabis for eight years, I have observed that the dosage\ncannabis is unlike any therapeutic agent I was exposed to\nin my medical training. A basic understanding of key features\nCannabis dosage can help you make the most of this plant\nincredibly versatile, safe and effective.<\/p>\n\n\n\n

Some\npatients effectively use small amounts of cannabis, while\nothers use incredibly high doses. I’ve seen adult patients achieve\ntherapeutic effects with 1 mg of total cannabinoids daily, while\nothers consume more than 2,000 mg a day without adverse effects. And although a range\n2000 times dosing is unusual for a drug, the\nresearchers haven’t killed monkeys at even 300 times higher doses\nthan the highest dose I have seen in the clinic.<\/p>\n\n\n\n

Relations\nmultiphasic dose-response<\/strong><\/h2>\n\n\n\n

Within\nthis unusually wide dosage range, cannabis exhibits a relationship\nunusual between dose and expected response. For most of the\nmedications, a higher dose will result in a more therapeutic effect\nstrong and a greater probability of adverse effects; this is described as a\nmonophasic dose-response relationship. Cannabis just doesn’t follow this\nPattern.<\/p>\n\n\n\n

For the\nmajority of cannabis users, gradually increase their dose by\nprinciple will have stronger effects; but after a certain point (exclusive\nof each individual), subsequent dose increases may have effects\nincreasingly weak therapeutic, accompanied by an increase in the non-\ndesired.<\/p>\n\n\n\n

Consumers who continue to increase their dose to very high levels can often regain some or all of the benefit previously lost, and sometimes find additional therapeutic effects that are not achieved at the lower doses. Por supuesto, las dosis ultra altas son mucho m\u00e1s caras y generalmente producen m\u00e1s efectos secundarios no deseados. A la mayor\u00eda de los pacientes les va mucho mejor con la dosis efectiva m\u00e1s baja.<\/p>\n\n\n\n

\"\"<\/figure><\/div>\n\n\n\n

For many\ncannabis users, this means that less can be more. In a study of 263 cancer\npatients treated with opioids with poorly controlled pain, the group receiving\n21 mg of THC and CBD combined each day experienced significant improvements in\npain levels, more than the group receiving 52 mg per day. The group receiving\n83 mg daily reduced their pain no better than placebo, but experienced more\nadverse effects.<\/p>\n\n\n\n

How is this\npossible? The endocannabinoid system is a highly adapted and sensitive\nphysiological infrastructure designed to maintain balance at the cellular\nlevel. When cannabinoid receptors are overstimulated with high doses of\ncannabis, the cells attract the receptors inward, where they are recycled or\ndegraded. As cannabinoid receptor levels decrease, the effects of cannabis will\nalso decrease, even (or especially) with dose escalation. This is known as\n“tolerance development,” something that many regular cannabis users\nhave experienced.<\/p>\n\n\n\n

Therapeutic\nwindow<\/strong><\/h2>\n\n\n\n

The term\n“therapeutic window” describes the range between the lowest effective\ndose and the dose that produces unwanted or intolerable side effects. People\nwith little or no experience of using cannabis often have a very narrow\ntherapeutic window, while regular users develop a wider therapeutic window.\nThis is due to the fact that people develop tolerance to the various effects of\ncannabis at different speeds, and most develop tolerance to the unwanted effects\nfaster than the desired effects.<\/p>\n\n\n\n

Bidirectional\neffects of cannabis<\/strong><\/h2>\n\n\n\n

Cannabis\nalso has the ability to produce opposite (or bidirectional) effects in\ndifferent people, with different strains, and in different doses. For example,\nanxious people who take cannabis can relax while non-anxious people who take\nthe same dose can become anxious. The same dose of two different varieties of\ncannabis can cause opposite effects: one can be an awakening strain and the\nother could make you sleepy.<\/p>\n\n\n\n

Interestingly,\nthe symptoms of a cannabis overdose reflect the symptoms one would expect\ncannabis to alleviate at the appropriate doses: nausea, vomiting, diarrhea,\nsweating, spasms, tremors, anxiety, panic attacks, paranoia, incoordination,\nand sleep disturbances. Extreme overdoses can lead to hallucinations and even\nacute psychosis.<\/p>\n\n\n\n

Fortunately,\nthese symptoms are self-limiting, and most people return to their normal state\nin 12 to 24 hours. Although a cannabis overdose can make a person feel like\nthey are dying, such an experience will not cause toxicity or permanent harm,\nexcept perhaps in people who have unstable cardiovascular or psychiatric\nconditions, or in the event of a disability leading to a accident.<\/p>\n\n\n\n

Combining\nCBD and THC<\/strong><\/h2>\n\n\n\n

CBD and THC\nhave many overlapping therapeutic qualities, including pain relief, anxiety,\nseizures, and nausea, although they work through different mechanisms of\naction. When combined, CBD and THC can enhance the benefits of each other while\nreducing the unwanted effects, including the psychoactive or harmful effects of\nTHC. This is great news for cannabis users who want health benefits while\nmaintaining optimal performance at home or work.<\/p>\n\n\n\n

By adding\nCBD to THC, the therapeutic window, described above, becomes even wider.\nHowever, consumers should know that the total dose of cannabinoids needed to\ntreat a symptom or condition will also increase.<\/p>\n\n\n\n

For\nexample, in a study of 177 patients with cancer pain, one group received a THC\noral spray, while another group received a combined THC and CBD oral spray in a\nratio of approximately 1: 1. Both groups were given he allowed his dose to be\ngradually increased until they experienced satisfactory relief. The THC group\nended up using an average of 27 mg daily, while the CBD + THC group used about\n60 total mg daily, but the CBD + THC group had a greater reduction in pain. I\nsuggest this to many patients: Combine CBD and THC for optimal benefits, but be\nprepared to take higher overall doses.<\/p>\n\n\n\n

Ultra low dose<\/strong><\/h2>\n\n\n\n

Some\npatients do well with ultra high doses (hundreds or thousands of milligrams\ndaily). THC users have to work slowly to reach these high doses, but many\npatients can quickly reach high doses of CBD without adverse effects. On the\nother hand, ultra low doses can be extremely effective, sometimes even more\nthan the other extreme.<\/p>\n\n\n\n

Most people\nare surprised to learn that the therapeutic effects of cannabis with dominant\nTHC can be achieved in lower doses than required to produce euphoria. Cannabis\nmicrodosing, taking a non-psychoactive or slightly psychoactive dose in order\nto improve health and productivity, has been gaining popularity.<\/p>\n\n\n\n

People\nreport better mood, reduced anxiety, improved focus, increased stress\nresistance, less pain (and \/ or less bothersome pain), and other benefits\nwithout adverse effects. Most consumers find that 1-5mg works well for this\npurpose. Some emerging evidence even suggests that a practice like this could\nbe protective against damage from a heart attack or brain injury.<\/p>\n\n\n\n

Recommendations\nfor new and experienced consumers<\/strong><\/h2>\n\n\n\n

For new\ncannabis users, I adhere to an old adage I learned from one of my geriatric\ninstructors: “Start low, go slow, and don’t be afraid to go all the\nway.” I developed an easy-to-follow program to help you find your optimal\ndose, along with other helpful resources, such as a medicinal cannabis shopping\nguide, available for free at Healer.com.<\/p>\n\n\n\n

For\nexisting users who may have developed a certain tolerance for cannabis, I\nencourage you to try my 6-day awareness protocol, which has helped thousands of\npeople reduce their cannabis dose by 50% or more while improving benefits. If\nyou have not tried non-inhaled administration methods such as tinctures or\nsprays, and if you have not experimented with the combination of CBD and THC, I\nsuspect that both efforts will help you continue to unlock all the power of\nthis amazing plant.\n\nPosted by Leafly in February 2018\n\n\n\n<\/p>\n\n\n\n

References<\/strong><\/h2>\n\n\n\n
\n\n\n\n

\u00b7Thompson\nGR, et al. Oral and intravenous toxicity of \u03949-tetrahydrocannabinol in rhesus monkeys. Toxicology and Applied\nPharmacology.<\/em> 1974;27(3):648-665.<\/p>\n\n\n\n

\u00b7Portenoy\nRK, et al. Nabiximols for opioid-treated cancer patients with poorly-controlled\nchronic pain: A randomized, placebo-controlled, graded-dose trial. The\nJournal of Pain.<\/em>2012;13(5):438-449.<\/p>\n\n\n\n

\u00b7Hsieh C,\net al. Internalization and recycling of the CB1 cannabinoid receptor. Journal\nof Neurochemistry.<\/em> 1999;73(2):493-501.<\/p>\n\n\n\n

\u00b7Johnson\nJR, et al. \u201cMulticenter, double-blind, randomized, placebo-controlled,\nparallel-group study of the efficacy, safety, and tolerability of THC: CBD\nextract and THC extract in patients with intractable cancer-related\npain.\u201d Journal of Pain and Symptom Management.<\/em>2010;39(2): 167-179.<\/p>\n\n\n\n

\u00b7Waldman M,\net al. An ultra-low dose of tetrahydrocannabinol provides\ncardioprotection. Biochemical Pharmacology.<\/em> 2013;85(11):1626-1633.<\/p>\n\n\n\n

\u00b7Johnson-Sasso\nCP, Kao D, Walker LA. marijuana use and short-term outcomes in patients\nhospitalized for acute myocardial infarction. Journal of the American\nCollege of Cardiology.<\/em>2016;67(13):569.<\/p>\n\n\n\n

\u00b7Fern\u00e1ndez-Ruiz\nJ, Moro MA, Mart\u00ednez-Orgado J. Cannabinoids in neurodegenerative disorders and\nstroke\/brain trauma: From preclinical models to clinical applications. Neurotherapeutics.<\/em> 2015;12(4):793-806.<\/p>\n\n\n\n

\u00b7Nguyen BM,\net al. Effect of marijuana use on outcomes in traumatic brain injury. The\nAmerican Surgeon.<\/em> 2014;80(10):979-983.<\/p>\n\n\n\n

\u00b7Di Napoli\nM, et al. Prior cannabis use is associated with outcome after intracerebral\nhemorrhage. Cerebrovascular\nDiseases.<\/em> 2016;41(5-6):248-255.<\/p>\n","protected":false},"excerpt":{"rendered":"

Dr. Dustin Sulak The dosage is the key factor to achieve the greatest benefits and the least adverse effects of…<\/p>\n","protected":false},"author":2,"featured_media":4467,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[70,69],"tags":[],"yoast_head":"\nThe optimal dose of cannabis from a doctor's perspective. - Anandamida Gardens<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/anandamidagardens.com\/en\/the-optimal-dose-of-cannabis-from-a-doctors-perspective\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"The optimal dose of cannabis from a doctor's perspective. - Anandamida Gardens\" \/>\n<meta property=\"og:description\" content=\"Dr. Dustin Sulak The dosage is the key factor to achieve the greatest benefits and the least adverse effects of...\" \/>\n<meta property=\"og:url\" content=\"https:\/\/anandamidagardens.com\/en\/the-optimal-dose-of-cannabis-from-a-doctors-perspective\/\" \/>\n<meta property=\"og:site_name\" content=\"Anandamida Gardens\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/anandamidagardens\" \/>\n<meta property=\"article:published_time\" content=\"2020-07-16T06:09:08+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2020-07-25T21:08:08+00:00\" \/>\n<meta property=\"og:image\" content=\"http:\/\/anandamidagardens.com\/wp-content\/uploads\/2020\/07\/Dosing-web.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"2000\" \/>\n\t<meta property=\"og:image:height\" content=\"1336\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:creator\" content=\"@Anandagardens\" \/>\n<meta name=\"twitter:site\" content=\"@Anandagardens\" \/>\n<meta name=\"twitter:label1\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data1\" content=\"7 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"Organization\",\"@id\":\"https:\/\/anandamidagardens.com\/#organization\",\"name\":\"Anandamida Gardens\",\"url\":\"https:\/\/anandamidagardens.com\/\",\"sameAs\":[\"https:\/\/www.facebook.com\/anandamidagardens\",\"https:\/\/www.instagram.com\/anandamidagardens\/\",\"https:\/\/www.linkedin.com\/company\/anandamidagardens\/?viewAsMember=true\",\"https:\/\/www.youtube.com\/channel\/UCex9mrYYN26Kd9WNCb6dQgw\",\"https:\/\/twitter.com\/Anandagardens\"],\"logo\":{\"@type\":\"ImageObject\",\"@id\":\"https:\/\/anandamidagardens.com\/#logo\",\"inLanguage\":\"en-US\",\"url\":\"https:\/\/anandamidagardens.com\/wp-content\/uploads\/2016\/04\/Logo-AG17.png\",\"contentUrl\":\"https:\/\/anandamidagardens.com\/wp-content\/uploads\/2016\/04\/Logo-AG17.png\",\"width\":1906,\"height\":541,\"caption\":\"Anandamida Gardens\"},\"image\":{\"@id\":\"https:\/\/anandamidagardens.com\/#logo\"}},{\"@type\":\"WebSite\",\"@id\":\"https:\/\/anandamidagardens.com\/#website\",\"url\":\"https:\/\/anandamidagardens.com\/\",\"name\":\"Anandamida Gardens\",\"description\":\"\",\"publisher\":{\"@id\":\"https:\/\/anandamidagardens.com\/#organization\"},\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\/\/anandamidagardens.com\/?s={search_term_string}\"},\"query-input\":\"required name=search_term_string\"}],\"inLanguage\":\"en-US\"},{\"@type\":\"ImageObject\",\"@id\":\"https:\/\/anandamidagardens.com\/en\/the-optimal-dose-of-cannabis-from-a-doctors-perspective\/#primaryimage\",\"inLanguage\":\"en-US\",\"url\":\"https:\/\/anandamidagardens.com\/wp-content\/uploads\/2020\/07\/Dosing-web.jpg\",\"contentUrl\":\"https:\/\/anandamidagardens.com\/wp-content\/uploads\/2020\/07\/Dosing-web.jpg\",\"width\":2000,\"height\":1336},{\"@type\":\"WebPage\",\"@id\":\"https:\/\/anandamidagardens.com\/en\/the-optimal-dose-of-cannabis-from-a-doctors-perspective\/#webpage\",\"url\":\"https:\/\/anandamidagardens.com\/en\/the-optimal-dose-of-cannabis-from-a-doctors-perspective\/\",\"name\":\"The optimal dose of cannabis from a doctor's perspective. - Anandamida Gardens\",\"isPartOf\":{\"@id\":\"https:\/\/anandamidagardens.com\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\/\/anandamidagardens.com\/en\/the-optimal-dose-of-cannabis-from-a-doctors-perspective\/#primaryimage\"},\"datePublished\":\"2020-07-16T06:09:08+00:00\",\"dateModified\":\"2020-07-25T21:08:08+00:00\",\"breadcrumb\":{\"@id\":\"https:\/\/anandamidagardens.com\/en\/the-optimal-dose-of-cannabis-from-a-doctors-perspective\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\/\/anandamidagardens.com\/en\/the-optimal-dose-of-cannabis-from-a-doctors-perspective\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/anandamidagardens.com\/en\/the-optimal-dose-of-cannabis-from-a-doctors-perspective\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Portada\",\"item\":\"https:\/\/anandamidagardens.com\/en\/home\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"The optimal dose of cannabis from a doctor’s perspective.\"}]},{\"@type\":\"Article\",\"@id\":\"https:\/\/anandamidagardens.com\/en\/the-optimal-dose-of-cannabis-from-a-doctors-perspective\/#article\",\"isPartOf\":{\"@id\":\"https:\/\/anandamidagardens.com\/en\/the-optimal-dose-of-cannabis-from-a-doctors-perspective\/#webpage\"},\"author\":{\"@id\":\"https:\/\/anandamidagardens.com\/#\/schema\/person\/71c310421c6a533eb9db8a53fb308b8f\"},\"headline\":\"The optimal dose of cannabis from a doctor’s perspective.\",\"datePublished\":\"2020-07-16T06:09:08+00:00\",\"dateModified\":\"2020-07-25T21:08:08+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\/\/anandamidagardens.com\/en\/the-optimal-dose-of-cannabis-from-a-doctors-perspective\/#webpage\"},\"wordCount\":1440,\"publisher\":{\"@id\":\"https:\/\/anandamidagardens.com\/#organization\"},\"image\":{\"@id\":\"https:\/\/anandamidagardens.com\/en\/the-optimal-dose-of-cannabis-from-a-doctors-perspective\/#primaryimage\"},\"thumbnailUrl\":\"https:\/\/anandamidagardens.com\/wp-content\/uploads\/2020\/07\/Dosing-web.jpg\",\"articleSection\":[\"Clinics\",\"Informative\"],\"inLanguage\":\"en-US\"},{\"@type\":\"Person\",\"@id\":\"https:\/\/anandamidagardens.com\/#\/schema\/person\/71c310421c6a533eb9db8a53fb308b8f\",\"name\":\"Alexander Lyra\",\"image\":{\"@type\":\"ImageObject\",\"@id\":\"https:\/\/anandamidagardens.com\/#personlogo\",\"inLanguage\":\"en-US\",\"url\":\"https:\/\/secure.gravatar.com\/avatar\/68daf03bd2fa041b55368f5fcdc929f4?s=96&d=mm&r=g\",\"contentUrl\":\"https:\/\/secure.gravatar.com\/avatar\/68daf03bd2fa041b55368f5fcdc929f4?s=96&d=mm&r=g\",\"caption\":\"Alexander Lyra\"},\"url\":\"https:\/\/anandamidagardens.com\/en\/author\/lyradevega\/\"}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","_links":{"self":[{"href":"https:\/\/anandamidagardens.com\/en\/wp-json\/wp\/v2\/posts\/4384"}],"collection":[{"href":"https:\/\/anandamidagardens.com\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/anandamidagardens.com\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/anandamidagardens.com\/en\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/anandamidagardens.com\/en\/wp-json\/wp\/v2\/comments?post=4384"}],"version-history":[{"count":3,"href":"https:\/\/anandamidagardens.com\/en\/wp-json\/wp\/v2\/posts\/4384\/revisions"}],"predecessor-version":[{"id":4469,"href":"https:\/\/anandamidagardens.com\/en\/wp-json\/wp\/v2\/posts\/4384\/revisions\/4469"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/anandamidagardens.com\/en\/wp-json\/wp\/v2\/media\/4467"}],"wp:attachment":[{"href":"https:\/\/anandamidagardens.com\/en\/wp-json\/wp\/v2\/media?parent=4384"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/anandamidagardens.com\/en\/wp-json\/wp\/v2\/categories?post=4384"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/anandamidagardens.com\/en\/wp-json\/wp\/v2\/tags?post=4384"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}