Medical cannabis is a highly personal affair. When it comes to finding the perfect dose, dozens of variables factor into the equation. Differences in product types, potencies, individual genetics, weight, age, and so on produce unique experiences every time an individual chooses to consume cannabis.
With so little research available, it requires an ongoing effort to determine the best cannabis dose for each person’s specific medical needs. Doctors are a good starting point. However, it’s helpful to know how different factors play into your cannabis experience. This knowledge can empower you to make informed, safe decisions about your medical cannabis use.
In this article, we take a deep dive into finding the optimal dose, how to incrementally adjust the dose, and what to keep in mind when using different forms of medical cannabis.
Important Factors to Consider
Every person has a unique endocannabinoid system (ECS) and, as such, a different response when they consume cannabis. It’s essential to know what type of product at what potency produces what kind of response. Determine your medical cannabis goals and slowly work to find what allows you to reach those goals.
Some patients find success with 1 milligram of cannabis, while others require much more potent doses. However, while higher doses will have more potent effects for a time, subsequent dose increases will result in weaker effects accompanied by more adverse reactions. And the highest dose is hardly the most cost-effective. Medical marijuana is expensive, and consuming more doesn’t necessarily equate to more relief.
The optimal dose, then, is the lowest amount that provides adequate therapeutic relief without adverse effects.
The Therapeutic Window
A therapeutic window is a period in which one can observe measurable therapeutic effects, while adverse side effects are avoided.
The therapeutic window for novice cannabis users is much narrower than for seasoned consumers. The ECS is a highly tuned instrument that responds to overstimulation by diminishing cannabinoid receptors, meaning higher doses will be required to achieve the same therapeutic effect. With higher doses come higher chances of adverse effects. .
Clearly, there’s an upper limit to cannabis’ effectiveness. While to date, there is no known lethal dose to cannabis, it’s possible to experience unwanted anxiety or paranoia by consuming too much.
This is where incremental dosing comes into play.
Except in some states, physicians aren’t allowed to provide patients with a specific medical marijuana dose, as they would for other prescription drugs. Therefore these patients must gradually increase doing to figure out what works best for their physiology, symptoms, and cannabis goals.
Check for Cannabinoids
It’s essential to know precisely what’s in a medical cannabis product before purchase. Check the label for cannabinoid percentages (potency) and terpene content, which plays an important role in cultivar-associated experiences via the entourage effect.
The cannabinoid makeup of a medical marijuana product can dramatically affect the users’ experience. THC, the most well-known cannabinoid, is responsible for the psychoactive intoxication of cannabis and may provide a host of medicinal properties. CBD, the plant’s second-most abundant cannabinoid, has its own list of reputed therapeutic benefits, as well as overlapping qualities while acting on different physiological mechanisms than THC.
By starting with lower levels of potency, patients allow the ECS to self-correct and achieve equilibrium. Less potency will be needed for maintenance, reducing tolerance build-up, unwanted side-effects, and financial expenditure in the long run.
A clean slate allows you to establish a tolerance baseline from which you can determine your optimal cannabis dose. In an interview with Marijuana.com, Dr. Chris Emerson recommended regular users start with a 48-hour break to reset the system. More seasoned cannabis users might require a more extended tolerance break.
After the break, try a three-milligram dose of THC. Observe and write down how it feels. The next day, try three milligrams of CBD and observe those effects. Take the next week to try different combinations of THC and CBD while keeping the total less than 3 mg.
As you establish a baseline, you can begin to experiment with more precise doses. Keep your medical cannabis goals in mind as you mix different ratios, try dosing at various times during the day, timing meals with your dose, etc. From here, you can steadily increase your dosage in small increments as needed until you reach the lowest amount that delivers your desired results.
Microdosing is also increasing in popularity as people seek the therapeutic benefits of cannabis without diminishing cognitive capacity. Some users start with 1 to 2.5 mg, just enough to mitigate symptoms that would otherwise affect their ability to work.
Dosing Considerations for Different Product Types
Optimum dosing depends on the type of cannabis product. Some offer more consistent and precise options than others. Edibles, for example, can be broken into smaller serving sizes, whereas flower potency ranges based on cultivar type, its growing conditions, bioavailability, and cannabinoid makeup. Other products offer an innately more potent experience, such as dabbing concentrates, while others have longer onsets and durations.
Smoking cannabis flower provides a quick onset of effects within seconds of inhalation, hitting a peak at around 30 minutes, after which it lasts anywhere from one to three hours.
Each strain, or cultivar of marijuana flower varies in potency and cannabinoid content, and differences often exist in strains with the same name. A cannabis plant’s compounds can change based on it’s growing conditions and how it’s cured and dried. Purchasing a product from the same cultivator or brand help ensure a similar experience every time.
However, it’s difficult to accurately dose cannabis flower, even when it’s purchased from the same breeder and crop. Say a lab result reports that a strain has 10% THC, and you are buying one gram. This means that there are 100 milligrams of THC in the amount you purchased. When smoked, only approximately 50% of the THC in flower enters the bloodstream while the remainder burns off, leaving behind 50 mg of cannabis in our example. At this point, it’s hard to separate a single gram into several doses without guessing.
A good starting point is taking one or two hits off a small bowl and waiting up to an hour to see how you feel. You can always smoke more if you don’t achieve the desired result.
Vaporizers heat cannabis flower or extracts to their vaporization point, at which consumers inhale the vaporized trichomes and terpenes. Effects appear within seconds, peak within 15 minutes, and last anywhere between one and three hours.
Vaping flower presents similar challenges to smoking it, namely how to measure doses precisely. Vape cartridges, alternatively, typically show THC percentages on the box, and some manufacturers give a rough estimate of how many hits are in a single cartridge.
Cannabis oil, another vaping choice, is also more potent than flower, so fewer hits introduce more cannabinoids to your system.
Dabs are usually sold in half-gram or full gram amounts. If a dab has 60% potency, there are 600mg of THC in a gram of the concentrate.
Some types of concentrates are easier to break into smaller portions than others. Shatter, for instance, can be cut into even pieces and weighed on a small scale. Wax or resin, on the other hand, don’t lend themselves to easy measuring. Most consumers recommend starting with a single dab no bigger than the tip of a nail or ballpoint pen.
Using the right tool also makes it easier to portion a precise dab dose. A sharp, flat tool will more easily slice shatter, while a spoon scoops up more precise servings of gooey rosin.
Remember, start low and go slow. Dabs aren’t for the faint of heart. They are recommended for seasoned users or those who require more substantial doses.
The body processes THC in edibles differently than other cannabis products. After digestion, the liver transforms THC into 11-hydroxy-THC, a compound that’s more potent than THC, lasts longer, and has more sedating properties. It takes 45 to 60 minutes for edibles to kick in and effects last for up to six hours, depending on the dose and an individual’s metabolism.
Edibles’ packaging will list cannabinoid potency in milligrams per product. Many professional edible producers will evenly mix cannabinoids throughout the food, which allows consumers to divide it into smaller serving sizes. For example, an infused chocolate bar may contain 50 mg of THC total and be easily broken into 10 pieces of five milligrams each.
This precise division makes consuming smaller doses easier and produces more consistent effects. With edibles, it’s advisable to start with a low dose, such as one to five milligrams. Wait 24 hours to evaluate the dose’s efficacy and slowly increase by 1 mg every 24 hours until you reach the desired relief.
Tinctures are meant to be absorbed in the mouth. This requires a person to use their tongue to rub the product in, under the tongue and inside of the cheeks, allowing the product to remain in the mouth for 2-3 minutes. If a tincture is swallowed before it is fully absorbed, it acts more like an edible, and the effects can last up to 6 hours. Many patients use tinctures this way before bed, as a sleep aid.
Topicals are lotions, ointments, or transdermal patches that are usually non-intoxicating and provide relief for a host of benefits. Because they don’t present adverse side effects, topicals are an excellent choice for novice cannabis users or those with a low-THC tolerance.
In order to reap the benefits of topicals, they must be fully absorbed into the skin. This requires rubbing the product (such as a lotion) all the way in, until the skin is essentially dry. Many patients report the best results when they apply topicals frequently, up to every two hours.