Medical Mondays | Back 2 Basic
WHICH IS BETTER OR ?
Cannabidiol and (The High Causer) are the power couple of cannabis therapeutics; they work best together. and interact synergistically to potentiate each other’s curative qualities. enhances ’s painkilling and anticancer properties, while lessening ’s psychoactivity. can also mitigate adverse effects caused by too much , such as anxiety and rapid heartbeat. When both compounds are present in sufficient amounts in the same cannabis strain or product, will lower the ceiling on the high while prolonging its duration. (“Relaxing but not intoxicating” is how one patient described -rich cannabis.) broadens the range of conditions treatable with cannabis, such as liver, cardiovascular and metabolic disorders, which may be less responsive to -dominant remedies. and both stimulate neurogenesis, the creation of new brain cells, in adult mammals.
WHAT’S THE BEST WAY TO TAKE ?
The most appropriate delivery system for -rich cannabis is one that provides an optimal dose for a desired duration with few unwanted side effects. -rich cannabis flower varietals for smoking or vaping are available in many medical marijuana dispensaries, but most patients prefer non-inhalable products made with cannabis oil concentrates. Although banned by federal law, measurable doses of potent -rich cannabis remedies are available in many non-smokable forms and can be utilized in various ways. The time of onset and duration of effect vary depending on the method of administration. -rich cannabis oil products can be taken sublingually, orally (as edibles, lozenges, beverages, tinctures, and gel caps), or applied topically. Concentrated cannabis oil extracts can also be heated and inhaled with a vape pen. Inhalation is good for treating acute symptoms that require immediate attention; the effects can be felt within a minute or two and typically last for a couple of hours. The effects of orally administered -rich cannabis oil can last for four hours or more, but the onset of effects is much slower (30-90 minutes) than inhalation.
CAN CURE EPILEPSY?
Cannabis has a rich history as a medicine for quelling seizures and convulsions going back thousands of years. In the mid-19th century, the Pharmacopeia listed cannabis tincture as a treatment for pediatric epilepsy, and subsequent scientific studies have documented the anticonvulsant effects of , , and whole plant cannabis. -dominant/low- cannabis strains and oil extracts can facilitate dramatic improvement in some children with intractable seizure disorders. Between 10-15 percent of severe childhood epileptics who are given oil products experience a near complete cessation of seizures; most improve (with a decrease but not total elimination of seizures); and some children have worse seizures when they take . Many parents of epileptic children have learned through trial and error that augmenting -rich oil by adding some —or better yet, , the unheated, non-psychoactive form of that’s present in raw cannabis flowers and leaves—helps with seizure control. The take-home message: Low- cannabis oil products don’t work for everyone. Patients of all ages need access to a wide spectrum of whole plant cannabis remedies, not just high oil.
WHAT IS THE RIGHT : RATIO FOR ME?
Cannabis therapeutics is personalized medicine. There is no single ratio or strain or product that’s right for everyone. Optimize your therapeutic use of cannabis by finding the proper combination of and that works best for you. A person’s sensitivity to is a key factor in determining the appropriate ratio and dosage of -rich medicine. Many people enjoy the cannabis high and can consume reasonable amounts of any cannabis product without feeling too high or dysphoric. Others find unpleasant. can lessen or neutralize the intoxicating effects of . So a greater ratio of -to- means less of a high. In some states with medical marijuana laws, cannabis oil concentrates and other products with varying ratios of : are available so users can adjust or minimize psychoactive effects to suit their needs and sensitivities. Those who don’t like have the option of healing without the high by using a -rich remedy with only a small amount of . But a low remedy, while not intoxicating, is not always the most effective treatment option. In essence, the goal is to administer consistent, measurable doses of a -rich remedy that includes as much as a person is comfortable with.
ARE SPECIFIC : RATIOS BETTER FOR DIFFERENT CONDITIONS?
Some patterns are beginning to emerge. For anxiety, depression, spasms, psychosis, and seizure disorders, many people report they do well starting with a small dose of a -rich remedy with little . For cancer, autism, and many other diseases, some say they benefit more from a balanced ratio of and . Extensive clinical trials conducted outside the United States have shown that a 1:1 : ratio can be effective for neuropathic pain. Note: The : ratio in not an indication of how much or is present in a given cannabis product or strain. Some people use cannabis products with different : ratios at different times of the day (more for sunlight hours, more at night). Almost any cannabis strain or product theoretically could benefit a wide range of autoimmune and inflammatory disorders because and other cannabis components activate the cannabinoid receptor, which regulates immune function.
WHAT IS THE OPTIMAL DOSAGE OF ?
An effective dosage can range from as little as a few milligrams of -enriched cannabis oil to a gram or more. Begin with a small dose of high /low oil, especially if you have little or no experience with cannabis. Take a few small doses over the course of the day rather than one big dose. Use the same dose and ratio for several days. Observe the effects and if necessary adjust the ratio or amount. Don’t overdo it. Cannabis compounds have biphasic properties, which means that low and high doses of the same substance can produce opposite effects. Small doses of cannabis tend to stimulate; large doses sedate. Too much , while not lethal, can amplify anxiety and mood disorders. has no known adverse side effects, but an excessive amount of could be less effective therapeutically than a moderate dose. “Less is more” is often the case with respect to cannabis therapy.
WHAT SHOULD ONE LOOK FOR WHEN CHOOSING A -RICH PRODUCT?
Look for products with clear labels showing the quantity and ratio of and per dose, a manufacturing date, and a batch number (for quality control). Select products with quality ingredients: No corn syrup, transfats, s, artificial additives, thinning agents or preservatives. -rich products should be lab tested for consistency and verified as being free of mold, bacteria, pesticides, solvent residues, and other contaminants. Best to avoid products extracted with toxic solvents like , propane, hexane or other hydrocarbons. Opt for products that utilize safer extraction methods such as supercritical or food-grade ethanol.
IF IS SO GOOD, WON’T PURE BE EVEN BETTER?
Single-molecule will inevitably become a federally approved Big Pharma medicine. Products infused with a crystalline isolate, derived and extensively refined from industrial hemp, are already being marketed by unregulated internet storefronts. But single-molecule is less effective therapeutically than whole plant -rich oil extract. Scientific studies have established that synthetic, single-molecule has a very narrow therapeutic window and requires precise, high doses for efficacy, whereas lower dose, whole-plant, -rich treatment regimens are already showing efficacy for many conditions among patients in medical marijuana states. Whether synthesized in a Big Pharma lab or derived from industrial hemp, single-molecule lacks critical secondary cannabinoids and other medicinal compounds found in high-resin cannabis strains. These compounds interact with and to enhance their therapeutic benefits. Scientists call this the “entourage effect.” Numerous cannabis compounds have medicinal attributes, but the therapeutic impact of whole plant cannabis is greater than the sum of its parts.
IS THERE A DIFFERENCE BETWEEN DERIVED FROM HEMP AND DERIVED FROM MARIJUANA?
If you live in a state where medical marijuana is legal and available, look for products made from high-resin cannabis (rather than low resin industrial hemp) that are sold in medical marijuana dispensaries. Unregulated hemp-derived -infused products of varying quality are also available via dozens of internet storefronts. Many of these products are mislabeled. Compared to whole plant -rich cannabis, industrial hemp grown for fiber or seed is typically low in cannabinoid content. A huge amount of fiber hemp is required to extract a small amount of , thereby raising the risk of contaminants because hemp, a bioaccumulator, draws toxins from the soil. That’s a great feature for restoring a poisoned ecosystem, but it’s not recommended for extracting medicinal oil. Heavily refined paste or terpene-free isolate crystal is poor starter material for formulating -rich oil products. The debate over sourcing from cannabis rather than hemp will soon be moot as plant breeders succeed in developing high-resin -rich cannabis varietals with lass than 0.3% , the arbitrarily designated legal limit for hemp.
IS IT SAFE TO INHALE HEMP OIL FUMES FROM A VAPE PEN?
Many cannabis- and hemp-derived vape oil products include a thinning agent, which dilutes the oil that is heated and inhaled by vape pen users.
Beware of vape pen oil that contains propylene glycol. When overheated, this chemical additive produces formaldehyde, a carcinogen, as a byproduct, according to a 2015 report in the New England Journal of Medicine. Look for products that entail a safer method of extraction like supercritical .
Other additives to avoid: polyethylene glycol (another thinning agent) and, in general, flavoring agents, especially cream and cinnamon flavors as these are very toxic and should never be heated and inhaled. Look for cartridges that contain only natural, cannabis-derived terpenes. That means that the flavor of your vape cartridge came directly from the cannabis flower from which it was extracted.
DOES HAVE ANY ADVERSE SIDE EFFECTS? WHAT ABOUT DRUG INTERACTIONS?
is a very safe substance, but it can interact with many common pharmaceuticals. At sufficient dosages, will deactivate cytochrome enzymes, thereby altering how we metabolize painkillers, statins, blood thinners, insulin more. -drug interactions can be dangerous, but they can also help mitigate side effects while synergistically improving a patient’s quality of life. Cannabinoid-opioid interactions show great therapeutic potential. enhances the painkilling effects of opiates, while is can reduce withdrawal and dependence. Patients taking Big Pharma meds should monitor changes in blood levels and, if need be, adjust dosage. Problematic interactions are more likely when consuming high doses of isolate products.
WILL BIG PHARMACEUTICAL COMPANIES CONTROL THE MARKET WHEN CANNABIS IS LEGALIZED FOR ADULT USE?
Only if we let them. Cannabis is a medicinal herb and it should be regulated as an herb, not as a pharmaceutical or a street drug.