The Science Behind Medical Cannabis Dosage

One of the topics of greatest interest to those wishing to start using medical cannabis or those healthcare professionals considering integrating the plant into their medical practice is dosing.

Dosing is a crucial process because with cannabis "more" does not mean "better". For this, we must remember that the endocannabinoid system, made up of cannabinoid and endocannabinoid receptors, is responsible for the state of homeostasis or balance of the organism, and when this system has any alteration, different conditions or diseases occur.

That is why when medical cannabis is consumed to alleviate certain symptoms or pathologies, the aim is to equalize the balance that usually modulates the endocannabinoid system.

Therefore, as each person has a cannabinoid system with different characteristics, the dosage of cannabis has not yet been standardized. At the moment, the dose of cannabis is individual, starting with a minimum dose that is progressively increased while evaluating the response during the treatment, until the optimal dose is reached. Once the optimal dose is identified, it should not be increased because in that case, it would be decreasing the effectiveness and tolerance, causing unwanted side effects to appear.

Recommendations:

Start with a CBD-dominant strain due to the safety profile of this cannabinoid. Purified CBD has been shown to be safe and well tolerated up to 6000 mg.
The starting dose of CBD has been considered to be between 20 - 40 mg/day, increasing in small weekly intervals.
The starting dose of THC was established as 2.5 mg/day.
Considering that some strains have a THC to CBD ratio of 1:20, consuming 40 mg of this strain would be getting about 2 mg of THC.

CBD doses are higher than THC doses for several reasons, one of them is because THC has significant psychoactive effects associated with it, and another is the mechanism of action. CBD exerts an indirect action through protein channels, reduces intracellular endocannabinoid transporters and decreases endocannabinoid metabolism through its interaction with the FAAH enzyme and the P450 isoenzyme system. For this reason, the doses required are higher than those of THC, whose effect is direct on cannabinoid receptors.

In conclusion, the dosage of medical cannabis continues to be a dynamic process where each person must be individualized (pathologies, medications used, previous use of cannabis) in order to achieve an optimal dose to maintain the balance of the endocannabinoid system and alleviate the different discomforts or symptoms.

Source:

-Consensus recommendations on dosing and administration of medical cannabis to treat chronic pain: results of a modified Delphi process. Disponible en: [doi.org/10.1186%2Fs42238-021-00073-1]

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