Medical Cannabis Dosing Guide

You took a trip to your local dispensary, now you’re home with a bag of goodies thinking, “What does 25% THC mean? Indica Sativa? How much should I take?” Cannabis doses vary from person to person based on their body type, lifestyle, the symptoms they are treating, and the type of cannabis products they use. When it comes to finding your “perfect dose,” it is important to be patient and keep an open mind. Most patients go through a process of experimenting with different THC and CBD potency ratios, various strains, and different forms of consumption. In order to find the proper products and dosing for yourself, it is important to work with your local bud tenders and do your own personal research as you are right now.

Unfortunately, due to the fact that cannabis is a natural medicine in a developing industry, it can be difficult for patients to understand the complex information listed on their cannabis products. Here are 5 things to help clear up some of the confusion.

1. Weight

In the cannabis industry, in order to measure product amounts, grams and ounces are referred to in the same context. This means we are using two different mathematical systems; the metric system (milligrams, grams) and the USA’s unique system of customary units (pounds, ounces). Why? Not sure. First we would need the answer to: Why is the USA still the only country that doesn’t use the Metric System?

Smaller quantities of cannabis are commonly measured  in milligrams, then grams. Larger quantities are measured in ounces and then, once you reach Snoop Dogg or Seth Rogan status, pounds.

The units you will need to understand in order to properly read cannabis product labels are as follows:

Milligrams = mgGrams = gOunces = ozPound = lb
1000mg = 1g1000g  = 1kg16oz = 1lb

For reference, a gram of dried cannabis flower is roughly the size of quarter. So, exactly how many grams are in an ounce? 28 grams make up one ounce.

How do we convert grams to ounces? Well, 1 kg = 35.2739619 oz and there are 1000 kg in 1 gram: 1 gram = .0352739619 oz, therefore 1 ounce = 28.3495231… Of course then we just round down and say 28 grams.

So, if there are 28.34 grams in 1 ounce, how many grams are in 1 pound? Well, 16 ounces = 1 pound and

28.34 x 16 = 453.44 grams, which is typically rounded up to 454 grams.

In most dispensaries, you will see dry leaf flower in quantities from individual 1g units to 1 ounce. Beside individually packaged 1 grams for flower, here are a few examples of how of dried flower labels reflect weight:

3.5g = 1/8 oz7g = 1/4 oz
14g = 1/2 oz28g = 1 oz

2. What is actually in my products? Let’s start with cannabinoids and terpenes!

Looking at the label on cannabis products can seem overwhelming when you don’t understand what you are looking at. Each product will have a potency analysis listed somewhere on the package. This analysis is the lab test result taken from a sample of the finished product before it is packaged and distributed. The amount of cannabinoids in the product is required to be listed, but some cultivators may not list the terpenes on their product.

Cannabinoids? Terpenes? What the hell are they?

Cannabinoids are molecules found in many living things, such as cannabis, and humans. Yes, you. Phytocannabinoids are found in plants (phyto means of a plant). Endocannabinoids are found in humans (endo means within). Endocannabinoids interact with a unique biological system in our bodies called the Endocannabinoid System (ECS). This system is known to regulate many essential functions that help maintain homeostasis within the body. Homeostasis is the body’s state of balance. These functions include regulating sleep and mood, appetite, nausea, pain, memory, and reproduction. The ECS is made up of enzymes, cannabinoids, and receptors; CB1 receptors that are primarily found in the central nervous system, and CB2 receptors found in tissues throughout the immune system.

When you look at the label on your medical cannabis product, you see a long list of cannabinoids such as this:

  • THC: Tetrahydocannabinol              
  • THCVA: Tetrahydrocanabivarinic Acid                                 
  • Δ8THC (Delta-8): Δ8-Tetrahydrocannabinol
  • THCA: Δ9-Tetrahydrocannabinolic Acid           
  • CBGA: Cannabigerolic Acid   
  • CBD: Cannabinol                                   
  • CBDA: Cannabidiolic Acid 
  • CBGVA: Cannabigerovarinic Acid                      
  • CBDVA: Cannabidivarinic Acid 
  • CBCVA: Cannabichromevarinic Acid

Don’t feel overwhelmed, there is a lot to learn, even the experts are still learning! Focus on the most common cannabinoids we seem to have the most research on. What are they and what do they do?

THC(Δ9): Pain reliever, appetite stimulant, treats nausea and vomiting (anti-emetic). Also proven to be effective in treating insomnia, depression, PTSD, and other mood disorders. THC has anti-inflammatory and neuroprotective properties and is known to aid in the death of cancer-cells in tumors through a process called apoptosis. THC is psychotropic a.k.a. responsible for the euphoria associated with marijuana we call a “high.”

THCA: THCA is essentially THC in it’s raw form, before it is “activated.” THCA itself is non-intoxicating. It is essentially a THC molecule with a layer of acid around it, and once it is heated, THCA turns to THC through a process called decarboxylation. So, as you can guess, you can expect to receive the same medicinal effects of THC after heating THCA.

CBD: A a powerful anti-inflammatory. Effective in treating anxiety, sleep disorders, pain, muscle spasms and gastrointestinal issues. Also known to be successful treating epileptic seizures and inhibiting tumor growth.

CBN: This cannabinoid is popular for it’s highly sedating effects. A widely respected cannabis lab, Steephill, reported “2.5mg to 5mg of CBN has the same level of sedation as a mild pharmaceutical sedative, with a relaxed body sensation similar to 5mg to 10mg of diazepam.” It is also known to be a nueroprotectant, anti-inflammatory, and appetite stimulant. CBN is formed when THC molecules degenerate.

Every type of cannabis will have some THC and some CBD, along with other cannabinoids. The differences in these molecules are determined by the extent of their psychological activity. In the USA, the amount of THC and CBD determines whether the plant is classified as Hemp or Marijuana. Hemp is naturally high in CBD. Legal industrial hemp in the USA must have less than 0.03% THC by dry weight. Theoretically, anything over that may be classified as Marijuana. Currently, in Pennsylvania, Medical Cannabis Dispensaries are primarily selling high THC marijuana, though there are many cultivators who intentionally breed strains high in CBD as well. There is a cannabis product out there for everyone, including high quality hemp-based CBD products for those who aren’t interested in using THC or do not have access to Medical Marijuana.

Terpenes are the other key component of a strain alongside THC, CBD, and over 100 more cannabinoids. In all plants, terpenes are aromatic molecules that are responsible for the smell and therapeutic effects of the plant. These unique molecules determine whether a strain will have energizing or sedating effects. Many terpenes in cannabis are found in other common plants. For example, the terpene Limonene, a powerful anti-inflammatory and anti-anxiety, is also prominently found in the peel of lemons.

 Are terpenes the same as essential oils? Weedmaps answers this question by stating, “Terpenes are the primary components of essential oils — aromatics responsible for a plant’s regeneration, oxygenation, and immunity defense. Essential oils have been used for medicinal purposes for thousands of years, and extracted from a variety of plants and foods… What we have discovered is that cannabis terpenes support other cannabis molecules in producing desired effects.”

Whole plant cannabis products are broadly known to be the most effective type of cannabis medicine because they allow cannabinoids, terpenes, and flavonoids to interact synergistically to create the optimal medicinal effect known as The Entourage Effect. There are many different terpenes, so try to focus on a few to start:

  • Myrcene: powerful anti-inflammatory, relaxation, sedating, and appetite stimulant
  • Caryophyllene: stress relief, pain relief, reduces muscle spasms, and antibacterial
  • Limonene: uplifting, anxiety relief, anti-nausea, anti-inflammatory, mental focus, antibacterial
  • Terpinoline: energizing, uplifting, antifungal, antibacterial, said to inhibit cancer cell growth

3. How to read the required testing labels:

Now that you understand which components can be found in your medicine, you must understand how to read the potency analysis, and figure out your dose. In Pennsylvania, and most other states, the amount of each component is displayed as a percentage within that certain product. If you want to figure out how many milligrams of THC or CBD are in that product, you have to do some math.

African Thai #15 – Cultivator: Prime Wellness of Pennsylvania

For example, this single gram of African Thai flower comes in at roughly 26.21% between the THC and THCA. We now know that there are 1000mg in 1g, so we need to multiply the amount of milligrams the product weighs by 26.21% in its decimal form, 0.262. 1000mg x 0.262 = 262mg. So, this gram contains roughly 262mg THC. The label also claims there are about 10 doses in each gram. In order to find out how many milligrams of a component per dose, simply divide the total amount in the container by the amount of doses. 262mg ÷ 10 doses = 26.2mg THC per dose. The same equation should be able to be applied to calculate the amount of any compound within a product.

Keep in mind, the method you use to consume the plant will determine how much of the cannabinoid profile is preserved. Combustion (burning the plant) will result in the most loss of cannabinoids.

4. What type of product should I use and how much?

Strain Classification

Sativa, Hybrid, Indica…these are words used to describe how a strain makes you feel. The type of strain is determined by the terpenes dominant in that strain.

Indica: effects are usually calming and sedating, associated with the couch-clock feeling. Remember Indica means  ‘in-da-couch.’

Sativa: effects are usually uplifting and energizing, with a creative euphoria

Hybrid: a hybrid plant means one of the parent plants was a Sativa, one was an Indica, so the plant will have characteristics of both types of strain. Hybrid strains that commonly have more energizing effects are considered Sativa-leaning hybrids and those with calming/sedating effects are considered Indica-leaning hybrids. Then you have strains that are 50% indica and 50% Sativa like Girl Scout Cookies that is not energizing or sedating, just have a very balanced feeling.

When it comes to cannabis dosing, there is no one size fits all. The type of product you use and how much will be determined on what kind of relief you are looking for and your body’s bioavailabilityOxford University states, “bioavailability is the proportion of the nutrient that is digested, absorbed and metabolized through normal pathways. Consequently, it is not enough to know how much of a nutrient is present in a dietary supplement; the more important issue is how much of that present is bioavailable.” This means everyone absorbs different amounts of substances at different rates.

The general rule of cannabis medicine is “Start Low, Go Slow.” Start with low doses, continue that dose for a few days, then gradually increase your dose as needed. When choosing products, focus on the terpenes it contains rather than the THC level. You may have to experiment with different doses and types of products before figuring out what is best for your needs, so be patient.

Cannabinoid Ratios

There are many different types of products to choose from, depending on the type of relief the individual is seeking. Cannabinoid ratios vary, a ratio is the amount of one component in relation to the other. For example, a product that has equal amounts of THC and CBD, say 5mg THC : 5mg CBD, is labeled as a 1:1 ratio. Therefore, a product with 10mg THC : 5mg CBD would be considered a 2:1 ratio. There are any cannabinoids, but the 2 we know the most about and focus on are THC and CBD. In Pennsylvania, most cultivators list the THC content first and the CBD second, but occasionally you will see a product with it listed in the reverse.

What ratio should I look for? It is recommended for most new patients to start with a 1:1 ratio, and then gradually start using higher THC products if desired. Reminder, though the euphoria associated with THC is highly enjoyable for most MMJ Patients, that does not mean it is the most important component of cannabis medicine. 

1:1 ratios are known to be highly effective in treating many conditions, and even preferred by many patients treating symptoms of cancer, fibromyalgia, autism, neuropathy, insomnia, anxiety and MS. 

Methods of Consumption

There are many ways to use cannabis medications, including topical creams, vaporizing or smoking the dry herb, eating cannabis oil infused food or capsules (edibles), taking an oil tincture under the tongue (sublingually), vaporizing concentrated extracts, and transdermal patches or creams (absorb into bloodstream through skin).

Product TypeWhat is it?How much should I use?How long until I feel the effects?How long will the effects last?
Dry flowerDry herb cannabis that can be inhaled through vaporizaton or combustion of the plant1-15 hits per session, or more depending on needed relief.Almost immediate, effects peak around 10-40min after inhalation2-4 hrs
ConcentratesOil, Concentrate, or Extract- cannabis specially processed into a highly concentrated form. Can be vaporized or eaten (ie. “Dabs,” edibles, capsules and tinctures).Vaporization: 1-5 hits or moreOral Consumption: 2.5-30mg to start, up to 50mg or more as needed.Vaporization: Almost immediate-10min
Edibles/Capsules: 20min-2hrs
2-4 hrs4-10 hrs
Topical CreamsA cannabis oil infused cream, spray, or balm applied to the skin. Used to treat localized pain or inflammation. Does not penetrate bloodstream.Use as label recommends.Usually used similarly to a regular topical lotion or balm.5-30 min2-4 hrs depending on product
Transdermals  Transdermal creams, gels and patches are applied topically and are able to penetrate the skin deep enough to deliver the medicine into the bloodstream.Apply to veinous part of the skin such as inner wrist. Use as recommended on product label.10 min – 2 hrs6-12 hrs

5. Side effects of cannabis

Can you overdose on cannabis? In the past 8,000 years humans have used cannabis, there have been no reported deaths due to cannabis consumption. Compared to the many proven benefits of cannabis, there are very few negative side effects, most of which are associated with high THC cannabis. There is always more research to be done when it comes to cannabis, but contrary to popular belief, there has not been any proven cases of cannabis causing lung cancer. The common minor side effects of cannabis include:

  • High THC cannabis causes a euphoria we call a “high”
  • Dizziness
  • Heart rate fluctuation (increased or decreased heart rate)
  • Dry mouth and throat a.k.a. Cotton Mouth
  • Altered senses
  • Increase or decrease in appetite (depending on person and strain used)

Cannabis is not known to interfere with many medications, but if you are on prescribed medication, it is always recommended to consult your physician before using cannabis. The few common pharmaceuticals that do interact negatively with cannabis are Astemizole, Cisapride, Pimozid, Terfenadine.

Taking too much cannabis can also have a few minor, temporary side effects, such as:

  • Tension Headache
  • Nausea
  • Paranoia (usually caused by too much THC or sensitivity to certain terpenes like Terpinoline)
  • Increased Heart Rate

Why? Cannabis is a supplement similar to protein. If you take too much protein powder before the gym, you may get a stomach ache because your body can not process that much protein fast enough. Same thing with cannabis, taking too much can be uncomfortable because your body can only process so much of a compound at one time.

As stated above, there is a cannabis product out there for everyone. When choosing cannabis products, checkout your local dispensary’s menu before leaving home, read patient reviews online, and consult with your local bud tenders and cannabis professionals. Keeping a cannabis journal or a list of strains and products you have tried can be very helpful in finding the perfect cannabis routine as well.

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