The ultimate guide to dosing medical marijuana

It’s normal not to know where to start when dosing cannabis, especially considering that each person’s needs and tolerance are unique. Other variables, like age, sex, height, weight, lifestyle factors, other medications, and your specific symptoms must also be considered.

Thankfully, research is growing, which gives us better insight into how to dose cannabis on an individual basis. While there’s no one-size-fits-all approach to cannabis dosing, there are certain factors that can be considered to deliver optimal results.

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1. Why are you using cannabis, and what do you hope to achieve? 

Everyone who seeks out a medical marijuana card has a specific goal in mind, whether it be achieving relief from anxiety or managing the symptoms of irritable bowel syndrome (IBS). The condition you seek relief from and the severity of symptoms play a role in finding your ideal THC dosage.

Naturally, those who struggle with more severe symptoms may prefer a higher cannabis dosage than those with milder or more intermittent symptoms. For instance, patients who are prone to debilitating migraines may opt for higher-potency products compared to those who experience more minor tension headaches.

Many patients use medical cannabis to manage more than one condition. In this case, a higher-than-average daily dosage may be suitable to provide the body’s endocannabinoid system with an ample amount of cannabinoids.

2. Are you a first-time medical marijuana user?

If you’re a total cannabis beginner, it’s best to start with a very low dosage (like 2.5mg) and slowly work your way up as tolerated and needed. Everyone’s physiology is unique, and some people may benefit from consuming 20mg of a cannabis product daily, while others find the relief they’re looking for with just 5mg.

Keep in mind that it can take up to two weeks of daily use for your body to fully respond to a new cannabis routine. We recommend allowing for two weeks before you reassess the dosage that you’re taking. If you decide to increase your intake, do so in small increments until you find your dosage “sweet spot.”

3. Are you taking any other medications alongside cannabis?

Cannabis cannabinoids like THC and CBD suppress a liver enzyme, cytochrome P450 (CYP 450), which metabolizes many prescription drugs. In fact, over 50% of drugs are metabolized via the cytochrome P450 and other CYP enzyme pathways.

By inhibiting these enzymes, the effects of these medications can either lessen or be greatly increased with a longer duration. In general, medical cannabis has been shown to interact with these drugs and medications more than most others:

• Alcohol
• Antihistamines like diphenhydramine (Benadryl)
• Benzodiazepines like alprazolam and carbamazepine
• Blood thinners like warfarin
• Opioids like tramadol and oxycodone
• Some types of antidepressants, particularly duloxetine (Cymbalta) tricyclic antidepressants (TCAs) like amitriptyline and doxepin

This means that care must be taken if other pharmaceutical drugs are used in combination with cannabis. At the same time, cannabis may allow patients to lessen their dependence on these medications.

For example, a person with epilepsy may need to taper the amount of anti-epileptic drugs (AEDs) they are taking, or someone suffering from chronic pain may be able to reduce or replace their prescription opioids.

As a general rule, if an over-the-counter (OTC) or prescription drug has a sedative effect or affects mood in some way, it is likely to have some interaction with cannabis.

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4. What is your THC tolerance like?

THC is the primary psychoactive component in cannabis, and its intoxicating properties can affect everyone differently. THC is also known for its potential benefits that may help manage conditions like anxiety, depression, chronic pain, and more.

It can take some trial and error before you figure out the amount of THC that’s right for you. Tolerance to its effects can vary based on sensitivity and experience. THC tolerance does increase with repeated use, and beginners may be more sensitive to some of its side effects, which can include drowsiness, heightened anxiety, and lightheadedness. Most patients find that these side effects decrease over time.

In general, the advice with all cannabis products is to go slow and go low. This can help prevent over-intoxication, and help find one’s “therapeutic zone.” That is, the amount of THC that provides therapeutic effects without over-intoxication.

5. How does your endocannabinoid system respond to cannabis?

Some people may need high doses of a particular cannabinoid or set of cannabinoids to achieve the same results with the same condition. Moreover, as everyone has a different endocannabinoid system, what works for one person may not work for another. It’s important to listen to your body and take note of what dosage and product produces the best results.

Although everyone has a different ECS, we can make some generalizations. For example, younger people seem to be more sensitive to the effects of cannabis than older people, based on findings in animal studies. Women generally show more sensitivity to the effects of THC, likely due to hormonal differences. Diet and lifestyle factors may also make a difference.

6. Which product type are you looking to try?

Medical cannabis comes in a variety of product types, including:

• Concentrates
• Edibles (gummies, syrups, lozenges, etc.)
• Flower
• Tinctures
• Topicals
• Vaporizers

Each product type has a unique onset time, duration of effects, and potency based on how it is absorbed into the body. Inhalable products like concentrates, flower, and vaporizers take effect quickly and provide potent effects, but those effects usually dissipate within a couple of hours. Cannabis edibles, meanwhile, have a longer onset time (up to two hours), with effects that can last for up to eight hours per dose.

Concentrates stand out because of their extremely high potency. With concentrates, most patients need only a small amount to experience powerful effects.

If you’re using cannabis topicals, you can be a little more lenient with your dosing. The THC in a topical formula is unlikely to produce intoxication, as the effects are localized and the product is used externally.

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7. What is your body composition?

As is the case with many medications, body composition plays a role in finding the right THC dosage. Individuals who weigh more than average usually respond well to higher doses of medical cannabis. Meanwhile, minors who have a medical card usually respond well to below-average dosage amounts.

8. What are the cannabinoid and terpene profiles of your product?

Most cannabis products contain more than just THC. Full spectrum products are made up of over 150 individual cannabinoids and terpenes, with each chemical compound playing a role in the effects of the product. Then, some products contain concentrated extracts of CBD to maximize their therapeutic benefits.

Each strain has a distinctive THC concentration, which affects the potency of its psychoactive effects. Every strain also has a distinct terpene profile, which is why some strains can make you feel sleepy, while others can energize you.

All of this should be taken into consideration when you’re trying to figure out the best cannabis dosage amount. A strain with high THC content, like Gorilla Glue, can give you positive results in a low dose, whereas a high-CBD strain like ACDC is unlikely to make you feel very intoxicated.

9. When are you using medical cannabis?

Most medical marijuana patients want to stay awake and have their wits about them during the day. So, it would make sense to avoid taking too much THC. At the same time, patients who want to combat insomnia may find that a product containing THC and the terpenes linalool and myrcene helps them fall asleep more easily.

If you’re using medical cannabis during the day, like for pain relief, you’ll want to take into account the psychoactive effects of the plant, especially if using high-THC products. Because cannabis can cause drowsiness and mild impairment, it may not be practical to take a high THC dosage during the most active hours of your daily routine. Many people opt for CBD for daytime use, as it is not as psychoactive as THC, while still having anti-inflammatory effects.

10. What has your healthcare provider recommended?

Anyone who obtains a medical marijuana card will speak to a licensed healthcare professional about their condition, and how to use cannabis to best address their symptoms, including the proper THC dose. It’s always recommended to ask your healthcare provider about any questions you have regarding medicinal cannabis dosage, as they can take your medical history, symptoms, and overall needs into consideration.

Always remember: cannabinoids are “biphasic.”

If you plan to experiment with different cannabinoids, be aware that these compounds are biphasic. This means that cannabinoids can have different effects in different dosages.

• CBD can be energizing in low doses, and sedating in higher doses. CBG may behave similarly.
• THCV has anti-psychoactive effects in low doses but has psychoactive effects in higher doses.
• THC has antidepressant and anxiolytic (anti-anxiety) effects in low doses but can prompt anxiety and paranoia in higher doses.
• Different terpene combinations may also make a difference. Cannabis varieties high in myrcene, linalool, and humulene tend to be more sedative-like. Cannabis varieties containing less myrcene and more limonene, terpinolene, pinene, and beta-caryophyllene are described as more uplifting.

Finding your ideal cannabis dosage for maximum relief

The key to unlocking cannabis’ potential for relief is choosing the right dosage level for your particular needs. What works for one person may not work for you.

Consult a knowledgeable medical cannabis doctor to determine your ideal dosage and help you reach your therapeutic window. Leafwell is ready to help you obtain a medical card and speak to one of those medical professionals to find the best dosage for your symptoms.

Frequently asked questions

What is the best THC dosage for pain?

There is no standard dosage chart when addressing conditions like pain. There are simply too many factors to consider, like age, weight, personal tolerance, and severity of symptoms. Starting with a low THC dose and working your way up in increments can help you find your ideal dosage level.

Is it dangerous to take a high cannabis dosage?

While cannabis is considered nontoxic, taking too high of a dose, especially as a beginner, can cause some adverse effects. It’s best to build your tolerance up slowly to avoid side effects like drowsiness, impairment, and anxiety.

Can I microdose medical cannabis?

Many patients prefer to microdose cannabis, especially THC. A standard microdose amount is 1-3mg. This amount range may provide some relief of symptoms without strong psychoactive effects.

Resources 

• Cannabinoid Interactions with Cytochrome P450 Drug Metabolism: a Full-Spectrum Characterization: https://pubmed.ncbi.nlm.nih.gov/34181150/
• A chronic low dose of Δ9-tetrahydrocannabinol (THC) restores cognitive function in old mice: https://www.nature.com/articles/nm.4311
• Estrogen increases cannabis sensitivity: https://www.eurekalert.org/news-releases/796629
• Antioxidative and Anti-Inflammatory Properties of Cannabidiol: https://pmc.ncbi.nlm.nih.gov/articles/PMC7023045/
• Biphasic effects of cannabis and cannabinoid therapy on pain severity, anxiety, and sleep disturbance: a scoping review: https://pubmed.ncbi.nlm.nih.gov/38268491/

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