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Dosing Cannabis

Unlike most pharmaceutical drugs, cannabis is characterized by its wide dosage range, high safety profile, as well as its versatility in treating many symptoms and diseases. For a successful treatment, one of the most important issues is appropriate dosing.

Unlike with other medicines, the exact dosage cannot be determined based on body weight, age, or health condition. Every person has their own inner chemistry. Furthermore, the endocannabinoid system is very complex, thus the optimum dosage varies greatly between individual patients. Instead of blindly relying on your doctor (or anyone else) when it comes to dosage, you can use a simple method to determine the appropriate dosage yourself.

Wide Experience

Dr. Dustin Sulak, MD and his colleagues treat approximately 18,000 patients in New England using cannabis as a part of a so-called integrative medicine (a combination of conventional and alternative medicine). One of Dr. Sulak's major discoveries is related to optimum dosage. 

“When I began treating patients, it struck me that some patients needed only a small dose (e.g. one puff from a pipe), while others needed a much greater dose to achieve the optimum effect (e.g. a whole joint). Over time, I began to notice that with some patients, who were getting small doses, the results were better than with patients suffering from similar difficulties, who were getting large doses,” says Dr. Sulak. “Eventually, I found out that the majority of people have a certain threshold dosage. As long as the dosage does not exceed this threshold, the curative effect gradually keeps getting stronger. When dosage exceeds the threshold, however, patients begin to develop tolerance, the curative effect decreases and more side effects start to appear. This phenomenon is called a biphasic dose-response curve.”

Scientifically confirmed

Preclinical research confirms these claims and proves that using an appropriate amount of cannabinoids can increase endocannabinoid system reaction sensibility and that it can lead to increased endocannabinoid production, as well as cannabinoid receptor expression and affinity. This gradually decreases the need of large doses. On the other hand, endocannabinoid system reaction sensibility is decreased by persistent overloading (e.g. long-term high doses) and subsequent membrane receptor endosome internalization. The cell literally pulls the endocannabinoid receptor inside, thus the receptor cannot be stimulated any more.

By working with his patients, Dr. Sulak and his colleagues have succeeded in developing a program that helps cannabis users find their optimum dose in four days. They have also created the “sensitization protocol.” It allows patients to reset their endocannabinoid system reaction sensibility and to achieve much better results using small doses in six days. After using the sensitization protocol, 90% of patients have observed a decrease of necessary dosage and an increase of effects. On average, the dosage has decreased by 56%. Not only does this decrease improve desired effects and reduces side effects – It also saves patients' money and potentially makes treatment accessible to those who only have a limited access to cannabis.

Ten percent of patients require greater dosage to achieve optimum results. Often, a significant increase in dosage is necessary. For example, in case of patients who are more sensitive to cannabis, 3–5 mg of one strain will suffice, whereas some patients achieve the optimum results at 300–500 mg of the same plant.

Also noteworthy is the fact that if dosage is being increased slowly and with care, patients are often able to tolerate significant cannabinoid doses with minimum side effects. In case of specific and serious diseases, such as cancer and chronic infections, some patients may react better to very high dosage.

Generally, it can be said that for patients with better resistance and a more balanced physical condition, small doses are more beneficial, whereas for patients with long-term serious diseases, aggressive dosage may be better to keep the disease in check. These patients may switch to smaller doses later, when their health condition has improved.

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