How Much Medical Cannabis Do You Need? - dummies

How Much Medical Cannabis Do You Need?

By Kim Casey

If you’re a cannabis novice, you’re probably wondering, “How much should I take?” The answer to that question is simple: Take as little as possible to produce the desired effect and avoid potential adverse side effects.

Unfortunately, that answer provides little to no practical guidance for new cannabis users. The truth is that we can’t provide specific guidelines because the variables are so numerous. Products differ. Consumers differ. Situations differ. What’s too much for one consumer is not enough for another.

Some people achieve the experience they want with microdosing — taking a small dose (1–5 mg daily) of a non- or slightly intoxicating cannabis product to enhance overall health and productivity without getting high. Others achieve optimal results with megadoses of up to 2,000 mg daily without experiencing adverse side effects.

More isn’t necessarily better, although it can be. Increasing the dose up to a certain point initially produces stronger effects, but beyond that point, the desired effects may become weaker with an increase in adverse side effects. However, increasing the dose beyond the point at which it produces the desired effects may, in some cases, produce additional desirable effects.

The best approach is to follow the age-old wisdom of starting low and going slow and experimenting with products that have different concentrations and ratios of cannabinoids and different terpenes until you find your sweet spot.

Following is some additional guidance by helping you define the experience you desire and evaluate some of the key factors that typically impact the experience. Our hope is that by following our guidance, you can find your sweet spot faster and reduce the amount of trial and error — although trial and error can make the experience more enjoyable as well.

Define your desired cannabis experience

People consume cannabis for different reasons. Some take it for pain relief or seizure prevention. Others take it at parties to relax and remove some of their inhibitions. Some take it to boost their productivity or enhance their athletic performance. And many certainly take it to feel the buzz.

To determine the optimal dose of cannabis for you, first define your desired experience. The experience you want can certainly change over time, and it may change based on the situation. For example, after a long, hectic day at work, you may want to use cannabis to relax, whereas pain relief may be your goal if you’ve suffered a physical injury.

After identifying your desired experience, you’ll find it easier to match the product, amount, and delivery method to best hit that target. If the desired effect is an uplifting experience in a social setting with friends, smoking flower may be the best choice. If relaxation at the end of a busy day is the outcome, similar to a glass of wine with dinner, perhaps a soothing cannabis tea or bath would be best to deliver the desired result.

Consider the chemical composition of products

Whether you’re smoking flower/bud, vaping oil, consuming edibles or tinctures, or using a cannabis lotion, consider the chemical composition of the products. Different blends of cannabinoids, terpenes, herbs, and other ingredients produce very different effects that can vary among individuals.

Know your strains

Numerous strains (breeds) of cannabis plants exist, but they all originate from two primary strains: indica (sometimes referred to as “in da couch” for its sedative properties) and sativa (a more stimulating strain). The table compares the general effects from these two major strains.

Indica and Sativa Compared
Strain Qualities
Indica Nighttime use

Metal relaxation (sedative)

Muscle relaxation

Decreased nausea

Pain relief

Appetite stimulation

Sativa Daytime use

Stimulant (improved focus and creativity)

Anti-anxiety

Anti-depressant

Chronic-pain relief

Indica and sativa are only two of many strains. These two primary strains have been cross bred to create numerous hybrids with colorful names, such as Blue Dream, Pineapple Express, AK-47, Chernobyl, and Tangerine Dream. To add to the variety, these strains come in numerous phenotypes — variations resulting from the interaction of the plant’s genotype (nature) and environment (nurture).

To find out more about the various strains and phenotypes and their effects, check out the Cannabis Strain Explorer at Leafly. For a specific recommendation, describe the effect you desire to your budtender, who can suggest various strains that are likely to do the trick.

Evaluating products by strain is only one way, and not necessarily the best way, to determine whether a product will deliver the desired effects. You may find that cannabinoid concentrations and ratios and terpene profiles provide a better indication of the effect a product is likely to have. However, strains provide a quick and easy way to reference and talk about different products, especially if you’ve discovered certain strains you really like.

Check out cannabinoid ratios and amounts

Cannabinoids are the primary active ingredients in all cannabis products, so the ratios and quantities of the different cannabinoids provide a fairly accurate indication of what you can expect from any given product. Although cannabis contains about 100 cannabinoids (by some estimates), only two (THC and CBD) are responsible for delivering a majority of the benefits (and any adverse effects) and only two others are notable at this time:

  • Tetrahydrocannabinol (THC): THC takes most of the credit for producing the euphoric high associated with cannabis. It’s strongly psychoactive, meaning it changes brain function, which can result in alterations in mood, memory, perception, thinking, and behavior.
  • Cannabidiol (CBD): CBD can help alleviate symptoms of certain medical conditions, such as pain, inflammation, and anxiety, without the intoxicating effects associated with THC. In fact, CBD tends to modulate the psychoactive effects of THC.
  • Cannabinol (CBN): When THC oxidizes, it converts to CBN, which decreases the concentration of THC. CBN is a fairly strong sedative that provides other potential benefits. It can be helpful as a sleep aid, pain reliever, antibacterial, anti-inflammatory, anti-convulsive, and appetite stimulant and has been shown to promote bone growth.
  • Cannabigerol (CBG): CBG is a precursor (building block) of THC and CBD. Like CBD, it’s not intoxicating, and it may help with a host of medical conditions, including glaucoma, inflammatory bowel disease, Huntington’s disease, cancer, bacterial infections, cachexia (muscle wasting), and bladder dysfunction.

When shopping for cannabis products, examine the amount of each cannabinoid in the product and their ratios. The CBD-to-THC ratio is particularly important and should be included on the packaging of any cannabis product. Ratios can be broken down into the following three categories:

  • THC dominant: High THC and low to no CBD produces the intoxicating, euphoric high associated with cannabis. However, higher ratios of THC have a greater potential to produce the adverse side effects.
  • Balanced: Balanced blends of CBD and THC are psychoactive, but less so than THC-dominant products. The CBD tends to lessen the intoxicating effect of the THC, and the two cannabinoids may work synergistically to enhance the overall experience.
  • CBD dominant: High CBD and low to no THC products are primarily for those who seek the medicinal benefits of CBD without the intoxicating effects of THC. However, even if you’re consuming cannabis purely for medicinal purposes, a little THC added to the CBD can improve its effectiveness.

Ratios tell you nothing about the amount of each cannabinoid in a product. Also check the amount per serving if you’re purchasing adult recreational products and the total amount of each cannabinoid (typically in milligrams) in the entire package. When dosing, pay particular attention to the amount of THC, because consuming too much may increase the risk of adverse effects. High doses of CBD are unlikely to produce any serious adverse effects.

Takea spin on the terpene wheel

Terpenes are the volatile aromatic compounds that give different strains and even individual plants their unique aromas. (Terpenes are part of products and natural substances not exclusive to cannabis.) Combining different terpenes with different cannabinoids produces what’s referred to as an entourage effect — the synergy of all ingredients in a cannabis product that produce the unique experience associated with that product. Think of the combination in terms of wine: CBD and THC content is like a wine’s alcohol content, but each wine has its own aroma, flavor, acidity, and texture, which are comparable to the characteristics of terpenes.

This table lists and describes the eight most prevalent terpenes in cannabis.

Common Terpenes
Terpene Aroma Found in Benefits
Caryophyllene (CYE) Pepper, spicy, woody, cloves Black pepper, cinnamon, cloves Anti-inflammatory

Pain reliever

Protects cells lining the digestive tract

Humulene (HUM) Earthy, woody Basil, cloves, coriander, hops Appetite suppressant
Limonene (LME) Lemon Citrus fruits Mood elevation

Stress relief

Reduces acid reflux

Anti-anxiety

Linalool (LNL) Floral Lavender Calming

Sedating

Anesthetic

Anti-convulsant

Pain reliever

Anti-anxiety

Myrcene (MYR) Earthy, herbal, cloves Mango, lemongrass, thyme, hops Calming

Sedating

Enhances THC’s psychoactivity

Muscle relaxant

Ocimene (OCM) Sweet, herbal, woody Basil, pepper, parsley, mint, mangoes, orchids Antiviral

Antifungal

Antiseptic

Decongestant

Antibacterial

Terpinolene (TPE) Floral, herbal, pine Lilac, lime blossoms Calming

Sedating

α-Pinene (PNE) Pine Pine needs, rosemary, basil, parsley, dill Mental alertness

Memory retention

Anti-inflammatory

Anti-bacterial

Terpene characteristics and benefits are often presented in the form of a terpene wheel. You can find numerous terpene wheels online by searching for “terpene wheel.”

Sample other ingredients

Cannabis is commonly combined with other ingredients to intensify the effects of the cannabis or of the other ingredients and enhance the consumer experience. Other ingredients commonly added to cannabis products include tobacco, coffee, tea, chocolate, alcohol, herbs, and spices.

Compare methods of cannabis consumption

How you consume cannabis can have a tremendous impact on the way it affects you, including the speed and intensity of your response and the overall sensation. The following table lists your options and presents pros and cons of each to provide you with a quick reference guide for choosing a method that’s most conducive to the desired effect in any given situation.

Comparing Consumption Methods
Consumption Method Pros Cons
Smoking Fastest acting

Intense sensation

Lots of variety

Great for social situations

Irritates the lungs

Smell lingers

Not discreet

Somewhat complicated

Vaping Discreet

Portable

Easier on the lungs than smoking

Smoother hits

Easy to use

Fast acting

May be more expensive than smoking

Less variety (than smoking)

Less intense onset

Edibles Discreet

Long-lasting

Easy to use

Strong effect on both mind and body

Slow acting

Highest calorie option

Difficulty taking enough without taking too much

Topicals Discreet

Localized

Non-intoxicating

Non-intoxicating
Transdermal patches Discreet

Localized and full body

Timed release

Expensive

Weak or non-intoxicating

Tinctures and pills Discreet

Easy dosing

Faster acting than edibles

Easy to use

Slower acting than smoking or vaping

Some people have a favorite consumption method they rely on exclusively. Others like to switch it up or use different methods for different purposes or in different situations; for example, smoking socially and vaping when alone.

Account for other medications or substances used

While some medication may have little to no known interaction with marijuana, others are well known to intensify its effects, and many can have unintended consequences based on the type of cannabis and an individual’s health. For example, some strains or blends can increase a person’s blood pressure raising the risk of heart attack or stroke in vulnerable individuals.

Don’t mix marijuana with alcohol or other psychoactive substances. If you have a history or family history of any medical conditions or you take any medications (prescription or over-the-counter) or supplements, consult your physician before using cannabis.

Examine your body’s biochemistry

Two people who consume the same cannabis at the same dose in the same way at the same place and time can have a vastly different experience. These differences can be attributed primarily to variations in their biology and chemical makeup (and perhaps in their emotional state or mind-set, as well). Factors that may impact your biochemistry and thereby influence the experience you have include the following:

  • Age: Many users report that their experience with cannabis has changed over time; for example, cannabis that once helped them relax now makes them feel anxious, or cannabis that once made them paranoid now makes them feel more creative.
  • Gender: Cannabis appears to affect men and women differently, although the research in this area is limited. For example, in small doses, cannabis seems to increase sexual desire in women, whereas in men, smoking or vaping cannabis reduces sexual desire and sperm production.
  • Recent meals: Whether you’ve eaten anything before consuming cannabis and what you’ve eaten can impact its effects, especially with edibles. Consuming cannabis on an empty stomach increases the rate at which it is absorbed, thus increasing the potential risk of anxiety and paranoia. Certain foods may intensify the effects, whereas others modulate the effects; for example, mangoes are thought to intensify the high, whereas lemon is thought to lessen it.
  • Body composition: Your height and weight, or more accurately your ratio of muscle mass to fat-soluble tissue may impact the onset time and the intensity and duration of the effects. THC binds to fat, which is why meals can impact the effects of cannabis. Your body’s makeup may also have an impact. It may also be involved in determining how long THC may be identified in your body through testing.
  • Altitude: The effects of high altitude together with the effects of the cannabis itself can make you feel higher, so if you’re consuming at a high-altitude location, particularly a location you’re unaccustomed to, start lower and go slower to find your sweet spot. This is a recognizable effect with alcohol, as well.
  • Genetic disposition: Genes (heredity) play a major role in how any given individual responds to cannabis. Just as amphetamines (stimulants) tend to calm people who have attention deficit hyperactivity disorder (ADHD), a cannabis strain that makes one person anxious may have a calming effect on another.
  • Consumption frequency (tolerance): Regular heavy cannabis users build up a tolerance for it. Over time, you may find that you need higher doses to experience the same effects.
  • Susceptibility to certain mental health conditions: Certain people are more susceptible to certain mental health conditions (such as anxiety, depression, and psychosis) than others, so they may be more prone to experiencing adverse effects, especially at high doses.

Consider the environment or setting and your mood or mind-set when consuming marijuana

Just as a restaurant’s ambience, the people you’re dining with, and the person who’s serving you all impact your enjoyment of your meal at a restaurant, the environment, the people you’re with, and your own mood or mind-set influence your overall cannabis experience. Of course, if the cannabis doesn’t suit your tastes, you’re not going to have the greatest experience, but assuming it’s the right product, and you’re in an enjoyable setting with great people and are in a good place yourself, you can expect to have a delightful experience. On the other hand, if you’re in an uncomfortable situation with unfamiliar people and are feeling uptight, you may have a terrible experience, even if you’re consuming the right product.

Start lower and go slower in unfamiliar situations with unfamiliar people or when trying any cannabis products you haven’t used in the past. Also, if you know you’re going to be consuming in an unfamiliar setting or with strangers, avoid trying any new products. If possible, bring your own product — one you’ve used in familiar and comfortable surroundings — so you’re better able to anticipate your response to it.