How to use cannabis

Every thing you want to know about using marijuana.

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Fortunately consumers are gaining control over what kind of experience they can expect from using cannabis. There are now ways to take it with little to no euphoria (getting high), ways that will leave you inebriated for 6-8 hrs from one dose, as well as many options in between.

Dose:

Figuring out how to use and dose with precision is relatively difficult in the beginning with cannabis. There are genetic differences on both sides (human and plant).  Plants vary significantly in potency and concentration of the various cannabinoids in the plant. There is also variation in how the plant is prepared for use and also in how it is consumed. On the human side there is genetic variation of concentration and receptivity of cell receptors (CB1) and the metabolism of the cannabis. With that said, there are some established trends. Cannabinoids are starting to be labeled in terms of milligrams present or by percentage of concentration.  Although it is somewhat debated at this point, 2.5-30mg of THC is a good general range to consider.  Cannabis researcher Dr Russo indicates “In general, 2.5mg of THC is a threshold dose for patients without previous tolerance to cannabis, 5mg is a moderate dose, 10mg a large dose that may be problematic for naïve patients, while 15mg or more at a time risks psychiatric adverse events (Grotenhermen, 2001; Sellers et al., 2013)”.

Synthetic THC daily dose ranges are: Marinol® (dronabinol), 2.5, 5 or 10 mg; Cesamet® (nabilone), 0.25, 0.5 or 1 mg;  Sativex® (nabiximols), one spray (2.7 mg THC & 2.5 mg CBD) to 16 sprays (43.2 mg THC & 40 mg CBD).

First time users of cannabis (cannabis naive) often experience absolutely nothing.  It may take several attempts for the effects to be realized. Patients should be cautious, however, and expect to be incapacitated for a few hours on subsequent uses. If you experienced no effect with the first use, be cautious with the 2nd and 3rd attempts. People have taken too large a dose the second time using because they felt no effect the first time. This is especially true with edibles.  New users should titrate the dose (small incremental increases over time). For edibles wait at least two hours before taking a second dose.  Here is a link to an article about first time use

Decarboxylation is a chemistry term that relates to a change is the chemical structure of cannabis when it is heated. THC and some other cannabinoids need to be heated to a specific temperature to reach their active form. Raw unheated THC is relatively non-psychoactive (doesn’t get you high).  Many of the medicinal benefits, however, are still available in the unheated form.  Cannabis products are starting to become available both ways (decarboxylated or not).  Guidelines to which form is most ideal for individuals and for various pathologies are still emerging. If you want to avoid euphoria, then unheated cannabis is a good place to start; next compare effectiveness and side effects with heated cannabis. Here is a link on decarbing

Strains:

The plant comes in three varieties (cultivars): Cannabis; sativa, indica, and ruderalis. The sativa strain is known for being light, energizing, mentally and creatively stimulating. Indica is known for being calming, sedating and more physically oriented. Ruderalis is industrial hemp used in textiles but found to have a higher % of canabidial (CBD) which is starting to be extracted in seclusion of other cannabinoids.  Most commercial varieties are now hybrids typically ranging from 30-70% sativa or indica.  For example; A hybrid that is 60% indica and 40% sativa is referred to as an indica dominant hybrid. Unfortunately botanist say that the above varieties have undergone so much hybridization that now the names are somewhat meaningless.  But short of genetic testing they are all that we really have.  Here is a link to more  LEAFLY or MEDICALJANE

Forms:

Smoking is the most common method of delivery. This delivers cannabis with extreme rapidity allowing titration (incremental steps) to appropriate dose level. This is especially effective for nausea and pain.  Smoking delivers a concentrated dose very rapidly (minutes), lasting 2-4hrs.  Smoking cannabis may lead to coughing and or even bronchitis, but is not currently associated with lung cancer. Tobacco smokers, unfortunately, who also smoke cannabis experience a greater risk to lung health than just smoking tobacco. The uncommon adverse effect of anxiety is most commonly brought on with smoking, probably due to the fast, widespread onset.  See Tools below for more info, and here is an article on smoking

Vaporizing Machines are a modern miracle and generally fall into two broad categories. Cannabis herb vaporizers and cannabis concentrate vaporizers (V-pen). The herbal type vaporizers introduce the precise amount of heat to vaporize the cannabinoid crystals (trichomes) while avoiding plant combustion. Higher quality vaporizers have a digital temperature control which allows the machine to produce vapor with more or less concentration (typically 360-390 deg F). The higher the temperature, the more smoke-like and harsh the vapor. The residual cannabis can be used in other preparations (like salves and topical oils) and some people eat it. Most of the THC will be gone, but not the whole cannabinoid spectrum.   Chronic smokers need to give vaporizing at least a three-week trial period to overcome the lack of sensation intensity associated with smoking. V-pens work like electronic-cigarettes but with a cannabis oil concentrate inside. They typically contain propylene glycol.

Oral / Edible administration requires 30-90 min for the effects to be felt. The effect lasts much longer (typically 4-8hr) than smoking and it is useful for patients suffering from insomnia. Edibles can be a little tricky in the beginning, especially if you do not know how many milligrams of THC are in them. Too large of a dose most often happens with edibles.  For example, someone with no prior cannabis experience eats a whole unlabeled cannabis-laden cookie and experiences no effect. They wait until next day and try two cookies. An hour later they still feel nothing. “What the heck,” they figure and eat a third one. Twenty minutes later they break out in a cold sweat, feel nausea, perseverate on their heart rate, and feel totally ill for the rest of the day. They never touch it again. Not a pretty picture. It has happened.  Start low, go slow. With that said, eating is one of the best ways to go. It takes a little longer, but lasts longer. The plasma concentrations don’t spike as high as with smoking, but you will “feel something”. Chronic smokers sometimes need to take “one hit” of smoke and an edible at the same time. With this combo, the edible is usually taking effect just as the smoked hit starts to lessen in intensity.

Liquid Extracts / Tinctures are mild in effect and typically are not psychoactive (most people don’t get high). This method is portable and many patients can work and function with no impairment and not bother other people by taking their medicine. The alcohol extracts are more potent than glycerin extracts. Vegetable oil is also used to extract cannabis (but is not considered a tincture). Patients sensitive to alcohol can add the extract to a cup of warm water and the alcohol will quickly evaporate off.  Some companies add a cannabis concentrate to other liquids. This is just a preparation variance.  There may be subtle differences, but as a consumer just watch for effect (and maybe taste) preference. Most liquid extracts can be taken sublingually by holding the liquid under the tongue for 1-2 min. This yields a faster onset than swallowing the liquid. Onset and duration vary considerably with the intensity of concentration but it typically comes on faster and is shorter lasting than edibles.

Topicals. Vegetable oil extracts, salves and lotions have an excellent empiric record of treating peripheral joint and/or shoulder pains. There have also been occasional cases of headaches, low back pain and abdominal issues responding positively to topical applications. They are the most mild in effect and least psychoactive. It is a good idea to actually measure out how much you put on in the beginning. The carrier will have a major effect on how fast it penetrates the skin and on how greasy it feels.  I’ve heard a fair number of stories from patients about numerous skin pathologies responding to topical cannabis, but I don’t have any real facts about this possibility.  It is hard to imagine, however, that a cannabis-laden topical would make a skin condition worse. Of course people have random allergic reactions to many things.

Concentrates; Hashoil, Butane Honey Oil (BHO), Waxes, Shatter. There are numerous ways to extract and concentrate cannabis, which have led to a whole new array of ways to use cannabis. These concentrates can go up to 60-90% THC. So very small amounts can be used (about the size of a grain of rice).  Smoking these is not medically recommended as it is extremely psychoactive and will most certainly lead to tolerance of milder forms.  Their use in V-pens however, is a way to lessen exposure to the lungs when compared to smoking directly. They can be added to foods, drinks and topical preparations.

Smoking concentrates (“dabbing”) requires special equipment. Basically it requires a blow torch to heat up a specialized glass bowl or titanium nail head until it is red hot. Then the dab of concentrate is added and inhaled. This delivers an extremely large dose of cannabis in seconds.

Traditional hashoil is a thick tar that sticks to and stains everything.  Wax is thicker like its name implies and not as sticky. Shatter is crystallized and resembles glass. These can be produced from a variety of solvents. Some solvents that are used for these are toxic (eg butane) in full strength but are safe when the final product is properly purged. There is an assortment of lab equipment coming onto the market for small to industrial scale extractions.  There is skill and art involved in these processes and a major risk of fire and explosion.  Don’t try these without professional training or without a legitimate laboratory.  Just image search “BHO explosions” to more fully understand. What is the difference between Shatter or Wax, read more here.

Types of solvents.  Butane is very effective in extracting a full spectrum of cannabinoids. Unfortunately it has to be purged with specialized vacuum equipment or toxic residues of butane will remain in the final product. It is also the most prone to explosions.  CO2 (carbon dioxide) doesn’t require the extreme level of purging that butane does, but equipment costs are much higher and extreme pressures are needed.  Ethanol (grain alcohol) is a food grade extract that is easy to purge and not toxic in small amounts but is flammable and explosive. The bottom line is that if a lab hasn’t certified that the concentrate is free of toxins, you just don’t know.  Much less volume of cannabis is actually consumed, which can potentially reduce the harm of smoking large volumes of crude cannabis.

Pills, Tablets, Capsules. Cannabis and concentrates of cannabis can be made available in pill form. The guidelines are basically the same as the above Oral/Edible section. Concentrates in pill form will work faster than the crude herb and will be more potent. Vegetable oil infusions are also a common way to prepare capsules.

Raw Cannabis. Eating or juicing fresh raw cannabis is a viable option for people with access to fresh plants. Some even grow 30 plants at a time and eat one every day each month. This form will be very non-psychoactive and mild but still deliver many cannabinoids in the non-decarboxylated form. Additionally people can consume larger doses without getting high. This video covers many key aspects of the raw form.

Tools:

For smoking there are a lot of options. I’ve heard a lot of debate about the pros and cons of each option.

Cigarettes: the proverbial joint. This method reduces temperature (depending on how far down it is consumed) and an element of filtration as the smoke passes over the rolled herb.  They can be extinguished and relit, but the taste and potency will intensify as it is consumed.

Pipes allow more specific and limited amounts to be used. Pipes with metal bowls tend to concentrate the heat and burn off the herb faster. Shorter pipes = more intense heat in the mouth and lungs.  They offer no filtration, but single fresh doses, i.e., “hits”, can be taken, or multiple hits if more is “packed” into the bowl.

Water Pipes: the proverbial bong. This method allows the smoke to pass through water which offers some filtration, hydration of the smoke and reduction of heat. This allows larger doses to be taken in more deeply in a single hit. This is a more intense way to consume cannabis.  It is not uncommon for someone to have to sit down after taking a bong hit. Modern water pipes have an extreme variety of shapes and options. Some are designed to hold ice in the upper stem away from the water for additional cooling. Some have multiple “chambers” of water for repeated cooling effect. Some offer multiple tubes (tree peculator) which divide the smoke into smaller openings (typically 4-12 splits) which has an atomizing effect which significantly cools and thins the smoke.