MICRODOSING Can less be better than more?

HealthyLivingIn medicine, dosing is critical—too little and the medicine is not effective. Too much and it can kill you or at least make you feel excruciatingly nauseous. Cannabis doesn’t fit that rule as it is so safe that there is little concern over proper dosing with many people taking the attitude if a drop is good, a bathtub full is better.

Just because you can’t overdose doesn’t mean how much you consume is not critical. Cannabis is bi-modal meaning that low doses can have one effect while high doses can have an opposite effect. This becomes a critical component in the ability of cannabis to provide symptomatic relief for a variety of ailments but especially in the treatment of pain which is the number one reason patients cite as their reason for the use of cannabis medicinally.

Enter the concept of micro-dosing where a patient consumes a significantly lower amount of cannabis than what has been used previously. That a lower dose can be as effective as a higher dose has been found in a number of studies including a recent study undertaken by the University of California, San Diego Center for Medicinal Cannabis Research. Patients in the study being treated for neuropathic pain reported that cannabis with 1.29 percent THC provided as much pain relief as cannabis with a 3.53 percent THC level i.e. no loss of pain relief properties while providing a significant reduction in psychoactive effects.

“Complicating the picture is that it is nearly impossible to develop a standard cannabinoid dosage as every person has their own personal response to the ingestion of cannabis due to the complexity of the endocannabinoid system and the resultant individualistic responses to cannabis ingestion—one person’s low dose could easily be another person’s high dose.”

Why a lower dose may provide as much or even more pain relief than a higher dose is explained by the biphasic dose-response curve—a scientific term noting that people have a specific individualistic threshold for cannabis effectiveness. Cannabis use below their specific threshold can provide an increase in health benefits, but if used above that level diminishing benefits will be experienced as a tolerance is developed to increasing concentrations of THC and other cannabinoids.

What is happening is that lower doses of cannabinoids can upregulate or increase the response of the cannabinoid system to a stimulus, whereas the development of a tolerance caused by higher doses of cannabis can cause the cannabinoid system to downregulate and become less responsive to stimulus resulting in a reduction of pain relieving properties.

Not only can higher doses cause a reduction in pain relief, but it can also cause extensive discomfort. In the clinical trials of Sativex, a cannabis based spray used for treating pain and insomnia associated with cancer, GW Pharmaceuticals found that high doses resulted in greater discomfort resulting in a 22 percent dropout rate as compared to just five percent in the low dose group and seven percent in the medium dose group.

Complicating the picture is that it is nearly impossible to develop a standard cannabinoid dosage as every person has their own personal response to the ingestion of cannabis due to the complexity of the endocannabinoid system and the resultant individualistic responses to cannabis ingestion—one person’s low dose could easily be another person’s high dose. Each person needs to determine their own specific threshold level in order to determine their optimum dose.

One thing is fairly certain though—the more out of balance or sicker a patient is, the more they will most likely need higher dosing. As health improves and a return to a balanced physiological state progresses, lower dosing would be effective.

Micro-dosing is but one avenue to consider when deciding on the amount of cannabis to consume as the reasons for ingestion will play a big role in the decision. At one time a person may want to use cannabis for pain, another time for insomnia and another time for its legendary recreational properties.

Although it might take a bit of experimentation to discover what cannabis doses work best, unlike all other medications and social stimulants, there is no danger in finding out.

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