Microdosing with Cannabis
Billee Sharp
In the twenty years since medical marijuana was legalized in California cannabis strains have become much stronger in THC content. Growers take two or more high THC strains and cross fertilize them. Certainly the THC rich strains available legally in California are very much stronger than the strains from thirty years ago. Most dispensaries offer some variety in the strength of THC strains but recreational use THC is in most demand and generally high THC is what is stocked. Dosages of high THC cannabis have been shown to have therapeutic value in pain mediation and anti-cancer protocols, but the psychoactive side effects deter many patients.
Luckily for the many of us who are reluctant to use high THC medications, there is a growing community of cannabis advocates and clinicians who are pushing for lower doses for therapeutic protocols. New research is yielding positive results from microdosing studies which deliver very small amounts of THC and other cannabinoids.
Low dosages are referred to as “microdoses” and this approach has been popularized by protocols for mental health issues which include microdosing psychedelics like LSD, MDMA or psilocybin.
Microdosing cannabis is taking small amounts of cannabis in order to reap the medical benefits of THC while avoiding its psychoactive effects that can interfere with the demands of daily life.
“Most people don’t know about microdosing,” says Michelle Ross, founder of IMPACT network, a nonprofit organization that uses medical research to find new cannabis-related treatments. “They just blast their system with cannabis or high amounts of THC, and that is not always the best approach for whatever condition they have.”
Many experts now believe that the threshold for the medical benefits of THC is far lower than many people think and that high doses can be counterproductive.
“When you raise the dose sometimes you get diminished benefits, and sometimes you get the opposite of what you are looking for,” says Dr Dustin Sulak, an osteopathic physician based in Maine who treats many of his patients with small doses of cannabis. For example, while a little cannabis can help reduce anxiety, too much can actually cause it.
According to Dr Sulak this is why many patients are now turning to microdosing in order to treat conditions such as depression, stress, anxiety, pain, and to help improve focus and promote sleep.
While more research is needed there are some clinical studies that suggest that less is in fact more when it comes to medicinal cannabis. In a 2012 study, patients with advanced cancer who were unresponsive to traditional opioid painkillers were given Nabiximols, a THC/CBD compound, at low, medium, and high doses. Patients who received the lowest dosage of cannabinoids showed the greatest reduction in pain, while those receiving higher doses actually experienced more pain.
In another study, a prison group of individuals were given low (four milligram) doses of Nabilone, a synthetic cannabinoid, to help treat their post traumatic stress disorder (PTSD) and its associated symptoms. The results, published in 2014, showed significant improvements in PTSD-associated insomnia, nightmares, general symptoms, and even chronic pain.
Cannabis can be effective for helping to control other chronic conditions. As we have seen with members of Synergy Wellness, multiple sclerosis can be controlled with daily microdoses of THC and CBD, larger doses are only administered to control painful flare-ups of symptoms.
Other Synergy members have established THC:CBD microdosing protocols for chronic health problems including neuropathy and fibromyalgia.
Microdosing is beneficial on a daily basis, a tiny sub-psychoactive dose of cannabis reduces stress, helps with mental focus and general sense of healthiness.
So how to discover your optimal dose of cannabis really depends entirely on you. Each individual has a THC tolerance level which can only be identified by the individual. The level of tolerance can be affected by individual differences in liver metabolism, genetics, previous usage, among other variables.
The goal is to find the dose that gives the most minimal noticeable effect. Microdosing is personal that way, everybody has to experiment until you find the dose that works.
As a rule of thumb, a microdose regime starts with a 2.5 mg dose and stays at that dose for two or three days. Particularly sensitive types can start even lower at 1mg if so desired. Cannabis tincture might be the simplest and most accurate form of microdosing cannabis, edibles tend to start at around 10 mg per serving so a cookie or gummi will have to be cut down which is difficult to get accurate. Vaping or smoking can be the method but again it is difficult to calibrate; one puff is the start point.
For those who use cannabis regularly, a microdose protocol would be initiated by a 48-hour of cannabis abstinence. This is enough time for the endocannabinoid system to reset. While this might seem like a brief moment after potentially years of usage, a brain imaging study published in 2022 tracked the number of cannabinoid receptors during a period of abstinence from cannabis. The results indicated that even in heavy smokers, the receptors bounced back to baseline levels after just two days.
After a 2- day cleanse, microdosers can gradually reintroduce cannabis into their system, starting with just one milligram.
The aim with cannabis microdosing is to have a therapeutic effect without psychoactivity, so the patient must try and notice the slightest psychotropic effect. When you do notice a slight effect, stay at this dose for a few days and add more slowly if needed. Most patients settle at a daily microdose of 1 to 3 mg, which is very modest.
Lower doses can actually lead to increased sensitivity to cannabis over time, underscoring the importance of staying at low levels for the first few days of microdosing. As you build tolerance to THC you also build tolerance to your own endocannabinoids which promote balance and health. A highly sensitive endocannabinoid system is extremely valuable for responding to systemic threats: illness, injury and stress, so a microdose regimen keeps the ECS ( Endocannabinoid System) primed with phytocannabinoids on a daily basis.
For somebody who uses cannabis irregularly or is just starting to use cannabis, 1 milligram of a 1:1 THC:CBD blend will further ease any psychoactive effect, the 1:1 microdose can gradually be increased until some alteration is felt, then stay at that level for four days.
Over time many people feel the need to increase their dose for effectiveness. When the microdose feels like it is not working any longer, that means that the optimal dose for the user has been passed. In a sense finding the optimal dose is established by means of going past it.
Microdosing may yet become the go-to method of maintaining endocannabinoid health, a daily microdose of cannabinoids to support the ECS , much like a multivitamin!
Sources:
“Rapid Changes in CB1 Receptors Availability in Cannabis Dependant Men after Abstinence from Cannabis”
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4742341/
Use of a Synthetic Cannabinoid in a Correctional Population for Posttraumatic Stress Disorder, related Insomnia, Nightmares,Chronic Pain
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4165471/
Nabiximols for Opioid-Treated Cancer Patients With Poorly-Controlled Chronic Pain: A Randomized, Placebo-Controlled, Graded Dose Trial
https://www.sciencedirect.com/science/article/pii/S1526590012000193