Medications taken over long periods of time often stop working effectively. This is as true in pharmaceutical medicine and in herbal modalities. If you notice that a medication is not performing as usual the first thing to investigate is your dosage. Increasing dosage of cannabinoid medications should be by small increments, for example if your daily dose is 10mg, try adding 2-4mg. Keep adding incrementally until the desired effect is achieved.

When increasing dosage isn’t successful, the next step is to try a decreased dosage. At this point, it is worth considering a cleansing reset; stop taking cannabinoids for 48 hours to reset the EndoCannabinoid System (ECS). Although this isn’t long enough to remove all cannabinoid traces, it is long enough for the ECS to get to a baseline with only endocannabinoids ( the cannabinoids we make in our bodies) in play.

There are studies which show that small cannabinoid doses, often referred to as ‘microdoses’, can be very effective. The best method is to start with a dose lower than your last effective dose and keep daily notes on the effects felt. Again incrementally increase or decrease the dose if needed.

When experimenting with dosage isn’t getting the right results, the next step is to change the strain of cannabis used in your medication. Cannabinoid medications have a big advantage when effective delivery has declined, this is because cannabinoids can be delivered by many different compounds, and these are called terpenes.

Terpenes exist in many plants, lavender and citrus are good examples, characterized by their powerful aromas they work synergistically in the body with the ECS. In the body, each terpene acts differently and elicits unique responses.

In addition, Cannabinoid medication can be restored to effectiveness by changing the type of terpene delivery. This means finding a new cannabis strain which contains the desired cannabinoid, say CBD, but, has a different terpene profile from the medication that has stopped working.

Terpenes have a synergistic action with cannabinoids which is known as the ‘entourage effect’. This operates when the cannabinoids are in a broad spectrum form with the terpenes intact. Terpenes interact with different receptors than cannabinoids, with the notable exception of Beta- Caryophyllene, a terpene with affinity for CB2 receptors, allowing it to act as a cannabinoid in the ECS.

Finding an alternative CBD-rich strain with a different terpene profile is a process of learning and discovery for the individual and relies on access to properly researched medical cannabis products.

Synergy Wellness is one of the few medical cannabis companies that make a range of cannabinoid-specific products with different terpene profiles. Taking CBD-rich medication as an example - Synergy offers five distinct CBD-rich strains to choose from. There are approximately 200 terpenes in most cannabis strains, the most abundantly present across strains in Myrcene, which has a relaxing effect, works well for anxiety relief and is useful as a sleep aid. Two of the CBD-rich strains Synergy uses have Myrcene as the dominant terpene, the Remedy strain and Valentine X. If either of those strains are no longer working well we would recommend either AC/DC which has Limonene as the dominant terpene or Ringo’s Gift with Linalool as the dominant terpene.

Choosing a new strain doesn’t have to be a guessing game , by knowing what qualities to expect from different strains it is possible to find the right fit. Staying with the CBD-rich strain choices, advising on a change from a Myrcene dominant strain to Limonene or Linalool would depend on exactly what was needed. Linalool is the terpene in Lavender and associated with calmness, relaxation, pain relief and trouble sleeping. Limonene on the other hand, has the zest of citrus fruit, it is stimulating and uplifting, good for alleviating depressive states, lack of energy and pain relief.

One of Synergy’s members, who has been using our products for over ten years and has had amazing success managing the symptoms of Multiple Sclerosis. Now in her 70s, Leenie is active, walking several miles a day and is far from debilitated by her condition. Leenie has kept scrupulous notes on the strains and dosages that work for her. After more than a decade of treating herself with cannabinoid medications she recommends keeping several different strains on hand and rotating them to prevent any one becoming less effective through overuse.

This is a strategy for long-term use and Leenie developed her rotating strain program because she found that when using a single strain over time it inevitably declined in efficacy. Another strategy Leeny has adopted is changing her cannabinoid ratios to treat particular symptoms. For example, when she knows a cold weather front is approaching her area she adds THC to her CBD dosage and this staves off the painful body aches that start when there is a drop in temperature or barometric pressure.

Cannabinoid medications have a very wide range of applications and can be used for short-term issues, as well as ongoing or chronic conditions. We recommend having a second alternative CBD-rich product on hand if you are taking CBD daily, so if you do begin to feel lessening of effect you can switch to another strain. The product we most often recommend is #160 CBD Medley , made from four distinct CBD-rich strains: AC/DC, Valentine X, Therapy A and Electra. This blend adds Bisabolol to the mix; a rare terpene, also found in Chamomile and recommended for mood modulation, anti-anxiety and anti-aging.

Our bodies will always strive to create the endocannabinoids the ECS needs to function. Phytocannabinoids will always be a viable source of the cannabinoids our bodies need to maintain healthy balance.

Cannabinoid-based medications can maintain therapeutic value in long term use and trying out new strains and ratios of cannabinoid gives more options and potential benefits.