How To Use Cannabis As A Medicine

Edibles, Capsules and Pills, Tinctures

Edibles encompass and represent an infinite variety of possibilities when it comes to manufacturing and consuming cannabis. You can literally infuse any type of food, beverage, pill, tincture, and food ingredient with THC, CBD, or any of the cannabinoids and terpenoids contained in the cannabis plant. This versatility allows for medical edible makers to craft and cook medicines that may actually fit into more specific dietary needs.

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Consuming edibles can also be a very very potent form of therapy. Oral ingestion of THC and the other cannabinoids leads to activation of both CB1 and CB2 endocannabinoid receptors in one’s body, versus inhalation which activates only CB1 and a small amount of CB2 receptors. Additionally, ingesting THC and the other cannabinoids produces effects different and more magnified than if you were simply to smoke the plant - this is especially evident with THC; the psychoactive experience of THC when ingested are indeed different than those found in joint hits, bong rips, and dabs.     

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From a therapeutic standpoint however, activation of the CB2 receptors made possible by ingesting cannabinoids opens up a plethora of treatments for a wide array of debilitating symptoms and diseases. 

The concept of Clinical Endocannabinoid Deficiency (CED) was covered in the Cannabis Science section, and as stated there, one can indeed offset CED significantly by orally consuming cannabis.

Cannabis Edibles, are however, a double edge sword. It is very easy to overdose on THC found in edibles. Even experienced users can have difficulties with taking too much, and the resulting negative side effects of THC Toxicity include but are not limited to: Nausea, Disorientation, Anxiety, Vomiting, and severe Dysphoria which can last hours, sometimes even a few days in especially sensitive users. Edibles can totally ruin someone’s day or even turn them away from cannabis entirely. It is important to stress responsibility and proper dosing when consuming, discussing, and recommending edibles.  

This is due to the fact that when THC is orally ingested, a new compound known as 11-Hydroxy-THC is synthesized in the consumer’s liver. This compound does possess inherent therapeutic properties, but know that it can cause the above side effects even with heavy cannabis smokers - simply put, if your body has not developed a tolerance to edibles, and you are not used to having this compound in your body, no matter how many years you have been smoking or even dabbing, this compound can and will mess you up! 

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Note that at the very least, despite these side effects, YOU STILL CANNOT DIE FROM AN OVERDOSE OF CANNABINOIDS.

Below, we will cover some of the various classes of edibles available on the market for both medical and recreational users.

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Capsules and Pills 

Capsule and Pill forms of cannabis are easy to manufacture and they come in varying doses, with different ratios of active cannabinoids, and with the medicine suspended in various emulsifiers contained in the capsule such as coconut oil, olive oil, grapeseed oil, and more in order to meet various dietary restrictions. Companies can even formulate them in an “AM/PM” fashion, or have CBD dominant ratios to help manage anxiety during the daytime, or even mixes to help with focus - there are certainly many possibilities and with time, more finely tuned medicines could be produced! These kind of edibles also offer medical patients a familiar form of dosing no different from other pharmaceutical pills. Each pill or capsule comes with a specified milligram content of each cannabinoid and this makes it easy for consumers to journal and adjust their dose accordingly. 

Tinctures

Tinctures have made a resurgence in the cannabis industry and their usefulness is a boon to many a patient. Tinctures are a liquid suspension of the cannabinoids and terpenoids contained in the plant, and these compounds are likely decarboxylated and activated. They typically come in small milliliter bottles and with a squeezable dosing pipette, but may also come in a spray form. Tinctures are meant to be consumed sublingually - that is under the tongue. This mode of consumption makes for a faster onset of effects (typically within 10-15 minutes) than traditionally eating or drinking a cannabis edible (onset of effects from ingestion is typically 30 minutes to a little more than an hour). The actual overall effects of tinctures are the same as other edibles, but they come with the added benefit of providing faster relief and ease of dosing than what you might encounter with an edible cookie, cake, or drink. Additionally, tinctures can also be used as a topical!

Premade Candies, Confectionery, Drinks, Snacks, Ingredients 

Again, cannabis can be infused into literally anything edible, and oftentimes they are! Edible makers creatively manufacture many kinds of candies, confections, snacks, drinks, and even other cookable ingredients so that users can concoct something of their own! Edible dosing has infinite possibilities and these items come in a large variety. As such it is sometimes hard to recommend specific dosing, but most responsible edible companies will lab test and list their contents and potency on their packaging.

Full Extract Oil (Rick Simpsons Oil or RSO)

Full Extract Oil or Rick Simpson’s Oil also known as RSO (named after the Nova-Scotian Farmer who rediscovered the process for making hemp oil) deserves special mention and it’s own section. There is a lot of lore, myth, even hype, and information on the internet regarding this effective medicine - there are multiple documentaries on youtube depicting it. With that said, there are indeed numerous case studies and success stories involving Rick Simpson’s oil, a crude and simple but effective extraction of the cannabis plant’s trichomes and cannabinoids which has been used to help with many severe diseases such as Epilepsy, MS, Alzheimer’s, ALS, HIV/AIDS, Obesity, and even with combating and killing Cancer cells. This is just a small list of diseases and ailments that users report back as being manageable with Full Extract Oil. 

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These oils are made using a grain alcohol to extract the medicine. The alcohol is then boiled off leaving a thick tarish oil (unfortunately many of the valuable terpenoids are also lost in the creation of the oil, but it is still an effective way to consume THC and even CBD). The oil is typically very potent when made. It is then consumed like an edible or used topically, but in small amounts - the size of a grain of rice. This is done on a daily schedule, and there are varying reports on what doses people used to treat their individual symptoms. Virtually all studies done on this oil are unfortunately isolated case studies; we still lack the necessary double blind clinical trials needed in order to deduce and test varying doses for varying ailments and diseases. More information about Rick Simpson can be found on pheonixtears.ca/  and the documentary “Run From the Cure”. Credit should be given here as this documentary helped to spark the conversation of cannabis as a cancer cure in the public eye. Unfortunately the medical and scientific community does not currently recognize these oils as official medications for the treatment of cancer. 

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It is important to stress that these oils are very concentrated and contain large amounts of THC and CBD. It must be stressed that dosing with these should be done in small increments as it will be easy to overdose and experience THC toxicity on just a small amount of oil. With that said, users who can develop a tolerance, or patients who are in a terminal situation can find near miraculous results with this product - many times finding quality of life changing benefits!

Making Edibles From Scratch

Prior to the rise of legalization and before the establishment of legal edible companies, throughout prohibition many home growers, recreational cannabis fanatics, and even resourceful medical patients would make their own edibles. Consumers typically made their own butters and chocolates by cooking plant matter with melted butter or chocolate, and then straining the resulting material with a cheesecloth. Other methods of making edibles are varied and one includes decarboxylating hash or concentrates in an oven for a short amount of time and then directly adding in the decarbed material to a recipe. 

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Homemade edibles can be a little hard to dose without a lab test, but there are mathematical methods of getting a ballpark estimate of what might be contained in any freshly or handmade edible. As with all edibles, caution and responsibility with their consumption must be stressed!

A Few Nuances to Familiarize Yourself With Making Edibles:

Decarboxylation - 30 minutes at 215°F or 15 minutes at 230°F. These temperatures represent the proper “cooking” time for decarboxylating cannabinoids and making THCA into the active Delta 9 THC.

Trim vs Concentrate - Edible makers will typically use either of these in edible creation. Trim is flatout cheaper than purchasing bulk bud, and Concentrates can be used in significantly smaller amounts to achieve higher doses and more potent products.

Medical Application of Edibles and Dosing

Many patients who opt to use cannabis are turned off by the idea of smoking, and many first time medical users of cannabis nowadays prefer to consume cannabis as a pill, tincture, or edible. The onset of effects may be slower, but much longer lasting. With that said, there is indeed a wealth of benefit that is possible with consuming edibles from a medical standpoint, but it is also important to remember that there are very real side effects when consuming too much. 

As was mentioned previously, oral consumption of cannabis activates more receptors within your Endocannabinoid System, and the potential therapies and possible ailments to treat are vast. With our more modern understanding of cannabinoids, the ECS, and how they work, medical professionals and medical patients are heavily involved with tackling some of the following and much much more:

• Killing Cancer Cells and managing cancer chemotherapy and radiation therapy.

• Reducing Opiate and or Alcohol Abuse

• Near eliminating seizures in epileptics

• Managing severe, chronic, and or neuropathic pain

• Managing countless diseases and ailments and their respective symptoms ranging from IBS, Crohn’s, HIV/AIDS, ALS, Fibromyalgia, Multiple Sclerosis, Alzheimer’s, Parkinson’s, PTSD, Dementia, Lethargy, Insomnia, Viral and Bacterial Infections, and many more.

When ingesting cannabis, users can expect the onset of effects to occur anywhere between 30 minutes to an hour and a half (tinctures being the exception as they have an onset of 10-20 minutes when administered under the tongue), with the duration of the medicine lasting anywhere from 4 - 12 hours depending on the amount of cannabinoids consumed and the individual’s tolerance. If considerable time has past (2 hours) and no effects from the cannabis is felt, the user may increase the dose, though small incrementations are recommended. It is important to start with small doses, and the following recommendations are based off of the opinions of experienced industry professionals, doctors, and patients:

• New User: 2.5 mg - 5 mg of THC

• Intermediate User: 10 mg - 30 mg THC

• Experienced User/Patient In Need of High Dose: 30+mg of THC
  Increase and self-titrate over several days to determine which is tolerable.

• Patient with a terminal ailment or cancer: 5-20 mg of THC and/or CBD per kg of the patient’s body weight. (This dose was borrowed from the US Patent Filing: Phytocannabinoids in the Treatment of Cancer. Note that this patent actually experimented with doses of 1, 10, and 100 mg of THC per kg of body weight. The 5-20 mg range is a bit more practical for patient use).
  Eg. A 175 lb man is roughly 79 kg. The minimum recommended dose at 5mg x 79 kg = 395 mg THC and/or CBD daily. If we use the high dosing, that same patient will be taking 20 mg x 79 kg = 1580 mg THC and/or CBD daily. Note that these doses are easier to achieve with THCA which is also non psychoactive - consuming raw cannabis or raw cannabis concentrate will achieve these high doses as well. Last but not least, Full Extract Oil or Rick Simpson’s Oil (RSO) will typically be made with high concentrations of THC as well - these oils have been helping and saving lives for more than a decade now, and more information on utilizing these oils can be found with simple internet and youtube searches, but the best direct source for this information would be phoenixtears.ca

If these doses are found to be ineffective, increase THC in 5-10 mg increments and self-titrate over several days to determine which is tolerable. CBD will be easier to experiment with but keep in mind that a small amount of THC should be in the medicine to ensure that the full effects of CBD and the Entourage Effect are received. Again, CBD isolate is nowhere near as effective with accompanying cannabinoids.

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This article and page continues further in the following subsections:

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Main Page - The Medicine In Cannabis

Flower and Plant Material - Raw Juicing and Smoking and Vaping

Concentrates - Smoking and Vaping

Edibles, Capsules and Pills, Tinctures and More 

Topicals, The Cannabis Patch, And Suppositories

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Written and Organized by 

Danny Gagaoin

Cannabis Education and Research Director

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