New to Medical Cannabis? You're not sure what CBD is? If you have anyone you know that would like this education, please feel free to pass it on!! Here is a short video on CBD, which stands for Cannabidiol, one of the many medicinal components of the cannabis plant and a major cannabinoid. Dr. Bonni Goldstein, Weedmaps and SC Labs put this together...good info!
I am reposting this transcript because it is an important one. Many people have a goal to get off of their opioids and cannabis is certainly a great alternative. This article also talks about dosing and this is one of the biggest questions people have about cannabis...how much should I take? Since I am not a doctor, I am grateful for Dr. Sulak's expertise in this area...please visit his website www.healer.com for more info.....
The following is a transcript of Dr. Sulak’s Opioid Event:
Now that you understand the science behind my claims that cannabis can be used to reduce and replace opioids, treat the withdrawal, and prevent dosage escalation, I’m going to show you how to do it.
We’re going to start with some general dosing terminology around cannabis. And I’m going to show you a few caveats that are unique to medical cannabis compared to other medications. And we’ll go straight into what I recommend for people who are new to cannabis and for people that are experienced with cannabis, and then we’ll go to specific guidelines for cannabinoid opioid combination treatment. Finally, we’ll wrap it up with case studies and patient narratives.
So clinical dosing terminology – it’s important to have a language to talk about this stuff, especially if you’re new to cannabis. So here is a pipe with herbal cannabis in it. That’s for smoking. A lot of you probably recognize it. When we talk about dosing with smoking we’re usually referring to how many puffs a person is taking a certain number of times per day. And you’ll find people that are smoking a whole joint which might be 20 or 30 puffs, and you find people that are taking just one puff off of a pipe. So there’s quite a range in how people use it. And also quite a range in how big those puffs are or how much of the actual medicine is absorbed versus is exhaled.
Here we have a liquid extract of cannabis, often called a tincture, which by definition is an alcohol extract, but also people call other liquid cannabis medicines tincture as well, even though that name isn’t exactly right on for it. Often these are being made with oils. And these can be dosed by the drop. So someone might know with this particular potency of the liquid medicine I’m going to take five drops or eight drops.
Dosing by the Milligram
Over here we have a tube of cannabis concentrate, actually in a syringe, you’ll notice there’s no needle (which is a good thing) because that syringe can be squeezed to express just a small amount of this very potent concentrate. These concentrates can be up to 50 percent cannabinoids by weight. So even something the size of a pinhead can be a really substantial dose when you’re dealing with this stuff. And for people that aren’t prepared this can cause some overdose reactions, which are safe, but quite uncomfortable. And here we have a close up of the cannabis flower.
So as a physician, when I talk about dosing medications, I usually like to talk about milligram dosing. And right now, in cannabinoid medicine we’re talking about milligrams of THC and milligrams of CBD, primarily. There’s other trace cannabinoids and acidic cannabinoids that we refer to in certain cases, but in general we’re talking about how many milligrams of THC and CBD.
So, when I look at the dosing range, the effective dosing range in my practice, it’s unlike any other medication. We’ve seen when dosing by body weight – just to orient you – we’ve seen responses as low as .015 mg per kg of body weight per day, all the way up to 30mg per kg of body weight per day. Now it doesn’t make a lot of sense to dose and adult by their body weight, but I wanted to put it into this perspective for you. This means someone about my size might do well at the very low end taking 1mg of cannabinoids per day versus somebody taking over 2,000mgs. That’s the safe, effective dosing range. It’s an incredibly broad range but it’s still well below the lethal dose – if there even is one. Now, some of you know that researchers have really tried to kill animals with incredibly high acute doses of THC; they haven’t been able to do it. So here we have 300 times the maximum dose I see in my practice, and monkeys are still surviving. But I don’t think they’re having a pleasant experience.
Now within that broad dosing range, we have non-linear dose response curve. So this is unlike the dose response I showed you of morphine and pain earlier. This is, on the bottom here, we have a low dose to high dose and on the side, low benefit up to high benefit. What we often see (not always, but often) in cannabinoid medicine is that if someone starts at a low dose and gradually increases, they get more and more benefit up until a certain point. Beyond that point, as they increase their dose, they actually start getting diminished benefits and when they use high doses, sometimes they’re barely feeling anything at all. Often, when they use ultra-high doses, this curve will come back up again, way at the other end of that extreme.
Now, this has been shown in animal studies, not just my clinical observation. So here’s loco-motor activity in rats. This is how much the rats are running around basically. And here’s there’s baseline level. Given a very low dose of THC, so this is .2mg per kg, the activity is going down quite a bit. This activity level could be analogous in treating a human to something like spasticity or anxiety. Then, as the dose of THC increases the activity level actually goes up. Then as the dose increases even more, the activity level goes back down again. But you’ll notice up here, at 5mg per kg, they didn’t get as strong of a result as they got at 0.2mg. What they did get was the emergence of a side effect, in this case catalepsy, which means remaining still in an unusual position.
So what this shows is that at the very low doses – doses that are so low that some rats or some humans might not even start that low, they might overshoot it, and start up here and think they’re getting an efficacy at an optimal level by the time they get up to the high doses. We’ve been finding in our practices, that ultra-low doses can work very well for some people. And this has been shown in humans. So here was a study on 263 people that were already receiving opioids for the treatment of chronic pain, and they were given that standardized cannabis preparation I mentioned … which is about a 1:1 ratio of CBD: THC. Here’s their baseline pain level at the top. Here’s how much pain relief they got from a placebo, which I’d like to mention is really powerful. So, our bodies have an internal pharmacy. If we use the power of our mind and the power of our belief to make ourselves better, we actually get better. It’s not just that we think we’re better – we don’t just think we’re better – we actually do get better. We can change our physiology, we can change the structure and function of our bodies, or our brains, just using our mind-power. And it’s been shown that endocannabinoids, the molecules that we make that are very similar to the substances in the cannabis plant that are therapeutics, cannabinoids have an important role in the placebo effect.
But anyway, back to the study, the 20mg group had this much reduction in pain. The 52mg group had just a little bit better than placebo. And the 83mg group really didn’t do much better than placebo. So this clearly shows that with cannabis, less can be more; lower dose is often more effective, a higher dose can be less effective.
So now you know some of the basics. I just want to walk you through how we approach our patients, both patients that are new to cannabis and patients that have experience with cannabis.
New to Cannabis
So starting off with new to cannabis: I have a picture here of my grandmother, Elaine Sulak. She just passed away a couple of months ago at age 91. But for the last six or so years of her life, she was using a cannabis tincture quite effectively. And during that time, her mind became clearer; she had reduced pain, improved function, and better mood, her entire quality of life changed. It was really incredible. And she didn’t know what she was getting the whole time. She didn’t have any side effects from it because we were very careful with our dosing strategy. We were able to achieve this incredible improvement in quality of life without any side effects. So what do we do if someone comes that’s brand new to cannabis? The trick is to start sub-therapeutic, and this requires a little bit of patience on the part of the patient because some of them want instant results. We say, we want you to intentionally start at a dose that’s below your optimal dose, obviously. And then we increase very gradually to the minimum noticeable effect. So you start sub-therapeutic, you gradually work up until you can just feel a little bit of something, a little pain relief, a little anxiety relief, and then you hang out at that dose for three days. During those three days something really interesting is happening. And I’m not going to bore you with the science behind it, but the body is actually getting more sensitive to cannabis. And patients will find that staying at the same dose, on day three, they’re actually getting more relief then they got on day one. But then on day four, go ahead and increase to the dose that you find most effective. And we give instructions on how to do that, especially something that I call the “inner inventory,” which is a very quick self-awareness technique for checking in and figuring out how am I feeling right now, how have I responded to that dosage of cannabis that I just took. You can find all of this on healer.com, free patient education with videos that will literally walk you through step-by-step or walk someone through who’s brand new to cannabis. We have a shopping guide that helps them figure out how to get the right cannabis when they go to the dispensary or when they talk to a caregiver. We really want to make it easy for people to have great results – like my grandmother – without the side effects.
With experienced users we have a few other strategies. So the first is what I call the “sensitization protocol.” And the purpose of that six-day protocol is to take people from here and get them back to here. And the thing is, everyone has a different optimal dose. I can’t pick you out and say “here’s your optimal dose,” I’m going to tell you what it is, you can dose cannabis in that way and you’re going to do just fine. But what I can tell you is a methodology for how to find that optimal dose. And almost – not almost all – but quite a few of the patients that are experienced cannabis users coming into our practice, they want to use cannabis for symptom relief or real medical treatment figure out that they’re actually here, and by reducing their dose they’re able to get more benefits, they’re able to spend less money on the cannabis, they’re having less side-effects from the cannabis. If they’re inhaling, they’re saving their lungs from that exposure. It’s just better for everyone when they do the sensitization protocol.
And on the next slide I’ll show you some of the results. But before I go there, a lot of patients that are experienced users have only inhaled cannabis via smoking or via a vaporizer. In switching to a liquid extract, and oral mucosa absorption, so the medicine is actually getting absorbed through the blood vessels in the mouth and tongue, and then some of it’s getting swallowed and being absorbed through the digestive tract, that’s a really wonderful delivery method that can often be used to prevent symptom instead of chasing symptoms around. And when patients figure out how to best use the oral mucosa delivery, they’re often having improved quality of life, less symptoms, better function. And finally, a lot of experienced cannabis users haven’t explored CBD yet. CBD, as I mentioned earlier, is that sister molecule to THC. It’s non-psychoactive but it tends to enhance the benefits and reduce the side effects of THC. They work really well together. So for people that haven’t tried it, we recommend that they do try different ratios of CBD and THC, perhaps to find something that works well during the day so that they can get symptom relief without having any impairment. And then they can use something else at night or weekend that might create a little bit of a psychoactive affect, which I’ll cover later in this talk because there are some real benefits to the psychoactivity of cannabis as well.
So here is the sensitization protocol, again it’s just six days, and it’s basically two days of cannabis abstinence followed by four days of very specific dose titration. The program is free on healer.com/programs. We surveyed 48 of our patients that did it a couple of years ago: 90 percent of them successfully reduced their dosage, and the ones that did, reduced their dosage on average 56 percent. So they’re using less than half the cannabis they were using previously and getting equal or greater benefit, usually with less side effects.
Specific guidelines for cannabinoid-opioid combination treatment
Those are the basics. Now let’s talk specifically about what to do for people that are using opioids that want to try combination cannabinoid-opioid therapy. So, the first rule is to take a small amount of oral or oral mucosa cannabis with every single dose of opioids. Don’t allow those opioids to pass your lips unless you’re taking some cannabis at the same time. It’s really basic from a scientific perspective. It makes sense. We know these medications synergize with each other. We know that the cannabis can widen their therapeutic index and prevent tolerance building. But so many people approach this in the exact opposite way. They think they’re going to use their cannabis or they’re going to use their opioids, that it has to be one or the other. No. Please use them together, and it can be as little as 1mg of THC. So a dose of THC that’s not high enough to reduce pain, that’s not strong enough to cause any psychoactivity, can still potentiate the opioids. I also mentioned that “inner inventory,” so use the inner inventory in healer.com to find the minimal effective dose. Again, you don’t have to do a lot of cannabis. Figure out what you’re minimal effective dose is and then combine that with every single administration of the opioid. If you’re doing a long-acting opioid like a fentanyl patch, for example, then you’ll probably going to want to do an oral or an oral mucosa dosing every four to eight hours, depending on how long the effects last for you, which can be highly individualized with cannabis.
So that’s the mainstay of the treatment, is this oral dosing. Then you can use inhaled cannabis for breakthrough symptom management and to reduce cravings. So you’re doing the opioids, you’re doing the cannabinoids, if a craving comes up and you get that thought “man I wish I could take that next pill right now instead of waiting four more hours, that’s something I’m considering doing”; don’t do it. Reach for the cannabis. You can inhale cannabis. It has such a rapid onset when it’s absorbed through the lungs, that one minute later you’ll be feeling better. It’s a great solution to problems with craving. It can really change your mindset, reduce your pain, and take you off that track, shift you to something else. Now you’re suddenly looking at where you were two minutes ago, and realizing, wow that’s how I was thinking, that’s how I was feeling just two minutes ago, I was considering taking an extra pill when I knew I’d be out at the end of the month (or whatever). Cannabis patients always tell me, cannabis can change that, shift their perspective and help them see themselves in a new light.
If it is available, I’d recommend selecting some combination of CBD and THC, again, to enhance the benefits and decrease the side effects. A 1:1 ratio, so equal parts of CBD and THC, works very well. It’s broadly effective and well tolerated. It’s still a little bit psychoactive, but it’s not very strong. And I just want to mention, because I know a lot of people with opioid addiction also have Hepatitis C, that’s been contracted through IV drug use, there’s some information that high doses of THC in people that have liver fibrosis or inflammation – when the liver disease is active – high doses of THC can potentially make that process worse. We have evidence that suggest this. So for those people, I recommend more CBD than THC, at least a 2:1 ratio. We also have evidence that CBD will do the exact opposite, it actually protects the liver in some situations where there is inflammation or scarring going on, and it can prevent progression of liver disease. So CBD is a great choice for people that have Hepatitis C and other liver conditions.
A lot of people don’t have the luxury that some of us have where we can just go shopping and figure out, I’m going to get something with a 1:1 ratio and I know how many milligrams per millimeter it has and that’s how many drops I should take to follow my doctor’s advice. It’s not always that easy, but it’s getting easier and easier all the time. I just want to point out for people that are dealing with herbal medicine, you can’t just look at it and smell it and know what it has in there. You can’t just look at the morphology and recognize it as a THC strain or a CBD strain. You actually have to get it analyzed and that’s what we’ve been doing in our lab.
So here’s a few examples: here’s a cannabis flower that’s really just THC dominant and barely has any CBD or any of the other cannabinoids in it. Here is a cannabis flower that looks almost identical. I’m not sure how it smells in comparison but you wouldn’t be able to tell the two apart. But the contents are actually vastly different. So this strain has a little more CBD than THC. This would be an excellent choice for someone that’s working with recovering from addiction. And then here’s another strain that looks very similar. This is almost all CBD with barely any THC at all in it. So these three cannabis flowers are going to have vastly different effects if they were prepared in a liquid form, than those three different oils or tinctures would have different effects. And you need to know what’s in there before you can get optimal results in most cases.
So continuing on, on how to combine these two medicines. So cannabis can be used to enhance other health-promoting activities. I strongly recommend this, our patients come back telling us it really enhances the effects of exercise, meditation, prayer, journaling and reflecting, and psychotherapy. And there’s actually some experimental evidence that suggests both CBD and THC, in two separate studies, can improve the response to fear extinction training, which is basically a model of how to get out of that PTSD reaction mode, and no longer be afraid of something that’s not present in front of us. I put these on the slide because these are really important things, a very effective lifestyle approaches to managing both chronic pain and addiction, or both. So, exercise is huge, even if you’re in pain I’m sure there’s something you can figure out how to do that you can tolerate with the body that you have. On healer.com I have a whole page of wellness activities, very simple breathing exercises that will actually get your heart rate going, simple Qigong and yoga-based practices that I make very accessible. The videos are short, two to five minutes, and I promise that everyone can find something that they can do for exercise. And if you’re going to be healthy, if you’re going to recover from opioids, you need exercise in your life. You need a time to reflect. And I really recommend journaling. It’s amazing. It’s not about what’s going into the journal, it’s about what’s going on up here while you’re holding the pen. And that process of reflecting and thinking about what’s important about my day today and then getting ready to write that down helps us gather information, helps us learn from our experiences, and really can help us literally turn the page on our limitations, and start the next day in a new way.
Finally, use cannabis to promote regular sleep patterns – using sedating strains only in the evening. Those of you who know cannabis, know that there’s different strains that have different effects. Some cannabis is better for pain. Some is better for muscle spasms. Some is better for anxiety. All these different strains have different ratios of the various components. So there’s the cannabinoids, there’s the terpenoids (which are molecules that give cannabis its smell, its aroma), and all of those have physiologic effects. So the unique blend from each of these different varieties gives it a different effect in the body. There’s some strains that will clearly keep people awake. And they might be great for late-night creativity sessions, but don’t do it if you’re trying to recover or if you’re dedicating yourself to a healthier life that’s free from opioids or if you’re working to reduce and stabilize your opioid dosage, trust me getting regular restorative sleep is going to be one of your best assets. So you can use cannabis to promote great sleep.
Now we’ve seen clinically when patients are cannabis-naïve, they have excellent responses to starting this combination treatment. So “cannabis-naïve” means they haven’t used cannabis ever or haven’t used it in a long time. They come in on a bunch of opioids, their pain is not well controlled, we get them started on that approach I showed you for the new user – sub-therapeutic, work up slowly, stay there for three days, and then work up a little bit more – they use that approach and they come back and they say within the first two weeks I reduced my opioid dosage by 50-80 percent. It’s just incredible when they get they right dose of cannabis how much they can reduce the opioids in the first couple of weeks. Progress after that first couple of weeks continues, but it’s a bit slower. Really there’s no rush. This is a long-term change. We’re not trying to rush people off their opioids. But really, take advantage of that therapeutic window in the first couple of weeks. When I first started this, before I even knew what was happening, before I recognized these trends in my patients, people were coming back saying I just started cracking those tablets in half because they felt too strong. They literally, when I was taking them with cannabis, they were too strong for me. I couldn’t tolerate the dose that previously wasn’t enough.
For experienced cannabis users that are currently using opioids, before you start to decrease your opioids dose, I recommend first going through the cannabis sensitization program – that six-day protocol. And what this will do is tonify your cannabinoid system, it will up regulate your cannabinoid receptors, it will get your body to start creating cannabinoids and make you more sensitive to the medicine, so that the cannabis can have the optimal effects in helping you with your opioid taper. Stay at the optimal dose to avoid building tolerance throughout the taper, which means if you get to the point where you notice, well I’m needing more and more cannabis to get me the same results, you might consider doing another sensitization round to reset your sensitivity to cannabis. And for people that are only inhaling cannabis, I really will strongly encourage you to try the oral and oral mucosa delivery routes, figure out what your optimal dosage using those delivery routes, before you start tapering the opioids. So you want to really arm yourself with the best tools to be successful in reducing or discontinuing opioids.
Now, I’m describing using cannabis to slowly reduce opioids, and this is what works best for everyone. But I’ve also seen a number of patients that are so fed up with their addiction, they don’t want the slow process, they’re ready for a rapid change. And that’s probably just a personality thing. It could be better for some people to have an abrupt change that. Maybe they’re changing a lot of things in their life all at once, which has been shown scientifically to promote lasting changes. So for those people, they can just get everything ready on the cannabis side, go cold turkey on the opioids, use cannabis at probably than their maintenance dose to treat the opioid withdrawal symptoms, and then after the withdrawal symptoms are gone they can reduce their cannabis dose and use it for maintenance to prevent cravings, to treat pain, to help with whatever reason they have for getting into opioids in the first place.
For some patients, low dose cannabis is not effective. But for most patients, it is. I have had several reports of people that are using extraordinarily high doses of cannabis concentrate to help them reduce and discontinue the opioids. And it seems to me that for the patients that don’t respond well to the low-dose approach this actually works well and it can be safe if you do it carefully. So, as I mentioned earlier, one pinhead of this would probably be a very strong dose for most people in this room. But if you start at a tiny dose of this cannabis concentrate, most people would just put a small amount in between their gum and their cheeks to gradually absorb through the oral mucosa, and do that two or three times a day. Over the course of a month and gradually work up to a bigger and bigger amount, up to even 100-500mg of cannabinoids per dose – this is expensive, but if you access to it, it can be very effective and people can use this to get through those really challenging times with opioid taper and opioid abstinence.
More and more in the clinic, we’ve had people coming in that are brand new to cannabis who not only want to try cannabis cautiously, they don’t want to get high. They want no psychoactive experience with their cannabis use. And as I mentioned, that’s totally achievable. You can do that with CBD, in combination with THC. You can do that using THC alone, in very controlled doses. And we have a whole program on that on healer.com, the non-psychoactive strategies for using cannabis. But I want to just mention that the psychoactivity can be quite beneficial and not to fear it, but to embrace it. It’s one of the gifts of cannabis. And when people experience that psychoactivity, this is what they’re reporting – positive mood, relaxation, laughter, socializing, distortion of time (which can be quite helpful for people that have had trauma, that are always thinking in the past about that trauma or worrying about the future), it brings people into the present moment. Intensification of ordinary experiences, things like eating, listening to music, watching films, having sex – these things can feel better under the influence of cannabis. People have reported this from separation of symptoms and suffering, where prior to using cannabis all of their suffering was like in one big ball and they just saw it as this thing that was nagging them or destroying their life or limiting their function. And then after they used cannabis, they can start to separate it out. Here’s the signaling of pain from this area of my body, but at first it’s a neutral signal, it’s coming from, say, an arthritic knee up to my brain, but then my brain is perceiving it as pain and then it’s actually judging that pain as a bad thing, and then I’m attaching some suffering to it because I’m experiencing a bad thing and having anxiety about having more pain in the future. And then all this behavior that goes into how I deal with the pain and what I want to do to treat the pain. That’s all one big ball, separating it out into these different levels is incredibly helpful for patients and that’s another one of the gifts of the psychoactive aspect of cannabis, which again is mostly dependent on the THC. People report increased self-awareness, a sense of connection to the universe, viewing oneself from a different vantage point, fostering acceptance, helping people find creative solutions to their problems – people have these ideas that they never would have thought of without the help of cannabis, so they report. And promoting mental, emotional, and physical flexibility and capacity to change. I put it like that “mental, emotional, and physical flexibility” because they often go together. And as people start feeling more loose and relaxed in their body, as they start maybe doing a bit of yoga or some of the exercises on healer.com, and getting greater range of motion in their body and literally in their nervous system, their thought starts changing, their emotional flexibility increases. So the other things about these gifts from cannabis consciousness, is that they outlast the acute effects of cannabis. I was speaking with a patient recently who told me that under the influence of cannabis she suddenly had this realization that everything in the universe is connected to everything else, and she saw the underlining fabric of reality. And after the cannabis wore off, she took that lesson with her and was able to relate to people in a new way, to connect with nature in a new way, to accept that everything is connected, and that gave her great peace in her life. So some of these lessons will stay with us.
Case Study and Patient Narratives
So let’s move on to a case study. This is kind of the bread and butter of our practice at Integr8 Health, we see a lot of different conditions, but about 70 percent of our patients have chronic pain. And I chose this case because it’s fairly typical of what we see, and I think a lot of you can relate to it. So, a 43-year-old man with chronic pain, a victim of a hit and run motor vehicle-pedestrian accident at age 25, resulting in spinal disc herniation. When he first came in he had already tried cortisone injections, chiropractic, physical therapy, and prescription medications. (I’ll show you his medication list on the next slide.) He did not have satisfactory improvement. He saw an orthopedic specialist who recommended surgery based on the patient’s physical exam, which included weakness in one of his legs, and that is an indication for surgery. But the patient didn’t want surgery at age 43; he wanted to postpone it as long as possible.
He was a high school graduate and worked at an electronics store and at the time he had a 15-month old, first-born child. He came in with an average pain level, 6-7 out of 10. He had a little cannabis history, tried it at age 16, but hadn’t used it in 20 years. He didn’t have any history of adverse affects with cannabis. He simply wasn’t using it. And here’s his medication list: He was on muscle relaxants, two anti-inflammatories, tramadol (which is an opioid pain reliever), hydrocodone (which is another opioid pain reliever), an anti-nausea drug because the pain relievers cause nausea, blood pressure medication, and cholesterol medication. He had previously tried gabapentin (which is an anti-convulsant medication and often used to treat pain and Lyrica, which is in that same category).
So he came back in six months, after cannabis certification. He started using edible cannabis in the form of cookies – not something I typically recommend, I like standardized dosing better where you know how many drops you’re taking or you know how many milligrams – but he was able to access cookies. And then he was also smoking cannabis, not every day, but two to three times weekly, just taking two to three puffs for breakthrough symptoms. Initially he had an adverse affect from the edible, from the cookie, again because it’s really hard to know what the dosage is, but once he adjusted the dosage he was able to use the cookie without any side effect.
At six months, he had stopped hydrocodone and tramadol, the two opioids, and also stopped one of the anti-inflammatories. The anti-muscle spasm medication that he was using daily, he was now using around once a month, just when he needed it. His average pain was 3-4 out of 10, instead of 6-7 out of 10. He had a significant decrease in muscle spasms. And, his physical exam improved. He was actually walking normally, when the first time he came in he had weakness in his leg that made the surgeon want to schedule him for surgery. Now he had normal strength in his lower extremities. Perhaps that’s because he had improved function, perhaps that’s because the muscle spasms had been under control for so long his spine was able to get back into alignment, perhaps it’s because cannabis has anti-inflammatory properties itself and reduced the inflammation that was pressing on that nerve root – probably all of the above. He reported that he was able to carry his son, was able to enjoy fatherhood. And that’s an incredible result!
When I was in my medical training, if I would have seen that happen, I would have thought I was in some alternate reality. How did this patient get such good results? How did he actually come off of all his opioids and medications? This is normal for us now. We see this all the time.
As part of the survey data that I showed earlier, we also invited patients to submit their narratives. We received over 100 very compelling narrative reports of what patients were doing with combining cannabis and opioids. I chose three to share with you, but there is many more that I wish I could share with you, and sometime maybe we’ll compile all of that and give you an overview.
So here’s one of them. I’m just going to read it. “I was in a car accident about 13 years ago. I had a hip injury that was deemed permanent and a severe head injury. I was immediately placed on 24-hour opiate painkillers. Throughout the 12 years, I’d been prescribed just about every different type. I was also on several other mediations ranging from nerve pain meds to blood pressure meds. I became determined to get off the opiates because they truly never eliminated the pain. I use medical cannabis to help me withdraw. It was quite a substantial process due the length I’d been taking them, 24-hours a day for 12 years. It made the withdrawal much easier. I’ve been in much less pain and was able to eliminate all the other medications I was on at the time. It gave me my life back. It was amazing. I credit cannabis for much of my success.”
“I am 38-years-old and I struggled with opiate and alcohol addiction for about 15 years, long hours as a chef and a couple of minor surgeries where I was prescribed opiates, led me to become dependent on them to get through my day. Pretty soon I was fully consumed by addiction. Even after going to two detoxes and a 28-day rehab in 2010, I still struggled to stay clean for the next two years. The 12-step meeting that I was going to several times a week discouraged cannabis use, so I tried to do it their way and didn’t use any. That didn’t work, and it led me to several relapses. In 2012, I decided to start using a little bit of cannabis before bed to help me get a good night sleep and when I was getting stressed, angry, etc. It was very effective in keeping me centered and on the path to recovery, although I didn’t feel comfortable – and still don’t – sharing this with fellow addicts at meetings. I had been a cannabis smoker on-and-off since age 18 and always enjoyed the effects. In the throes of my opiate addiction, however, I got out of the routine of regular cannabis using. I believe that this is because cannabis use tends to magnify my own problems and shortcomings in my mind when I use it, and no drug addict wants to take such an honest look at themselves. As of right now, I have been free of active addiction from January 2012. I’ve also been a patient of Interg8 Health since 2012. Cannabis is the only thing that I am currently prescribed, and the only substance I use for pain, stress, etc. I don’t know if I would be here today, and sober, if it wasn’t for cannabis. I use cannabis throughout the day and before bed, and live a happy, healthy, and productive life with my wife and two daughters.”
I just want to comment on a couple of great issues that he brought up. The acceptance – or non-acceptance of cannabis in recovery circles – Martin touched on this earlier, it’s really important that we start bringing this out in the open because for those of you that are in recovery, and you look around the room at the meetings, there’s probably several other people there that are either using cannabis secretly or have an idea that cannabis could be helping them. It’s time to bring that conversation out into the open. I’ve heard it called the “green recovery treatment” option. It’s something that’s becoming more well-known and more talked about in recovery circles. We have a long ways to go. Meanwhile, people are drinking coffee and smoking cigarettes, let’s replace even some of those things with cannabis – healthier option, cannabis. And then this part where he was looking at himself. Yes, cannabis forces us to do that. And it can look really ugly sometimes. But if we don’t take a solid look at ourselves then we can’t change. That inner awareness, that connection with who we really are – because people that are addicted to opioids lose track of who they are. I’ve seen people go from very strong and capable to very weak and very limited. You know, their whole lives changed. And, some people that used to be able to help others, and get a lot done, and feel like they were in service to their community, suddenly find themselves in the situation where they’re dependent on others, where they feel like they’re sucking the energy and the time from the people around them, and they’ve changed that dynamic. Yes, we need to look at that. And if you use cannabis, even if you use it in the way that I’ve described in this presentation, it might show you something that you don’t want to see. But trust me, you need to see it to make that change.
I’m going to offer one more narrative. “I took opiates for 15 years, along with various forms of benzos [again those are the anti-anxiety and anti-muscle spasm medications like valium]. I had legitimate pain. I fractured my back in three places when I was 19. I healed from the initial injury, but the pain got worse over the next few years, to the point where I was drinking to get by. I had an uncanny knack for being able to walk into a doctor’s office and get almost anything I asked for, due to my injury. Anyway, I took opiates to the tune of two Oxycontin 80s and 12mg Dilaudids for PRM [which means as needed, that’s quite a high dose]. At some point, it wasn’t just about the pain anymore, it had become more about the addiction. In retrospect, the opiates were only working on the emotional pain, not the physical pain. So to make a long story short, I’ve been to detox 27 times since I was 27. I’ve been in three 30-day rehabs from here to Ohio. I tried halfway houses, Suboxone treatment, etc. It’s been 21 months since my first visit to your office, and I literally have not used an opiate since. Thank you. P.S. I truly believe that medical marijuana has saved my life.”
That’s incredible. We’ve got a lot more of those, too. So, because I know that this information is now in your hands but it may not be in the hands of your doctor, and that’s an important next step to take, not just for yourself but for all the other patients that your doctor treats, on healer.com we have a free download that’s a succinct summary of what a healthcare provider needs to know if they’re taking care of a patient that’s using medical cannabis. I also want to promote the Society of Cannabis Clinicians, this is a professional organization for people that are practicing cannabis medicine, and I invite you to check out their website that’s full of great resources.
Since the world of cannabis medicine is new to ALOT of people, I realized that people usually know what a tincture is, but might not know what RSO oil is. Since we have it available on our website I wanted to talk a bit about it so that you might be educated and empowered!
"RSO" stands for Rick Simpson Oil. For those of you who do not know who this man is here is a link to his website Phoenix Tears. He explains how to make your own medicinal cannabis oil. He does not supply the oil!! You can check out his website to see how it is produced but in short it is a cold extraction using a solvent (there are a number to choose from but I feel the most safe is pure non-denatured ethanol.) to extract the cannabinoids and other plant compounds out, then under low heat cook off the solvent and what you have left is about 60 grams of a thick resinous oil that is the concentrated oil that contains cannabinoids, terpenes, flavinoids and other beneficial components of the cannabis plant. If you are interested in the Rick Simpson story here is a link to purchase his book.
RSO oil is beneficial for those that have gone through chemo, radiation and have problems keeping weight on. Cannabis has been proven to relieve and mitigate chronic pains, as well as helping with migraines, nausea, cramps, arthritis, diabetes, IBS, Crohns, MS, Lupus, Alzheimers, Parkinsons, Autism and high blood pressure, among many other issues. Dr. Christina Sanchez has done many studies on how THC kills cancer cells. Have sleeping problems?? Many people do these days and THC oil promotes healthy and restful sleep!
Topical skin conditions, rashes and sores have all shown improved signs of healing when treated with Cannabis oil lotions.
Since it is high THC, you must be very careful and start off with a very small dose, the size of 1/2 grain of rice.....pretty small huh?? Here is a video explaining the dosing that he recommends....for people with serious issues ie: cancer, there is a 60-90 day protocol he recommends....
Many people cannot or will not make their own RSO oil, so we are lucky to have a local man make this important medicine!! Fully decarboxylated and solvent free. It is lab tested for molds and cannabinoid ratios. Since this can have some psychoactive effects in large doses, it is best used at night about an hour before bed. If you take it orally, it has to be broken down by your digestive system and liver, so this takes a little time. A word of caution....it is always best to start slow to see how your body responds, it you start off with a large dose to quickly you can experience some uncomfortable effects like: extreme drowsiness, dizziness, inability to concentrate, lack of focus, rapid heartbeat, feelings of euphoria or paranoia...These effects are not life threatening, just uncomfortable.....soooooo give it the respect is deserves and start at the lowest dose possible!!
One other tip to keep in mind, if you ever have uncomfortable effects from THC, always keep some High CBD tincture on hand, it naturally counteracts the effects of the THC. So hopefully this gives you a better idea of what it is...if there is still some questions that have not been answered, there are many sites online to find them or drop me a line!
Best of Health
Elizabeth, Pianta Tinta
Back in February of this year a excellent Israeli study was done documenting the superior therapeutic properties of whole plant CBD-rich Cannabis extract as compared to synthetic, single-molecule cannabidiol (CBD) which is made in the lab. The notion that botanical extracts are "low grade and crude" as opposed to pure single molecule synthetic compounds made by the pharmaceutical companies is what was challenged. The study was Published in the journal Pharmacology & Pharmacy (Feb. 2015).
The study showed that administration of pure, single-molecule CBD resulted in a bell-shaped dose-response curve, that means when the amount of CBD exceeded a certain point its therapeutic impact declined dramatically. “Healing was only observed when CBD was given within a very limited dose range, whereas no beneficial effect was achieved at either lower or higher doses,” the authors observed. This characteristic of single-molecule CBD—manifested as a bell-shaped dose response—imposes serious obstacles that limit its usefulness in a clinical context.
The Israeli team sought to determine whether the administration of a whole plant CBD-rich extract would also generate a bell-shaped dose-response curve when administered to mice. Or would cannabidiol extracted from CBD-rich Cannabis avoid this liability? But a different dose response pattern was observed when the whole plant extract was administered to mice. Rather than showing a bell-shaped curve, where a therapeutic effect could only be achieved at a certain concentration of pure CBD, the whole plant CBD-rich extract caused a direct, dose-dependent inhibition of pain, inflammation, and TNFa production.
Moreover, the Israeli researchers found that a small amount of CBD in the whole plant extract was needed for significant pain relief compared to the much larger amount of pure single molecule CBD required to achieve the same analgesic effect. And whereas pure, single-molecule CBD precipitated a dramatic drop in efficacy if more than a specific dosage was administered, an “overdose” of whole plant CBD-rich extract did not undermine its therapeutic potency.
The body recognizes and can utilize substances that are natural, from nature. That is how we are made. Anything that is synthetic is hard for the body to know what to do with it, yes, it can have an effect but in my opinion not as great an effect. The whole plant has not only cannabinoids, but terpenes and flavinoids and many other compounds which all work together synergistically and have positive effects in the body.
We here at Pianta Tinta are proud of our High CBD tincture in that we use the whole plant to extract out as much cannabinoids and other compounds to make the best medicine we can!
The above is just a small portion of the study done, if you wish to read the actual study click here.
A thank you to projectcbd.org for originally posting the article!
Elizabeth Knight, Pianta Tinta
Recently I attended an event at Rossmoor, in Walnut Creek. Little did I know that they have a senior community of 10,000. How great it was to see acceptance, education and people TALKING about medical cannabis!! There was a report on site, Joe Garofoli and this is the article that came out in the SF Chronicle.
by Joe Garofoli
Updated 1:59 pm, Tuesday, April 21, 2015
Doug Stiles shows a bottle of liquid cannabis in his home at the Rossmoor retirement community in Walnut Creek. Stiles takes 20 drops before bed to help with his anxiety and help him sleep.
Pot was for fun in Rossmoor resident Doug Stiles’ youth. Now he takes it in liquid form to ease anxiety and help him sleep.
There is a club for Bay Area marijuana enthusiasts where most members don’t want to get high. Mostly because they’re afraid of falling. Or getting too disoriented.
The club is in Rossmoor, the senior citizen community of 10,000 near Walnut Creek.
With an average age of 76, Rossmoor is the kind of place where smoking is banned, though many puff cigars in plain sight on the golf course. But before the Rossmoor Medical Marijuana Education and Support Club held its first meeting in 2011, marijuana was rarely seen, smelled or discussed on the facility’s surgically trimmed grounds.
Since then, the club has grown into a 250-member juggernaut, illustrating the growing acceptance of marijuana in America by seniors — and their growing frustration with mainstream pharmaceuticals prescribed for pain relief.
In 1986 — the heyday of the nation’s War on Drugs — 9 percent of the generation of Americans born between 1928 and 1945 supported legalizing marijuana. That has jumped to 29 percent among that demographic, according to a Pew Research report released this month.
The survey also showed that it might be time to dig through Grandpa’s golf bag: 19 percent of Americans over 70 have tried weed, including 2 percent in the last year.
That might be an undercount, according to some Rossmoor weed aficionados. Many residents are cultivating more than azaleas at home.
“Oh, sure, I’ve got a plant. A lot of people here do,” one woman said after a club meeting last week in Rossmoor. “But I can’t give you my name.”
That’s a common sentiment. One club member asked to remain anonymous because “my son owns a business near here.” A few still haven’t told their kids they’re members because they have spent the last 50 years telling them not to smoke dope.
Perhaps because of the reluctance of seniors to discuss their marijuana habits, neither AARP nor the Marijuana Policy Project could provide any studies of cannabis use by seniors. AARP doesn’t have a policy on medical cannabis, even though it is now legal for medicinal use in 23 states and Washington, D.C.
Appropriately, it was on a Rossmoor golf course where the club held its first clandestine meeting four years ago. Twenty cannabis-curious pioneers set up folding chairs near the first tee box at 4 p.m., when they knew most of their golfing neighbors would have already left for cocktail hour, which, like many things in Rossmoor, starts a little early.
“People were still not sure if they wanted to be out about (marijuana) then,” said Renee Lee, a 63-year-old retired therapist who is president of the club. “There was still a stigma about it.”
Lee was among those who wanted to call themselves the 420 Club, but that reference to the weed smokers’ holiday of April 20 never stuck because, as Lee said, “a lot of people didn’t know what it meant.”
They went six months without a name. But club members quickly bonded over their shared disappointment in pharmaceuticals they had been prescribed. Either the pills weren’t helping them or the side effects were more onerous than their actual ailments.
Their knees and elbows and backs creaked. They had trouble sleeping. They were anxious. All they wanted was some relief.
So why not try a little pot?
Sometimes it was their adult children who suggested it. More often the notion came from a medical-cannabis-card-carrying neighbor, who would offer a weed-infused lemon drop or a dab of a topical cream. It was a leap of faith for seniors who never tried pot — or hadn’t indulged since the Kingston Trio was topping the charts.
“The most common thing they say is, 'I’m not doing this to get high,’” said Rachna Patel, a Walnut Creek osteopath who has treated about 100 Rossmoor residents who use cannabis for pain relief. “A lot of them will first say, 'I can’t believe that I’m doing this.’”
But many are soon smiling at the results. Doug Stiles hadn’t partaken in years until he moved to Rossmoor about four years ago. Then he started rubbing a cannabis-infused topical solution into his wife’s knees to help with her arthritis. Four months later, she was moving more easily. Now Stiles takes cannabis-infused drops at night to soothe his anxiety and help him sleep.
Back in the day
That’s not how he used marijuana during his occasional indulgences as a young man.
“I remember at a party smoking with a brother-in-law, then going out to the liquor store. But we had to pull over in the park because we were laughing so hard,” Stiles said. But “now it’s about pain — and feeling better.”
What initially “surprised me,” said Eloise Theisen, a nurse practitioner in Lafayette who helps dozens of Rossmoor residents manage their health conditions with cannabis, “is how open they’ve been to trying new things.”
But club members aren’t your typical stoners. “Everybody always shows up 15 minutes early for the meetings,” said Lee, who used cannabis to help her with the aftereffects of acoustic neuroma surgery.
Dozens of Rossmoorians are now smoking or vaping or nibbling at edibles, mostly in the quiet of their homes.
Just for fun
Nobody smells weed outside. Unless maybe it’s coming from members of Rossmoor’s other cannabis club — a group focused less on education and support and more on enjoying the herb’s recreational pleasures. Unlike the Rossmoor Medical Marijuana Education and Support Club, the other group is not officially recognized by the administration.
The harder question for some is one that’s rarely been uttered in the half-century history of this 1,800-acre enclave: How can I score some weed in Rossmoor?
Medical cannabis dispensaries are banned in Walnut Creek, and there are few east of the Caldecott Tunnel.
And forget getting pot through that newfangled smartphone technology. The app-based marijuana delivery service Eaze — which promises cannabis within minutes for card-carrying Bay Area users — said only 2 percent of customers are seniors. Eaze is launching a pilot program with a San Diego senior community to learn how to make it easier for seniors to get deliveries.
“There’s definitely an untapped market there,” said Eaze spokeswoman Caroline Vespi. “There’s still that perception among some seniors that the only place you can get (cannabis) is from the dealer on the corner.”
After accepting an invitation to speak to the club a couple of years ago, the Harborside Health Center arranged for a tour of the Oakland medical cannabis dispensary. Now it counts dozens of Rossmoor residents as customers.
But nurse practitioner Theisen said venturing unaccompanied into a dispensary can be overwhelming for some seniors.
So, many Rossmoor residents get their weed from what once might have been an unlikely source: their grown children. State law allows medical cannabis patients to designate someone as a caregiver.
As the general public’s attitude toward marijuana has warmed over the past few years, the club’s membership has swelled, and some of the region’s top cannabis figures have appeared before them.
Last week’s meeting drew a record 81 members to hear John Malanca, founder of United Patients Group, a website that offers news and information about medical cannabis.
“How many people here think the only way to take marijuana is to smoke it?” Malanca asked the audience.
Not a hand went up.
“Wow,” Malanca said, rocking back a step. “When I was here a few years ago, 60 percent of the people raised their hands.”
After the meeting ended, Malanca said, “When I asked that, people just looked at me like, 'That was the most boneheaded question.’ But that’s why when I visit retirement communities around the country, I tell them about the amazing things going on at Rossmoor.”
Orange County aficionados
But while Rossmoorians are becoming weed sophisticates, they still lag behind their demographic peers at the Laguna Woods Village — formerly known as Leisure World — in Orange County. Cannabis-using residents there have established a relationship with a Humboldt County grower and created a distribution network in the community that has the administration’s blessing.
Down there, if Laguna Woods Village Cannabis Club organizer Lonnie Painter wants to smoke a joint outside his residence, he just sparks one up.
“Oh, sure,” said Painter, a 69-year-old retired restaurateur. “I do that almost daily.”
Joe Garofoli is a San Francisco Chronicle staff writer. E-mail: email@example.com Twitter: @joegarofoli
Here is a great article from United Patients Group in which 3 Doctors using Medical Cannabis in their practices have seen similar trends in dosing and results..."How much should I take?" This is a question that comes up often and although dosing is an individual issue, these Doctors have worked with enough patients to see what is working.......
Doctors Weigh In – Medical Cannabis Dosing: Why Less May Be More
Many medical cannabis patients take an overly aggressive approach to treatment. If one hit off a joint or one square of chocolate helps a little, then a whole joint or a whole chocolate bar will help a lot, right? Not quite. In many cases, while taking in ‘more‘ cannabis will make you ‘more‘ high, it won’t necessarily make you ‘more‘ healthy. In fact, reducing your dosage may actually make it ‘more‘ effective.
Dr. Dustin Sulak, the Medical Director of Integr8 Health, LLC, a network of three (3) holistic health clinics in New England, where he and his colleagues treat nearly 20,000 patients with medical cannabis as part of an integrative medicine approach to health, have found that many of his patients benefit more from low doses—they have better results and fewer side effects.
“When I started my practice, I was surprised to see that some patients were using very low dosages (e.g. 1 puff), while other patients require much higher dosages (e.g. 1 joint or a potent edible) to achieve optimal benefits,” notes Dr. Sulak. “Over time, I began to notice that most patients using small amounts of cannabis were getting better and more sustainable results than their high-dosage counterparts with similar conditions. Eventually I discovered that most people have a certain threshold dosage of cannabis, below which they’ll actually experience a gradual increase in health benefits over time, and above which they’ll start building tolerance, experiencing diminishing benefits, and more side effects.”
Preclinical research supports these observations, demonstrating that administration of cannabinoids can upregulate endocannabinoid system function at acute and lower doses via increased endocannabinoid production[i], cannabinoid receptor expression[ii], and cannabinoid receptor affinity[iii], as well as downregulate endocannabinoid system function upon persistent agonism (e.g. long-term high doses) via membrane receptor endosome internalization[iv]. This dosing phenomenon is known as a biphasic dose-response curve.
Dr. Sulak has moved many patients down to doses as low as 3–5 mg with his “sensitization protocol,” which helps current users to reset their endocannabinoid system. After just six days on the protocol, 90 percent of patients can decrease their dosage with improved benefits. His patients have an average reduction of 56 percent.
“This reduction not only improves benefits and reduces side effects – it saves patients a lot of money, and potentially makes more cannabis available for those with limited access,” says Dr. Sulak.
Dr. Bonni Goldstein, Medical Director of Canna-Centers, located throughout California, has noticed similar results with her patients. “Many of my patients using low doses for pain, mood, and sleep find that low doses give the effects they are looking for, and over time, due to the enhancement of their endocannabinoid system, they find that they don’t need as much phytocannabinoids to achieve the desired effects.”
Her observations are backed by a study from the Medicinal Cannabis Research Center at the University of California, San Diego, that tested vaping cannabis to treat neuropathic pain. The results showed that patients who used small-dose cannabis (1.29 percent) felt as much pain relief as patients who used medium-dose (3.53 percent) cannabis.
Why might this be? The functioning of the body’s endocannabinoid system, and its interaction with phytocannabinoids (from the cannabis plant), is not yet fully understood—marijuana’s quasi-legal status makes this difficult to study. Dr. Sulak and Dr. Goldstein both hypothesize that small doses of phytocannabinoids enhance the endocannabinoid system, while larger doses cause the system to down-regulate, making the receptors less responsive.
He points to studies by GW Pharmaceuticals, makers of Sativex, that show better results from low or medium doses than high doses. One study of cancer patients found that low doses (1–4 sprays per day) resulted in statistically significant reductions in pain and sleep disruption, while high doses (11–16 sprays per day) did not result in better outcomes but did cause a much higher dropout rate (22 percent, versus 5 percent in the low-dose group).
Cancer patients are typically treated with extremely high doses of cannabis, but Dr. Frankel questions the wisdom behind this approach.
“I have seen at least 7 patients with stage IV cancer who initially responded to RSO dosing [Rick Simpson Oil, which is often dosed as high as a gram per day] and then had new metastases, went on low dose CBD:THC and had clearing of metastases.”
He points out that nobody knows what “dose” or regimen is “best” for cancer. “In fact,” says Dr. Frankel, “probably a number of different cannabinoid ratios and doses for certain have anti-cancer effects through a multitude of mechanisms.” He says that, on average, across numerous ailments, his sickest patients use a dose of around 30–40 mg of cannabinoids—far lower than the RSO recommendation.
Dr. Sulak cautions that while he generally sees better results from lower doses, he has observed that about 10 percent of his patients only respond to very high doses—as much as 300–500 mg per dose.
He explains, “In general, patients with greater resilience and who are closer to balance in their physiology are more likely to succeed with lower dosages, while patients who have been sicker for longer sometimes may require aggressive dosing to control the disease process, then are able to convert to low dosages later, after they too are closer to health and balance.”
Dr. Sulak’s sources:
[i] Burstein, S, Hunter, S. 1995. “Stimulation of anandamide biosynthesis in N-18TG2 neuroblastoma cells by δ9-tetrahydrocannabinol (THC).” Biochemical pharmacology 49, no. 6: 855-858.
[ii] Cichewicz, D, Haller, V, Welch, S. 2001. “Changes in opioid and cannabinoid receptor protein following short-term combination treatment with Δ9-tetrahydrocannabinol and morphine.” Journal of Pharmacology and Experimental Therapeutics 297, no. 1: 121-127.
[iii] Oviedo, A, Glowa, J, Herkenham, M. 1993. “Chronic cannabinoid administration alters cannabinoid receptor binding in rat brain: a quantitative autoradiographic study.” Brain research 616, no. 1: 293-302.
[iv] Hsieh, C, et al. 1999. “Internalization and recycling of the CB1 cannabinoid receptor.” Journal of neurochemistry 73, no. 2: 493-501.
We are proud to present our newest products, SUPER High CBD Tincture and our 50/50 blend!!
These are available for purchase to our members....not a member? It's free to sign up! You must have a doctor's recommendation and CDL...please visit our website for more information....
Here's a sneak peak
SUPER High CBD Tincture:
20 mg/ml CBD (600mg CBD per 1oz!!)
0.72 mg/ml THC
Lab Tested - Steep Hill Halent
1 fl. oz/ 30ml
12 MG/ML CBD
LAB TESTED - STEEP HILL HALENT
All test results are listed on our website...feel free to call or email us!
Tinctures offer the best way to deliver nutrients in stable soluble form, optimal for assimilation. Tinctures retain volatile and semi volatile ingredients, usually lost in heat treated and especially reprocessed dry extracts. The importance of these ingredients for health beneficial action is hard to overestimate.
Due to convenient dosing, tinctures are one of the safest herbal preparations on the market
One of the things that people overlook when buying a High CBD tincture or oil is what is on the label! Make sure that the CBD content is listed so that you know how much of it you are getting and if you are paying a fair price. In liquid the CBD is measured in mg per ml. There is approximately 30 ml of liquid in a 1 fl oz bottle. If the label says for instance that there is 3 mg per ml of CBD, then there is a total of 90mg of CBD in that 1 oz bottle. Some companies charge a high price for a very low amount of CBD content so it is important to shop around. With a higher quality tincture with a higher CBD content per bottle (250-300 mg) would mean you can take less of the product and get great results.
Another number to look at is the ratio between the CBD and THC. Our tincture has a 22:1 ratio meaning there is 22 times more CBD than THC!
- Consider the condition you’re treating. For anxiety, depression, spasms, and pediatric seizure disorders, you may do better with a moderate dose of a CBD-dominant remedy—look for a CBD:THC ratio of more than 14:1. For cancer or pain, you may need more THC, for instance, a 1:1 ratio.
So, just because a product says High CBD on the label, or Ultra High CBD, don't assume that's what it is.... Do a little research on your own and make sure they list the test results either on their label or on their website!! It's a bit like our food industry, some labels say the product is all natural yet it is filled with junk!!
Just a couple of days ago, a new study was posted to the journal JAMA of Internal Medicine, and a very interesting article was written by Dr. Jamie Zimmerman, ABC News.
What they said was states that have legalized medical marijuana appear to have 25% fewer deaths from overdoses of prescription painkillers. As we all know painkillers are used and abused in this country and 100 Americans die EVERY DAY from narcotic painkiller overdose according to the U.S. Centers for Disease Control and Prevention. Quite shocking!
Dr. Marcus Bachhuber, a physician and researcher at the University of Pennsylvania and his colleagues analyzed the data on all 50 states between 1999 and 2010. While painkiller overdose rates climbed across the States, the states with medical marijuana laws climbed much slower and as the result those states had 25% fewer deaths from overdoses. They anticipated some differences but were very surprised at such a huge difference!
The results from the study: Conclusions and Relevance Medical cannabis laws are associated with significantly lower state-level opioid overdose mortality rates. Further investigation is required to determine how medical cannabis laws may interact with policies aimed at preventing opioid analgesic overdose.
So the Medical Marijuana laws can protect those that want to control their pain with cannabis. Some people do not like the side effects of narcotic drugs and the potential for overdoses so they turn to a more natural remedy. Others might take prescription painkillers but also take cannabis which can lower the possibility of an overdose because they are taking less of the narcotics. Of course the question always is....what is causing the pain in the first place? If you can address that, then the pain can be resolved but if it is pain management that you are looking for, this study surely gives us other way of looking at pain control.
Visit our website at www.piantacbd.com for more information on High-CBD cannabis tinctures.