'Microdosing' can provide just enough cannabis for medicinal effects.
For many
of us who came of age in the 1960s and 1970s, smoking pot (also called
marijuana or cannabis) was an integral part of the social scene. But
whether we never touched the stuff, gave it up decades ago or still
maintain a relationship with the plant, many boomers today are eagerly
exploring cannabis in its various forms to address a whole host of
conditions, including chronic pain, anxiety and insomnia.
Older
adults, particularly those over 65, represent one of the fastest growing
segments of the cannabis consumer market, according to New Frontier
Data, a leading cannabis market research firm.
Medical marijuana is now
legal in 33 states and the District of Columbia; 10 states also permit
recreational use.
'Microdosing' cannabis for medicinal benefits
Still,
many people who could benefit from cannabis are reluctant to do so out
of concern over "getting high." This aversion to intoxication is one of
the factors driving the meteoric popularity of hemp-based cannabidiol
(CBD) products, which contain only trace amounts of tetrahydrocannabinol
(THC), the psychoactive compound in cannabis. Yet CBD alone is
considered to be less effective for medicinal purposes without the
presence of THC.
The good
news is that it takes very little THC to safely achieve significant
therapeutic effects. This is the rationale behind "microdosing," an
approach to using medicinal cannabis in very small doses to achieve
medicinal benefits without the high.
Dr. Dustin
Sulak, a Maine-based osteopathic physician who has treated thousands of
patients with medical cannabis, is a strong advocate of microdosing and
believes it is especially helpful for older adults.
"Microdosing involves
using cannabis at a dose below that which would cause impairment, either
to relieve symptoms or simply as a tonic, to promote health and prevent
disease," Sulak says. "Basically, my entire practice involves treating
patients through microdosing. They are looking for relief, not to get
high."
Microdoses vary by individual
Sulak
emphasizes that what constitutes a microdose will vary from person to
person, based on physiology, the type of cannabis product selected and
many other factors. He typically advises his patients to choose a
cannabis product that contains a specific ratio of THC to CBD, depending
on their condition.
Sulak also
recommends using an oil or tincture administered under the tongue,
which is broadly effective and well tolerated. He finds this is the best
method to achieve very specific dosing, down to the smallest
increments.
Patients
start with a dose that has no effect, then gradually increase it until a
notable positive effect is observed. If a higher dose causes dizziness
or sleepiness, it is an indication that the ideal microdose has been
exceeded. The adverse effect will be mild because the extra dosage is so
small.
Cannabis for acute and chronic conditions
Dr. Jordan
Tishler, a cannabis physician and instructor of medicine at Harvard
with a practice in Boston, also treats his patients for pain and other
chronic conditions using very low doses of THC.
For Tishler, the
preferred mode of delivery for fast treatment of acute conditions, such
as migraine headaches, is inhalation of very small quantities of
vaporized flower — a part of the cannabis plant.
Vaporization is
achieved using a technologically sophisticated portable convection
device, better known as a vaping device.
For
chronic conditions that need ongoing maintenance, including amyotrophic
lateral sclerosis, multiple sclerosis and Parkinson's disease, Tishler's
treatment plan may center around low-dose gummy chews.
Dr. Laurie
Vollen, a cannabis physician in the San Francisco Bay Area, also
recommends vaping very small, controlled quantities of flower. But she
cautions patients to avoid disposable vape pens, which can contain toxic
chemicals and have not been proven clinically safe over long-term use.
Vollen teaches her patients, whose average age is in the 70s, how to use
a vaporizer in a special "Inhalation 101" course she developed.
Before
Tishler's patients go to a dispensary, he counsels them to avoid certain
products, including disposable vape pens and cannabis lotions and balms
for the skin, which are costly and, in his opinion, of questionable
utility. Flower is the most economical form for purchasing cannabis, so
it has the added value of being a highly cost-effective way to manage
your medicine, he says.
Sulak
points out that cannabis is an excellent anti-inflammatory and pain
reliever. And because the only possible adverse effects from properly
microdosing cannabis are mild, transitory and easy to notice, it is much
safer than over-the-counter drugs like ibuprofen and acetaminophen,
which can quietly damage the gastric lining, kidneys and liver.
Tishler
says it's the THC in cannabis that works on pain. And he contends that
the psychoactive side effects from THC are not something to be feared.
"There are plenty of medications, including opioids and even
antibiotics, which affect our mental state. Those are just side effects
that have to be managed," he says.
One
positive aspect of a cannabis-induced mental state is how it influences
the "affective component of pain," or how we relate to it
psychologically and emotionally. As Sulak observes, "Patients report
that not only is the pain a little less intense, but it is less
bothersome — that it doesn't get in their way anymore."
Cannabis for sleep issues
Sulak also
notes that he gets excellent results using cannabis to treat sleep
disorders in all ages, but particularly in older adults.
"Cannabis
isn't a hypnotic," he explains, "so it won't knock you out like
pharmaceutical sleep aids.
But it will mitigate the symptoms that are
disturbing sleep, like pain or discomfort, anxiety, excessive mental
activity or restless limb syndrome. And one can be more liberal with the
dosing before bedtime, because once a person is asleep, any impairment
won't matter. Yet, like any sleep agent, there is a potential risk of
falling that needs to be taken into account."
He says
he's has also had extremely good results using cannabis to treat
"sundowning," a state of confusion and agitation that some people with
dementia experience in the late afternoon and evening.
Sulak
believes a small daily dose of cannabis can work as a kind of tonic for
general wellness, too, improving resilience to stress, decreasing
inflammation and promoting healing. "It may even be more powerful for
keeping people healthy than it is for treating people with severe
conditions," he says.
Find what works for you
Vollen,
Sulak and Tishler concur that CBD without some measure of THC is not an
effective medicine. According to Sulak, "A lot of people are misled
because they think they are trying cannabis with an over-the-counter CBD
product, and they are disappointed when it doesn't work. CBD is a great
medicine but it's very weak and people usually need a lot of it to
address their symptoms, which becomes cost-prohibitive. So they try a
little and then give up. My biggest piece of advice is to find
cannabis-derived CBD which contains some THC."
The Americans for Safe Access (safeaccess.org) website has information about how to safely use cannabis. To find a qualified cannabis physician, the Association of Cannabis Specialists (cannabis-specialists.org) and the Society of Cannabis Clinicians
(cannabisclinicians.org) are helpful resources.
No comments:
Post a Comment