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100+ different types of cannabinoids and terpenes
Concentrations or percent of each type of cannabinoid ranges widely from plant to plant and strain to strain.
The first identified and best-known cannabinoid is THC (delta-9-tetrahydrocannabinol). THC has the most significant psychoactive effect of the cannabinoids. The ratio of THC to other cannabinoids varies from strain to strain. While THC has been the focus of breeding and research due to its various psychoactive and therapeutic effects, nonpsychoactive cannabinoids have physiologic effects that can be therapeutic.
• Cannabidiol (CBD) relieves convulsions,inflammation, anxiety and nausea—many of the same therapeutic qualities as THC but without psycoactive effects. It is the main cannabinoid in low-THC cannabis strains, and modern breeders have been developing strains with greater CBD content for medical use.
• Cannabinol (CBN) is mildly psychoactive, decreases intraocular pressure, and seizure occurrence.
• Cannabichromene (CBC) promotes the analgesic effects (pain relief) of THC and has sedative (calming) effects.
• Cannabigerol (CBG) has sedative effects and antimicrobial properties, as well as lowers intraocular pressure.
• Tetrahydrocannabivarin (THCV) is showing promise for type 2 diabetes and related metabolic disorders.
In addition to cannabinoids, other cannabis plant molecules are biologically active. A few other molecules known to have
health effects are flavonoids and terpenes or terpenoids (the flavor and smell of the strain). Cannabinoids, terpenoids, and other compounds are secreted by the glandular trichomes found most densely on the floral leaves and flowers of female plants.
Effects
Different people have different experiences. One individual may feel stress release, while another feels over-stimulated
and stressed, while another feels energized and on-task.
There are many factors that impact the effect:
- Amount used (dosage)
- Strain of cannabis used and method of consumption
- Environment/setting
- Experience and history of cannabis use
- Biochemistry
- Mindset or mood
- Nutrition or diet
- Types of Cannabis
Though cannabis is biologically classified as the single species Cannabis Sativa, there are at least three distinct plant varieties: Cannabis Sativa, Cannabis Indica, and Cannabis Ruderalis, though the last is rare. There are also hybrids, which are crosses between sativa and indica
Sativas
The primary effects are on thoughts and feelings. Sativas
tend to produce stimulating feelings, and many prefer it for
daytime use. Some noted therapeutic effects from use of
Sativas:
- Stimulating/energizing
- Increased sense of well-being, focus, creativity
- Reduces depression, elevates mood
- Relieves headaches/migraines/nausea
- Increases appetite
Some noted Side-Effects from use of Sativas
- Increased anxiety feelings
- Increased paranoia feelings
Indicas
The primary effects are on the body. Indicas tend to produce
sedated feelings, and many prefer it for nighttime use.
Some noted Therapeutic Effects from use of Indicas:
- Provides relaxation/reduces stress
- Relaxes muscles/spasms
- Reduces pain/inflammation/headaches/migraines
- Helps sleep
- Reduces anxiety
- Reduces nausea, stimulates appetite
- Reduces intra-ocular pressure
- Reduces seizure frequency/anti-convulsant
Some noted side-effects from use of Indica’s
- Feelings of tiredness
- “Fuzzy” thinking
Hybrids
Strains bred from crossing two or more varieties, with typically one dominant. For example, a sativa-dominant cross may be helpful in stimulating appetite and relaxing muscle spasms. Crosses are reported to work well to combat nausea and increase appetite.
Cannabis Consumption Basics
How Can I Use Cannabis More Safely?
One of the great aspects of cannabis is that there are many ways to use the medicine effectively.
Ingest via Eating
This is one of the safest ways to consume your medication, but understand that the effects from eaten cannabis may be more pronounced and onset of the effects will be delayed by an hour or more and typically last longer than inhalation. Using edible cannabis effectively will usually take some experimentation with particular product types and dosage. Digesting cannabis also metabolizes the cannabinoids somewhat differently and can produce different subjective effects, depending on the individual.
Use small amounts of edibles and wait 2 hours before gradually increasing the dose, if needed. Take care to find
and use the right dose-excessive dosage can be uncomfortable and happens most often with edibles.
Try cannabis pills made with hash or cannabis oil or ingest via Tinctures/Sprays
Find your ideal dosage to enhance your therapeutic benefits.
Start with no more than two drops and wait at least an hour before increasing the dosage, incrementally and as necessary.
Apply via Topicals
This is one of the safest ways to consume your medication and may be the best option for certain pains or ailments.
Rubbing cannabis products on the skin will not result in a psychoactive effect.
Inhale via Vaporizer
This is the safest way to inhale your medicine because it heats the cannabinoid-laden oils to the point where they become airborne vapors, without bringing the other plant material to combustion, drastically reducing the amount of tars and other chemical irritants that you otherwise would inhale. Vaporizers also emit much less odor than any type of smoking.
Know Your Variety
Cannabis comes in many varieties, roughly divided between sativa’s that originated near the equator and indica’s that
come from northern latitudes, though modern breeding programs have created a wide range of hybrids. Each variety
has its own cannabinoid and terpene profile and subtly different effects. Whether you use Sativa-dominant, Indicadominant, or a Hybrid makes a difference.
- Take note of what effect each variety produce for you (therapeutic and side effects); keeping a
log can be helpful. - Use higher potency cannabis so you use less medicine. Concentrates can be useful, particularly
if you need higher doses. - Experiment with high CBD strains, particularly for nausea, appetite, and pain.
- Take a medicine vacation occasionally. While cannabis does not produce tolerance in the way
opiates do, reducing or ceasing cannabis use can yield enhanced effects when restarted. Either
reduce or stop for however long it feels comfortable for you. - Change the variety if the one you're using seems to be losing its effectiveness.
- Whenever possible, choose organic cannabis products.Never consume cannabis that has been
treated with pesticides
Apply via Topicals
No significant interactions between cannabis and other drugs are known at this time, though research indicates cannabis enhances the effects of opiate painkillers. Little is known about the interaction of cannabis and other pharmaceutical medications, but it is important to consider any complementary effects
Some studies show interactions with barbiturates, theophyline, fluxetine, disulfiram, sedatives, antihistamines, etc
A synergistic effect can occur with alcohol use; limit mixing the two
Consider Safety. For yourself and your community
Indicas can cause drowsiness-avoid driving or operating heavy machinery when using your medicine.
Don't consume cannabis and drive. Cannabis use can impair motor skills. Find a safe environment to consume your medicine. Wait at least 1-2 hours after you medicate before getting behind the wheel.
Managing Medicine Costs
If paying for your medicine is an issue, try a few of these tips
Track your costs to get an accurate picture of your spending on cannabis
If you access your medicine through a dispensary, use discount cards or investigate other ways to receive free or discounted medicine (like a lowincome program, sliding scale program, activism volunteer)
Store your medicine properly to maintain quality over time. Airtight glass jars kept in a cool dark space work best
Managing Medicine Costs
If paying for your medicine is an issue, try a few of these tips
Track your costs to get an accurate picture of your spending on cannabis
If you access your medicine through a dispensary, use discount cards or investigate other ways to receive free or discounted medicine (like a lowincome program, sliding scale program, activism volunteer)
Store your medicine properly to maintain quality over time. Airtight glass jars kept in a cool dark space work best
Managing Medicine Costs
If paying for your medicine is an issue, try a few of these tips
- Track your costs to get an accurate picture of your spending on cannabis
- If you access your medicine through a dispensary, use discount cards or investigate other ways to receive free or discounted medicine (like a lowincome program, sliding scale program, activism volunteer)
- Store your medicine properly to maintain quality over time. Airtight glass jars kept in a cool dark space work best
Keeping a Cannabis Log
To establish an optimal treatment regime with cannabis, you will need to balance the effects of different strains, doses, and
methods of ingestion. It may be helpful to record your therapeutic relationship with cannabis on an ongoing basis. One method is
through keeping a cannabis-use log that captures your experience, including thoughts, feeling and behaviors. Periodically
reviewing the log can help both you and your doctor make decisions about what works best.
To start, keep a detailed log, as described below, for at least one week. Once you've got a week's worth of information, complete
the self-assessment worksheet that follows. This worksheet will help you better understand many things about yourself, including:
your ailments and symptom patterns, your treatment behaviors, and the efficacy and side effects of the cannabis medicines you
use
In keeping a medication log, try to keep things standardized, and be as consistent as possible. Here are some logging tips on
useful information to collect:
- Date/Time: Record every time you consume cannabis with the current date and time of day.
- Amount: The amount of cannabis used (gram estimate or other consistent measure)
- Strain: The name, strain or variety of the cannabis strain or variety of cannabis medicine used. If you don't know the name, write a detailed description of the medicine.
- Code: Strains are generally described as Indica, Sativa, or hybrid. You may want to code your entries: I=Indica, S=Sativa, S/I=Sativa-dominant Indica Cross, and I/S= Indica-dominant Sativa Cross.
- Type is the form of cannabis consumed: dried bud flower, concentrates, tincture/sprays, edibles/drinks or topical. You may want to use: F=flower, C=concentrate, T=tincture/spray, E=edible, TO=topical
- Cannabinoid Content: refers to the percent of THC, CBD and/or CBN. If you have this information available to you, write down percentages of each cannabinoid. If you're using edibles or similar, a description of potency and preparation is helpful.
- Mode: Write down how you used your medication. Either inhale via S=smoke or V=vaporize, E=eat/digest, T=tincture or spray, TO=topical.
- Therapeutic Effects: List any positive effects experienced (physical, mental, social, behavioral,
etc). - Negative Side Effects: List your negative effects
- Timing: How quickly did you experience the first therapeutic effects? When did you feel the peak of relief? When did it start to noticeably dissipate? How long until effects were gone?
- What prompted your cannabis use? List the specific factors that told you it was time for medicine, as well as the general symptoms or conditions being treated (e.g. pain, nausea, anxiety, etc
- How did you feel (mindset)? Record your mood and feelings before and after you used cannabis.
- Where were you (setting)? Were you at home, at a collective, in your office? Sitting, standing, lying down?
- Who were you with? Were you by yourself, with a friend, a large group, among other cannabis consumers, etc?
- What were you doing? Just before you used cannabis, what was going on? What were the activities or circumstances leading up to it?
Proper Dosage
There are some things worth mentioning about the dosing and administration of cannabis first. In small doses, cannabis
it can be helpful for things like nausea, appetite, pain, sleep, mood and anxiety. However, in larger doses, cannabis can have the opposite effect, leading to an increase in anxiety, pain and/or depression
The bi-directional effects of cannabis make it is essential that patients "start low and go slow" to avoid experiencing any adverse reactions. The most common side effects of Delta-9 tetrahydrocannabinol (THC) are dizziness, dry eyes and mouth, euphoria, increased heart rate, decreased blood pressure, fatigue and increased appetite.
Cannabidiol (CBD) can cause psycho-activity: dizziness, jitteriness, diarrhea, palpitations and even decreased appetite with prolonged use. With proper guidance, patients can utilize medical cannabis with optimal results and minimal adverse reactions
Delivery Methods
Today we have many different delivery methods for
cannabis. Long gone are the days in which the only option
was smoking. Now patients can choose from vaporizing,
edibles, tinctures, suppositories, topicals and even transdermal patches. There are pros and cons to each delivery method.
Inhalation
The most well-known and popular delivery method for deriving effects from cannabis is smoking. Smoking cannabis flowers provides relief of symptoms within 5 to 15 minutes. For many patients with chronic pain, anxiety or acute nausea and vomiting, this delivery method is ideal. The number one concern with smoking cannabis is potential lung damage and/or cancer. Tashkin looked at the possible longterm effects on the lungs in chronic cannabis smokers, and found that there was no link to an increased risk of lung
cancer or chronic obstructive lung disease. In fact, researchers found that cannabis may have some protective effects against these illnesses in users who smoke it.
When patients smoke cannabis in a joint or pipe, they are heating the medicine at a high temperature (close to 600 degrees). At that temperature, burning cannabis is more likely to produce carcinogens and tars. While smoking has not been correlated with any increased risk of lung damage or cancer, it can lead to chronic bronchitis and/or chronic cough.
It should also be noted that smoking raw cannabis is currently prohibited under Florida law.
Vaporizing
An alternative to smoking is vaporization. There are many different products available for vaping. Some patients vaporize the flowers or buds of the cannabis plant, while others prefer to vaporize concentrated cannabis. Some other names of concentrated forms of cannabis are oils, dabs, waxes, shatter, nail hits and rosin. Concentrated forms of cannabis are often extracted with chemical solvents such as butane. Testing for residual solvents is a must to avoid inhaling high levels of residual solvent chemicals. Also, some concentrated forms of cannabis oil have been mixed with propylene glycol to ease inhalation administration.
Inhalation of propylene glycol has been linked to respiratory and immune disorders. The concentrated forms are higher potency ranging from 50% to 90% THC. There is much debate about whether high potency cannabis is truly medicinal or just an attempt by people to get extremely intoxicated. For many patients with neuropathic or cancerrelated pain, highly concentrated cannabis is most effective at relieving their pain.
Inhalation is a quick and easy way to medicate. Contrary to popular belief, inhalation is low-dose and easiest to control. Patients can titrate up slowly. While the onset of relief is fast, the length of relief is only around 2-3 hours. Inhalation requires more frequent administration and may not be ideal for long-lasting relief.
Ingestible Cannabis
Ingestibles can include anything from cookies, brownies, candies, capsules, tinctures, sprays, tea, and oils. The advantage of ingesting cannabis is that it will provide much longer relief than inhalation. In general, patients can experience a reduction in their symptoms for 6-8 hours or more. Most ingestibles in the form of edibles (cookies, brownies, candies, sodas) come in dosages that far exceed the necessary amount to obtain relief.
When cannabinoids are ingested they are processed through the liver. The liver converts delta-9 tetrahydrocannabinol (THC) into 11-hyrdroxy-THC (11-OHTHC) which is a much more potent form of THC. The bioavailability of ingested cannabis ranges from 4% to 20%. Cannabis is fat soluble, delaying full onset of action from 1-3 hours. These factors make it difficult to dose a majority of THC rich-edibles. The high variability of ingested cannabis, coupled with the delayed onset of effectiveness, can lead to potential over-medicating. Often, while a patient is waiting for relief they will consume more than they need, thinking that they didn't take enough originally. Unfortunately, this leads to side effects that can be unpleasant and uncomfortable. In higher dosages of 10 mg or more, patients can experience anxiety, paranoia and/or hallucinations.
Edibles
Edibles, such as baked goods, lozenges and capsules, can be difficult to part out in equal amounts. Take the example of a brownie that has 100 mg of cannabinoids per package. How can you guarantee, when you break that brownie down into several small pieces, that within each piece the cannabis is evenly distributed? In a cannabis-naïve patient, a recommended starting dose is generally between 2.5mgs to 10 mgs of cannabinoid. The more potent the product, the higher chance a patient has of over-medicating.
Tinctures, Sprays and Oils
Liquid forms of cannabinoids can be a great way to start low and slow. As long as the products are clearly labeled with dosing, patients can start with as little as one drop or one spray. By definition, a tincture is in an alcohol or glycerin base. Among many cannabis products, tinctures are now being developed in an oil base (such as olive oil, coconut oil or medium chain triglycerides (MCT) oil).
Sprays can also be a great way to start low and slow. Many cannabis sprays deliver a metered doses allowing patients to self-titrate.
Topicals and Transdermals
Topical cannabis products can be beneficial for localized issues. Pain, muscle spasms, eczema, psoriasis, bug bites and/or burns can be treated with topical cannabis. The advantage is that the cannabinoids will act locally (and not regionally), thereby decreasing the potential for systemic side effects. Animal studies have shown that THC topically is two times stronger than hydrocortisone. Topical THC can be effective at reducing itching and inflammation on the surface of the skin. CBD has also been shown to decrease inflammation, muscle tightness and itching. As a topical, CBD absorbs into the skin 10x better than THC. When using a topical, patients can expect to experience relief within 20 minutes, and that relief can last for several hours.
Transdermal products can come in patches and/or topical gel pens. The transdermal products have been designed to penetrate the skin and reach the blood stream for more systemic relief. Patches can provide relief within 20 minutes, and the effects can last for 12 hours. Additionally, if a patch is removed, the adverse reaction will dissipate within 20 to 30 minutes. It can be a great way to introduce cannabis into a patient who is concerned about negative side effects and allow them some control over dosing and administration.
Special Considerations
As with all cannabis products, patients should be looking for medicines free of pesticides, solvents, molds, fungus and bacteria. Without standards in place, pesticide use in growing cannabis is unregulated. Solvents, such as butane, hexane and isopropyl alcohol are used to extract concentrated forms of cannabis. Testing the final cannabis product for pesticides, mycotoxins, residual solvents and potency would help ensure the safety of the medicine being consumed.
Finally, cannabis is best when it is individualized to the patient. Dosing is not a one-size-fits-all model, nor is it a sliver bullet.