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The Truth about Cannabis

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Taken from CRC(Cornerstone Research Collective)

Cannabis dosage, purity, side effects and drug interactions

 

We are not physicians or pharmacists. This material is provided solely because there is virtually no information provided to medicinal marijuana patients in California concerning the dosage, purity, potential side effects and drug interactions associated with medicinal cannabis use. This information is not intended to be prescriptive and has not been approved by the FDA, NIDA, or anyone that owns a mug with initials on it.

Dosage - Inexperienced users of medicinal cannabis often use more cannabis than needed to address their symptoms. Because cannabis is relatively nontoxic, overdosage is very common. Some ill-informed recreational users have promoted the dosage strategy that “more is cooler” and this ignorance has spread to some medicinal cannabis patients. The key to intelligent medicinal cannabis dosage is to use only enough cannabis to address their symptoms. A recent study confirms that there is a “sweet spot” for medicinal cannabis dosage. Patients in the study that consumed too small a dose received no relief of their symptoms, while patients who overdosed also achieved no relief. Exceeding the “sweet spot” dosage point is a waste of medicine.

 

Titrating (adjusting) the cannabis dosage seems easiest for patients that choose to smoke cannabis, even though smoking cannabis presents its own specific health issues. One method is to take a single deep inhalation of .1 gram of smoked cannabis, then wait five minutes to gauge the effect of this dose. Holding the smoke in the lungs does not increase the amount of THC that will be absorbed through the lungs, but does increase the amount of toxic tars that will coat the lung passages. Many patients who take large inhalations of smoke and hold their breath subsequently develop chronic lung irritation. With “creeper” strains of cannabis, which have a slower onset of effects, the patient may wish to wait fifteen minutes to assess whether effective dosage has been achieved.

 

When vaporizing cannabis, it is easier to overdose than when smoking, since the lack of irritation, in comparison with smoking, makes it more likely that too much of the vaporized cannabis ingredients will be inhaled. This lack of precision can be adjusted by carefully weighing the amount of cannabis to be vaporized and using only familiar cannabis strains. Take a single inhalation of vaporized cannabis, exhale and wait five minutes. “Creeper” strains of cannabis are not as easily vaporized, since they require a higher temperature, though precision vaporizers such as the Volcano and Vapezilla can be used effectively with these strains.

 

Eating cannabis is by far the most difficult method by which to achieve precision dosage. This is made more difficult when using readily available “edibles”, since there is no standard formula for dosage. “5x”, “10x” and other dosages found on “edible” packaging are absolutely meaningless and completely unreliable. To effectively consume cannabis orally requires the presence of a fat to help digest the active ingredients found in cannabis. Additionally, the cannabis should be heated for five minutes at 350 degrees F, to convert the active ingredients so that they can be absorbed through the digestive tract. Thorough heating also kills any harmful bacteria that might be present on the raw cannabis.. Selecting the appropriate dosage of cannabis to be consumed orally is a process of trial and error, though there are a few techniques that might help. First, use a specific strain to prepare the edible preparation, since there will be less variance in cannabinoid content. Second, use the same kind of oil or fat to distribute the active cannabis ingredients throughout the edible mixture. Third, use the same exact amount of cannabis each time you prepare the edible mixture. Fourth, wait four hours after consuming the edible mixture before assessing whether you’ve achieved the correct dosage. Lastly, always keep notes on your dosage. Consistency is the key, though there will always be some variance with the effects of orally consumed cannabis.

Purity - Raw herbal cannabis may be contaminated by bacteria, molds, fungi and viruses. The average microbial counts found on raw cannabis vary, though these counts can be significant and can pose a health threat to patients. Some bacteria found on raw cannabis may cause gastrointestinal illness. Additionally, the small cystolith hairs found on the stems of raw cannabis can severely irritate the human digestive tract.

The bottom line: never eat raw cannabis.

 

Mold and fungi infestation found on some contaminated cannabis can pose a health risk to patients using cannabis. Mold growth is common on cannabis grown indoors. Patients should learn to recognize the more common molds found on contaminated cannabis. The most common mold infestation on cannabis is mildew. Mildew often appears on the tiny sugar leaves that surround the bud and appear as bright white trichomes (”hairs” or “crystals”), similar to the actual transparent milky or amber trichomes found on the flower surfaces of healthy cannabis. Unscrupulous cannabis growers often attempt to conceal mildew infestation by trimming back these leaves. Close visual inspection of cannabis flowers can usually reveal any mildew contamination. The health repercussions of consuming mildewed cannabis are unknown, but caution is certainly advised.

 

Very rarely, cannabis can be contaminated by aspergillus mold. Aspergillus can produce aflatoxins, which are extremely toxic and responsible for the only death in the US directly attributable to contaminated cannabis. Aflatoxins are not destroyed by heat and can be inhaled by cannabis smokers. Aspergillus mold can grow on cannabis cured in paper bags, so-called “sweat curing”. Cannabis should never be cured or stored in moist conditions.

 

Concentrated forms of cannabis, including hashish, oils and tinctures, present their own set of contamination risks to patients. Medicinal concentrates are typically made from byproducts of the process of manicuring cannabis flowers. The collection and storage of these byproducts is often unsanitary, while the actual methods by which many concentrates are produced, often introduces new contaminants. Hashish and kif are made by separating the trichomes from underlying plant material. Traditionally, this process was achieved by dry sieving the cannabis through fine screens to collect the trichomes. In recent years, water trichome extraction methods have been introduced that greatly increase the likelihood of mold contamination in these concentrates. Almost no hashish available to patients is free from mold contamination. Oils and waxes are usually made by extracting the active ingredients from cannabis by using solvents or compressed gases such as butane. Often these solvents and gases contain extremely toxic and carcinogenic substances that remain in the concentrates after the extraction process. The bottom line is that patients that choose to use concentrated forms of cannabis are at greater risk of exposure to dangerous contaminants.

 

Side effects - Speak with your physician if you experience any side effects from cannabis use.

The physical side effects of cannabis use may include:

Tachycardia - rapid heartbeat

Dry mouth

Dizziness

Orthostatic hypotension - dizziness or loss of consciousness when standing or sitting up while medicated on cannabis.

Headache

Insomnia

Increased sensation of heat or cold in extremities

Red or burning eyes

Muscle weakness

Irritation of airways in cannabis smokers

Cognitive impairment - long-term use of cannabis does seem to effect cognition (ability to think), but any cognitive impairment arising from cannabis use appears to be reversible.

 

The psychological side effects of cannabis use may include:

Anxiety

Lethargy

Confusion

Panic

Reaction time

 

Many of these side effects are dosage dependent and can be reduced by ingesting smaller doses of cannabis.

 

Contraindications - Patients with the following illnesses or disorders should discuss these conditions with their physician before using medicinal cannabis.

Heart disease, arrhythmia, or angina

Acute high blood pressure

Pulmonary disease - smoking cannabis is not recommended for these patients.

Schizophrenia

Immune disorders

Pregnancy and breast-feeding - Use of cannabis during pregnancy and breastfeeding is not recommended. Children exposed to cannabis during the mother’s pregnancy have been shown in certain, but not all, studies to score lower on cognitive function examinations. The active ingredients in cannabis are present in breast milk.

Dependence - Over time, medicinal cannabis users can become physically dependent upon cannabis. Cessation of long-term cannabis use can produce mild withdrawal symptoms including restlessness, irritability, insomnia and, rarely, nausea.

Tolerance - Many patients claim to develop a tolerance over time to medicinal cannabis that requires these patients to increase their dosage. In our experience, we feel that most cannabis tolerance issues are myths. It has been shown in research studies that overdosing on cannabis reduces its effects. Most tolerance is caused by overdosing. Many cannabis users believe that tolerance can be avoided by switching among cannabis strains, which is another myth. The variations in the effects of different cannabis strains are caused by the different ratios of cannabinoids and pharmacologically active essential oils found in each cannabis strain. The variance in these essential oils is one of the primary causes for why different cannabis strains produce individual effects. It’s possible that certain essential oils in cannabis lose their effectiveness when taken continuously over time, but this has not been proven in research studies. The only way to reduce so-called “tolerance” is to reduce dosage.

 

Drug interactions - When taken orally, the active ingredients in cannabis can interact with enzymes in the body to increase or decrease the effect of cannabis. Special caution should be used when taking oral cannabis with the following drugs. The interaction of smoked or vaporized cannabis with these drugs is unknown, but caution is advised.

 

The following drugs can increase the effects of oral cannabis.

Clarithromycin (Biaxin) - antibiotic

Erythromycin (Robimycin, Ilosone, Acnasol) - antibiotic

Itraconazole (Sporanox) - antifungal

Fluconazole (Diflucan, Trican) - antifungal

Ketoconazole - antifungal

Miconazole (Monistat) - antifungal

Diltiazem (Tiazac, Cardizem, Dilacor) - high blood pressure, angina

Verapamil (Calan, Veralan, Isoptin) - cardiac arrhythmias

Amiodarone (Cordarone) - cardiac arrhythmias

Ritonavir (Norvir) - HIV protease inhibitor

Isoniazid (Nydrazid, Rifamate) - tuberculosis treatment

 

The following drugs can decrease or interfere with the effects of oral cannabis

Rifampicin (Rifampin, Rifadin, Rifater, Rimactane) - antibiotic

Carbamazepine (Tegretol, Equetro, Carbetrol) - anticonvulsant

Phenobarbital - sedative, anticonvulsant

Phenytoin (Dilantin) - anticonvulsant

Primodone (Mylosine) - anticonvulsant

Rifabutin (Mycobutin) - MAC disease

St. John’s Wort - herbal antidepressant

 

Additionally, cannabis (smoked, oral, or vaporized) increases the effects of alcohol, benzodiazepines (Valium, Xanax, Restoril, Librium, Ativan, Lorimet, Halcion, etc.) and opiates (morphine, Fentanyl, codeine, etc.).

 

Because THC is strongly bound to plasma proteins, caution is advised when taking other medications that are also strongly bound to plasma proteins.

 

Please take the time to discuss the information provided with your physician. Medicate smart.

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Very good article, only it's a bit of a shame that the references are missing... I was thinking of writing a description like this, with all the references included and then sending it to all doctors I can find... (that's a lot of em). They'd probably trash it though...

 

Well great job on posting this here.

 

If anyone has some critizism on this article please quote the piece of text you mean ONLY or copy and highlight it, this will make this topic a lot neater. We might be able to work ourselves into a proposal for publication...

 

Greets,

 

Kees.

 

(pinned)

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These are some sources for you KT along wit their original Q & A...(Once again taken from the Cornerstone Research Collective website)

 

General Questions

 

What is the most efficient method to smoke cannabis?

 

A clean, waterless glass pipe with a small amount (0.1 gram or less) of high-potency cannabis.

Source: Iversen, L. The Science of Marijuana, Oxford University Press, 2000: Chapter 5, p. 194

 

Are sativa and indica categories helpful to patients in selecting medical cannabis strains?

 

The sativa vs. indica concept is incorrect. Drug strains of cannabis are indica, afghanica or kafiristanica, while true cannabis sativa is used for making hemp fiber. According to the latest research, what are commonly called sativas are actually indicas, while indicas are afghanicas.

Source: McPartland, J. The Medicinal Uses of Cannabis and Cannabinoids, Pharmaceutical Press, 2004: Chapter 4 pp. 74-78

 

Are medicinal cannabis concentrates safe?

 

Some concentrates, such as water hash are often contaminated by molds, while butane cannabis oil extractions (honey oils) are often contaminated by chemicals.

Source: McPartland, J. Cannabis and Cannabinoids, Haworth Press 2002: Chapter 30 pp. 337-343

 

How should cannabis be stored?

 

Refrigerated in an airtight container. Freezing is not recommended.

Source: Grotenhermen, F. Cannabis and Cannabinoids, Haworth Press 2002: Chapter 31 p. 351

 

Should cannabis smoke be held in the lungs after inhaling?

 

No, breath holding does not increase THC absorption, but it does increase the absorption of tars.

Source: Iversen, L. The Science of Marijuana, Oxford University Press, 2000: Chapter 5, p. 193

 

Are vaporizers safer than smoking?

 

Vaporizers, especially the Volcano by Storz and Bickel, seem to do an excellent job of vaporizing cannabinoids without creating the wide range of toxins produced by smoking. Never set a vaporizer to a temperature higher than the manufacturer recommends, otherwise carbon monoxide may be produced by the device.

Source: Gieringer, D. MAPS/CaNORML Vaporizer Studies

 

Is eating cannabis effective?

 

Yes, but cannabis must be heated first before eating to convert the cannabinoid acids to their psychoactive form. Eating cannabis is essentially unpredictable, though for some patients it is the only method available. When eaten cannabis can sometimes require four hours before the effects are felt. Only about 10% of the THC consumed will end up in the blood, with another 10% made available by the liver’s conversion of delta- THC into delta-11 THC, which is also psychoactive. It is common for patients to underestimate the dosage consumed when they eat medicinal cannabis products.

Source: Iversen, L. The Science of Marijuana, Oxford University Press, 2000 Chap. 2 pp. 47-49

 

Is stronger cannabis better than less potent cannabis?

 

For patients experienced with the use of medicinal cannabis, stronger cannabis allows them to use a small amount to achieve the proper dosage. For inexperienced patients, correct dosage can be more difficult, therefore Cornerstone recommends using less potent strains.

Source: Earleywine, M., Understanding Marijuana, Oxford University Press, 2002 p. 130

Are patients put on a government list if they receive a doctor’s recommendation for cannabis?

 

No. Doctors do not share the names of patients for which they have recommended cannabis with the state or federal agencies. However, if a patient chooses to get a voluntary California Medical Marijuana Card, the state will maintain a record on that patient for verification purposes only. All information held by the state of California’s MMJ ID Card program is considered by the state to be confidential and can only be released with permission of the patient.

Source: official California Medical Marijuana Program FAQ: http://www.dhs.ca.gov/mmp/Frequently_Asked...ons/default.htm

 

Best Regards,

 

-O

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NOTE: Karl Hillig at Indiana University did a morphological survey in 2004 of cannabis species. He found that what we have called sativas are, in fact, indicas. What we've previously called indicas are afghanicas. So if you're looking for a "sativa" effect, then you should look at indicas. If you prefer an "indica" effect, try afghanicas.

 

Best Regards,

 

-O

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On that last comment, I don't understand the least bit of it...

 

If I want a sativa effect, then I want what I know as a sativa effect... Right?

 

Kees.

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The issue is mis-info, what you think is a sativa is really an indica, and what you think is an indica is a afghanica or Kafiristanica, for the most part. These are all the sub-species that I know of/for Cannabis:

 

Cannabis sativa L.

C. sativa subsp. sativa

C. sativa subsp. sativa var. sativa

C. sativa subsp. indica

C. sativa subsp. indica var. indica

C. sativa subsp. indica var. kafiristanica

 

Best Regards,

 

-O

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Recent Swiss trials in outdoor plots of clones grown at different altitudes have shown that there is correlation between higher altitude and increased potency (although there seems to be a trade off in yield). This likely means that THC-rich resins act to protect the plant and its seed from both higher light intensities and ultraviolet presence. It's no surprise that cannabis has developed a chemical to protect itself against the Sun's damaging UV rays, as they can be injurious to all forms of life...continued here

 

Best Regards,

 

-O

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Now the article says that it produces higher levels of resin or trichs, it does not state percentage of thc. Quantity does exactly translate in to quality. Plus I hope you understand that global warming and the ozone hole is a marketing ploy and fake.

 

Best Regards,

 

-O

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Pregnancy and breast-feeding - Use of cannabis during pregnancy and breastfeeding is not recommended. Children exposed to cannabis during the mother’s pregnancy have been shown in certain, but not all, studies to score lower on cognitive function examinations. The active ingredients in cannabis are present in breast milk.

 

 

this is not true, unless you add that there have also been studies where the cannababies scored higher and more even.

 

At 1 month, however, comparisons between exposed and nonexposed neonates revealed that the neonates of using mothers had significantly higher scores on the Autonomic and Reflex clusters of the NBAS (see Table 3). On the supplementary items, these neonates scored higher (were less irritable) on the General Irritability item.

 

Comparing the heavily exposed and the nonexposed infants, the Brazelton clusters on day 30, showed that the offspring of heavy-marijuana using mothers had significantly higher scores on the Orientation cluster, on the Autonomic Stability cluster, and on Reflexes (see Table 4). Due to the intercorrelation among the variables comprising each cluster, no t scores or P values are reported for individual items. Nevertheless, a comparison of individual item scores showed that neonates of heavy users had higher scores on habituation to auditory and tactile stimuli, and to animate auditory stimuli, the degree of alertness, capacity for consolability, irritability (ie, less irritable), and had fewer startles and tremors. The comparisons on the supplementary items revealed significant differences on all seven variables, with the neonates of mothers who were heavy-marijuana users performing more optimally on these items.

 

http://www.druglibrary.org/schaffer/hemp/m.../can-babies.htm

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Non-medical user here but great read and I'm sure very helpful for many. Even some non-medical newer smokers should think more about their dosage.

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Thank you sly for clarifying that for us. We were not aware of the case study you presented. Plus one study will not define the nature of how people perceive cannabis. We are merely giving examples that we think are helpful to all in this wonderful forum. So that being said all corrections are welcomed as well as any article, case study, info, etc...

 

Best Regards,

 

-O

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Plus I hope you understand that global warming and the ozone hole is a marketing ploy and fake.

 

Never a good idea to make bold claims about subject areas beyond your field of expertise.

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Never a good idea to make bold claims about subject areas beyond your field of expertise.

 

i will back him up, its not that bold of a claim. in fact no real scientist that does independent studies has EVER validated the claim of global warming, in fact they have dis-proven it. the earth goes through heating and cooling cycles every 30-50 years, and right now we are nearing the peak or may have peaked at the heating cycle. back in the early seventies we had peaked at a cooling cycle. now about the supposed hole in the ozone, simple observations can prove this a fallacy. every year the ozone opens and closes depending on the season. if i'm not mistaken it is at it's largest in the summertime and at its smallest in the winter. in the early seventies when they started doing the studies, the people doing the studies had an agenda, and that agenda was to ban their competitors products so their companies could corner the market and get monopolies. so they decided to study the known effect of the ozone hole getting bigger and bigger part of the year and then getting smaller until it pretty much closes up. so what they did is start taking measurements when it was at its smallest, and each year they took the measurements a little later in the year so that it appeared over 20 years that the hole was getting bigger. this is all bunk science made up to create fear and panic and create profits in the way of legislating the competition out of business. this isn't out of my field of expertise, I can easily read the studies for myself and draw the same conclusions that thousands of scientists have drawn. simply that both are a hoax driven by marketing ploys to create profits. plain and simple. you wont find a single independent scientist in the entire world that doesn't work for one of the foundations responsible for spreading this mis-info to validate the claims. it was quite a bit warmer in the late 16th century world wide as it is right now. a strain of grapes was growing in Greenland that won't survive anywhere else in the world other than a specific micro climate along the Mediterranian yet they were flourishing in Greenland in the late 16th century. just one example of their bullshit theory, another is the fact that in the early seventies the very same organizations and foundations who's scientists are screaming global warming now, were then screaming we were going to go into another ice age soon. (i was taught that in elementary school.) they cant have it both ways. this is history, look it up for yourself. but i forget, most people under 40 or so weren't taught to think for themselves, they are already brainwashed. i feel sorry for the generation we(over 40) will have no influence on. they will believe anything they see on TV, oh wait that's already happening, but at least we can tell them its a lie. but not the next generation . sorry, off rant. but its all true and you can prove it to yourself if you take the time to read the actual studies, and not the summation of the study. the scientists that did these studies for the rockefellar foundation and others manipulated the data in their summaries of the studies much the same as the scientists that worked for the government manipulated all the data on the cannabis studies to fit their agenda. wake up and educate yourselves before its too late!

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Weed is a standout amongst the most manhandled medications on the planet. There is a continually developing crevice between the most recent science about pot and the myths encompassing it. A few people believe that since it is legitimate in a few spots, it must be sheltered. Be that as it may, your body doesn't know a lawful medication from an unlawful medication. It just knows the impact the medication makes once you have taken it. The reason for this production is to clear up a portion of the misconceptions about pot.

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This is an old thread!

 

I was never able to use edibles because of overdosing.

 

Making Bhang allowed me to get my dosage right.

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This is an old thread!

 

I was never able to use edibles because of overdosing.

 

Making Bhang allowed me to get my dosage right.

Oh I could help you with that :)
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All people under 40 can't think themselves? I think that dude overdosed on the pot.

 

I have several friends who are both ,under 40 and Phd'd scientist in various fields. They are far more capable of reason and honesty than "chief running bud".

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The use of medicinal plants is the best natural therapy for the treatment of many diseases. Phytotherapy is old as the history of human civilization. Using herbal teas and natural balms is less harmful than chemical means. Marijuana stops cancer cells from spreading- a compound found in marijuana forces cancer cells to freeze and prevents them from spreading. Visit https://lazychipmunk.com to know more.

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A very good article, yes indeed medical marijuana is helpful in treating the various ailment. But like any other drug. It should be taken as per the prescription of the doctor.

Dr. Dre maybe!
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Here in Holland they have artists on the news today, talking on social media about going to rehab for their cannabis addiction. One said he smoked 5 grams of weed a day, spread out over 10 joints, which makes it clear he smokes even more grams of tobacco, but apparently that ain't a problem. At the same time the media is rambling that weed is a gateway drug, another fairytale about our beloved plant that keeps coming back. But let's face it: if weed was really as addictive as they claim, which drug is it the gate way too than? An even more addictive one like tobacco? I mean, if i am addicted to weed than i don't go look for heroine and if weed is a gate way to heroine than shoot me up now!

 

Where is my green card to get into the country of green leaves and happy hipsters? I'm coming over to the US guys and gals, the land of milk, honey and free weed for everybody! Was signed a jealous flying Dutchman.

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