FAQs – CBD Oil

What is CBD ?

And what is the difference between cannabis and CBD ?

Cannabis is indeed a plant that includes many organic compounds, 480 in total, the main ones being terpenes, flavonoids and cannabinoids.

The latter are themselves 80 in number in cannabis, but only four are in major concentration: THC or 9-tetrahydrocannibinol, CBN or cannabinol, CBD or cannabidiol and CBG or cannabigerol.

Cannabidiol or CBD is therefore one of the molecules derived from hemp and not a mixture like cannabis.

This distinction is essential for the legislator or the pharmacologist, because CBD does not cause physical dependence and has no narcotic action.

This is why Indian hemp, richer in CBD, is widely used in certain countries as therapeutic cannabis.

Check also this short video :

How to dose CBD oil ? 

If there is one area of medical use of cannabinoids that raises the most doubt among clinicians, patients and their families, it is the question of dosage.

All of parameters, which are commonly used in medicine, have been established on the basis of many years of pharmacological study and an equally long period of clinical practice.

The same system applies to the vast majority of pharmaceuticals in use today: the doses used are weight-dependent in the case of children, and are set at a standard dose in the case of adults.

However, none of this applies when using cannabis for medicinal purposes.

I would therefore like to share some thoughts that may help readers understand the complexity of standardizing dosing in the case of cannabis.

THC dosing as the sole active agent is not identical to that of cannabis

CBD oil dosage
CBD oil dosage

Since the first human trials with THC, the vast majority of studies conducted using perfectly quantified doses of cannabinoids have involved THC alone.

The pharmaceutical formulation of the isolated THC molecule is called dronabinol and is marketed under the name Marinol®.

The results of studies on this drug have been somewhat disappointing in terms of effectiveness. In addition, it has shown considerable side effects, especially at the psychological level.

This is quite logical, knowing that THC is better tolerated when it is accompanied by other cannabinoids, like CBD or terpenes, than when it is administered alone in monotherapy.

Initial doses used in these studies typically range from 2.5 mg to 10 mg (sometimes up to 20 mg) of THC per dose, depending on the research objective.

The 2.5 mg dose is typically given to the elderly and children – although surprisingly, children tolerate the psychoactive effects of cannabis better than adults.

This is due to the lower density of CB1 receptors in immature brains compared to adult brains (Franjo Grothemner).

However, the situation in everyday clinical practice is very different; Marinol® (THC) is used in minute proportions compared to its herbal form, Sativex®, or edible cannabis.

The dosage of the only pharmaceutical grade drug extracted from the plant varies considerably

Given that THC has a different bioavailability rate than CBD, in pharmacological terms, Sativex is not comparable to other commonly used drugs.

Cannabis is not one molecule, but many

Medicinal cannabis is a substance with multifaceted therapeutic potential, because different combinations of cannabinoids and terpenoids create products that are more suitable for one condition or another.

For example, some varieties are ideal for treating insomnia or anxiety, while others have a powerful euphoric and antidepressant effect.

This wide variation in effects is not only due to different combinations of cannabinoids; it also depends on how the cannabinoids are combined with the different terpenoids in each combination.

Given all the possible combinations of cannabinoids and terpenoids, medicinal cannabis should not be considered a single type of “medicine”, like paracetamol.

Herein lies the main problem with cannabis dosage…. Administering 5 mg of THC through a pure Sativa variety with a high concentration of the terpenoid limonene.

It will never have the same effects as 5 mg of THC administered using a pure Indica variety with a high concentration of pinene.

As a result, cannabis cannot be dosed like other pharmaceuticals.

To make matters even more complex, it is also important to take into account the genetic variability of each patient; the same 5 mg dose of any strain will have different effects in two different individuals, even if the product is strictly identical.

There is only one way to address all of these obstacles when determining the dose of cannabis.

Individualization of treatment

An individualized treatment consists of giving each patient the dose that best corresponds to his or her disorder and that will depend on the individual.

Previous experience with cannabis, any concomitant medication he or she may be taking, like the type of THC metabolizer, the product used (proportion of THC and CBD, terpenoid content, ratio  of Sativa/Indica, etc.) and the route of administration (oral, sublingual, spray, etc.).

However, the protocol for determining the appropriate dose for each individual will always be the same:

Start with a low dose and gradually increase it until you find the dose that improves the individual’s symptoms while not intensifying the side effects to the point where they interfere with adherence – in other words, the dose that provides the most effective balance between symptom improvement and side effect intensity.

It is important to spend enough time finding this balance. If the dose is increased too quickly, it can lead to side effects that will cause the patient to reject the treatment.

On the other hand, if it is increased too slowly, treatment may be discontinued due to its apparent ineffectiveness.

In summary, cannabis treatment will always require an individualized dose for each patient.

Treatment should begin with a low dose and be increased gradually and at an appropriate rate until the optimal dose for each individual is found.

This involves balancing symptom improvement with the patient’s tolerance to side effects (majorly THC) It will also depend, to a large extent, on the type of product like ratio CBD : THC or the route of administration.

source : fundacion-canna

When to take CBD oil ?

Many people prefer to take their CBD first thing in the morning, along with other supplements/medications and with their coffee and breakfast.

But not everyone feels this way, and some would rather take CBD in the evening with dinner or right before bed.

For the most part, it boils down to what is easiest to remember and what time is the most beneficial for each person.

Some people feel energized and alert when they take CBD, so taking it first thing in the morning makes sense.

Others prefer to take it a few hours later when their afternoon exhaustion starts to kick in, giving them an extra boost to make it through the day.

On the other hand, some people report feeling relaxed and sleepy after taking CBD, so in those cases, it would best be taken in the evening or before bedtime.

Does CBD oil work for chronic pain management ?

Researchers compiled the results of multiple systematic reviews covering dozens of trials and studies.

Their research concluded that there is substantial evidence that cannabis is an effective treatment for chronic pain in adults.

While many studies have suggested CBD oil is helpful for pain, more research is necessary, especially in long-term studies with human subjects. However, CBD oil does show a lot of potential for pain relief.

Anecdotal evidence suggests that it can be used to help manage chronic pain in many cases.

CBD oil is especially promising due to its lack of intoxicating effects and possible lower potential for side effects than many other pain medications.

People should discuss CBD oil with their doctor if they are considering using it for the first time.

For example, CBD stops the body from absorbing anandamide, a compound associated with regulating pain.

So, increased levels of anandamide in the bloodstream may reduce the amount of pain a person feels.

Cannabidiol may also limit inflammation in the brain and nervous system, which may benefit people experiencing pain, insomnia, and certain immune-system responses.

CBD : THC ratio oil – Therapy recommandations 

Treatment recommendations from/for the practice

SSCM is currently working on therapy recommendations, whereby the following topics will soon be available:

MS-related spasticity, fibromyalgia, dementia, tourette- and restless legs syndrome.

Further recommendations are planned, such as for pain, oncology/palliative care, psychiatry, epilepsy and movement disorders.

Please contact daniela.eigenmann@cannabis-med.ch if you have an appropriate expertise or clinical experience and are interested in a cooperation. We would appreciate any active collaborative efforts.[/vc_column_text][/vc_column][/vc_row]