Cannabis dos­ing

data pro­vides in­sights

The Georgia Straight - - Front Page - > BY PIPER COURTENAY

As the death knell tolls for pro­hi­bi­tion, the rapid pro­lif­er­a­tion of data sup­port­ing the ther­a­peu­tic ben­e­fits of cannabis draws an in­creas­ing num­ber of Cana­di­ans to­ward the plant to al­le­vi­ate com­mon ail­ments such as in­som­nia, anx­i­ety, and pain. In­con­sis­ten­cies in stan­dard­ized dos­ing guide­lines, how­ever, leave most to fend for them­selves as they nav­i­gate the murky wa­ters of self-med­i­ca­tion.

As one of the coun­try’s best-known pa­tient ad­vo­cates, Hilary Black found her ex­pe­ri­ence in es­tab­lish­ing the B.C. Com­pas­sion Club So­ci­ety in 1997 shed light on the need for clear and pre­cise dos­ing in­struc­tions. Now work­ing as the di­rec­tor of pa­tient ed­u­ca­tion and ad­vo­cacy for Canopy Growth Cor­po­ra­tion, she has re­fined a sys­tem she rec­om­mends to clients to al­low a pos­i­tive ex­plo­ration of medic­i­nal cannabis.

“The best way is to start with 2.5 mil­ligrams of THC [tetrahy­dro­cannabi­nol] and equal or greater of cannabid­iol [CBD] and then step it up day by day by that amount un­til you find a dose that works for you,” Black says by phone, adding that mi­cro­dos­ing, though a much slower process, is the best place to start for new pa­tients.

Al­though you can­not se­ri­ously over­dose on cannabis, con­sumers can suf­fer ad­verse ef­fects, like nau­sea and para­noia, from con­sum­ing more than they can han­dle.

“I’ve seen so many peo­ple take too much at once, have a neg­a­tive ex­pe­ri­ence, and then never want to touch it again,” Black says. “That is worse than tak­ing your time to find the right dose.” She notes that pa­tience, though dif­fi­cult, is the key to suc­cess.

Black suggests a wait­ing pe­riod of 24 hours be­fore a sec­ond round so ef­fects can be mea­sured ac­cu­rately with­out the risk of cu­mu­la­tive dos­ing (con­sum­ing more cannabis be­fore the on­set of the first dose).

Canopy Growth of­fers this dosage method to its clients, but Adolfo Gon­za­les, a cannabis-mar­ket­ing con­sul­tant and ed­u­ca­tor, says that level of speci­ficity is rare when it comes to la­belling and con­sumer ed­u­ca­tion within the rest of the mar­ket.

“There are a whole host of mis­takes hap­pen­ing be­cause in the grey mar­ket there’s no stan­dard pro­to­col for how to pack­age,” he says in a phone in­ter­view, “and in the le­gal sec­tor, where there are pro­to­cols, they’re fo­cused on re­ally only pro­vid­ing the cannabi­noid quan­tifi­ca­tion of their prod­uct very thor­oughly, with­out other im­por­tant in­for­ma­tion, like the ter­pene con­tent.

“They think be­cause they pro­vide those ba­sic statis­tics now, it [the prod­uct] is safe for use.”

As a self-pro­claimed data geek with more than 15 years of ac­cu­mu­lat­ing pa­tient-needs in­for­ma­tion, he says con­sumers are ask­ing for more than just a list of in­gre­di­ents.

“Com­pa­nies need to de­fine a min­i­mum dose that is safe for a starter client and de­scribe how to ob­tain that mil­ligram dosage phys­i­cally from that spe­cific prod­uct for­mat,” Gon­za­les says, adding that most only pro­vide one or (more of­ten than not) nei­ther. For ex­am­ple, al­though some com­pa­nies list a stan­dard dose, they won’t in­clude the fact that “one square of choco­late” or “half a drop­per” is the phys­i­cal amount to ob­tain said amount of cannabi­noids.

Cal­i­for­nia-based com­pany Do­sist, which makes the first and only con­trolled-dose cannabis va­por­izer on the mar­ket, is an ex­am­ple of the type of com­pany lead­ing the way in mit­i­gat­ing th­ese con­sumer con­cerns.

With formulas based on six key “need states” (like “sleep” and “calm”), Do­sist pens vi­brate to in­di­cate when a user has in­haled 2.25 mil­ligrams of the CBD and THC vapour, erad­i­cat­ing any po­ten­tial dis­crep­an­cies. Cre­ated with med­i­cal-grade ma­te­ri­als, the pens are also tam­per­proof and child­proof, and have an en­tirely sealed sys­tem, elim­i­nat­ing ques­tions about prod­uct safety.

“Sim­plic­ity is the beauty of it,” Do­sist pres­i­dent Josh Camp­bell says.

“Cus­tomers know when they grab our pen they’re go­ing to get the ex­act same ex­pe­ri­ence ev­ery time. And we’re clear about how to achieve that.”

Do­sist also pro­vides ed­u­ca­tional ma­te­ri­als re­gard­ing how to use its prod­uct, dos­ing guide­lines, the cannabi­noid and ter­pene pro­file of the pen’s dis­til­late, thor­ough test­ing stan­dards, and re­cy­cling op­tions, all in or­der to al­le­vi­ate con­sumer doubt as much as pos­si­ble.

With the prod­uct al­ready avail­able in the U.S., Camp­bell says the date set for it to en­ter the Cana­dian mar­ket de­pends on leg­is­la­tion dur­ing the com­ing months. He says he is work­ing closely with Health Canada to en­sure the pens reach re­tail shelves by June 2019 at the lat­est.

“It [cannabis] is the only medicine where there is no set dos­ing, and we want to be part of lead­ing that con­ver­sa­tion as Canada moves into le­gal­iza­tion,” he says.

Un­til the fed­eral gov­ern­ment cre­ates stan­dard­ized dos­ing guide­lines con­sid­er­ing of both med­i­cal and recre­ational cannabis and al­lows for con­trolled-dose prod­ucts like edi­bles, how­ever, it is up to the pa­tient to de­velop a per­sonal rou­tine.

Black says one way to achieve that is through a dos­ing di­ary.

“Track your cannabis use, in­clud­ing the time of day, the va­ri­ety, the cannabi­noid pro­file, the qual­ity, how you’re us­ing it,” she says.

“Then write down what your symp­toms feel like be­fore­hand and af­ter­wards.”

Once pa­tients ac­cu­mu­late sev­eral weeks of data, it cre­ates a foun­da­tion of knowl­edge on which to de­velop a self-dos­ing guide­line and can also be pre­sented to med­i­cal prac­ti­tion­ers as re­spon­si­ble ev­i­dence of symp­tom re­lief.

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