Medical marijuana doctor in Tampa, FL
Cannabis dosing to support opioid reduction
Cannabis can be used in so many different ways to individually tailor a treatment depending on one’s needs. Could specific approaches to dosing further increase the effectiveness and reduce the potential harm of cannabis in the setting of opioid dependence? Here are the guidelines I provide to my patients in Florida:
1. Take small doses of cannabis first
Always take a small dose of cannabis, preferably using a noninhaled delivery method, with every dose of opioids. Many people make the mistake of thinking they should choose one or the other, but it’s clear for all the reasons discussed in this article that the combination works best. In most people, only a low dose of THC is needed to augment the effects of the opioids, so I instruct my patients to start at 1-2 milligrams of THC per dose and gradually increase until they notice the opioid pills are starting to feel much stronger. Once reaching this dose of THC, many will begin tapering the opioid drugs by cutting tablets in half and/or taking them less frequently.
2. Use inhaled cannabis to manage breakthrough symptoms and to reduce cravings.
The rapid onset of vaporized or smoked cannabis makes it perfect for addressing these challenges that so often interfere with successful opioid tapering. I encourage my patients to reserve inhaled cannabis for when it’s needed most, ideally three times daily or less, and to use the lowest effective dose, taking one or two puffs and repeating every five minutes as needed, to prevent building tolerance to cannabis.
3. Use cannabis to promote regular sleep patterns.
Reducing and discontinuing opioid drugs is a challenge at every level of our being: physical, mental/emotional, and spiritual. There is no medication or herb that can make this easy, and people dedicated to this change need every ounce of strength, determination, and resilience they can muster. This is why restorative sleep is essential and should be addressed at the beginning of this process. Only sedating strains of cannabis should be used in the evening, and an oral dose of cannabis (e.g. capsule) should be taken before bed if needed. While proper use of cannabis is often enough for most people to achieve healthy sleep, the cannabis can also be safely used in conjunction with other natural and pharmaceutical sleeping aids.
4. Use cannabis to enhance health-promoting activities such as exercise, meditation, prayer, journaling and reflecting, and counseling or behavioral therapies.
As mentioned above, the enhanced neuroplasticity of the endocannabinoid system can help these essential components of a healing plan work even more powerfully. Many of my patients find themselves more likely to participate in these activities when they’re combined with cannabis. So when using inhaled cannabis to treat breakthrough symptoms or cravings (suggestion 2), I tell my patients to take a walk outside, try some exercises and meditation, or sit down with their journal immediately after using cannabis.