Microdosing: Healing without the high
By Annie Conner, Pharmacist, Maitri Medicinals
As a member of the pharmacy team at Maitri, one of the first questions I ask patients in a consultation is about their preferred level of psychoactivity, or euphoria. Anecdotally, I find that about a third of patients are looking for this effect, another third wants to avoid it altogether, and the final third don’t really care as long as the medical marijuana reduces their pain, helps them to sleep, or improves their anxiety, for example. For those patients looking for relief of their conditions without affecting mental clarity, microdosing THC may be their best course of action.
The premise of microdosing THC involves starting with very low doses of THC, usually 1-3mg, and increasing slowly until the patient notices an improvement in their condition. At this point, the patient should remain at this minimum effective dose until they build up a tolerance and no longer notice relief. This emphasis on establishing the minimum effective dose reduces such side effects of THC as euphoria, dizziness, dry mouth, and drowsiness.
Recently, researchers in Israel studied the effects of microdoses of THC (0.5-1 mg) on regular cannabis users suffering from severe chronic pain. On a pain scale of 0-10, they found that the patients receiving 0.5-1mg doses reported a 2-3 point reduction in pain for 150 minutes compared to patients receiving placebo. Furthermore, they found no evidence of cognitive impairment in the test group.
Because of precision in dosing, capsules and tinctures tend to be the simplest products to microdose. For example, to target a 2.5mg dose, a patient could take one Grassroots 2.5mg tablet, Liberty 2.5mg capsule, Vireo Green 1:1 soft gel, or one spray of Cresco’s Relax or Awake spray tincture. For doses smaller than 2.5mg, or to dose down to a specific milligram, tinctures are the perfect option because a patient could take a drop, a dropperful, or somewhere in-between. For personalized information on dosing tinctures, ask your Maitri pharmacist!
Microdosing with inhaled formulations such as dry leaf, cartridges, or concentrates can be tricker, because it can be almost impossible to determine exactly how long or forcefully you need to inhale to target a specific dose. I recommend patients new to cannabis or to microdose with very short inhalations (a “sip”) and wait 10 minutes to determine the effect and whether more is needed. New dose-controlling technology, like that in the Pax Era Pro allows the user to program the device to give a preset microdose.
Sources & Further Reading
https://onlinelibrary.wiley.com/doi/10.1002/ejp.1605
https://www.leafly.com/news/cannabis-101/microdosing-weed-guide