What is RSO? Is it a fit for me?
By Markita Wilburn, PharmD and Rebekkah Ranallo
After visiting a Maitri dispensary, you may have wondered about the syringes in our display cabinets. Or, you may have read the acronym “RSO” scattered throughout our menu and wondered “what’s up with that?”
Of the many forms of approved formulations we dispense, RSO is the subject of our most frequently asked questions. What exactly is it? How do you use it? Is it really as potent as they say it is?
So, what exactly is RSO? RSO stands for Rick Simpson Oil (more on Rick Simpson later!) and is a highly potent cannabis oil. We typically recommend it for patients medicating symptoms of terminal illnesses, conditions requiring higher dosages, or simply, for experienced patients who have a higher than average tolerance.
RSO is the end product of a simple extraction technique that yields very high concentrations while ensuring all components of the plant are present—cannabinoids, terpenes and flavonoids. It is immensely dark in color, thick, and sticky in consistency, similar to that of tar. It is packaged and stored in a syringe for easy consumption, not for exact dose measuring as many assume (do not take a whole syringe of RSO!). This makes it easier to withdraw doses prior to consumption.
You do not need to be critically ill to benefit from RSO. For example, I am cannabis experienced and enjoy consuming RSO in small doses for overall wellness purposes. I’m a big fan of the entourage effect, so getting the whole plant in a concentrated formulation offers me all the flavonoids and terpenes I’m seeking on my medical marijuana journey. I don’t want to miss out on any of the medicinal properties that the whole plant has to offer.
Now, back to Rick Simpson. Simpson was diagnosed with skin cancer almost 20 years ago. Because he’d had success medicating with cannabis for other conditions, he designed his own cannabis extraction method to yield the highest cannabinoid concentration. He applied the resulting oil to his skin cancer topically, and within days, the cancerous bumps on his skin disappeared. He became world famous when he shared this technique with the world.
How do I dose it? How do I consume it?
Thankfully, RSO is an activated formulation, meaning no heat needs to be applied to the product when consuming it. Because of this, patients have many options on how to administer it. RSO has a strong, bitter taste that can linger, so I always suggest to take it with a snack high in fats (like a spoonful of peanut butter, avocado, or yogurt) to not only mask its bitter taste, but to increase its absorption throughout the body. We have some patients who like to freeze individual doses on a piece of parchment paper, and then dilute it in their morning tea or coffee.
As the oil is potent, we advise to start low and slowly increase doses only after four or more days of consistent consumption. We recommend measuring doses in comparison to the size of a dry grain of rice. A typical dose is one rice grain. Patients new to cannabis should start with 1/3 of a rice grain size. More experienced patients may start with 1/2 the size of a rice grain.
Effects are generally felt within 30 minutes of sublingual (under the tongue) consumption and last up to 5 hours.
Tips from the Pharmacist
Because RSO is consumed orally, you will find it categorized under “Infused Edibles” on our menu.
If you have trouble extracting a dose from the syringe, try submerging the syringe in warm water for 10 to 15 minutes to allow the oil to loosen. Make sure the cap is securely fastened prior to doing so.
In terms of THC content, RSO can be up to four times stronger than most dry leaf forms. It can be microdosed and utilized cost-effectively, but be sure to consult with your medical marijuana pharmacist.
If self-dosing with an RSO syringe intimidates you (you’re not alone!), you can also look for RSO available in capsules on our menu.
I believe that cannabis is easily the most diverse plant in how vastly it is utilized across a variety of medical conditions. We still don’t fully understand all the ways in which it can be consumed. But if you’re looking to try something new in your wellness journey that offers you the benefits of a whole plant experience, I recommend giving RSO a shot. Just remember: start low, and go slow.
Sources and Further Reading
https://pubmed.ncbi.nlm.nih.gov/1159836/
http://phoenixtears.ca/faq-about-rso/
https://www.leafly.com/news/cannabis-101/what-is-rick-simpson-oil