There are several different ways to use the cannabis plant in order to attain its therapeutic benefits; each may be more effective for certain symptoms or circumstances, and can be used in a manner that promotes its safety and efficacy.
Print the BCCCS Safe & Effective Use of cannabis pamphlet and take it to your health care practitioner, distribute it to your community, or have it on hand for your own reference.
On this page you will find information that will help you use cannabis safely and effectively, including:
- using the whole plant
- different modes of ingestion
- options for safer smoking
- strain selection, potency and tolerance
- side effects
- drug interactions
- safety considerations
Please note that the following should not be construed as the giving of advice or the making of a recommendation and it should not solely be relied upon as the basis for any decision or action. It is based on our research and experience. Every individual, however, is different in terms of how they find benefit from cannabis. Additional resources are provided for your information.
The whole cannabis plant may be efficiently utilized. The flower (“bud”) is the most resinous and therefore potent part of the plant. This makes the bud ideal for smoking. The leaves (“shake”) and stems are less resinous, and therefore are better suited for baking and making tinctures.
Modes of Ingestion
Smoking: Smoking is the easiest way to find the appropriate dosage since the effects are usually felt within 30-60 seconds, and develop fully within 5-15 minutes. The effects may last from 30 minutes to 5 hours. It is ideal to smoke as little as possible in order to reduce costs and respiratory irritation. We recommend you take 1-2 puffs and wait 15 minutes in order to find the right dosage. Increase dosage as necessary.
Ingesting (eating and drinking): Cannabinoids can be extracted into fat (butter or oils) and then ingested. The effects of ingested cannabis may be felt within 30 minutes to 2 hours (depending on metabolism), and may last from 2-8 hours. Effects of ingested cannabis tend to be much more pronounced than smoked cannabis, both physically and psychoactively, and vary depending on strain used in the preparation. An elevated dosage, though not lethal, can be very uncomforable (i.e.vomitting, panic). Therefore it is important to take care in finding the right dosage. Small amounts should be ingested, and it is recommended to wait 2 hours before increasing the dosage gradually, if necessary.
Tinctures: Cannabinoids can also be extracted into alcohol or glycerine, and made into tinctures. Tinctures may be dropped or sprayed into the mouth to be absorbed into the mucous membranes. Effects of tinctures are usually felt within 5 minutes to 1 hour, and last about 4 hours.
It is recommended to start with about 3 drops of tincture, and wait an hour before increasing the dosage, incrementally and as necessary. Alcohol based tincutres may also be dropped into hot water in order to let the alcohol evaporate, and then ingested. Effects will be the same as they are for ingested cannabis (above).
Options for Safer Smoking
There are various methods of smoking cannabis that can reduce bronchial irritation while obtaining the medicinal benefits of the plant. These methods include:
- Cannabis may be ground or cut and then rolled into a “joint”. Using natural (without artificial ingredients or flavours) rolling papers such as those derived from hemp or rice is recommended for both health reasons and to avoid using tree products.
- Pipes can be used to avoid smoking paper and are useful when smoking small quantities. We recommend glass pipes to prevent ingestion of possible harmful by-products.
- Water pipes can be used to cool the temperature of inhaled plant matter.
- Vaporizers can be used as a smokeless alternative and also provide a uniquely “clear” psychoactive effect. Vapourization heats the cannabis to a temperature high enough to release the active ingredients without actually combusting the plant matter.
- A blend of herbs that soothe the lungs can be rolled and smoked with cannabis. We recommended (as well as offer) an herbal smoking blend made up of the following 4 herbs: damiana, coltsfoot, mullein, and peppermint. We do not recommend rolling cannabis wtih tobacco.
Strain Selection, Potency and Tolerance
The efficacy of cannabis is directly related to strain selection, therefore we recommend care be taken in selecting appropriate strains to meet your needs.
You will require less of a high-potency cannabis to reach the desired effect. Potency varies with strains.
If you find yourself needing to use greater quantities or more often in order to achieve the desired effect, reduce or stop intake for some time. Changing the variety of cannabis normally used will also help you to return to a minimized effective dosage level.
Some effects of cannabis use may not be therapeutic. They can be mitigated through awareness.
- Cannabis may cause dizziness upon standing due to lowered blood pressure.
- Initial increase in heart rate and/or blood pressure may be problematic for those with heart conditions or severe anxiety.
- Cannabis may cause a decrease in coordination and cognitive abilities, and short-term memory loss while medicated.
- Pure Sativas especially result in psychoactive effects or feeling “high”, which for some is an undesired side effect. Using strains with an Indica component will reduce the psychoactive effects.
- There are no significant withdrawal effects when cannabis use is ceased or decreased, however symptom relief will cease or be decreased. Minor restlessness, nausea, fatigue or sleeplessness may be experienced.
Clinically significant interactions have not been detected. Studies on the interaction of cannabis and pharmaceutical medications is sparse and inconclusive.
Pharmacy Magazine reported in June 2001 that *:
- Cannabis has been shown to decrease the clearance of barbiturates so they remain in the body longer, and may need to be reduced.
- Cannabis has been shown to increase the clearance of Theophyline, therefore its dose may need to be increased.
- There can be side-effects when cannabis is combined with Fluoxetine or Disulfiram. These effects can include mild mania and excitement with moderate behaviour change.
- Cannabis may enhance the effects of amphetamines, anticholinergics, anihistamines, cocaine, hypnotics, physchotomimetics, sedatives or sympathomimetics.
* this study does not take into account different strains.
Results from a survey of BCCCS members overwhelmingly indicate that they do not find negative drug interactions. Many reported that they are able to reduce their dosage of some of their pharmaceutical drugs (particularly opiates) and that cannabis mitigates negative side effects of various medications, which in some cases is the reason for their use of cannabis.
Those receiving Digitalis or other cardiac medications should use cannabis under careful supervision by a medical doctor.
1:40 ratio (cannabis : alcohol)
Each small tincture contains 0.9 grams of cannabis
Each large tincture contains 3.6 grams of cannabis
Extra Strength Tincture
1:10 ratio (cannabis: alcohol)
Each small tincture contains 2.8 grams of cannabis
Each large tincture contains 11.25 grams of cannabis
Learn about concentrates and extracts for those who need higher doses.
As a first dose, start with an amount of extract that is the size of the head of a pin. The dose will take effect within 10 seconds. The level and duration of the effect depends on the strain, so check which strain(s) is used to make the product. Extracts are for those who have a high tolerance and/or need high doses.
Extracts made using strong sativa strains can increase anxiety due to their potency; if you have anxiety opt for extracts made with indicas or crosses. For more on this, read High Times’ extensive article on extracts, “To Dab Or Not to Dab?” available online, or Beyond Buds by Ed Rosenthal.
- Do not drive or operate heavy machinery if impaired by cannabis ( indicas can be especially sedating).
- Cannabis mixed with alcohol may cause vomiting and nausea.
- Heavy smoking with no harm reduction techniques (i.e. smoking small amounts of high potency organic cannabis) may lead to respiratory irritation.
- Hold shared joints and other shared smoking implements so as not to touch your lips to them.
- Choose organic cannabis whenever possible to minimize exposure to radioactivity and chemicals. This is especially important for people with compromised immune systems.
- It is still illegal in Canada to possess, grow, or distribute cannabis. Know your rights and take precautions to avoid the harmful effects of arrest, cannabis seizure, imprisonment and criminal record.