The Medical Cannabis Guidebook. Mel Thomas

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The Medical Cannabis Guidebook - Mel Thomas

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      The dose should be increased slowly every three to five days depending on the patient’s tolerance, until they are able to take one gram daily. A set of digital scales accurate to a tenth of a gram are required to enable patients to accurately measure their consumption, however, it is not possible to overdose on cannabis oil and your body will not become dependent. Medically a patient has to be in remission for five years before being declared cancer-free, so once the course has been completed, it is recommended that you continue a maintenance dose of cannabis oil, the general consensus being between one tenth to one fifth of a gram per day.

      There are basically five methods of administering cannabis: inhalation (smoking), ingestion (eating), suppositories (anally), topically (creams) and also by intravenous injection (IV).

      When choosing a route of administration it is important to exercise caution and build up your dose slowly. The side effects of over-consuming cannabinoids wear off quickly and will not have any detrimental long-term effects, but the immediate experience can be unpleasant for some individuals. The two most widely used routes of administration are inhalation and ingestion.

      Vaporizing or smoking cannabis is the preferred method for pain relief, as the effects are felt very quickly. When cannabinoids are drawn into the lungs, they rapidly enter the bloodstream, with the initial effects being felt within 20 seconds. First-time consumers who choose to try inhalation are advised to leave at least ten minutes between medications so they can gauge the effects. It is much easier to get the correct dosage when you inhale cannabis; as soon as you feel the effect you wish for, you should stop inhaling.

      For most smokers, the preferred method is the traditional joint, which is simply made using cigarette papers rolled into a cigarette containing cannabis; it is not recommended that you include tobacco. When you smoke a joint, the combustion occurring at the tip generates temperatures of around 1,112°F (600°C); when you draw (inhale) the temperature rises to around 1,652°F (900°C). These temperatures deliver the cannabinoids. However, the act of combustion also creates harmful gases such as benzene and toluene. There are conflicting arguments concerning the harmful effects of smoking cannabis. Some studies have indicated that smoking cannabis without tobacco is much less harmful than when they are consumed together, but other studies have concluded that even the smoking of cannabis without tobacco is damaging.

Consuming cannabis with tobacco is not recommended.

       Consuming cannabis with tobacco is not recommended.

      The results from one of the most comprehensive studies ever carried out on cannabis use and lung disorders was published in The Journal of the American Medical Association.19 Researchers working on a long-term study of risk factors for cardiovascular disease (the Coronary Artery Risk Development in Young Adults or CARDIA study) tested the lung function of 5,115 young adults over the course of 20 years, starting in 1985 when they were aged between 18 and 30. Whilst tobacco smokers showed the expected decrease in lung function, the research found that cannabis smoke had unexpected and seemingly positive effects. Low to moderate users actually showed increased lung capacity compared to non-smokers on two tests. The first test, known as FEV1, is the amount of air someone breathes out in the first second after taking the deepest possible breath; FVC is the second test and records the total volume of air exhaled after the deepest inhalation. Dr. Mark Pletcher, Associate Professor of Epidemiology and Biostatistics at the University of California, San Francisco and the lead author of the study, stated:

A pure cannabis joint containing no tobacco.

       A pure cannabis joint containing no tobacco.

      “FEV1 and FVC both actually increased with moderate and occasional use of marijuana. That was a bit of a surprise, there are clearly adverse effects from tobacco use and marijuana smoke has a lot of the same constituents as tobacco smoke does so we thought it might have some of the same harmful effects. It’s a weird effect to see and we couldn’t make it go away.”20

      Results indicate that smoking cannabis, even regularly and heavily, does not lead to lung cancer. Donald Tashkin of the University of California at Los Angeles, a pulmonologist who has studied cannabis for 30 years, states:

      “We hypothesized that there would be a positive association between marijuana use and lung cancer, and that the association would be more positive with heavier use. What we found instead was no association at all, and even a suggestion of some protective effect.”21

      Water-cooled pipes or bongs can also be used for inhalation, and many medical users choose this method. Smaller hand held pipes can also be used, and as long as you choose a small bowl model designed specifically for cannabis, the fumes inhaled when smoking will not be unnecessarily hot. Pipes and bongs are readily available for purchase online if you do not have a suitable store nearby. It should be remembered that smoking is not a very efficient method of delivering your medication, as the act of combustion destroys over 50% of the cannabinoids.

      A much more efficient and precise method of inhalation is a specially designed vaporizer. These units don’t actually burn the cannabis material, but instead gently heat to set temperatures that release the cannabinoids as a mild vapor that can be inhaled.

      A vaporizer does not use combustion, so none of the cannabinoids are consumed by flame, making a vaporizer very economical. With a quality vaporizer you are receiving 100% of the cannabinoids from your herbal cannabis, as opposed to losing over half of the cannabinoids through combustion when smoking. Vaporizers are usually portable and can be carried with you, with some being small enough to place in your pocket. The non-portable types are larger, and ideally you should purchase one that includes a variable temperature function that gives more precise delivery of the cannabinoids. The ability to choose the temperature at which you vaporize will allow you to administer the cannabinoids you wish, and, whether your desire is to medicate or get high, this essential facility gives you total control. It is the higher temperatures involved in smoking that are responsible for the production of carcinogenic hydrocarbons, and these are almost completely eliminated by the use of a quality vaporizer, as the lack of combustion suppresses the formulation of the health-damaging compounds. In 2007, a study of vaporization conducted at the San Francisco General Hospital concluded:

Volcano vaporizer. The vapor is collected in the bag for inhaling.

       Volcano vaporizer. The vapor is collected in the bag for inhaling.

      “Vaporization is a safe and effective cannabinoid delivery mode for patients who desire the rapid onset of action associated with inhalation while avoiding the respiratory risks of smoking, as they significantly reduced the intake of gaseous combustion toxins, including carbon monoxide.”22

      The vaporizer used by the 18 participants in the study was a Volcano Vaporizer, manufactured by Storz & Bickel, which was chosen for its reliability, efficiency and its accurate temperature control. Many Volcano owners find that its advantages more than compensate

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