I think most people can relate to this: somebody getting higher than expected from their cannabis and suffering from increased feelings of anxiety and paranoia. Whether it was you or a friend, the experience can be traumatizing for patients susceptible to anxiety attacks and paranoia. While this is certainly not the norm of marijuana use, there are factors that can exacerbate this feeling, and patients need to be aware of the risks associated with first-time or heavy-consumption marijuana use. Just like any other medicine, dosing, social environment, and strains can all have varied effects on the patient’s reaction.
How to Properly Dose Marijuana
We understand that this may be the first time patients are using marijuana; and if it is not their first time, it may be the first time it will become a regular occurrence for these patients; with higher THC percentages than most people are accustomed to. According to a study that tested the THC and CBD content in street marijuana, in 2014 the average street marijuana tested at 12% THC. Compare this to the lower-dose Tier-1 marijuana in Ohio, which can reach up to 23% THC, while Tier-2 marijuana can reach all the way up to 35% THC.
When you visit with our doctors, based on the Intake form and discussion of your symptoms, they will put together a treatment plan with you to ensure that you are taking the proper dosage and using the particular strains that should work best. Of course, over time, the dosage will need to be changed as your body becomes acclimated and stores THC in fat, and that can be quite concerning for patients that worry about having a negative reaction to their medicine.
While we are always available to talk with and help direct you to the proper resources, I wanted to discuss a few different resources that patients can utilize to get a better grip on properly dosing with the correct strains:
Cannabis Pharmacy (book): this is one of the most informative yet understandable books on using cannabis to address symptoms associated with an array of ailments and conditions; including information on how cannabis works with the body’s own endocannabinoid system, how best to prepare and administer it, and how to modify and control dosage.
The Leafly Guide to Cannabis: A Handbook For The Modern Consumer (book): this is a great beginner’s guide to those new to cannabis consumption. Learn about different flavor profiles, cerebral and body effects, and different methods from vaporization to combustion to topical application.
Healer.com (online resource): this is a website dedicated to medical marijuana education created by expert cannabis clinician Dr. Dustin Sulak. The website offers resources on how to find the right product/dose and why medical marijuana works for so many conditions! His research is based on his evidence from his MMJ patients in Maine.
Releaf (mobile app): this is an app that allows you to track your cannabis use and record exactly how it make you feel, what symptoms were treated, log your feelings, and any side effects you experience. It’s a great app to keep track of the strains/products that you use and work best!
Potbot (mobile app - Apple only): this app helps patients better understand the medical properties of cannabis to find the best strain to work with your condition and maintain a log of strains and products!
Leafly (mobile app & website): one of the most popular marijuana apps in the world, this app is used to find the cannabis product that is right for your condition, user-submitted reviews, the nearest dispensaries and what products they have in stock. The app comprehensively breaks down each strain to better understand the terpene profiles, average CBD/THC levels, common effects of the strains, and what they look/smell like.
How Does Marijuana Reduce Anxiety?
There is evidence that marijuana’s interaction with the neurotransmitter GABA can be utilized to counteract feelings of anxiety; GABA levels are what are targeted by benzodiazepines, the most common anti-anxiety drug prescribed. Endocannabinoids can also modulate GABA activity that resemble those of other GABA-mediated drugs. Furthermore, research has shown that marijuana can also lower cortisol, which is the stress hormone.
Moreover, CBD displays characteristics of reducing anxiety while also positively affecting serotonin levels. Research has shown that with both human and animal subjects, anxiety was significantly decreased in subjects who received CBD, as opposed to a placebo. In another study, it was shown that CBD is effective in relieving social anxiety - even during public speaking.
As the evidence has revealed, CBD is the main component that our patients dealing with anxiety should be searching for, although low-concentrated THC strains will also be ideal. The main consideration when choosing a strain should be dictated around a balanced CBD/THC ratio.
What Strains of Marijuana Work Best For Anxiety?
Unfortunately, due to the way in which Ohio’s law was written, it is highly possible that the strains - which are recognized and named identically across the country - have had their names altered in Ohio. This can make it more difficult to accurately track and identify the genealogy of a product, and therefore making it more difficult to make the most-informed decision on the strain that will be best for you.
Generally, you want to aim for a THC/CBD ratio of at least 1:1 (THC:CBD) . Terpenes - the fragrant essential oils secreted from cannabis - to keep an eye out for include linalool, myrcene, and bisabolol, according to Leafly. Linalool, primarily found in indica-dominant strains, has anti-anxiety and sedating properties and is found in lavender, while myrcene, which is found in mangoes, also has a sedating property to it. Linalool-rich strains include Lavender, LA Confidential, and Master Kush; and myrcene-rich strains include Pure Kush, White Widow, and Jack Herer. Bisabolol has recently been being investigated more thoroughly, revealing that it includes anti-irritant properties. Popular bisabolol-rich strains include Headband and Master Kush.
Apothecarium provides a guide for the ideal ratio:
THC dominant options (0:1) will provide varying degrees of psychoactivity. THC induces appetite, reduces inflammation, and can provide relaxing and/or cerebral effects. Adverse effects may include tachycardia, anxiety, and paranoia. These can be reduced by introducing CBD into the equation.
A 1:3 ratio of CBD to THC results in a some psychoactivity while minimizing THC’s unwanted side effects, producing a calming sensation with reduced anxiety, stress relief and exhibiting anti-inflammatory properties. This ratio can act an as advanced pain reliever with the synergistic benefits CBD and THC provide.
A ratio of equal parts CBD to THC (1:1) is considered highly effective for pain relief, anxiety, spasticity, fibromyalgia, insomnia, nausea and appetite stimulation. This ratio shows promise in relieving symptoms associated with Multiple Sclerosis and may be able to kill certain cancer cells and inhibit tumor growth. A 1:1 can be a good starting point for many due to the multitude of conditions it may treat with minimal impairment.
Higher CBD options, such as 2:1 or 3:1, may be an ideal ratio for combating autoimmune disorders, gastrointestinal issues such as Crohn’s and colitis, arthritis, and psoriasis with little to no psychoactivity.
CBD dominant ratios of 25:1 or 1:0 (hemp based CBD) offer no psychoactivity and may be most effective for curbing high anxiety, depression, seizures, psychosis, PTSD, and neurodegenerative conditions such as Parkinson’s and Huntington’s Disease. “
What To Do If You Get Too High
You can not only prevent these feelings of anxiety, but even counter them! There are a few different things suggested:
Use a low-THC and/or high-CBD strain. With a significant amount of CBD in a strain, the CBD will actually compete with THC to bind to endocannabinoid receptors, meaning that the CBD will block the uptake of THC into your system while still providing medical benefits.
Start with a small dosage and work your way up. While this may seem obvious, the effects of marijuana can often be delayed for a multitude of reasons, but will eventually take effect. This is especially true of consumable products and topicals, as the process to breakdown the cannabinoids and feel the effects of the marijuana can often take anywhere from 30 minutes to an hour and a half to kick in. Vaporizable products offer better dosage control compared to these products, as the effects are more immediate and don’t last as long.
Find a comfortable environment. When using THC, you do have to remember it is a mind-altering compound. When you are under the effect of marijuana in an uncomfortable environment, this can often compound that feeling of discomfort and anxiety. Curl up and watch a movie, go out and play with the kids or pets, read your favorite book - do what makes you happy and comfortable! A common yoga breathing technique used for relaxation is the 4-7-8 breath: sitting comfortably, empty your lungs with a full breath out the mouth; then, take a deep breath in through the nose (with mouth closed) for 4 seconds, hold your breath for a count of 7 seconds, and slowly exhale through your mouth for 8 seconds. Repeat this process until you feel calm and relaxed.
Find the right strains for your conditions - and keep track of which strain works! The most powerful thing about medical marijuana treatment is it allows the patient vastly more freedom and control over their treatment and goals. We are always here for support, but nobody is going to understand the effects each strain has on you better than you. Having trouble with high-THC strains? Try using an indica strain, which has a much more balance ratio of THC to CBD. Avoid using sativa strains that are characterized by high-THC and low-CBD balance. (You can keep track of all of your purchases through the Releaf app I mentioned above.)
And just remember, if you do have an episode of anxiety, it will pass. It is not permanent, and, depending on the method of ingestion, it can be over within hours. It is a scary feeling, and one that we want all of our patients to avoid. If you are ever in doubt, consult with a resource; whether you give our Patient Support Center a call, call the dispensary where you bought the product, or use the resources provided in this article. You are not alone - due to prohibition blocking medical marijuana research, we’re all figuring this out together.
If you are an Ohioan suffering from one of these 21 medical conditions you may be eligible to treat your ailment with medical marijuana, which includes both CBD and THC products, including dry flower.
Click here to learn more about what Ohio Marijuana Card's state-certified medical marijuana doctors can do for you, or give us a call at 1-866-457-5559 and our friendly support team can walk you through the entire process, and set you up with an appointment.