Interactions
Cannabis (marijuana) has no known lethal dose or LOSO. This makes cannabis one of the least toxic substances known. Therefore, it has very few drug interactions and low potential to cause combined adverse effects. Although, a few have been reported that should be discussed.
Alcohol effects may be increased when combined with cannabis, increasing risk of dizziness, loss of coordination, nausea and vomiting. Theoretically, cannabis is an anticonvulsant and may suppress vomiting and lead to alcohol poisoning. However, this is not significantly reported
Opiate medications are highly toxic, having a high potential for overdose, causing death. Combined cannabis use does not increase the risk of overdose by opiate medications. In fact, studies are suggesting that cannabis may make opiate medication more effective at managing pain at lower doses
Sedatives can make patients very drowsy. Combining these medications with cannabis may cause excessive sleepiness. Examples: clonazepam (Klonopin), lorazepam (Ativan), phenobarbital (Donnatal), Zolpidem (Ambien)
Disulfiram (Antabuse) manufacturer reports that combined with marijuana may cause irritability and disturbances of sleep
SSRI’s and other mood altering drugs have had a few reports of interactions such as irritability and nervousness. Patients taking these medications should discuss their medical cannabis use with the prescribing physician. Examples: fluoxetine (Prozac) and sertraline (Zoloft)
Please Note
Non-prescription drugs and over the counter supplements, such as Tylenol and herbs, may cause an interaction with medical marijuana. Please contact your physician for advice on using these products with medical marijuana.
Cannabis use, along with other changes in lifestyle and health, may initiate fluctuations in vitals, blood pressure, blood sugar and other parameters that may require alterations to prescription medication recommendations and dosages
Always communicate any health and/or medication changes with your primary care physician!
CANNABIS (MARIJUANA) DELIVERY METHODS
The following are general guidelines. Each individual patient will respond differently to dosing methods. A general rule is to start with a smaller dose until you are comfortable with the level necessary to achieve the desired effect. You must take into consideration the length of time to feel full effects. With smoking or vaporizing, the onset is almost immediate and, therefore, dosage is easy to self-regulate. For other methods of delivery, such as tinctures or edibles, the effects can take up to 90 minutes. When choosing a method with a longer onset, it is important yet sometimes difficult to know exactly how much you are consuming. Lab tested medication is highly recommended for this very reason. We recommend that you keep a journal to help you find your ideal dosing method and start low, especially when trying something new.
Smoking
The following are general guidelines. Each individual patient will respond differently to dosing methods. A general rule is to start with a smaller dose until you are comfortable with the level necessary to achieve the desired effect. You must take into consideration the length of time to feel full effects. With smoking or vaporizing, the onset is almost immediate and, therefore, dosage is easy to self-regulate. For other methods of delivery, such as tinctures or edibles, the effects can take up to 90 minutes. When choosing a method with a longer onset, it is important yet sometimes difficult to know exactly how much you are consuming. Lab tested medication is highly recommended for this very reason. We recommend that you keep a journal to help you find your ideal dosing method and start low, especially when trying something new.
Tinctures
Tinctures are an extraction of cannabis, commonly vegetable glycerin or alcohol. A tincture provides a non-smoking alternative to medicating. Glycerin tinctures are sweet and may be cooked or cold pressed. Alcohol tinctures may burn under the tongue but can also be cooked or diluted for easier consumption. Typically, tinctures allow the patient to remain high-functioning with pain relieving benefits. Patient’s often compliment medical effects with smoking but is not necessary to gain benefits. Dosing is sub-lingual and can be adjusted easily. Tincture can also be added to liquids for ingestion, i.e. hot tea or coffee.
Vaporizing
Vaporizing is a technique for avoiding irritating respiratory toxins in marijuana smoke by heating cannabis to a temperature where the psychoactive ingredients evaporate without causing combustion. Cannabis vaporizers are designed to let users inhale active cannabinoids while avoiding harmful smoke toxins. They do so by heating cannabis to a temperature of 180⁰ – 200⁰C (356⁰ – 392⁰F), just below the point of combustion where smoke is produced. At this point, THC and other medically active cannabinoids are emitted with little or none of the carcinogenic tars and noxious gases found in smoke. Many medical marijuana patients who find smoked marijuana highly irritating report effective relief inhaling through vaporizers.
Edibles
Edibles are an extraction of cannabis to butter, oil or syrup. Edibles are ingested and are found to be most effective on an empty stomach. Edibles are typically baked goods or candy such as brownies, cookies, chocolate, hard candies, etc. For those with strict diets, healthier options can be prepared and are only limited by the cook’s creativity.
Topicals
Topical preparations are made through extracting cannabis into handmade creations (lotions, salves, lip balm, soap, etc.). Topical delivery can be effective for arthritis, muscle spasms, rashes, etc. Recent studies have shown topical applications to be as or more effective than oral delivery methods for some conditions. The majority of patients who use topical preparations do not feel the internal medicating effects that come with smoking or other oral preparations. Often, topical preparations are only felt in healing the skin and muscles.limited by the cook’s creativity.