Staying ahead of your pain is an important concept. If you’ve ever suffered from acute pain, you may have learned that waiting until you’re hurting badly causes your pain medication to be less effective.
Whether you are new to cannabis as a medical patient or you’ve been using it for a long time, the amount you use and how it affects you is an important part of your decision-making. Microdosing is one aspect of cannabis usage everyone can benefit from if it’s utilized correctly. This guide to microdosing cannabis should get you headed in the right direction.
Understanding pain and how pain medications work
In order to help you understand the concept of microdosing, I’d like to take a minute and introduce you to something one of my pain doctors used to call the “psychology of short acting pain medication.” When you take short acting opiates, such as Vicodin or MSIR, there is a process that goes on in your body. It takes this type of medication 60-90 minutes to kick in. Relief is optimized for two to 2 1/2 hours, and then the benefits start to taper off. This results in something rather like a roller coaster ride. You feel better, then you start feeling worse. It goes up and down because there is not a consistent dosage of the medication in your system. What you end up doing is watching the clock. I know when they first started me on Vicodin back in 2005, I lived by that clock. I knew exactly when my doses were due, and I grouped my activities around those doses. It consumed my life. On the days when the pain was bad, that six-hour gap was almost unbearable. I had entire days where I could barely get off the couch. I stayed curled up in a fetal position, and told God more than once that if I had to keep living like this, it wasn’t worth the bother.
After several months of being on Vicodin, my pain doc decided to let me try methadone. Because I have a history of abdominal surgery, I cannot take long acting pain medication. However, methadone has up to a 72-hour half-life, so it works effectively like a timed-release dose. It took several months for me to build up to the point where I didn’t have to take Vicodin for breakthrough pain, but once I was on the optimum dose of methadone, the amount of medication in my bloodstream was maintained at a consistent level, and I was more able to function on a daily basis. I didn’t have the sporadic relief that Vicodin had provided. I could be an hour or two late with the dose, and I wasn’t in such pain that I couldn’t tolerate life.
We can apply the same concepts to cannabis dosing. If you dose by using a vape pen, the relief you obtain is going to be almost immediate. However, it doesn’t last very long. Within two hours, you’re going to need to hit that pen again. While it is good for short term management of pain or symptoms, it does not give the consistency of relief that a lot of people need.
In order to obtain a steady level in your blood stream, there are several options available. You can use capsules, suppositories, or edibles. Ingesting your cannabis orally, in or on food, will give you a more long-lasting effect. Maintaining a constant level in your blood stream can help you with symptoms that short-term relief may not touch. It can lessen or even eliminate symptoms of anxiety and/or depression, PTSD flashbacks, and seizure disorder. Where you might need a higher level of cannabis to obtain relief if you vape or smoke it, smaller doses taken routinely can have a greater effect than smoking. In fact, you may discover you need far less cannabis if you include microdosing in your daily routine.
Staying ahead of your pain
Staying ahead of your pain is an important concept. If you’ve ever suffered from acute pain, you may have learned that waiting until you’re hurting badly causes your pain medication to be less effective. Part of this is because physiologically your body responds differently when you’re in more pain. It takes longer to attack that pain because of the muscle tension, stress, and extra neurons firing; those are all actually advanced signs that you have waited too long to medicate. Taking a pain pill when you first start feeling pain will help that pill work better. It’s the same with cannabis. If you put it off until you are really in need of the medication, it will not be as effective as if you utilize a proactive method like microdosing.
In PCA (patient controlled analgesia), a computerized pump called the patient-controlled analgesia pump, which contains a syringe of pain medication as prescribed by a doctor, is connected directly to a patient’s intravenous (IV) line. In some cases, the pump is set to deliver a small, constant flow of pain medication. One of the reasons for the advent of the PCA machine for post-op patients was the discovery that if a patient can control the level of medication in their bloodstream, they often recover more quickly. Because of the nature of hospital care, nurses cannot always get to a patient right away with pain medication. Sometimes, it may be half an hour between the initial request for pain medication and the patient actually getting it. Having access to the PCA, with the ability to push the button and deliver a prescribed dosage, enables the patient to help take control of their own healing process.
Studies actually found that these patients do not require as much medication as those who were taking pills, they are moving around easier and faster, and their recovery time is shortened. One of the reasons is that the patient with the PCA machine routinely maintains a more consistent drug level in their bloodstream. It’s the same with cannabis. Lower dosing on a regular basis can be far more effective than larger doses taken sporadically or at larger time intervals.
Dosing specifics
What exactly is a microdose? Microdosing is patient specific. Some literature says it only includes amounts between 1-3 mg; if you happen to be someone with a history of routine cannabis use or you’re experiencing a lot of chronic pain/symptoms, you may need to use a higher dose. The sweet spot with microdosing is the smallest amount you can take to achieve the relief you need. You’re not aiming for the complete absence of pain or symptoms, but increased functionality and the ability to what you need to do in as much comfort as possible. It’s good for people who need cannabis for pain or anxiety, but who also need to work, drive, or parent without being impaired. Another thing to remember is that microdosing is not the same as taking your normal daily dose and dividing it into five or six smaller doses. Someone who routinely takes 250 mg of cannabis daily for pain may find that if they microdose correctly, they can get away with taking far less while still achieving relief and the ability to function throughout the day.
For newbies or cannabis novices, a good starting point is 1-2 mg. You can add it to coffee, put it on a cookie, stir it into your yogurt, or whatever you prefer. Take the dose, wait 60 to 90 minutes, and see what kind of effect it has. Pay close attention to any changes in the symptoms you normally deal with. You may notice even with this minimal amount of cannabis they begin to lessen. If not, take another dose. Remember, you’re not looking to fly. The goal is symptom relief.
When using edibles, it’s best to eat within 20 minutes of taking the dose. This will help with digestion as well as transporting the medication to your body. Because THC is processed through the stomach with the help of the liver and gallbladder, eating something with fat ( cheese, butter, milk, beans, nuts, steak, ribs, a chocolate bar, etc.) will enhance the properties of the medication. As the food is digested, and the nutrients are transported through your body, the THC will hitch a ride. Not only will the effect be more intense, but because it is going into your bloodstream and not just your brain, it will last longer. This is why cookies, cakes, brownies, and other edibles made with oil or fat tend to affect you longer than a lollipop or hard candy.
Another thing to remember is that some foods boost the effect of THC due to the natural terpenes or found in them. Mango, chocolate, peppermint, coconut oil, black or green tea, and broccoli all contribute to an enhanced sensation when used in conjunction with cannabis intake. You may find other foods that work well for you in addition to the ones I just listed. Keep track of those, and keep a couple on hand to help you optimize your experience.
Dosing is going to be different for each individual. Some of us can function with more pain than others, or make it through the day with an anxiety level that another person might find crippling. This is why there is no one-size-fits-all guideline for micro dosing cannabis. As with any other medication, it needs to be individualized to the patient. For example, I function quite well with 2-3 mg every six hours on a normal day. It depends on what I need to accomplish, where my pain is, and how I slept the night before as well as other factors. At least I know what my starting point is, and I can adjust my medication from there. If I have a busy day, or I’m doing a lot of driving, I may not even take the 2-3 mg dose. When driving, if I haven’t taken my usual microdose, I do carry a vape pen so I can use it if needed. It can help me control my anxiety level if I hit bad traffic, or get stuck behind a stupid driver.
Other considerations
As with any other method of cannabis use, micro dosing is dependent on many variables. The efficacy of the medication can be affected by diet, recent food intake, stressors, environment, timing, and other things I probably forgot about. Strain properties as well as THC and/or CBD content also play an important role.
For example, if you are under stress, hypervigilant, or worrying about whether or not your medication is going to work, that is going to affect the amount of time it takes to kick in as well as the intensity of the effect. I can take a dose of medication, sit back and watch a TV show, and I can tell when the cannabis starts to affect me. However, if I take the same amount and work on a puzzle, or clean the house, or go for a walk, I may not get that same sensation telling me that the medication is doing its job. I may think it’s not working because I didn’t feel it. That’s not always accurate. Sometimes we get so tied up in a certain indicator that we focus on it to the point of excluding other signs that we are getting what we need. When you’re trying a new method or strain, you should attempt to be as relaxed as possible. Make a genuine effort to optimize your environment and mental condition so that your medication has the best opportunity to affect you in a positive way.
If you have taken a break from cannabis in order to reset your tolerance level, microdosing can be an excellent way to reintroduce it to your body. Using the “start low, go slow” concept, you may be able to achieve alleviation of your symptoms with a much lower dose than you thought possible. Once again, it’s important to pay attention to your body. It’s not an inherent behavior, but it is something we can learn to do. Some people even keep a notebook or journal so that they can monitor how different doses affects them at different times of the day or under various stressors or circumstances.
Remember...
Bigger is not always better. A higher dose is not always more effective. While achieving couchlock now and again isn’t a bad thing, we can’t live like that. It’s kind of like eating Godiva chocolates combined with the economic concept of the law of diminishing returns. The first chocolate is really good. The second one may be really good, too. By the time you hit that fourth or fifth piece of candy though, you’re not getting the same enjoyment you got with the first bite. In fact, you may be starting to get a stomachache. Your body is telling you you’ve had enough. It’s the same way with cannabis. It is quite possible to think that you need a lot more than you really do.
Microdosing is one way to find the optimal dose for your situation, and can prove highly effective if used correctly. It can also be an excellent adjunct to relaxing with a higher dose after work, on the weekend, or whenever you can just let down and enjoy yourself. Finding the microdose that works for you can help you have a better quality of life and maybe even enjoy the journey a bit more.
