The best way pharmacists can do better at maxing the opportunity of talking to their patients about medical cannabis is having the knowledge to address the most common questions patients may have. Hence have access and quick responses on how to address patients’ questions.
Let’s start with this simple comparison: think of dried cannabis as an apple and oil as apple juice. In this example 1gram of dried (apple) is equivalent to 6 millilitres of oil (juice). This is an important description since physicians are still required by Health Canada to authorize cannabis in grams, even if the patient is only interested in the oil products.
Unfortunately, it’s not quite that simple to determine how much oil a patient would need based on how much dried cannabis they’ve used in the past. Meaning if the patient used 2 grams of dried cannabis per day, I would not recommend they start off with 12 millilitres of oil per day.
The effects of inhaled cannabis – whether smoked or vaporized – will be felt in a matter of minutes. Oils are introduced through the digestive system and metabolized by the liver. As a result, the onset time is much slower and can take up to 1 ½ hours before the effects are felt. Many patients may need a much lower dose of oil than dried.
Recommend patients ‘start low and go slow’ with oils. A starting dose of 0.5 ml at bedtime daily is optimal and then increase gradually every three to four days until they reach a desired effective dose. The total daily dose can be divided into three or four times per day as desired, but advise them to allow a minimum of four hours between doses. There are not established guidelines for dosing but this approach is a simple approach.
The best way to determine which dose is most effective is by getting patients to track their progress using a log book.