Education

September 30, 2021

Advanced Dosing Recommendations Explained

medical-marijuana

Recently, during a free webinar by Dr. Dustin Sulak at Healer.com, I got excited when I heard about an open-access article in The Journal of Cannabis Research entitled  Consensus recommendations on dosing and administration of medical cannabis to treat chronic pain: results of a modified Delphi process. 

The article includes the collaboration of 20 medical cannabis experts from nine different countries, with backgrounds in primary and palliative care, internal, family, pain management, and osteopathic medicine, general psychiatry, anesthesiology, neurology, rehabilitation, and addiction medicine. 

I felt invigorated over the thought that prominent medical cannabis experts were finally brought together to develop flexible dosing protocol recommendations to assist other clinicians in understanding the safe treatment of chronic pain with medical cannabis. 

With three flexible dosing protocols, Routine, Conservative, and Rapid, the recommendations present three different ways for clinicians to treat patients with individual needs, with medicine that every patient responds a little differently too. 

The comprehensive nature of this article gives clinicians examples of dosing, treatment goals, follow-up, and monitoring care, with safety guidelines to assist with positive treatment outcomes. Additional safety considerations address contraindications or pre-existing patient diagnoses that clinicians should consider when ruling out using medical cannabis as a treatment and drug interaction warnings. 

What I really like about these recommendations is that they focus on oral preparations that support harm reduction principles to help prevent lung injury associated with smoking and e-vaping but also discuss treatment considerations using dried flower vaporization effectively for breakthrough pain. 

Why am I so encouraged by this article? Most cannabis patients ask for expert guidance from a trusted source to assist with choosing the right kind of cannabis medicine that fits their needs. Especially the new ones who have never tried cannabis before. Patients in our expanding medical cannabis community need to be experienced, expert clinicians teaching other clinicians how to use cannabis safely and effectively as medicine. Articles like this also build bridges between cannabis-positive clinicians, their patients who use cannabis as their choice of medicine, and responsible dispensary staff who are trying to help patients make the right cannabis choices to fit their needs. 

Hopefully, this article and more like it will help cannabis-neutral clinicians be more comfortable with trying cannabis as a treatment option, inspire more dosing recommendations for other illnesses that are currently being treated with cannabis, and lead to more gold standard cannabis studies. 

Clinical dosing Protocol

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This document was last updated on May 9, 2019

A 329 Hawaii Medical Cannabis Card is required to enter any Hawaii dispensary. Medical cannabis is legal for certified patients with the following eligible debilitating medical conditions

  • Amyotrophic Lateral Sclerosis
  • Cachexia or Wasting Syndrome
  • Cancer
  • Crohn’s Disease
  • Epilepsy
  • Glaucoma
  • HIV / AIDS
  • Lupus
  • Multiple Sclerosis
  • Post-Traumatic Stress Disorder
  • Rheumatoid Arthritis
  • Seizures
  • Severe Pain
  • Severe Nausea
  • Severe Muscle Spasms

Talk to your primary care physician about cannabis as a treatment option for you and how it can complement your current treatment plan. If you need a certifying medical professional, a directory of certifying physicians and APRNs on Oahu is available below for Hawaii residents.