I am sure there are some medications that do not benefit from dosing, but nearly everyone does. Even when we are drinking alcohol “medicinally” we generally know what our dose is based upon the alcohol content. We ALL know we can drink more wine/beer before our blood levels are potentially too high than liquor because we know the % of the medicine in the bottle.

Think about this for a moment. Many of us know how many shots of liquor or how many glasses of wine we can drink and expect to “blow negative” if stopped by the police. Can we control our smoking dose to know really “where we are”?

When patients are dosing themselves at home with cannabis, or with alcohol for that matter, the dosing is much more flexible. It is more flexible because there are way less consequences of taking a bit too much at home vs on the road or at work.

When I first began practicing cannabis medicine, I was troubled by the general lack of patients being able to use the medicine I was advising, during the day. There were/are lots of situations where using smoked cannabis cannot be done. Period. However, even if it were totally socially acceptable and convenient to smoke anywhere and any time, most of us would not be inclined to do so during the day for many reasons.


1.What if the cannabis used during the daytime were not smoked?

2. What if the cannabis used during the day generally required only once or twice daily

to be fully effective; not smoked every hour or two?

3. What if this medicine were in a little bottle and just required a spray under the tongue

or a capsule swallowed?

4. What if the molecular composition of the cannabis plant the extract was derived from

were rich in the cannabinoid “CBD” – CANNABIDIOL – and seriously helped anxiety,

pain and many other conditions while leaving the patient feeling very well focussed,

alert and feeling better in general with their anxiety/pain much more under controlled?

How would it be possible for any whole plant extracts, as I am “alluding” to, to be very effective if they are not dosed? To obtain consistent results, the medicine has to be consistent. If it is not consistent, there is nothing the patient nor physician can do to help the patient very much. Do you just try less and then try more? Titration is always necessary for every disease and every patient, but without any consistency in the medicine, reproducible results are very difficult.

Hey, as my friends know, it is no secret that I enjoy more casual cannabis use as well, but we can help a lot more patients by knowing what medicine our patients are taking.



  1. There are capsules and extracts that have extremely little THC – low enough to not be psychoactive. These strains have a CBD:THC ratio = 24:1.

    However, whenever possible, I treat patients with prostate CA with equal amounts of THC. For the patients who can’t tolerate THC, we use CBD and VERY SLOWLY add a little THC to the regimen.

  2. Dr. Frankel,
    I saw your testimonial about the patient using CBD tincture and having relief. I am 60/male with prostate cancer that’s gotten pretty bad, have pretty much become housebound.. I have insomnia and severe joint and muscle pain and was hoping the CBD’s would be the answer but the ‘kids’ behind the counters don’t seem to understand when I say “no THC”, I mean NO THC! . They’ve given me lotions and chews that had a miniscule amount but I still had an unpleasant reaction.. Is there a tincture that doesn’t have any THC????? In fact, is there any strong CBD medication without THC? Would it be worth the effort for me to come and see you?

  3. Hello, I take many psych and pain meds. I have constant neuropathy, taking 600 mg Lyrica, 20 mcg Butrans patch, 10 mg Percocet 3x day. I have tried Marinol but the “high” made psych issue worse. I want to try CBD with calming and pain reduction. Do you have phone consutations. Could I try something before I move. Thanjs. Kevin

  4. Dr. Frankel,
    I was diagnosed with prostate cancer with high-end gleason & 2nd opinion, in 2005, age 49, and am now suffering with increasing, constant pain in my shoulder/neck/back muscles & joints. I can’t sleep, (dx with insomnia and sleep apnea in ’99, on RX sleep-aid) and want to stop RX pain meds which I only take at night.

    Took doctor’s RX of Casodex & Lupron for less than a year, about the 2nd year after dx, quit and turned to nutrition.

    I got my ‘letter’ but have not had any luck with pain or sleep. I CANNOT, repeat CANNOT, have any THC, it makes me crazy. I tried the 1 oz/20 mg. CBD topical but it wasn’t any better than my cheap Ben-gay rub. I tried a tiny piece of the Cheeba chews but could start to feel that liitle bit of 2%THC….can’t do that.

    Have had low BP and a good quality -of-life until this May when I decided to lose weight starting at 326/6’4″. Quit sugar and processed foods, lost 25 lbs. the first month, to be expected, then, out-of-control weight loss, 130 lbs. in 3 months. Now, skin & bones. Ph- water has been a great help but still can’t sleep, eating causes gas, horrible pain all day.

    Regular allopathic doctors just want to radiate, chemo, etc. Am hoping you’ll have a better direction.
    Thanks and will look forward to your thoughts.

  5. Thank you for the info on Dr. Sean McAllister. I spent a good deal of time searching out his current work. It seems as of late 2013 he was preparing to start human cannabis/breast cancer clinical trials and planning to get them underway during the 2014 calendar year. However, at this point in time they have not yet begun, some of the posts suggest that additional funding is required.



  6. A good way to begin is by calling my office and setting up a visit or a phone consultation. Every patient is so different – even identical twins, and we need to do this in a more formal manner.

  7. Dr Frankel,

    Many thanks again for our conversation this past Friday, Dec. 5th. During that conversation I believe you mentioned that there is a current FDA approved human test using cannabis regarding its effectiveness with respect to mitigating the effects of breast cancer. Could you point me to that study. I believe you mentioned the name of the doctor(s) conducting the testing and said that it has been going on for about 10 months and was being conducted in California. Looking forward to your response.

  8. Hi, I have high cbd medicine (nordle cbd crew)
    I also took risperidal 0.5 mg, micardis80mg norvasc 5mg, somac 20mg, piax 20mg and lexapro 5mg.

    Three of those medicines are metabolised by the p450 enzymatic system. I have since halved the doses of all medicines. My bp is in normal range. My question is: does cannabidiol completely turn of the p450 enzymatic metabolism? Or does it just slow it down? I live in Australia, is there any way I could organise a phone consult with you?.

  9. great topic.
    I am just venting so my apologies. Moved to Fla for increased oxygen from my Colorado home 2 years ago. Was 2 year Mmj patient and know the benefits. After stopping smoking and daily oil in edibles, I have been on oxygen since.
    Now stage 4 copd emphysema along with ripped shoulders, and old damaged neck up to cord deformity from buldging and misalignment, old fracture.
    Sitting here almost dead with no support or relief. Can’t even fly to Co to visit my grown kids and retry oil for treatment.
    Oil was premeasured in insulin syringe.

  10. I have severe Rheumatoid disorder(“arthritis”) and being exposed to both hep B and turberculosis( both treated and inactive) I cannot take the biologics.Methotrexate was stopped due to side effects so Im regulated to nsaids and plaquanil.The inflamation is “‘off the chain “bad .Ive had amazing sucess with marijuana as it help the pain disapear but dont want to be dirty.I have reluctantly stopped partaking but am curious about the cbd.How would I go about approaching my Rheumatoligist about possibilities?Thank you for the work you do,and many blessing to you and family.

  11. Dr. Frankel,
    I have an important item to speak to you about. It is discreet, so I would rather speak to you about it via Email. It has to do with something of yours I may have found. It has your name on it.

  12. I would like to be part of a clinical trial utilizing CBD’s for advance prostate cancer. Can you direct me a link?



  14. I don’t know anyone
    Who feels comfortae doing what I am doing

    I would suggest going to any cheap clinic in your area to get the physician letter. Then we can talk or skype and discuss a treatment plan


  15. I’m just starting to get educated about CBD and am impressed by all your info here and by your thoughtful answers. I have always wanted to try CBD for my cluster headaches, but I couldn’t find any data on it and all the dispensaries seemed for stoners. You have changed my mind! I see that you do not prescribe over the phone/ Skype. Do you have any referrals for docs like you in the SF Bay Area?

  16. That is an impossible question to answer as we don’t know if CBD or any cannabinoids truly “cure” cancer. It seems pretty clear that they help us manage the disease much better, both with respect to symptoms and with respect to anti-tumor effects.

    My personal feelings on “average”/ballpark numbers is around 40 mg of TOTAL cannabinoids per 24 hour with it distributed as 2/3 CBD and 1/3 THC. Again, we DON’T REALLY KNOW, BUT THIS IS MY BEST GUESS AS TO WHAT IS REASONABLE OR WHAT I WOULD PERSONALLY DO.

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