Over my thirty years practicing Internal Medicine, I have greatly changed my opinion regarding what I consider “excessive” use of medications. I now include Cannabis in my assessment as well. So, when patients ask me, when is “too much” Cannabis really too much? I respond that as with all drugs, too much is when the drug is controlling the patient.
It might not be apparent to the patient they are controlled by cannabis, but it becomes obvious to most people who know them. Those who know the patient can see the affects on the patient’s life – they can tell if the Cannabis is interfering with work, or an issue at home with kids or family or is causing responsibilities to be neglected.
If so, it is a problem that must be addressed. However, (and you might be surprised by this), the problem is NOT directly related to the amount of Cannabis being used. Consider this: just as with pharmaceuticals and alcohol, everyone is very different in their response and sensitivity to drugs. The various strains of Cannabis have a similar effect: a lot for one person can be trivial to another.
If the patient is using Cannabis and is acting responsibly, then what better result could anyone hope for? If friends and family continue to believe cannabis is adversely affecting the patient when there is no evidence, I think a good look at personal biases against Cannabis are in order.
Allan I Frankel, MD