Dear Dr. Frankel:
I gave up smoke last January because I got tired of the constant coughing and pernicious effects. The edibles I have obtained from some of the dispensaries around Venice are overpriced and generally weak potency. So far I have not gotten any result from them. Would you recommend using a vaporizer? If so, do you have a brand name that is affordable? That “Volcano” is pretty pricey. Please let me know whether you think they are a safe alternative to smoke and if they are harmful in any way to the respiratory tract.

Thanks.

Your Patient
D

Dr. Frankel Responds:

Hi there,

Here are some thoughts.

1. Consider making your own edibles

2. Try using Indica or Sativa tinctures. They are now in better supply in the Venice Dispensaries. You can google “make cannabis tinctures home” and find lots of cool recipes for making tinctures. They can be made VERY strong at home just using nearly pure alcohol (the drinking kind) and the strain of your choice. It will probably be very bitter, but experiment with flavorings and if you develop a good recipe, email it to me. I might then post a tincture page.

Again, the most significant difference between a tincture and an edible, is that with the tinctures you can control the “effect” as the cannabinoids are absorbed directly into your blood stream. With edibles, all the cannabinoids are absorbed through the liver making the cannabis experience very sedating and very long acting.

3. There are vaporizers under $100.

Hope this helps,

Allan

I routinely discuss with patients the different effects of Sativas and Indicas. I counsel them to try different strains and see which is most effective in treating their symptoms. In a recent e-mail survey I asked 447 patients to correlate the effects they achieved with the strains that they used. The results:

EFFECT STRAIN

Focus Sativa (81%)
Motivation Sativa (94%)
Relaxation Indica (92%)
Increase Appetite Indica (72%)
Reduce Anxiety Sativa (65%)
Daytime Anxiety Sativa (89%)
Reduce Nausea Indica (82%)
Feel Happier Sativa (90%)
Severe Pain Indica (90%)
Tranquility Indica (88%)

It has always been a challenge with cannabis to predict the results after medicating, especially with edibles. Tinctures have really made a difference for people who need to use cannabis at therapeutic doses during the day without getting high. Many of our patients now have access to a tincture that has very consistent effects and a predictable time of activation. This tincture doesn’t work for every single patient (only 85%) who have tried it, but what medicine does?

I’d like to talk about the use of cannabis in a dose and manner consistent with feeling well but not “high”. In this blog, I’ll explore tincture usage and in my next blog I’ll talk about strains that don’t make you feel “high”. These strains are intended for patients who are in need of treating pain, anxiety, depression or other symptoms that make them feel ill during the day and therefore must be treated during the day. So, how do we use cannabis during the day at therapeutic doses but without getting high? Today I will speak about using daytime sativa tinctures. By the way, how many of us have used prescriptions for pain/anxiety/ADD that clearly make us quite “high” but are socially and legally permissive?

During follow up visits, I have been collaborating with patients on how to assess their tincture dosage. Then we work together to improve the results by modifying how they take the tincture. I tell them to slowly increase the number of “spritzs” under their tongue until they feel a little buzz. Then I ask them to decrease their dose to 50% from that amount and use that dosage as their daytime Sativa dose. The results have been that they do not feel high, in fact they really don’t “feel” anything. They just feel well with the ability to handle their pain or anxiety much better.

Additionally, with this method, many patients sleep through the night with much less cannabis or other medication.

Thoughts?