Marijuana is among the most widely used drugs in the world; it has a highly developed culture surrounding its consumption and its psychological effects are well known. The medical marijuana movement of the past decades as well as the legislative battles being fought over legalization in many US states are changing long-held impressions and have increased interest in systematic research into the use of cannabis for medical purposes.
Recent polls show that a majority of Americans now support legalization of marijuana and support is growing each year. Several states have already decriminalized marijuana, legalized it for medical use, or legalized it completely. As marijuana moves towards broad legalization, there are more and more experienced doctors and practitioners available to guide your process. Consult with them! We hope this guide will provide some useful background and starting points to explore.
Due to marijuana’s legal status in many countries, research that could conclusively determine effectiveness in treating various diseases and disorders is limited. Ironically, while marijuana is better known and is moving more quickly towards legalization than other psychedelics, research organizations have found it more difficult to get medical studies on marijuana approved compared to mushrooms, MDMA, and LSD. However, anecdotal evidence is strong and growing that marijuana can be a useful medicine with few side effects for a variety of ailments, including anxiety and depression.
How it Works: The Endocannabinoid System
Scientific research into cannabis in the past 25 years has elaborated the existence of naturally occurring compounds and receptors in the brain and body broadly referred to as the endogenous cannabinoid system. Cannabinoids, neurotransmitters natively produced in the body, play an important role in the regulation of mood, pain, memory, appetite, and immune response.
Two of the main active compounds in cannabis are tetrahydrocannabinol (THC) and cannabidiol (CBD), among many others. THC is an analogue to the naturally occurring neurotransmitter Anandimide (which can also be found in chocolate) and is responsible for marijuana’s psychoactive effects. CBD is non-psychoactive and may have a range of beneficial effects, including as an anti-inflammatory and anti-anxiety agent.
The endocannabinoid system has broad impact throughout the body and mind, and cannabis contains a large range of the specific compounds that impact this system, in varying ratios; therefore marijuana’s effects on the body can be very diverse and seemingly subjective, and differ according to the strain and dosage ingested. Individuals need to test strains and dosages to calibrate an effective medical use.
Many people have experienced mild to severe anxiety while using marijuana; these reactions are due in large part to consuming more than expected. While it is not possible to overdose on marijuana, anecdotal reports of panic attacks, paranoia, and nausea are common, especially in inexperienced users. These ill effects can easily be avoided with some caution.
Cannabis may lower blood sugar levels. A sudden drop in blood sugar levels can lead to a variety of unpleasant symptoms. Preparing for this by eating beforehand is recommended.
Modern marijuana, bred and engineered for high yields and potency, can be very strong. In addition, many beneficial effects of the drug are present at low doses. Therefore there is every advantage in starting slowly and adjusting as necessary. Some benefits, such as anti-nausea effects, may be achievable at very low doses, below the level at which subjective experience is altered.
Methods of Ingestion
Smoking marijuana in a pipe or joint allows for fairly precise dosing. Effects will be felt within minutes. One or two inhalations may be all that is necessary for people who have experience smoking; for non-smokers, some additional effort may be required to properly inhale.
Vaporizing, the heating of cannabis to release its active ingredients into an inhalable vapor without burning it, has become a popular alternative to smoking, and is much better for lung health and better for indoor use. Since the vapor is much less dense than smoke, but is also more concentrated in active ingredients, risks of over-consumption are higher; again, starting slowly is recommended, perhaps with one inhalation.
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Consumption of marijuana dissolved into oil and mixed into food (such as brownies) or made into tinctures is an alternative to smoking that has a few advantages. Smoking involves combustion and inhalation of a range of noxious and potentially carcinogenic compounds, as with tobacco, and is unhealthy. Secondly, eating cannabis provides a deeper and longer-lasting effect, sometimes described as a sense of warmth and well-being.
It is difficult to regulate the amount of cannabis dissolved into oil, and therefore its concentration in the final edible product. In addition, the effects of eaten cannabis will not be apparent for a delay of time, as digestion occurs; this could be anywhere from 30 minutes on an empty stomach to upwards of 120 minutes on a full stomach. For these reasons, you should always exercise caution when trying edible cannabis. If you have a portion that is intended for one person, first try eating a quarter of that, and waiting for at least an hour before taking more.
Varieties and Potency
There are different species of the cannabis plant that are psychoactive in humans; most commercially available marijuana is either Cannabis Sativa or Cannabis Indica, or a hybrid of the two. Though as of yet there is no basis in scientific research for the effects of these strains, experienced users and medical dispensaries have described clear differences between the two strains. Broadly, Sativa is seen as a stimulant and Indica as a depressant. Many popular strains are hybrids of the two in various ratios.
Cannabis Sativa is often said to be good for daytime, active use. It has stronger perceptual and intellectual effects (psychedelic effects), and seems energizing. This is perhaps due to a higher THC to CBD ratio. Sativas could be applied towards alleviating depression, ADHD, and social anxiety. However, Sativa is also more likely to produce anxiety and paranoia in large doses for susceptible users, such as sufferers of bipolar or anxiety disorders.
Cannabis Indica is said to lead to feelings of relaxation and “body high,” even drowsiness, and is often recommended for nighttime use or for sedative purposes, such as pain relief. Indica-dominant cannabis is therefore useful to alleviate anxiety and insomnia, and can act as an alternative to addictive anti-anxiolitics like Xanax and Klonopin or sleep aids like Ambien.
Several active veterans’ associations are lobbying to have PTSD included in the list of ailments for which cannabis can be prescribed, in places where the medical use of marijuana has been permitted. Marijuana’s effect on memory formation may soften or help in the processing of traumatic memories, or it may be that PTSD sufferers benefit from the anti-anxiolitic or analgesic effects. Research on this topic, such as a study proposed by MAPS, has yet to be cleared by regulating agencies.
Special Safety Considerations
In addition to our standard safety suggestions, there are three particularly important precautions for marijuana use:
- Get a sense of the potency of the batch of marijuana you are going to ingest. Start with a small dose.
- Cannabis can cause a drop in blood sugar levels. Some symptoms of low blood sugar are sweating, shaking, anxiety, hunger, dizziness, faintness, pounding heart, personality changes, confused thinking, impatience, numbness of lips and tongue, headache, nausea, blurred vision, slurred or slow speech, convulsions, coldness, white hands and face. Make sure you have eaten recently before using marijuana to avoid these effects.
- Do not use marijuana if you are at risk for schizophrenia (have a family history) or have experienced episodes of schizophrenia in the past.