Cannabis as Medicine¶

Critical Legal and Safety Information

Legal status: Cannabis remains federally illegal in the United States, though many states have medical and/or recreational programs. Laws vary by country and jurisdiction. Know your local laws before proceeding.

Not for everyone: Cannabis is contraindicated for some people. See the Safety Considerations section below.

This is educational information, not medical advice. Work with a knowledgeable healthcare provider if you choose to explore medical cannabis.

The Skeptic's Journey¶

Bram's initial reaction when Emma first suggested cannabis:

"That's for lazy stoners. I don't do drugs."

His image: teenagers in basements, unmotivated, glassy-eyed. Not medicine. Not for serious people.

Emma's response:

"You were taking 2000mg of ibuprofen daily. That's a drug. And it was destroying your stomach."

Valid point. But Bram's resistance wasn't rational—it was cultural, generational, tied to decades of propaganda.

What changed his mind wasn't arguments. It was desperation, data, and direct experience.

Understanding the Endocannabinoid System¶

The human body has a built-in system designed to interact with cannabinoids:

The Endocannabinoid System (ECS):²

Network of receptors throughout the body (CB1, CB2)¹
Regulates inflammation, pain, mood, sleep, appetite, immune function³
The body produces its own cannabinoids (anandamide, 2-AG)
Plant cannabinoids (from cannabis) interact with this system

Key Insight

We're designed to use cannabinoids. This isn't some foreign drug—it's supporting a system that already exists in your body.

Key Cannabinoids¶

CBD (Cannabidiol):

Non-psychoactive (doesn't get you "high")
Anti-inflammatory⁴
Anxiolytic (reduces anxiety)⁵
Neuroprotective
No addiction potential⁶
Legal in most jurisdictions (when derived from hemp)

THC (Tetrahydrocannabinol):

Mildly psychoactive at higher doses
Analgesic (pain relief)⁷
Anti-inflammatory
Sleep-promoting⁸
Muscle relaxant
Requires more legal consideration

The Entourage Effect: CBD + THC together often work better than either alone. The compounds modulate each other's effects.⁹

Medical vs. Recreational Use¶

These are completely different approaches:

Aspect	Medical Use	Recreational Use
Goal	Symptom relief	Intoxication
Dosing	Low, precise, consistent	Variable, often high
THC levels	Low to moderate (2.5–10mg)	High (25–100+mg)
Timing	Scheduled, strategic	Spontaneous
Feeling	Mild relaxation, like one glass of wine	"High" or intoxicated
Products	Tinctures, capsules, measured edibles	Smoking, high-dose products

Bram's approach was entirely medical: precise dosing, consistent timing, minimal psychoactivity, maximum therapeutic benefit.

Phase 1: CBD Only¶

Bram started conservatively—CBD only, no THC.

The Protocol¶

Week 1–3:

Morning: 25mg CBD oil (sublingual, hold under tongue 60 seconds)
Mid-day: 15mg as needed for breakthrough pain
Evening: 40mg before stretching routine

The Experience¶

Week 1:

No noticeable pain relief
Slight improvement in sleep quality
Maybe less irritable (hard to tell)
No side effects
No impairment whatsoever

"This is expensive snake oil," Bram thought after day 5.

But he committed to the three-week trial.

Week 3:

Something had changed—so gradually he'd barely noticed:

Baseline pain lower (3–4 instead of 5–6)
Sleep definitely better
Taking less ibuprofen (down from 6–8 pills to 2–4 daily)

CBD Patience Required

CBD isn't like ibuprofen—you won't feel immediate relief. It takes 2–3 weeks of consistent use to see full effects. It regulates inflammation at a systemic level, not just masking pain.

Phase 2: Adding Low-Dose THC¶

Six weeks into CBD, Dr. Chen suggested adding small amounts of THC for enhanced pain relief and sleep.

Bram's resistance flared: "I don't want to get high."

Dr. Chen's response:

"You won't. We're talking 5–10mg of THC, combined with CBD. That's a therapeutic dose, not a recreational dose. You'll feel mild relaxation—like having one glass of wine, not like being intoxicated."

The First THC Experience¶

Dose: 5mg THC + 25mg CBD, after dinner, two hours before bed

What Bram felt:

Time	Experience
15 min	Slight warmth in body
30 min	Mild relaxation, similar to one glass of wine
45 min	Evening stretching—could go deeper without pain
90 min	Ready for bed (unusual—usually wired at night)
Sleep	8 hours straight, deepest sleep in months
Morning	Refreshed, no grogginess, 5 min morning stiffness

"Huh. Okay."

Finding the Right Protocol¶

Over the next month, Bram dialed in his optimal dosing:

Daytime:

20–30mg CBD (morning and mid-day)
No THC (needed to be clear-headed for work)

Evening:

30mg CBD + 10mg THC (2:1 ratio) after dinner
Sometimes topical CBD/THC balm on knees and hands

Nighttime (as needed):

1:1 CBD:THC (15mg each) for sleep if pain was preventing rest

Product Forms¶

Form	Onset	Duration	Best For
Tinctures/oils	15–45 min (sublingual)	4–6 hours	Precise dosing, Bram's preference
Capsules	1–2 hours	6–8 hours	Consistent daily dosing
Edibles	1–2 hours	6–8 hours	Longer-lasting relief
Topicals	15–30 min (local)	2–4 hours	Localized joint pain
Vaping	5–10 min	2–3 hours	Acute breakthrough pain
Smoking	5–10 min	2–3 hours	NOT recommended (respiratory concerns)

Bram avoided smoking entirely—respiratory concerns plus stigma/smell.

Dosing Guidelines¶

Start Low, Go Slow

This is the golden rule. You can always take more; you can't take less.

CBD Dosing¶

Level	Dose	Use
Starting	10–15mg	Test tolerance
Low	15–25mg	Mild anxiety, sleep support
Moderate	25–50mg	Pain, inflammation
High	50–100mg	Severe symptoms

THC Dosing¶

Level	Dose	Effect
Microdose	1–2.5mg	Subtle, no impairment
Low	2.5–5mg	Mild relaxation, therapeutic
Moderate	5–10mg	Noticeable relaxation, some psychoactivity
High	10–25mg	Significant psychoactivity (recreational territory)
Very high	25mg+	Strong intoxication (not medical use)

Ratios Matter¶

Ratio (CBD:THC)	Effect	Best For
20:1 or higher	Minimal psychoactivity	Daytime, anxiety
4:1 to 10:1	Very mild psychoactivity	Daytime pain
2:1	Mild psychoactivity	Evening pain relief
1:1	Moderate psychoactivity	Sleep, severe pain
High THC	Significant psychoactivity	Not for medical beginners

Quality Control¶

Not All Products Are Equal

Bram learned this the hard way—bought cheaper CBD oil from a gas station, noticed zero effects after two weeks. Lab testing revealed it contained 8mg CBD per serving instead of the labeled 25mg, plus contaminants.¹⁰

Buy from licensed dispensaries. Look for:

Third-party lab testing (COA—Certificate of Analysis)¹¹
Accurate cannabinoid content
No pesticides, heavy metals, or solvents
Organic cultivation when possible
Transparent company practices

Quality costs more. But ineffective medicine is more expensive.

Safety Considerations¶

Who Should NOT Use Cannabis¶

Contraindications

Pregnant or breastfeeding: Can affect fetal/infant development¹²
Personal or family history of psychosis/schizophrenia: THC can trigger or worsen psychotic episodes¹³
Adolescents and young adults under 25: Brain still developing¹⁴
Certain heart conditions: THC can increase heart rate and blood pressure¹⁵
History of substance abuse: May have higher risk of problematic use

Medication Interactions¶

Cannabis can interact with medications metabolized by cytochrome P450 enzymes:¹⁶

Blood thinners (increased bleeding risk)¹⁷
Sedatives/benzodiazepines (enhanced sedation)
Certain antidepressants
Some blood pressure medications
Immunosuppressants

Always inform your healthcare providers about cannabis use.

Impairment Warning¶

Even low-dose THC can impair:

Driving ability
Operation of machinery
Complex decision-making
Reaction time

Do not drive or operate heavy machinery for 4–6 hours after THC use. Legal and safe are different things.

Tolerance and Dependence¶

Cannabis dependence is possible (about 9% of users), though less common than alcohol, opioids, or benzodiazepines.¹⁸

Bram's approach to tolerance:

Every third week, skip THC for 3–4 days
Effects reset after the break
Prevents dose escalation

Common Challenges¶

I feel nothing from CBD

Possibilities:

Product quality issue (common)—try a different, verified brand
Not enough time (need 2–3 weeks consistent use)
Dose too low—try increasing gradually
Individual variation—some people need higher doses

THC makes me anxious

This can happen, especially with higher doses or THC-dominant products.

Solutions:

Lower the THC dose significantly
Increase CBD ratio (CBD modulates THC anxiety)
Try different strains (indica vs. sativa)
Some people simply don't tolerate THC well—CBD alone may be better

How do I talk to my doctor about this?

Be direct:

"I'm interested in exploring medical cannabis for [condition]. I'd like your guidance on whether it's appropriate for me and how to use it safely."

Some doctors are knowledgeable; others aren't. If yours dismisses it without discussion, consider finding a cannabis-informed practitioner.

Will I fail a drug test?

CBD alone: Usually no (but some products contain trace THC)
Any THC: Yes, it will show up for days to weeks depending on use frequency

Know your employment situation before using THC.

Is this just getting high with extra steps?

At recreational doses, yes. At medical doses, no.

5mg THC for pain relief is fundamentally different from 50mg THC for intoxication. The intent, experience, and outcomes are different.

The Results¶

After 6 months using cannabis as part of his recovery protocol:

Pain management:

Baseline pain: 2–3/10 (down from 7–8)
Breakthrough pain episodes: Rare
Ibuprofen use: Occasional, not daily
Stomach issues from NSAIDs: Resolved

Sleep:

Sleep quality: Dramatically improved
Hours per night: 7–8 (up from 4–5 interrupted)
Morning stiffness: 5 minutes (down from 45)

Function:

Could do evening stretching routine more deeply (relaxed muscles)
Better recovery between workdays
Improved mood and stress tolerance

Bram's Final Position¶

"I spent 20 years popping ibuprofen like candy, damaging my stomach and kidneys, because it was 'normal' and 'safe.' Then I used a plant that humans have used medicinally for thousands of years, and I was scared and ashamed because of propaganda.

Cannabis isn't a magic cure. It's one tool in a comprehensive healing approach. But it's a damn good tool. It reduced my inflammation, improved my sleep, and helped me manage pain without pharmaceutical side effects.

If you're in chronic pain, if inflammation is destroying your quality of life, if you've tried everything else—look into medical cannabis. Find a knowledgeable practitioner. Start low, go slow. Give it a fair trial.

And ignore anyone who judges you for using medicine that works."

Continue to Medicinal Mushrooms or return to Protocols Overview

CB1 receptors are primarily found in the brain and central nervous system. CB2 receptors are mainly in the immune system and peripheral tissues. ↩
The endocannabinoid system was discovered in the early 1990s by researchers studying THC. See: Devane WA, et al. "Isolation and structure of a brain constituent that binds to the cannabinoid receptor." Science 1992;258(5090):1946-1949. ↩
Pacher P, et al. "The endocannabinoid system as an emerging target of pharmacotherapy." Pharmacol Rev 2006;58(3):389-462. ↩
Burstein S. "Cannabidiol (CBD) and its analogs: a review of their effects on inflammation." Bioorg Med Chem 2015;23(7):1377-1385. ↩
Blessing EM, et al. "Cannabidiol as a Potential Treatment for Anxiety Disorders." Neurotherapeutics 2015;12(4):825-836. ↩
WHO Expert Committee on Drug Dependence. "Cannabidiol (CBD) Critical Review Report." World Health Organization 2018. Found CBD has "no potential for abuse." ↩
Whiting PF, et al. "Cannabinoids for Medical Use: A Systematic Review and Meta-analysis." JAMA 2015;313(24):2456-2473. ↩
Kesner AJ, Lovinger DM. "Cannabinoids, Endocannabinoids and Sleep." Front Mol Neurosci 2020;13:125. ↩
Russo EB. "Taming THC: potential cannabis synergy and phytocannabinoid-terpenoid entourage effects." Br J Pharmacol 2011;163(7):1344-1364. ↩
The FDA has issued multiple warning letters to companies selling mislabeled CBD products. See: FDA Regulation of Cannabis and Cannabis-Derived Products. ↩
A Certificate of Analysis (COA) is a lab report showing exactly what's in the product—cannabinoid levels, terpene profile, and testing for contaminants like pesticides, heavy metals, and residual solvents. Reputable companies make these available on their websites. ↩
American College of Obstetricians and Gynecologists. "Marijuana Use During Pregnancy and Lactation." Committee Opinion No. 722, 2017. ↩
Di Forti M, et al. "The contribution of cannabis use to variation in the incidence of psychotic disorder across Europe." Lancet Psychiatry 2019;6(5):427-436. ↩
National Institute on Drug Abuse. "Marijuana and the Developing Brain." 2020. ↩
Page RL, et al. "Medical Marijuana, Recreational Cannabis, and Cardiovascular Health." Circulation 2020;142(10):e131-e152. ↩
Cytochrome P450 is a family of liver enzymes responsible for metabolizing many drugs. CBD in particular can inhibit CYP3A4 and CYP2D6, potentially increasing blood levels of other medications. ↩
Brown JD, Winterstein AG. "Potential Adverse Drug Events and Drug-Drug Interactions with Medical and Consumer Cannabidiol (CBD) Use." J Clin Med 2019;8(7):989. ↩
National Institute on Drug Abuse. "Is marijuana addictive?" Research Report Series, 2020. Notes 9% overall dependence rate, rising to 17% for those who start in adolescence. ↩