The government of British Columbia has recently closed their public call for feedback on recreational cannabis policy and is now reviewing the results. Apparently this survey was one of the most engaging in the history of BC government with over 48, 000 entries. That is an incredible amount of people and we want to express our gratitude to all that contributed.
While edibles were not included in this survey, and will not be included under the recreational framework until 2019, there is currently a THC potency limit for ACMPR produced cannabis oils which can be use alone or put in food. Licensed producers are limited to 30mg THC per ml. But are these limits based on any evidence or clinical studies that suggest that 30mg per ml is the safest effective dose?
We asked a community of cannabis patients who used cannabis in the form of edibles or oils to see what their effective doses were for their specific conditions, and to find out what they thought about potency limits imposed by the government.
Here are the results from our 82 responses:
- There should be no limit on potency for edibles – 41
- I require a relatively high THC potency in edibles for my condition-21
- I don’t know my edibles potency limit – 9
- I know my edibles potency limit- 8
- Potency should be limited for edibles- 3
The patients we surveyed used cannabis to treat many kind of conditions, from Ehlers Danlos Syndrome to rare forms of MS that causes seizures and tumours, degenerative diseases, life impairing and deeply threatening illnesses that are responsive to cannabis in a range of different dosages. We can see from the results that patients strongly oppose any limits on thc potency in edibles and that many require a higher potency than is legally allowed.
Diversity in Doses
The saying goes, start low and go slow. But when you have a pre-existing tolerance from past use, a natural tolerance due to your individual biology, or require larger doses to treat your specific illness, your “start low” might not be as low as someone else’s
One patient told us that they require 50-100mg of THC for pain relief from migraines that are brought on by a brain tumour and that they much prefer consuming it in the form of edibles over smoking. A patient with MS said they used extremely pure THC oil to help stimulate appetite, relax muscles, and relieve neuropathic pain as well as aide in the recovery from major brain surgeries. This patient also remarked that his wife has noticed a major boost in his libido which she is grateful for. Another patient explained that they require 500mg of THC every 8hrs to treat a serious form of osteoporosis called degenerative disc syndrome. His spine is so fragile it crumbles from simply rolling over in bed. He also suffers from esophageal stenosis and chronic nausea and vomiting. His list of ailments is excessive but he said he found relief from his pain through THC medicine and that he could only find what he needed from a local company, not an LP. We also heard from a responder that they could only handle about 5mg of THC in edibles and that any more would have them going off the walls. The diverse requirements and reactions to THC in a range of doses is obvious, but the reasons for the current limitations are not.
Who Should be Drawing the Line?
The current limits on potency don’t make sense as the diversity of the human makeup is a constant variable that needs to be accounted for. The differences in rates of metabolism, sensitivities, and reactions make it irresponsible to apply blanket approaches to medicinal cannabis since different bodies require different amounts. As a treatment method, cannabis requires a period of experimentation to determine the lowest effective dose. But as we can see the most effective dose is different for everybody.
The ones who should be making the call on potency limits are the ones who best understand cannabis. Presently, those experts are the patients, long time users, and workers in the grey industry, ie: dispensaries. Ideally, the people who should be advising on potency limits are doctors and scientists. But the reality is that they have been blocked from cannabis research and education so they are not informed on how to prescribe it effectively. It is up to the patient to experiment and as we can see from our survey, many require much larger amounts than what Health Canada permits.
Individual Care and Guidelines
As it stands, medicinal cannabis is being approached with the one-size-fits-all mentality that is traditionally used when prescribing pharmaceuticals. Cannabis cannot be prescribed like a regular pharmaceutical drug, but since doctors and lawmakers are not trained or experienced with the nature of cannabis, they do not know how to go about prescribing it effectively. They just adhere to the protocols of the status quo, but as we can see that is simply not effective.
An individualized system is the best method of care for those seeking cannabis as a treatment method. Since medicinal cannabis requires a period of experimentation, patients need to be equipped with guidelines and well trained doctors who understand how THC works so they can assist patients on their individual cannabis healing journey. Instead of creating arbitrary limitations on THC out of fear of its psychoactive properties, or applying the Big Pharma approach of standardized dosing, the government and medical community ought to invest in better understanding the complexity of cannabinoids. That way they can provide care for people based on their individual needs.
Oversimplifying THC and creating general limitations will end up hindering the treatment of several patients who suffer from severe, but potentially treatable, conditions. The best approach by far is to start low and go slow, but as we can see in our survey results, dose requirements are extremely varied. Suggesting that THC should be limited across the board will only create more obstacles for patients, and we cannot forget that the patient care always come first.