Medicinal Cannabis

August 29, 2009

Patient Experience with Cannabis Use & Side Effects – check blood pressure & pulse

Don’t forget to check blood pressure and pulse before and after each dose

Please add your comments at end – they will be kept confidential – and check back later as more patient experiences and comments are added.

I understand that tolerance develops to the psychoactive side effects. It would help to hear from others. If that is true, how long does it take?

The potential for pain and symptom management:

1. CBD causes no psychoactive symptoms and is much more helpful for symptom relief. We need more help finding clones using GC/MS assay. Any leads?

2. Cannabis may be an affordable alternative to FDA approved medications

3. Partial opioid substitution may help to relieve cumulative side effects of the opioid such as daytime sleepiness.

4. Substituting cannabis instead of an opioid at bedtime or at least part of the 24 hour day, will lower the 24 hour dose of opioid.

5. Cannabis may be better than the opioid both for relieving pain and insomnia.

6. Opioids create pain and relieve pain. Using less opioid may be an advantage.

7. Opioids may cause central apnea in sleep. That is untreatable and interferes with the ability to treat obstructive sleep apnea which increases risk of stroke, heart attack, weight gain, and daytime sleepiness due to sleep apnea.

Patient DJ:

Patient with progressive painful peripheral neuropathy, now no longer relieved for several months by opioid prescription and too sedated at a dose that partially relieves pain. Unable to wear closed shoes due to pain. If dose is not taken every 6 hours, side effects of nausea and “icky feeling” are intolerable.  Must set alarm to waken for dose or be very uncomfortable for hours after waking. At the very least, the hope is that the patient may be able at the very least to use cannabis at bedtime and accomplish above goals# 3 ,4, 5 and 6, and avoid developing #7.

–Tried cannabis in a sublingual glycerin liquid using one eye dropper full.  Felt 100% relief of opioid withdrawal symptoms in a few minutes lasting about 3 or 4 hours but only 1 point decrease in pain level.

–Next day, used a vaporizer with digital read out. Initially set temperature higher than 300 degrees Fahrenheit, used Cannabis Sativa, not moist but not dry

Took the first 8 to 10 puffs. The first puff was deep, “really sucked it in” and felt burning in lungs and “coughing like crazy”

Changed technique to breathe in very slowly in small amounts, very little with each puff. No burning or coughing.

At 11:50 AM, before the vapor, blood pressure was 142/60; after use, blood pressure 108/51, pulse unchanged 72 before and 70 after.

5 or 10 minutes after vapor used, pain dropped from 6 to 3; and two hours later, pain in feet was rated 4 to 5/10, other areas of pain rated 3 or 4 — slowly creeping back up. It also relieved opioid withdrawal that has occurred in recent months: icky feeling with nausea that goes away after dose of opioid.

Side effects: felt light headed, loopy continuing at 1:45 PM when blood pressure 129/60, still loopy, still a little light headed though the side effects were 50% better.

Patient MR

Patient with multilevel bilateral cervical radiculopathy (pinched nerves from disc disease in neck at several levels, nerve pain, muscle spasm). Pain interferes severely with falling asleep and staying asleep. Loss of sleep leads to more pain, irritability, difficulty concentrating, relating to others and working.

Vaporizer is easy. It takes about 3 to 5 minutes to start to relieve pain. It starts by almost dulling the sharp pain, then settles in for a reduction from 7 or 8 to a 4 on scale of 10. I really think it halves it. Relief lasting about 2 hours for a level of 4, then creeps up slowly over the next 4 hours until it is back to original level. 6 hours of some kind of relief is very interesting.

Pulse went up a bit right after but settled back in 10 minutes from 80 to 96 and then back to 80 or lower! Blood pressure before 148/100, after (still taking Norvasc) 126/78.

Finding the right strain is an adventure in personality analysis – a few of the collectives seem knowledegable, and a few more haven’t got a clue. I’ve tried a glycerin tincture. I am not sure it works well. I am pretty sure it is the specific tincture I bought. Having some experience with making herbal tinctures, I don’t think it was prepared for maximum effect. I am still checking out the collectives. All are not alike by any means, and my search for ones with some solid advice is ongoing. So far the collective we discussed at our meeting is so far the most informative I’ve found.

High percentage Indica is definitely soporific and not suitable for day use. I am still trying to find the best combo. Am working with 1/2 brownie and one vapor inhale.

The temp for the vaporizer is critical. We need to clarify Celsius or Fahrenheit – according to the  San Fransisco General people  aroung 170 – 190 C is the point where volatile compounds vaporize. CBD a little lower. That works out to 338 Fahrenheit. At that point my medical marijuana starts to scorch. When set to 312, it vaporizes without smoke. I tried lower settings and got some vapor going but it didn’t seem as effective as the higher temp (312 F).

The sleep comes only with a real focus on calming my mind. No question the stuff accesses parts of the brain that normally are in background mode. It is nothing of concern, but it helps to try meditation techniques the were not really possible with straight opioid therapy, quieting techniques. The vapor kicks in very quickly; the brownie, very slowly, but for nights when I just can’t stay asleep, the combo does seem to give me a few hours uninterrupted sleep, a vast improvement.

I haven’t found a good daytime strain that doesn’t give me a buzz at therapeutic levels, but I am told by a number of people to keep trying different strains.

Good choice of bud for me to help to sleep: Grand Daddy Purple or Green Kush.

A few herbalists I know said they consider the “freezing alcohol”  method of extraction to be the gold standard, but it does have the drawback of alcohol. They claim the number of cannabinoids leached is greater with this method than with the glycerin method. It also limits the time for organic changes in the marijuana – a few days versus multiple weeks with the glycerin. They all believe in utilizing all the cannabinoids for most effective.

Sativa and Indica have been so crossbred that a pure Sativa is almost mythical around here. The high CBD content strain is called “White Widow” and is not available in its clean form, but bred with “Train Wreck” to become, attractively, “Brain Wreck”. Such creativity is wasted on youth.



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is not a substitute for medical advice, diagnosis or treatment provided by a qualified health care provider.~


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