According to Marijuana Policy Project (MPP), there are over 1.2 million medical marijuana patients in the United States. For some of these people, the high that comes with cannabis is not the goal but an unpleasant side-effect that impairs their ability to live a productive and happy life.
Is there a way to use cannabis for a medical condition without getting one’s head stuck in the clouds?
A Tale of Two Cannabinoids: CBD and THC
Cannabinoids are the class of compounds responsible for the effects of cannabis. There are 113 identified active cannabinoids in cannabis, but the two most intensely researched are tetrahydrocannabinol (THC) and cannabidiol (CBD).
THC is well known as the primary compound behind the experience of getting high – the dreamy heightened sensory mind state most associated with cannabis. CBD affects a wide range of systems in the body and is the source of many of the remarkable medical benefits of cannabis.
An oversimplified rule of thumb: the higher the THC content, the higher you get. (There are, however, other components in cannabis — cannabinoids and terpenes — that influence the “high.”). Conversely, most patients achieve greater medical benefits with less of a “high” with higher CBD content.
So, the short answer is: yes, you can medicate with cannabis without getting high.
CBD is the answer. CBD acts as a counterbalance to THC, and there are a few strains and many products that contain CBD with little to no THC. It’s medical marijuana without THC.
The whole story, however, is more nuanced and medical marijuana without THC may not be the best solution depending on your condition.
It’s All About the Ratio
THC and CBD have inverse effects on the body and mind so the ratio of THC to CBD is vitally important for medical patients. Because research is just in its infancy, medical professionals have different opinions on the ideal ratio.
Dr. Jahan Marcu, a senior scientist with Americans for Safe Access claims a 1:1 ratio of CBD to THC provides the ideal medical benefit without a (much of) a high. He cites the synergistic nature of cannabinoids working together and that with a wider spectrum provides more system-wide benefits, and advocates whole plant vaporization for the best results.
A naturopathic doctor, Dr. Michelle Sexton, prescribes her patients a CBD oil with an 18:1 CBD to THC and then increases THC content as necessary, titrating to the absolute minimum THC necessary for that particular patient.
The reality is that there is an incredibly complex biochemical signaling process that is colored by all the different active compounds within a given strain. This is further complicated by the unique genetics and neurochemistry of the individual patient.
The ideal ratio for one person or one condition may not be suitable for someone with a different condition or different genetics.
Different Strains for Different Aims
Growers are endlessly experimenting and cross-breeding different cannabis strains to create new ones with different genetics and chemical profiles. Recently growers developed several high CBD strains like Pennywise, Harlequin, and Cannatonic to suit the needs of medical patients.
Keep in mind that there are 111 other active cannabinoids besides CBD and THC that are less understood, and each strain will have different levels of each of them. The variety is infinite and the only real way to find what is best for you is to research what has worked for others and experiment accordingly.
You can search the strain database at Leafly, read about other people’s experiences on Reddit forums, or visit Project CBD for more clinical information on how CBD can be helpful in different conditions.