Dosing cannabis properly is an important component of good medical care and one person who has extensive experience with that topic is Eloise Theisen, AGPCNP-BC,a co-founder and Chief Visionary Officer of Radicle Health, in Walnut Creek, CA. She is one of the first healthcare practitioners to bring a clinical dosing regimen to the cannabis space and she has treated more than 5,000 patients using cannabis. There are very few healthcare practitioners in the United States with a comparable level of cannabis expertise and experience. Recently Eloise had an interesting experience with Mary’s Medicinals 1:1 patches and has written the following case history.
Mary’s Prime Time blog welcomes case histories from active cannabis clinicians. Use of Mary’s Medicinals products, while desirable, is not necessary.
J.B. is 71 year-old male with a history of esophagectomyin 2004 that left him with gastric motilityissues. He also has a history of HIV and type 2 diabetes mellitus. On average, J.B. would vomit 15 times a day without cannabis. For the last 10 years, J.B. has been vaping high THC chemovars to control the vomiting and esophageal spasms. J.B. found the chemovar Blue Dream to be most effective and he maintained consistent use of that chemovar. In the last 6 months, however, vaping Blue Dream started to produce intense psychoactive effects that were limiting J.B.’s quality of life and ability to function. He reported having to set aside 3 hours after vaping due to the intense psychoactive effects.
After a review of J.B.’s medications and speaking to the producer of Blue Dream, I proposed two differential sources for the newly developed intense psychoactivity:
- The Blue Dream cartridges were over a year old and had possibly degraded into CBN thereby increasing the psychoactive effects.
- Some of the medications J.B takes can increase the effectiveness of cannabis and therefore there may have been a drug-drug interaction occurring even with vaping.
J.B. was not a candidate for edibles due to his motility issues. Tinctures would likely not absorb well and the onset can be less predictable and unreliable. J.B. need something that would bypass the liver and deliver a consistent dose of cannabinoids with little-to-no psychoactivity. I decided to look at another route of administration for J.B.
He was trialed on Mary’s Medicinals 1:1 THC:CBD transdermal patches. J.B. was instructed to cut the patch in quarters and apply it to the inside of his wrist an hour before his evening meal. At the 2-week checkup, J.B. reported that the patches were working. In fact, J.B. reported that he was getting the most relief ever in the last 10 years. He has not needed to vape since the patches were trialed. ❖