Vol. 3, Number 1
January 1, 2011
cheryl riley, editor & writer
Dr. David Bearman, writer
Gradi Jordan, writer
Who's Who
What's New
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AAMC El Dorado County CA
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AAMC Washington

What Dose of Cannabis Is Right for You? - by David Bearman, MD

The short answer is ask your cannabinoid medicine specialist. If one isn’t locally available, here is some starting information.

Your dose will depend on your medical condition, your route of administration, to a lesser extent the strain you are using, individual physiologic differences, and personal adjustments.

Therapeutic Application
The list of conditions that benefit from the therapeutic use of cannabis is unbelievably long, but believe. The endocannabinoid system is the largest neurotransmitter system in the body. It influences a substantial number of organ systems including not only the brain but the GI tract, the pancreas, bone formation, and artery health. Cannabis is an analgesic, an antiinflamatory, an axiolytic, an antioxidant and kills cancer cells. There have been over 20,000 experiments on cannabis and cannabinoids. So we know more about this class of therapeutic agent than almost any FDA approved pharmaceutical.

CBD has emerged from research as being a major contributor to the therapeutic application of cannabis. CBD not only has multiple therapeutic applications but for those who are concerned about dysphoria it has no euphoric effect. CBD has been shown to: treat intractable epilepsy; decrease infarct size in oxygen deprived tissue in the brain and heart; relieve symptoms of PTSD; kill cancer cells of many different types of cancer.

Routes of Administration
Patients use various routes of administration – smoking, vaporizing, sublingual spray or drops, tea, soft drinks, suckers, and topical. The route of administration has as much or bigger effect on dose than diagnosis although one symptom – moderate to high levels of pain usually requires a substantially higher dose than other indications. A few patients with significant PTSD require nearly the same range.

We can get some idea of the dose of delta 9-THC required to effectively treat different conditions by looking at dronabinol, synthetic delta 9-THC. Dronabinol, which only has THC, frequently has unacceptable side effects or is not as effective as cannabis which has 483 chemicals including over 65 cannabinoids. For some dronabinol is effective and if they have very very good insurance it may be more affordable than cannabis.

The effective dose of cannabis encompasses a wide range from as little as a puff or two as needed to between ¼ to ½ oz. per day. If one is smoking, the amount required to provide relief ranges anywhere from ¼ to 4 oz. per month. A smaller percentage of cannabis patients who just smoke may use up to 8 ounces/month and less than a handful use up to 16 oz./month. Most patients who require more than 4 ounces/month are vaporizing, making tinctures or edibles. Vaporizers usually use 1-4 oz./month, although slightly more is common. Edible medicating patients frequently use 8 oz. per month. Tincture users may require 12-16 oz./month. For patients using routes other than smoking the amount is generally 4-8 ounces but can be as much as 16 ounces. This is particularly true if tinctures or edibles are combined with smoking.

The most common conditions that cannabis is used for are: relief of pain, treating depression, promote sleep, and relieve nausea. Pain requires the highest dose of cannabis. It takes 15-20 mg. of THC if you’re prescribing Marinol. Irv Rosenfeld, who is one of the 4 remaining IND programs smokes fourteen .9 gram 3.95% THC joints/d. While the government provides 300 hand-rolled .9 gm cannabis cigarettes/month to the other three remaining IND patients, this does not mean that dose is right for everyone.

Nausea often responds to very low doses. Usually just a couple of puffs will do it. The same is often said to be true for the cessation of migraines. Some who use cannabis to prevent migraines get that result with as little as one joint per day or less. 2.5 mg. of dronabinol one to three times a day can have the same effect.

Chronic vs. Recurring Condition
Other factors influence the dose required for therapeutic effectiveness. If you have a chronic disease, with constant symptoms (fibromyalgia, failed back syndrome), or a chronic recurring illness that you wish to prevent (e.g., migraines, seizures, ulcerative colitis, asthma), you will require more than a patient who only needs to use it intermittently with the onset of symptoms (for a condition like migraine, asthma, IBS) and uses the cannabis to stop, shorten or otherwise make the symptoms less severe.

Frequency of Use
Further, some patients don’t like to have the side effect of euphoria while at work so only use cannabis at home after work. Still others may only use cannabis once a day, at night for sleep. This too would be associated with requiring less overall use.

This only scratches the surface. It does not address making tea from the leaves or making bubble hash. It does not address use of cannabis in cooking. I have not included research methods of IV, intraperitoneal or direct injection into a tumor. This column does provide a brief overview of the current range of common doses of cannabis.

Who's Who in Medical Cannabis - Valerie Corral - by c.a. riley

Valerie Corral’s long journey as a leading advocate for medical cannabis began in the Nevada desert in 1973 when a freak accident—the Volkswagen in which she was riding was scraped and knocked off the road by a low-flying small aircraft—left Corral with brain damage, brutal migraines, and epileptic convulsions.

Back home in Santa Cruz, California, prescription medications proved to be ineffective in providing relief as Ms Corral continued to suffer convulsions and grand mal seizures. Valerie’s husband, Mike, had read in a medical journal that cannabis appeared to control such seizures in mice. Desperate to help his wife, he suggested that she try cannabis for her seizures.

Taking her husband’s advice, with cannabis Valerie finally found alleviation of her symptoms, and she readily admits to maintaining a steady level of cannabis in her system ever since.

Having found effective relief for her own condition, Corral was motivated to help other patients. She created a hospice care center for patients who use cannabis in dealing with their terminal illnesses, and has been by the bedsides of most who have passed on. Corral says, "It is the greatest honor to be asked by a person who is dying to sit with them."

The Corrals’ enthusiasm for medical cannabis did not go unnoticed by the authorities. In 1992 Valerie and Mike were arrested by the local sheriff for growing five marijuana plants, and Valerie thus became the first California patient to challenge existing law by claiming medical necessity. Realizing that in liberal Santa Cruz, before a sympathetic jury, they would be unlikely to win the case, prosecutors dismissed it.

The next year, 1993, at about the time Dennis Peron was developing the Cannabis Buyers Club in San Francisco, in Santa Cruz the Corrals founded the Wo/Men's Alliance for Medical Marijuana (WAMM), the first legally recognized nonprofit medical cannabis organization in the nation.

Through WAMM, the Corrals grow and share their crop with seriously ill patients who have doctors’ prescriptions for cannabis. WAMM has long been considered the most legitimate medical cannabis cooperative in the US and provides cannabis to patients at no cost.

When the Corrals were again arrested one year after the 1992 arrest, the district attorney declared that he would never prosecute them, and asked the police to leave them alone.

The Corrals helped draft California’s Compassionate Use Act—Proposition 215—a few years later. When Prop 215 was approved by voters in 1996, California became the first state in the nation to allow patients with a doctor’s recommendation to use cannabis therapeutically.

The new law, however, did not provide complete protection from arrest. Federal law still prohibited the cultivation and distribution of cannabis for medical purposes. In an effort to protect the Corrals, the City of Santa Cruz in 2000 deputized them as medical cannabis providers.

Despite their status as medical cannabis providers for the City of Santa Cruz, Valerie and Mike’s farm was raided by armed federal agents on September 5, 2002, just a few weeks before harvest. More than 150 plants were uprooted and destroyed and the Corrals again went to jail, but were later released without being charged. This latest raid, recognized and proclaimed by the media to be against the terminally ill, led to negative worldwide press for the DEA.

WAMM members rallied in support of their leaders and a few weeks later medical cannabis was distributed from the steps at city hall in Santa Cruz. Although charges were never filed, the Corrals decided to challenge the federal law and eventually a San Jose judge ruled in their favor, making the Corrals the only people in the nation growing cannabis in their backyard with protection from state law, a local ordinance, and an injunction from a federal judge.

Valerie Corral has been at the helm of several efforts to deliver safe medicine to those most in need of it. She has taken her pursuit to the courts of the land, with favorable results overall, and she had a key role in the drafting of SB 420 legislation, which further clarifies provisions of Prop 215.

Ms Corral well deserves her reputation as a courageous pioneer in the quest for compassion.

What's New

Alabama: Considering a medical marijuana law.
   HB642 - The Michael Phillips Compassionate Care Act of Alabama

Arkansas: Considering a medical marijuana law.

Connecticut: Considering a medical marijuana law.

Delaware: Considering a medical marijuana law.

Florida: Medical marijuana petition drive underway.

Idaho: Considering a medical marijuana law.

Illinois: Considering a medical marijuana law.
   Bill Status of SB1381

Iowa: Considering a medical marijuana law.

Kansas: Medical marijuana petition drive underway.
   Marijuana Bill Reaches House

Maryland: Considering a medical marijuana law.
   Bill Status of SB 627

Massachusetts: Considering a medical marijuana law.

Minnesota: Considering a medical marijuana law.

Missouri: Considering a medical marijuana law.
   HOUSE BILL NO. 1670 - An Act relating to the use of marijuana for medicinal purposes
   Cottleville Mayor Don Yarber hopes Missouri legislature passes medical marijuana law

New Hampshire: Considering a medical marijuana law.

New York: Considering a medical marijuana law.

North Carolina: Considering a medical marijuana law.

Ohio: Considering a medical marijuana law.
   HB 478

Pennsylvania: Considering a medical marijuana law.
   HB 1393

South Carolina: Considering a medical marijuana law.

South Dakota: Medical marijuana petition drive underway.

Tennessee: Considering a medical marijuana law.

Texas: Considering a medical marijuana law.

Wisconsin: Considering a medical marijuana law.
   The Jacki Rickert Medical Marijuana Act

Featured Recipe - Canny Citrus Delight

The Best Seafood Prep on the Planet
Another in the Series of: Cannibal Q


1-Pound fresh fish fillets (Snapper or Chilean Sea Bass)

Any firm fresh white fish will do-those who add shrimp and/or scallops will find a reward in heaven. Clams, crawfish, mussels, and or oysters in the shell can also be added for a true seafood extravaganza.

Fresh seafood has no smell other than the ocean

2 Limes
1 Large Lemon
2 Large blood red Oranges
1/3- ½ cup Bud Oil (or butter)
2 tablespoons fresh Basil
1 teaspoon Tarragon
2 tablespoons freeze dried kief
1 tablespoon cracked black pepper
1-tablespoon Kosher salt
1-tablespoon Herbs de Provence
1-tablespoon dried red New Mexico Chilies
2/3-Cup Chardonnay

Marinade technique:

Make a large dish out of heavy aluminum foil

Slice citrus fruits and place in dish

Add bud oil, wine, and spices

Mix well keeping citrus slices whole

Place seafood in dish and refrigerate for one hour

(citrus will partially cook seafood during this time)

Q technique:

Heat up the barbeque and place aluminum dish on grill

Close cover to steam

Check frequently and remove when fillets are white and flaky. Shellfish will open from the steam. Serve with or on rice.

Side dish: Lightly steam sliced zucchini and yellow crookneck squash. Season with pinches of basil, kief, salt, and lemon pepper.

Recommended wine: Kendall Jackson- Estate reserve Chardonnay

Follow AAMC on:
6th National Clinical Conference on Cannabis Therapeutics
April 15-17, 2010
Providence, RI USA

Medical Marijuana States

District of Columbia
New Jersey
New Mexico
Rhode Island