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Cannabis Care Hub

This page is designed to provide educational information about the therapeutic use of medical cannabis. Whether you're new to cannabis or looking to expand your knowledge, you'll find helpful insights on different strains, THC and CBD concentrations, terpenes, dosage forms, and more.

 

Our goal is to empower you with the information you need to make informed decisions about your healthcare, in consultation with your provider.

 

Please remember that this content is for educational purposes only and should not replace professional medical advice.

Medical Cannabis: A Guide to Strains, THC, Terpenes, Doses, and Forms

What is Medical Cannabis?

Medical cannabis, also known as medical marijuana, refers to the use of the cannabis plant or its extracts for therapeutic purposes. It's often recommended for conditions such as chronic pain, anxiety, epilepsy, and more. Cannabis contains many compounds, most notably cannabinoids like THC (tetrahydrocannabinol) and CBD (cannabidiol), and terpenes, which contribute to its medicinal effects.

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Forms of Medical Cannabis

  • Flower (Bud): The dried flower of the cannabis plant is most commonly smoked or vaporized. Flower products vary in THC and CBD coacentrations, so check the labeling for the correct dose.

  • Edibles: Edibles come in various forms, including gummies, chocolates, and capsules. These are metabolized differently, leading to slower but potentially stronger effects.

  • Tinctures: Tinctures are liquid extracts of cannabis that can be taken sublingually (under the tongue) or added to food and drinks. They are fast-acting compared to edibles and allow precise dosing.

  • Concentrates: These are highly potent cannabis extracts, often used in vaporizers or added to flower. Concentrates have higher THC levels, typically ranging from 50% to 80%.

  • Topicals: Lotions, balms, and patches infused with cannabis are used for localized pain and inflammation without the psychoactive effects .

​​​Cannabis Strains: Indica, Sativa, and Hybrid

Cannabis plants are typically classified into three main categories: Indica, Sativa, and Hybrid. Each strain has unique characteristics and effects, often attributed to its genetic makeup, cannabinoid content, and terpene profile. Understanding the differences between these strains can help patients select the most appropriate type of cannabis for their medical condition or desired effect.

 

Indica: Calming and Sedative

Indica strains are typically associated with relaxing and sedative effects, making them ideal for nighttime use or for conditions that benefit from relaxation. They are often recommended for patients seeking relief from chronic pain, anxiety, insomnia, muscle spasms, and stress.

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  • Plant Characteristics: Indica plants tend to be shorter and bushier than Sativa plants. They have broad, dark green leaves, and their growth cycle is typically shorter, making them easier to cultivate in colder climates with shorter growing seasons.

  • Effects: Indica strains tend to produce a "body high," which is characterized by deep relaxation of the muscles and body. Patients often report feeling sleepy, calm, or "couch-locked." Because of their sedative properties, Indica strains are frequently recommended for patients with sleep disorders, chronic pain, or conditions like fibromyalgia that require muscle relaxation.

  • Common Indica Strains: Examples of popular Indica strains include Granddaddy Purple, Northern Lights, and Afghan Kush. These strains are typically high in myrcene, a terpene that enhances sedative effects.

 

Best Used For:

  • Sleep disorders: Indica strains are commonly used to treat insomnia or other sleep disturbances because of their sedative effects.

  • Chronic pain: Patients with conditions such as arthritis, fibromyalgia, or multiple sclerosis may benefit from Indica strains' ability to reduce pain and muscle tension.

  • Anxiety and stress: Indica strains can help with anxiety disorders by promoting relaxation and easing mental stress, although patients prone to anxiety from high-THC strains should use them cautiously.

 

Sativa: Energizing and Uplifting

Sativa strains are known for their energizing and uplifting effects, making them better suited for daytime use. These strains are often recommended for patients who suffer from depression, fatigue, or mood disorders, as they can promote creativity, focus, and a sense of well-being.

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  • Plant Characteristics: Sativa plants are typically taller and thinner than Indica plants, with narrow, light-green leaves. Sativa plants take longer to grow and mature, often thriving in warmer climates with longer growing seasons.

  • Effects: Sativa strains produce a "cerebral high," characterized by increased mental clarity, creativity, and alertness. Because of their uplifting nature, Sativa strains can help alleviate mental fatigue, making them ideal for patients with depression or conditions that require enhanced focus.

  • Common Sativa Strains: Well-known Sativa strains include Jack Herer, Sour Diesel, and Green Crack. These strains are often rich in terpenes like limonene and pinene, which contribute to the uplifting and mentally stimulating effects.

 

Best Used For:

  • Depression and mood disorders: Sativa strains are often recommended for patients with depression because of their uplifting and mood-enhancing effects.

  • Fatigue: Patients struggling with chronic fatigue may benefit from the energizing properties of Sativa strains, which can promote alertness and reduce tiredness.

  • Focus and creativity: Sativa strains are ideal for patients needing mental clarity, such as those with ADHD, or those looking for an increase in focus and creativity during the day.

 

Hybrid: Balanced Effects

Hybrid strains are created by crossbreeding Indica and Sativa strains to develop specific effects tailored to a patient’s needs. The effects of hybrid strains can vary significantly depending on the genetic composition and whether the strain is Indica-dominant, Sativa-dominant, or balanced.

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  • Plant Characteristics: Hybrid plants can vary in size, shape, and appearance, depending on the parent strains. These plants can have a mix of characteristics from both Indica and Sativa varieties.

  • Effects: Hybrid strains offer a blend of both body and cerebral effects, making them versatile for various medical conditions. A Sativa-dominant hybrid might provide mental clarity and focus with mild physical relaxation, while an Indica-dominant hybrid may induce relaxation without overwhelming sedation. Balanced hybrids offer more even effects of both mental stimulation and physical relaxation.

  • Common Hybrid Strains: Popular hybrid strains include Blue Dream (a balanced hybrid), OG Kush (Indica-dominant), and Pineapple Express (Sativa-dominant). Hybrids often have a varied terpene profile, making them suitable for a wide range of therapeutic applications.

 

Best Used For:

  • Versatile relief: Hybrid strains can be customized to address multiple symptoms, such as pain relief, anxiety, or fatigue, depending on the dominant parent strain.

  • Any time of day: Indica-dominant hybrids are suitable for evening use, while Sativa-dominant hybrids may be better suited for daytime when mild energy is needed.

  • Tailored effects: Hybrid strains are ideal for patients looking for customized effects, as they offer a mix of both physical relaxation and mental clarity.

 

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Hybrid: Balanced Effects

Choosing the right strain depends on the medical condition being treated, the desired effects, and individual tolerance. It's important to consult with a healthcare provider or cannabis specialist to determine which strain may be best suited for your specific needs. Many patients may start with hybrids to experience a balance between the mental and physical effects, gradually exploring more specific Indica or Sativa strains as needed. Always start with a low dose, particularly if you're new to cannabis, and adjust based on your body's response.

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Conclusion

Understanding the differences between Indica, Sativa, and hybrid strains allows patients to make informed decisions about which cannabis products to use based on their unique medical needs. Whether you're looking for relaxation, mental stimulation, or a balanced effect, there’s likely a strain that fits your therapeutic goals.

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THC Concentrations and Percentages: Understanding Potency and Effects

Cannabis contains numerous active compounds called cannabinoids, the most prominent of which are THC (tetrahydrocannabinol) and CBD (cannabidiol). While both have medicinal properties, THC is the primary psychoactive compound responsible for the "high" feeling associated with cannabis. The potency of medical cannabis is primarily measured by its THC concentration, expressed as a percentage of the plant material or product. This concentration has a significant impact on the intensity of the effects experienced by the user and can guide recommendations for different medical conditions.

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THC (Tetrahydrocannabinol)

THC is the cannabinoid responsible for the psychoactive effects of cannabis, including euphoria, relaxation, altered senses, and sometimes anxiety or paranoia at high doses. However, its therapeutic effects, such as pain relief, anti-nausea properties, appetite stimulation, and muscle relaxation, are also well-documented.

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Low-THC Cannabis (0.3% to 5%)

  • Definition: Strains or products with a THC concentration between 0.3% and 5% are considered low-THC. These strains are often referred to as “hemp” when the THC concentration is below 0.3%, according to the U.S. federal definition. Hemp-based products are commonly used for their therapeutic benefits without psychoactive effects.

  • Uses: Low-THC cannabis is typically used by patients who are sensitive to THC’s psychoactive effects or who need minimal psychoactivity. It is often prescribed for inflammatory conditions, mild pain, anxiety, or patients who are new to cannabis and want to start with a gentle dose.

  • Effects: Patients using low-THC strains generally do not experience a strong "high," but may feel mild relaxation or mood elevation. This range is ideal for individuals seeking relief without impairing daily functioning.

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Moderate-THC Cannabis (5% to 15%)

  • Definition: Strains with THC levels between 5% and 15% are considered moderate in potency. These products may provide a balance between therapeutic effects and mild to moderate psychoactive effects.

  • Uses: Moderate-THC cannabis is often used for chronic pain, nausea, muscle spasms, insomnia, and conditions where a stronger therapeutic effect is needed without overwhelming psychoactivity. Strains in this range may be appropriate for daytime use, depending on the patient’s tolerance.

  • Effects: While these strains may produce a noticeable psychoactive effect, it is typically not overwhelming for most users. Patients report pain relief, mood enhancement, and reduced anxiety at these THC levels. The "high" is present but may feel more controlled compared to higher-THC products.

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High-THC Cannabis (15% to 30% or higher)

  • Definition: Strains with THC concentrations of 15% or higher are considered high-potency. Some cannabis strains can reach THC levels of 25% to 30%, and certain concentrates (like oils or waxes) can exceed even this, often reaching THC percentages upwards of 80% to 90%.

  • Uses: High-THC strains are typically used for more severe conditions, such as chronic or neuropathic pain, chemotherapy-induced nausea, muscle spasticity, and severe anxiety or PTSD. These strains are also used for conditions where a potent psychoactive effect is desired or necessary for relief.

  • Effects: At these concentrations, THC can produce intense euphoria, strong relaxation, or sedation, making it suitable for nighttime use or situations where the patient does not need to function at full capacity. However, side effects like paranoia, anxiety, dry mouth, or dizziness can be more pronounced in individuals sensitive to THC.

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CBD (Cannabidiol) and its Role in Medical Cannabis

CBD is the second most prominent cannabinoid in cannabis, and unlike THC, it is non-psychoactive. This means that products high in CBD won’t cause the "high" associated with THC, but they can offer substantial therapeutic benefits. Some patients prefer high-CBD, low-THC products to avoid the psychoactive effects while still addressing their medical needs.

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How THC and CBD Interact

CBD can influence the effects of THC in several ways:

  1. Reducing Psychoactivity: CBD may reduce the intensity of the "high" caused by THC, making cannabis products with a balanced ratio of THC and CBD more manageable for some patients. For example, strains or products with a 1:1 THC to CBD ratio provide the benefits of both cannabinoids while mitigating the psychoactive effects.

  2. Enhancing Therapeutic Effects: The combination of THC and CBD can work synergistically, enhancing the pain-relieving and anti-inflammatory properties of cannabis. This entourage effect suggests that cannabis works best when its compounds are combined rather than isolated .

  3. Different Receptors: While THC primarily binds to CB1 receptors in the brain, causing psychoactive effects, CBD interacts with a broader range of receptors, including CB2 receptors in the immune system, and may inhibit the binding of THC to CB1, further reducing psychoactivity.​

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THC Concentrations in Various Products

  • Flower (Bud): The THC content in dried cannabis flower can range significantly depending on the strain. Low-THC flower may contain 1-5% THC, while high-THC strains may have up to 30% or more.

  • Concentrates (Extracts, Oils, and Waxes): Concentrated cannabis products like shatter, wax, or oil are highly potent, with THC levels ranging from 50% to 90%. These are generally recommended for experienced users and those who need potent relief, such as patients undergoing chemotherapy or dealing with severe chronic pain.

  • Edibles: The THC concentration in edibles is typically measured per serving. A standard dose of THC in edibles is 5-10 mg per serving, but the total THC content of a product (like a full chocolate bar) can be much higher, often exceeding 100 mg. Edibles take longer to take effect and tend to have more potent and longer-lasting effects than inhaled cannabis.

  • Tinctures: Tinctures allow for precise dosing, with THC concentrations ranging from 2 mg to 30 mg per dose. These are often used sublingually (under the tongue) for fast absorption and are commonly chosen by patients seeking a middle ground between inhalation and edibles.

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Conclusion

The THC concentration in cannabis plays a critical role in determining its potency, therapeutic use, and side effects. For new medical cannabis users, it is generally recommended to start with a low-THC product and gradually increase the dose as needed. More experienced patients or those with severe symptoms may benefit from higher THC concentrations, but the potential for psychoactive side effects should always be considered. Consult with a healthcare provider to determine the most appropriate THC concentration and cannabis product for your medical condition.

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Terpenes & Their Effects: A Closer Look

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Terpenes are natural aromatic compounds found not only in cannabis but also in many plants, fruits, and herbs. In cannabis, terpenes not only give each strain its distinctive aroma but also contribute significantly to the plant’s therapeutic effects. Recent research suggests that terpenes may work synergistically with cannabinoids like THC and CBD, enhancing or modifying their effects. This phenomenon is known as the entourage effect.​

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Here is a more detailed look at some of the most common terpenes in cannabis and their potential effects on health:

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Limonene

  • Aroma: Citrus-like, found in lemons, oranges, and other citrus fruits.

  • Potential Effects: Limonene is associated with uplifting, mood-enhancing properties. It has been studied for its potential role in reducing stress and anxiety. In addition, limonene may have antifungal, antibacterial, and anti-inflammatory properties, making it potentially useful for treating a range of conditions such as stress, depression, and inflammation .

  • Strains High in Limonene: Many Sativa-dominant strains, like Super Lemon Haze and Lemon Skunk, tend to have high levels of limonene. Patients often seek these strains for relief from stress, anxiety, or depression due to the uplifting effects of limonene.

 

Myrcene

  • Aroma: Earthy, musky, with hints of cloves and herbal undertones. Myrcene is also found in hops, thyme, and lemongrass.

  • Potential Effects: Myrcene is often recognized for its sedative and relaxing effects. It’s the terpene most commonly associated with the “couch-lock” sensation, which is why it’s typically found in Indica strains. Myrcene also has anti-inflammatory and analgesic properties, making it beneficial for those dealing with chronic pain or insomnia. Studies suggest myrcene may work synergistically with THC to increase its psychoactive effects and enhance relaxation .

  • Strains High in Myrcene: Indica strains like Granddaddy Purple, Blue Dream, and Northern Lights tend to have high myrcene levels. These strains are typically recommended for nighttime use, especially for patients dealing with insomnia, chronic pain, or anxiety.

 

Pinene

  • Aroma: Pine-like, fresh, also found in pine needles, rosemary, basil, and dill.

  • Potential Effects: Pinene is known for its anti-inflammatory and bronchodilator properties, which may help improve airflow to the lungs. It’s also thought to aid in memory retention and focus, counteracting the short-term memory loss sometimes associated with high-THC cannabis strains. Studies suggest that pinene may have antimicrobial and neuroprotective properties, potentially benefiting patients with conditions such as asthma, arthritis, and neurodegenerative diseases .

  • Strains High in Pinene: Some strains rich in pinene include Jack Herer, Chemdawg, and Blue Dream. These strains may be useful for patients seeking mental clarity, focus, or relief from inflammatory conditions.

 

Linalool

  • Aroma: Floral, lavender-like. Linalool is also present in lavender and birch bark.

  • Potential Effects: Linalool is believed to have calming and sedative effects, making it useful for treating anxiety, depression, and sleep disorders. It also has anti-inflammatory and pain-relieving properties. Linalool may enhance the relaxing effects of THC and CBD, making it an ideal terpene for nighttime use .

  • Strains High in Linalool: Strains such as Amnesia Haze, Lavender, and LA Confidential tend to have higher concentrations of linalool, often recommended for patients experiencing anxiety or difficulty sleeping.

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Caryophyllene

  • Aroma: Spicy, peppery, also found in black pepper, cloves, and cinnamon.

  • Potential Effects: Caryophyllene is unique in that it is the only terpene known to directly interact with the body’s endocannabinoid system (ECS), specifically binding to CB2 receptors, which are involved in regulating inflammation and immune responses. Because of this, caryophyllene is thought to have strong anti-inflammatory effects and may help manage pain, anxiety, and depression .

  • Strains High in Caryophyllene: Strains like Bubba Kush, Sour Diesel, and Girl Scout Cookies are known for their high caryophyllene content and may be helpful for patients dealing with chronic pain or inflammation.

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Humulene

  • Aroma: Woody, earthy, found in hops, coriander, and cloves.

  • Potential Effects: Humulene is thought to suppress appetite, making it different from other terpenes that might stimulate hunger. It also has anti-inflammatory, antibacterial, and pain-relieving properties. Humulene is often recommended for patients dealing with inflammatory conditions such as arthritis or chronic pain .

  • Strains High in Humulene: White Widow, Headband, and GSC are strains rich in humulene, often chosen for their potential anti-inflammatory benefits.

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How Terpenes Influence Cannabis’ Effects

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While cannabinoids like THC and CBD are the primary active compounds in cannabis, terpenes significantly influence the overall effects. For instance, a strain with high THC levels but also rich in myrcene may feel more sedating than a high-THC strain rich in pinene, which may promote mental clarity and alertness. This is why understanding terpene profiles can help patients make more informed choices about the strains and products that best suit their therapeutic needs.

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Conclusion

Terpenes play a crucial role in determining how cannabis strains affect the body and mind. Each terpene has unique properties that can influence your experience, whether you seek relaxation, pain relief, focus, or upliftment. When selecting a cannabis product, paying attention to its terpene profile in addition to its THC and CBD content can help tailor the effects to your specific medical needs.

Doses and Starting Recommendations

​When using medical cannabis, it is essential to start with a low dose and gradually increase as needed. Your healthcare provider will guide you on the correct dosage for your condition.

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  • Inhalation (Smoking or Vaporizing): Effects are felt within minutes, with peak effects within 30 minutes and lasting 2-4 hours. Start with 1-2 inhalations, wait 15 minutes, and assess how you feel before increasing the dose.

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  • Edibles (Gummies, Capsules, Tinctures): Edibles take longer to work, typically 30-90 minutes, and can last 6-8 hours. Start with a dose of 2.5 mg of THC, and increase by 1-2 mg as needed. Be cautious with edibles as the effects can be stronger and last longer.

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  • Topicals: These are applied to the skin and typically contain THC, CBD, or a combination. They are used for localized pain or inflammation and do not produce psychoactive effects. Apply as needed to the affected area.

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Medical Disclaimer

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The information provided in this document is intended for educational purposes only and should not be considered medical advice. The use of medical cannabis should be discussed with a qualified healthcare provider who can evaluate your individual medical condition and provide tailored recommendations. Always consult a healthcare professional before starting any new treatment or altering your current medications, including the use of medical cannabis. The content in this document is based on general knowledge about cannabis and its potential therapeutic effects, but individual results and experiences may vary.

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Medical cannabis may not be suitable for everyone, and potential side effects or drug interactions should be carefully considered. This document does not replace professional medical advice, diagnosis, or treatment.

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References

  1. Russo, E. B. (2011). Taming THC: Potential cannabis synergy and phytocannabinoid-terpenoid entourage effects. British Journal of Pharmacology, 163(7), 1344-1364.

  2. Bonn-Miller, M. O., et al. (2014). Cannabis use and risk of psychiatric disorders: prospective evidence from a U.S. national longitudinal study. JAMA Psychiatry, 71(8), 825-835.

  3. Grotenhermen, F., & Müller-Vahl, K. (2016). The therapeutic potential of cannabis and cannabinoids. Deutsches Ärzteblatt International, 113(29-30), 495-501.

  4. Lucas, P., & Walsh, Z. (2017). Medical cannabis access, use, and substitution for prescription opioids and other substances: A survey of authorized medical cannabis patients. International Journal of Drug Policy, 42, 30-35.

  5. Huestis, M. A. (2007). Human cannabinoid pharmacokinetics. Chemistry & Biodiversity, 4(8), 1770-1804.

  6. MacCallum, C. A., & Russo, E. B. (2018). Practical considerations in medical cannabis administration and dosing. European Journal of Internal Medicine, 49, 12-19.

  7. Abrams, D. I., et al. (2007). Cannabis in painful HIV-associated sensory neuropathy: a randomized placebo-controlled trial. Neurology, 68(7), 515-521.

  8. McPartland, J. M., & Russo, E. B. (2001). Cannabis and cannabis extracts: Greater than the sum of their parts? Journal of Cannabis Therapeutics, 1(3-4), 103-132.

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