Medical Cannabis Products
Cannabis-Based Medicinal Products (CBMPs) are botanical medicines produced from cannabis flowers. As plant-based products, CBMPs contain 100s of chemical elements, combining to have a variety of wanted (and potentially unwanted) effects.
This combination of (cannabinoid and non-cannabinoid) elements produces a ‘chemical signature’, which is highly variable, based on plant genetics, production methods and processing. Individual CBMPs can therefore have different therapeutic uses and effects, sometimes of greater potency than expected from the primary constituents.
This is known as the ‘Entourage Effect’.
The 2 most well-known cannabinoids (out of c.160 in cannabis) are Tetrahydocannabinol (THC) and Cannabidiol (CBD). CBMPs are primarily described in terms of their THC:CDB ratio, although as 'Full Spectrum' products, they will have a vast number of other constituents that make predicting individual response difficult. This also means that a patient may benefit from a particular strain of cannabis CBMP, but not others.
In the U.K., CBMPs are available either as dried cannabis flowers, or oils infused with the active constituents of the flowers.
CBMP oils can be; High CBD : Low THC (up to 100:0)
Low CBD : High THC (up to 0:25)
Balanced CBD : THC (up to 25:25)
CBMP Flowers; Low CBD : High THC (up to 0:25)
Balanced CBD : THC (up to 11:11)
High CBD : Low THC (up to 12:0)
Recommended prescriptions for mental health conditions are typically of High CBD formulations, although symptoms and prior experience with cannabis will be considered.
The principle of, 'Minimum Effective Dose' is recommended. Patients should take the minimum amount that eases their symptoms, escalating only if this is no longer effective.
Some patients can report a 'plateau' in beneficial effects after increasing dose for some time. This can be overcome by switching strains, taking a short break from use, or adding a small amount of a CBMP containing THC.
Patients typically start on a minimum of 15-30mg per day of CBD oil in divided doses and increase by 5-15mg every few days, with no upper limit and good tolerability profile.
THC in oil form , where prescribed will typically start at 1mg per day and may be increased cautiously every few days , if indicated. Using a separate THC oil can help with dosing during this phase, rather than combined CBD:THC oils.
As a guide for Flower, many patients use in the region of 1 gram per day.
Quality and Consistency
The products are manufactured to a high standard under 'Good Manufacturing Practice' standards and batch tested to provide a 'Certificate of Analysis' of the chemical composition of the CBMP, as well as any contaminates.
CBMPs are imported, distributed and stored under a strict legal framework, giving patients confidence that the products they are prescribed are of the highest quality, safety and consistency.
Cannabis Clinic Cardiff is not affiliated with any CBMP production company, importer or pharmacy. This gives them complete freedom to evaluate all products equally and without any bias to recommend the ideal CBMP for your condition.
Methods of Ingestion
Oral / Sub-Lingual: Cannabis-Based Medicinal Products (CBMPs) in oil form are typically administered through 'drops' from a glass pipette that comes with the product. The drops are of a specific volume and the bottle will inform you of the concentration of one drop, enable accurate dosing.
For sub-lingual administration, drops are placed under the tongue and left for up to several minutes and have a rapid absorption, within a few minutes and have a duration of effect of a several hours.
Oral administration takes 1-2 hours to reach peak effects, but also lasts longer, up to 6-8 hours.
Using oil for making 'edibles' is outside of the medically recommended administration methods and would nullify the prescription. Users taking CBMPs outside of medical advice continue to be subject to criminal proceedings. Dosing with 'edibles' is also difficult due to the significantly delayed onset of action, long duration and inconsistent distribution in the final product.
Vaporisers: A vaporiser is essential to administering CBMPs in Flower form and enable the user to titrate their dose of cannabinoid(s) very closely as both the speed of onset is within seconds, peak effects within 15-30 minutes and duration of action of 2-3 hours.
Vaporised CBMPs are commonly used for 'breakout' symptoms, where longer acting preparations have proven insufficient and rapid relief is required. Alternative methods of ingestion, such as smoking are NOT recommended by clinicians and would therefore be against medical advice and nullify the prescription.
Users taking CBMPs outside of medical advice continue to be subject to criminal proceedings.
Cannabis Clinic Cardiff recommend the following vaporisers;
The Mighty Medic (from Storz &Bickel)
The Volcano Medic (from Storz &Bickel)
Other vaporisers are available and the choice is very much up to personal preference and budget.
Cannabis Clinic Cardiff has no financial interest in recommending these products.