Cannabis:

THC Dosing of Inhaled Marijuana

As most people know, the THC content of marijuana can vary considerably. It is often the case that people will seek out the flower with the highest THC content in the mistaken, belief that they’re getting a better deal. Furthermore, the amount of THC delivered per inhalation varies considerably based on the habits of the individual, but of course, it is largely based on the THC content of the flower. This treatise puts a perspective on the THC content of cannabis flowers and correlates dose of THC when inhaling the flower..

 

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Definitions and Terms Related to Pain

 

THC Dosing of Inhaled Marijuana

The amount of THC in products currently made available at cannabis dispensaries in Louisiana, as well as most of the rest of the United States, has become increasingly high. THC products such as oil, shatter, dab, and edibles now include THC concentration upwards of 95%. There is absolutely no research that indicates this level of THC is beneficial 0or needed for any medical condition.

Because the majority of people using cannabis products for therapeutic benefits, choose to inhale their product by either smoking or vaping marijuana flower. The focus of this treatise is on the THC content of marijuana flower to review dosing based on different THC content percentages.

It should be acknowledged that patients with extensive long-term use of cannabis products, especially high THC content products, will develop significant tolerance to the effects of THC, including both therapeutic effects and side effects. Accompanying this increased tolerance is also the development of greater likelihood and severity of withdrawal symptoms which is reviewed here.

Clearly, patients with high tolerance to THC will require higher doses to obtain their therapeutic benefits. Nevertheless, it should be noted that there may be benefits in taking an extra puff or two of a lower THC concentrated flower so that the dosing will include higher terpene doses for the same THC dose, resulting in enhance therapeutic benefits.

THC Dosing Comparison in Cannabis Flower for Pain and Anxiety

This treatise compares dosing (number of inhalations) for cannabis flower with THC percentages of 3%, 10%, 15%, 20%, 25%, and 30%, assuming reliance on THC alone for analgesic (pain relief) and anxiolytic (anxiety relief) benefits.

Estimates are based on data assuming THC doses of 5-15 mg (absorbed into the blood) are generally effective for moderate symptoms and assumes inhalation absorption to be approximately  30% of inhaled dose.

Given the relatively recent availability of cannabis products for medical use, many patients have only started using THC products recently and are often older and potentially more sensitive to the side effects. Therefore it is important to emphasize the use of lower THC concentrate products, particularly in the face of dispensaries that offer only very limited selections of cannabis flower that have THC content less than 15 to 20%.

Additionally, it should be noted that frequent use of high-potency cannabis predicts a greater severity of THC dependence that is associated with greater risk of withdrawal symptoms. Interestingly. this effect as much stronger in those under the age of 25. By contrast, use of low-potency cannabis is associated with less dependence and less severity of withdrawal symptoms.

This treatise  provides estimates of THC dosing based on the THC% content of marijuan flower, smoked or vaped.

Overview of THC Dosing and Therapeutic Benefits

THC provides analgesia via CB1 activation in the spinal cord/brain and anxiolysis at low doses by modulating amygdala activity. For pain/anxiety, low-moderate doses (5-15 mg absorbed) are effective; higher doses (>20 mg) increase risks without added benefits. Dosing comparisons assume equivalent absorbed THC (10 mg average for therapeutic effects) and average inhalation (50 mg flower/puff, 30% absorption).

Use of high THC concentration allows fewer inhalations but risks over-consumption, leading to increased likelihood of developing greater tolerance, resulting in the need for higher doses and more expense as well as greater risk of developing dependence resulting in greater risk of withdrawal symptoms.

Assumptions for Dosing Estimates

  • Effective Absorbed THC: 5-15 mg for pain/anxiety (average 10 mg; Whiting et al., 2015; PMC, 2018).
  • Inhalation Efficiency: 30% THC absorbed (Huestis, 2007; CCSA, 2019).
  • Flower per Inhalation: 0.05 g (average puff; Veriheal, 2020).
  • THC per Puff: (THC % * 50 mg flower * 0.3 efficiency).
  • Vaping vs Smoking: Similar absorption (vaping slightly higher, 35-50%; used 30% average).
  • Therapeutic Threshold: Low THC sufficient; high THC for potency but not necessity (Frontiers, 2022).

 

Dosing Comparison (Number of Inhalations for 5-10 mg absorbed THC)

 (Assumes no CBD, which increases the risk of THC side effects)

THC %

THC per Puff (mg absorbed)

Inhalations for   5-10 mg THC

Notes

3%

0.45

11-22

Historical low-potency; more inhalations needed, increasing smoke exposure.

10%

1.5

3-7

Balanced for therapeutic; sufficient for pain/anxiety without high risks.

15%

2.25

3-5

Optimal for medical use – effective with few inhalations.

20%

3

2-4

Common in dispensaries; potent but risks anxiety and other side effects.

25%

3.75

1-3

High potency; minimal inhalations but increases side effects risk.

30%

4.5

1-2

Very high; serves recreational high; therapeutic benefits at low doses.
  • Mechanism: THC activates CB1 for pain reduction (spinal inhibition) and anxiety relief (amygdala modulation) at 5-15 mg; higher doses overstimulate, causing anxiety/paranoia.
  • Dosing Considerations: Low % requires more inhalations (e.g., 3% needs 22 puffs for 10 mg), increasing lung irritation. High % allows fewer puffs but risks side effects and over-intoxication. Vaping absorbs ~10% more.
  • Side Effects: Low THC: Mild (e.g., dry mouth 15%). High THC: Anxiety (15%), paranoia (5-10%), tachycardia (5%).
  • Safety Concerns: THC >20% increases psychosis risk 3-5x (PMC, 2018); low THC safer for medical. Compensating low THC with more inhalations increases carcinogen exposure but balances effects with CBD/terpenes.
  • Evidence Quality: Moderate (human pharmacokinetic studies for absorption; observational for therapeutic doses). Low for direct comparisons (no RCTs on % THC vs inhalations).

Arguments against THC >15-20% for Therapeutic Purposes

THC >15-20% is unnecessary for therapeutic benefits (pain, anxiety, sleep) and may serve recreational “getting high” more than medical needs.

  • Evidence Supporting: Low-moderate THC (5-15 mg, ~10-15% flower) is effective for pain/anxiety/sleep without high risks (Whiting et al., 2015; PMC, 2018). High THC (>20%) increases addiction (9%) and psychosis (3-5x risk), with no added therapeutic benefit (Frontiers, 2022). Low THC with CBD/terpenes provides balanced effects (entourage), sufficient for medical (e.g., anxiety relief without paranoia; Yale Medicine, 2023).
  • Evidence Against: For severe pain (e.g., cancer), high THC may provide faster relief (Johnson et al., 2010), but risks outweigh in most cases. Some patients tolerate high THC for sleep (PMC, 2018).
  • Conclusion: No strong argument for >15-20% THC therapeutically; higher serves recreational high. Low THC (<15%) with more inhalations can match effects but increases smoke risks; balanced strains recommended.

Conclusion

There is no good argument for THC content to be higher than 15 to 20% in marijuana flower used for therapeutic purposes. THC contents greater than 15 – 20% serves the purpose of marijuana to get high rather than for therapeutic benefits such as pain, anxiety and sleep which could be sufficiently obtained with cannabis flower with <15% THC in most cases.

Notes

  • Estimates: Inhalations for 10 mg THC (therapeutic average); actual varies by individual tolerance, flower density, and inhalation depth.
  • Clinical Application: Recommend low-moderate THC (10-15%) for therapeutic; higher THC (>20%) increases risks without benefits. Balanced CBD/terpenes enhance low-THC efficacy.

References

  1. THC Dosage- What’s the Right (and Safe) Amount? Good Rx
  2. Cannabis- Inhaling vs Ingesting
  3. Potency and Therapeutic THC and CBD Ratios- U.S. Cannabis Markets Overshoot – 2022
  4. The Problem with the Current High Potency THC Marijuana from the Perspective of an Addiction Psychiatrist – 2018
  5. Patient-Reported Symptom Relief Following Medical Cannabis Consumption – 2018
  6. Examining the profile of high-potency cannabis and its association with severity of cannabis dependence – 2015
  7. Adverse Health Effects of Marijuana Use – 2016
  8. Whiting, P. F., et al. (2015). Cannabinoids for medical use: A systematic review and meta-analysis. JAMA, 313(24), 2456-2473. https://doi.org/10.1001/jama.2015.6358
  9. PMC. (2018). The problem with the current high potency THC marijuana from the perspective of an addiction psychiatrist. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6312155/
  10. Frontiers. (2022). Potency and therapeutic THC and CBD ratios: U.S. cannabis markets oversupply products with high THC. https://www.frontiersin.org/articles/10.3389/fphar.2022.921493/full
  11. Yale Medicine. (2023). Marijuana: Rising THC concentrations in cannabis can pose health risks. https://medicine.yale.edu/news-article/not-your-grandmothers-marijuana-rising-thc-concentrations-in-cannabis-can-pose-devastating-health-risks/
  12. Johnson, J. R., et al. (2010). Multicenter, double-blind, randomized, placebo-controlled, parallel-group study of the efficacy, safety, and tolerability of THC:CBD extract and THC extract in patients with intractable cancer-related pain. Journal of Pain and Symptom Management, 39(2), 167-179. https://doi.org/10.1016/j.jpainsymman.2009.06.008
  13. Huestis, M. A. (2007). Human cannabinoid pharmacokinetics. Chemistry & Biodiversity, 4(8), 1770-1804. https://doi.org/10.1002/cbdv.200790152
  14. CCSA. (2019). Cannabis: Inhaling vs ingesting risks infographic. https://www.ccsa.ca/sites/default/files/2019-10/CCSA-Cannabis-Inhaling-Ingesting-Risks-Infographic-2019-en.pdf

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