Accurate Education – LA Marijuana Products – Tinctures

Tinctures absorbed under the tongue (sublingual) will have an onset of effect in about 30 minutes compared to more than an hour after swallowing. The effects should last up to 4-8 hours after use. When simply swallowed, the tincture will still provide benefits but they will be slower in onset and may last longer. Even when the product is placed under the tongue it is likely some of the dose will be swallowed. This is not a problem and may even offer advantages.

Due to the breakdown of the THC  by the stomach and liver, the final therapeutic benefit may be different when swallowed compared to sublingual absorption. Furthermore, if the stomach is full, especially with a high fat meal, absorption is enhanced with a longer effect although it may be slower in onset.

These methods of absorption with tinctures compare with the use of inhaled products that  nearly immediately enter the blood stream with rapid effects. Dosing with inhaled products however is less precise and differs based on the depth of inhalation and the length of time one holds the vape in before exhaling.

Initial Dosing of the Tinctures for the Inexperienced

The recommendations below are generalized and based on the manufacturer’s suggested dosing. Ultimately, dosing recommendations should be provided by the prescriber and based on multiple variables including the patient’s age, size, underlying medical conditions and current medications and experience with marijuana use.

CHOICE OF TINCTURES

The tinctures are available in 2 formulations: 

1. 1. THC and CBD in a balanced formulation with equal amounts of THC and CBD
   2. THC-only formulation

Because studies indicate that the benefits of both THC and CBD are enhanced when the two are given together, the balanced formulations are recommended as starting formulations, starting with the lowest concentration formula. Additionally, CBD is believed to reduce some of the side effects seen with THC, particularly the anxiety and paranoia that can sometimes occur with THC. For the uninitiated or naive patient this combination is likely to be better tolerated. If the initial use of the balanced formulation is associated with excessive sedation, either the THC dose or, possibly, the CBD dose is too high – usually the THC. Sometimes, however, CBD is associated with excessive sedation and it may be necessary to use the THC-only product.

BALANCED THC & CBD (1:1) SUBLINGUAL TINCTURE

Potency: 150 mg CBD and 150 mg THC in a 30 mL bottle (5 mg CBD & 5 mg THC/mL).

Initial recommendation:

Inexperienced patients start with a dose of 0.5 mL (1/2 dropperful) that provides 2.5 mg CBD & 2.5 mg THC to be taken 1 time per day at bedtime for 1 week.

Experienced patients may with a dose of 1.0 mL (5 mg CBD & 5 mg THC) 1 time per dayat bedtime for 1 week.

If desired relief is not achieved after 1 week:

Patients may increase initial dose to 2 times per day for 1-2 weeks.

If desired relief is not achieved after 3 weeks:

Patients may increase initial dose to 3 times per day for 2 weeks.

For greater relief:

Patients may increase initial dosing in a stair-step manner by adding 0.5 mL (1/2 dropperful) to the initial dose every 1-2-weeks as tolerated until the desired relief is achieved.

THC ONLY TINCTURES

If it is determined that the CBD component is not tolerated, one should rotate off the balanced formulation and try the THC-only formulation, starting with the lowest concentration formula.

Potency: 300mg THC/30mL (10 mg THC/mL).

Initial recommended starting dose:

Inexperienced patients start with a sublingual dose of 0.25 mL (2.5mg THC) 1 time per day at bedtime for 1 week.

Experienced patients start with a sublingual dose of 0.5 mL (5.0 mg THC) 1 time per day at bedtime for 1 week.

If desired therapeutic effect is not achieved after 1 week:

Patients may take initial dose 2 times per day for 1-2 weeks.

If desired relief is not achieved after 1-2 weeks:

Patients may increase initial dose to 3 times per day for 1-2 weeks.

For greater relief:

Inexperienced patients may increase initial dose in a stair-step manner by adding 0.25 mL to initial dose every 1-2 weeks until desired relief is achieved (e.g., progress from initial dose of 0.25 mL to 0.5 mL to 0.75 mL to 1.0 mL).

Experienced patients may increase initial dose in a stair-step manner by adding 0.5 mL to initial dose for a 1-2 week period until desired relief is achieved.

If necessary, one my progress slowly to the stronger formulations: 600 mg/ml and 900 mg/ml.

Supplementing the Tinctures

Depending on the tincture product selected, one may not fully achieve the therapeutic benefits desired. If trial and error switching between tincture products continues to fall short, another option is to supplement a tincture with other products, particularly CBD products that include terpenes. There are many such products available over the counter that allow for selective therapeutic effects when added to THC-only tinctures. By supplementing a THC-only product, one can precisely control the dose of THC to fine tune the specific THC benefits being sought while the supplemental constituents may be independently dosed to fine tune the benefits provided by the supplemental CBD/terpene blend.

An example of this approach is as follows. Perhaps the Ilera THC-only tincture one uses sufficiently addresses the pain benefits with specific dosing, but greater anxiety benefit is sought, perhaps targeting night time use to enhance sleep. In this case one may supplement the THC-only tincture with a CBD product with a blend of terpenes directed at anxiety and insomnia. The dosing of the CBD/terpenes can be modified as desired independently from the dosing of the THC.

Optional CBD/terpene products currently available include CarolinaCannabinoid’s “Relax & Sleep” and “Energy & Focus” that are themselves offered as “THC-free.” Terpene-only blends are also available that are formulated to mimic the content of popular marijuana strain (See: Terpenes).

For more information on dosing, See: Marijuana Dosing & Marijuana Dosing: “Pot” vs Pharmaceutical Cannabis

Ilera THC/CBD Tinctures (30 ml bottles): Shine and Shine+

The Ilera balanced  “Shine” THC/CBD tinctures come in 2 concentrations of balanced proportions of equal amounts of THC and CBD along with the terpenes. The dominant terpenes in these formulations are pinene and limonene (citrus flavored):

1. 1. 150 mg bottle: 5 mg THC & 5 mg CBD/ml (Shine)
      
   2. 300 mg bottle: 10 mg THC & 10 mg CBD/ml (Shine+)
      

Ilera THC-only Tinctures (30 ml bottles): THC+ and THC++

The THC-only tinctures come in 2 concentrations (without flavorings, additives, or terpenes):

1. 1. 1. 300 mg bottle: 10 mg/ml of THC (THC+)
         
      2. 600 mg bottle: 20 mg/ml of THC (THC++)