Frequently Asked Questions
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Cannabinoids are the main active ingredients in the cannabis plant. More than 100 have been identified. These ingredients are similar to the endocannabinoids produced by the human body and can be used in prescription medications. Two of the most well-known cannabinoids are THC and CBD, but all the cannabinoids have therapeutic potential research is still determining the real value of them. Cannabis also has terpenes which have therapeutic potential and are useful to be combined with CBD and THC to achieve different effects.
THC (or delta-9-Tetrahydrocannabinol) is the main active ingredient in cannabis. It’s responsible for many of the pharmacological effects of cannabis – including its psychoactive effect.
CBD (or cannabidiol) is cannabis’s second most prominent compound. Unlike THC, it’s not known to cause intoxicating or euphoric symptoms. In fact, it helps counteract these effects.
Cannabis should be avoided in the following:
- Children except for CBD/low THC products for intractable epilepsy
- Adolescents (< 20years and < 25 in young males)
- Pregnancy and Breast-feeding Mothers
- Those with unstable psychiatric conditions and where high risk of psychosis or schizophrenia (including family history)
- History of suicide attempt or suicide ideation
- Severe cardiovascular disease (arrhythmia/post MI)
- Post stroke
- Immunological conditions (especially liver related)
- Cirrhosis-Hep C related
- Kidney Disease
- Cannabis Use Disorder (THC)
As THC works on receptors in the brain, there is the potential for medical cannabis to have an additive sedation effect with other medicines that work on the brain such as antidepressants, alcohol, benzodiazepines and opioids.
There are a number of potential drug-drug interactions with cannabis-based medical products and other medicines or substances that are, metabolised through the cytochrome P-450 isoenzymes. Therefore, caution should be taken when cannabis-based medicines are co-administered with any medications that are CYP inhibitors or inducers.
However, clinically significant drug interactions are rare and there is no drug that cannot be given with cannabis if necessary.
There are two medicines that do require extra monitoring if given with medical cannabis medicines:
- High dose CBD and clobazam, where a dose reduction of the clobazam may be necessary.
- Warfarin: TBC and CBD increase warafin levels so INR monitoring is recommended during starting medical cannabis and white increasing the dose until effect is achieved.
Inhalation or smoking produces a quick response but wears off within several hours. It is good for rapid effect.
When using oils or soft gel capsules it’s important to start with a low dose and take it slowly – as the effects can be stronger and last much longer than through inhalation.
Depending on your metabolism, and how recently you’ve eaten, medical cannabis oil and soft gels can take 1-3 hours or longer to start working. The effects can then last 6-8 hours or longer – which is particularly useful at night, when longer periods of relief may be required.
|Onset||5-10mins||5-10mins||1-3 hours||15-45 mins||Variable|
|Duration||2-4 hours||2-4 hours||6-8 hours||6-8 hours||Variable|
|Bioavailability||2-56%||40%||6-20% (due to 1st pass Metabolism)||20%||5% systemic|
Your doctor will start you on low doses and slowly increase to 2-3 doses each day. They need to consider whether you have had cannabis before, what condition they are treating and therefore what composition of cannabinoids or terpenes they feel will treat your condition best.
If you experience symptoms like anxiety, nausea, dizziness, vomiting, or fainting, it’s important not to panic. Focus on your breathing, stay hydrated, eat something, and find a safe place to relax. Depending on your method of medical cannabis consumption, the effects should wear off on their own within 2-6 hours.
If you experience a severe reaction – such as chest pain, or persistent vomiting or dizziness – call 111, or go directly to the nearest hospital. Let your doctor know as soon as you’re able to.
Decarboxylation is the process of heat-activating cannabinoids by smoking or vaporising the plant matter above 120°C. Decarboxylation changes the acid form of` the cannabinoids into the CBD and THC – and all Eqalis oils and soft gels contain cannabis oil that’s already been decarboxylated.
“Indica” and “sativa” are botanical terms that describe the morphology (i.e. the shape) of different cannabis plants. They’re also often used to describe the range of possible effects of a cannabis variety. Some use the term “indica” to describe more sedating effects, and “sativa” to describe more energising effects. These terms aren’t scientific but can be a useful reference.