An extract from a Wild Rose College’s online course: Cannabis: An Introduction for Healthcare provider, starting mid-January 2020.
In One Toke Over the Line: part 1 of this blog, we discussed briefly some of the substances that could reduce symptoms of THC over-dose.
Substances that have been shown to reduce side effects
- Exercise
- Food and Water
- Black Pepper
- Lemons (containing terpene limonene)
- Pine nuts (pinene).
- CBD
- Chocolate
- Kava
- Smoke a small amount of Calamus (Acornus calamus)
- Caryophyllene
- Medicinal Mushroom: Reishi, Cordyceps, Lion’s manes
Other Phytocannabinoids to consider are:
- THCV
- CBG
- CBC
- CBCV
In this section we will look at possible forms of administration.
Goal to Create an Action of Reducing Symptoms
There are really only 5 ways to reduce perception of THC action.
- Time
- Reduce absorption
- Block or antagonize receptor site
- Slow down metabolism of THC in the system
- Distraction
Time itself to clear the THC from the system, is not a solution as a person in acute overdose situation want some positive action in the direction of reducing it in a very short period of time. Absorption is not function for inhaled product as that train has already gone. When it is ingested, especially in two or more doses, as often is the case in edibles when a person feel they didn’t get enough because of the delay action. Slowing down digest with a bit of distraction helps here. The idea of drinking lots of cold water, both slows down digestion of oil soluble substances like cannabinoids and further reduced absorption. Slowing down metabolism can be achieved with sedative botanicals, medicinal mushrooms (Reishi, Lion’s Mane), cannabinoids (especially CBD and THCV) and terpenes, but might conflict with symptoms that included ataxia. Distraction is a very viable, but a short-term solution that carries strong placebo effect. Blocking or antagonizing receptor sites and or Endocannabinoid System (ECS) in general seems to be the best option. So, by increasing competition for receptor site activity or antagonizing it is our best option. Possibly combined with other lesser function.
Conflicting Symptoms of THC overdosing
When it comes to overdosing complaints of THC there are two sets of semi-conflicting symptoms. We can split them into two to three camps.
The Yang camp: of over stimulation, needing a sedative action to clear:
Tachycardia, Increased blood pressure, Increased respiratory rate, Nystagmus (involuntary eye movement) Anxiety, Paranoia
The Yin camp: of being too relaxed, desiring a stimulant or at least not a sedative action:
orthostatic hypotension, Ataxia (Couch-lock), Slurred speech
Symptoms of toxicity: Conjunctival injection (red eye), Dry eyes, Dry mouth Increased appetite
Myrcene: Rich with tranquilizing effects and positively abundant in a myriad of strains, offers sweet relief when winding down for the night. Pair this famously anti-inflammatory terpene with herbal concoctions containing medicinal mushrooms, lemongrass, passion flowers or hops for a powerful calm that may put those numbered sheep to rest. This terpene can be found in many cannabis strains.
Caryophyllene: Spiced and peppery, caryophyllene reduces pain and quells stress, which makes it perfect for silencing those worries keeping you up at night. Bonus? You can get a pain-relieving boost when consuming cannabis products filled with this terpene.
These two terpenes are good for reducing symptoms from the yang camp; but might enhance, or even be partially responsible for symptoms in the yin camp.
Pharmacokinetics
There are several delivery systems for formulas related to reducing symptoms:
- Inhalation
- Ingestion
- Sublingual
- Suppository
- Absorption (topical)
We can pretty much ignore both ingestion and suppository due to lag-time for bioactivity is either too slow or too inconvenient for acute use.
Inhalation: is the best and fastest route with the shortest bioactivity curves suitable for acute action. The problem is that many people that feel too much of a buzz want to shun smoking, as they associate it with get too high in the first place. Carrying a strong nocebo effect.
Sublingual: is a good choice as its action is fairly fast and easy to apply. This might be best applied to homeopathic dosages.
Topical absorption: is slow and poor, but when related to aroma its action can be very effective, carrying a strong placebo effect.
Intranasal: is a good option as it can absorb fast and feels like a medicinal cure (placebo effect).
In our next blog we will get a little deeper into the mechanisms of the various methods.
to be continued . . .