Why we start low & go slow

Prescribing medical cannabis is not a straightforward matter. Even when the many legislative hurdles are overcome and a medical cannabis prescription is ready to be written, there are a number of factors that have to be considered to ensure that patients get medical cannabis care that is as safe and effective as possible. 

This is why doctors at our clinics create a rational cannabis care plan for patients where many different factors are considered before prescription takes place. In addition to the patient’s conditions and symptoms, factors that our doctors will consider when assessing the patient in question include:

• Whether the patient is cannabis non-naive (due to self-medication or recreational use) or naive (they’ve never used cannabis) prior to treatment
• What the most appropriate form of administration/ingestion would be for the symptoms in question
• What specific product would be best in each instance, with this depending upon the product’s cannabinoid make-up and its batch-to-batch consistency levels amongst other factors
• Whether daytime or nighttime dosing would be most appropriate for the symptoms being experienced 
• Whether the patient is taking any other herbal supplements or drugs
• The patient’s diet

Another crucial thing that our doctors will have to carefully consider when looking to prescribe different medicines is their THC to CBD ratios. 

In a lot of cases, medicines that have higher CBD levels and very little THC are initially prescribed for patients, as these medicines generally considered very safe and easier to start treatment on (particularly if the patient is cannabis naive) as they’re non-intoxicating and have a lower risk of adverse side effects than THC heavy options. 

While these medicines are of course considered to be very effective for a wide range of conditions, some patients may require more THC-heavy medicines over time to continue counteracting their symptoms. 

Starting low and going slow

Due to this relatively common need to make medicines increasingly THC heavy over time, a general prescription rule our doctors follow is to ‘start low and go slow’. 

In essence, this method entails initially prescribing patients medicines with higher CBD formulations before gradually introducing and increasing the levels of THC as required to suit the patient’s evolving needs if they become more tolerant to the original medicines. 

Although starting low and going slow is a method that may be used in some cases, this doesn’t stop different CBD and THC ratios being required in different cases depending upon the conditions being treated. For instance, while high CBD strains are typically used for the treatment of medical conditions like anxiety, treatment-resistant epilepsy, Crohn’s disease and multiple sclerosis, a balanced THC to CBD ratio may be more useful for treating conditions and symptoms like insomnia and muscle spasms. 

More THC dominant strains are often considered more effective than lower THC formulations for post-chemotherapy treatment and the treatment of chronic pain due to THC’s appetite increasing and nausea reducing qualities. However, it’s likely that the ‘start low and go slow’ approach would still be adopted when starting to prescribe these higher THC medicines, with CBD being used to counteract any anxiety that may occur with more THC-heavy medications.

It should also be noted that not everyone needs to escalate their THC consumption over time, as many will find that the initial medication prescribed continues to be effective. This is just an appropriate method to be used with some conditions in some cases.     

Overall, we feel that the ‘start low and go slow’ method allows us to provide a safe, patient-driven approach to prescribing cannabis-based medicinal products, which, when used in combination with our ongoing monitoring and adjusting of medication through follow-up appointments (after a week and then every month, for three months after receiving a prescription) means patients receive the most effective medical cannabis treatment possible with the fewest possible side effects.  

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We only recommend taking cannabis-based products following a consultation with a medical professional, and do not advise patients on the recreational use of any cannabis-based products. 

At Lyphe, our GMC registered specialists will identify the appropriate cannabis medicine care plan and products for patients following a comprehensive assessment which includes an in-depth evaluation of the main symptoms being targeted, current medications, pattern of symptoms and lifestyle factors such as safety-sensitive occupations. 

They will also monitor and adjust the medication on a regular basis to ensure the best effect with the fewest side effects. There is also a carefully designed process in place to monitor patients’ well-being, with follow-up appointments after a week and then every month, for three months after receiving a prescription.

To register for treatment with our specialists click here.