How Do I Choose the Medical Cannabis Product That’s Right for Me?

If you’re new to cannabis-based medicine, trying to figure out the best medical cannabis product to treat your condition can be downright confusing. In some states, product names range from humorous (Zombie Killer OG, Barack O Bubba, Crouching Tiger Hidden Alien) to downright awful (Green Crack, AK-47), but how does a patient determine what strain or product is best for them? Will Harlequin treat my inflammatory bowel disease? Is Zombie Killer OG useful for chronic pain?

Thankfully, things are much more straightforward in New York and much easier to understand. Especially with the Vireo staff and our three-step, user-friendly process to help determine the best medical marijuana products and dosage for you.

Most conventional pharmaceuticals that you may be familiar with are made up of a single active pharmaceutical ingredient (API), while cannabis is a highly complex plant with many dozens of active ingredients (known as cannabinoids and terpenes). This complexity is largely what enables cannabis to be so therapeutically versatile. Some might argue cannabis is Mother Nature’s medicine cabinet. But, cannabis’ myriad of natural ingredients — along with the dizzying varieties of strains and product names — present challenges to most patients who are trying to find relief for their symptoms.

The fact is, there is no “one-size-fits-all” treatment. Because cannabis is natural and comprised of so many active ingredients, finding the best medical cannabis product and dosage for your particular condition often requires a bit of trial and error.

So what’s a patient to do? Thankfully, the medical team at Vireo — which is comprised of leading physicians, pharmacists, and scientists in the field of medical cannabis — devised a three-step process and created an intuitive reference tool (the Vireo Spectrum™) to simplify the patient experience.

Step 1: Determine the Optimal Cannabis Chemical Profile Starting Point for Your Condition

Currently, the most important factor in finding the right treatment for your condition and the best way to ensure you are getting the same treatment every time is the ratio of the major cannabinoids THC (Δ9-tetrahydrocannabinol) and CBD (cannabidiol). While Vireo products still contain the other 104+ cannabinoids in the plants, dosing is mainly focused on THC and CBD which are the most-studied cannabinoids for treating disease.

THC is the only cannabinoid responsible for the intoxication (“high”) associated with cannabis. If you’re choosing a THC-dominant medical cannabis product, our pharmacists will help you choose a level of THC in our products that will minimize the risks of side effects including intoxication and the risk of inadvertent over-medication. Also, it’s helpful to know that CBD can potentially eliminate many of the side effects commonly experienced with THC.

When examining your options, consider your condition. According to Vireo’s chief medical officer, Dr. Stephen Dahmer, high CBD medical cannabis products are best for epilepsy. THC dominant products, on the other hand, are preferred by patients with chronic pain or who are undergoing palliative cancer care to help with the symptoms of nausea, vomiting, and low appetite. Medical cannabis is remarkably nuanced (each patient can benefit from very different ratios and very different doses for very different conditions). Our experienced pharmacists are a tremendous resource to help you find that optimal dose, stay at that optimal dose, and avoid side effects and complications.

Of course, don’t ignore personal preferences and your unique physiology. Are you new to cannabis? If so, you may want to start with a medical cannabis product that is higher in CBD and lower in THC, or at least more balanced. If you’re suffering from a condition that may be more responsive to THC, you can always work your way up over time. Medical cannabis is a unique medical treatment in that the body develops tolerance to side effects faster than it does to the therapeutic benefits.

To find medical cannabis products that match your optimal cannabinoid ratio (THC to CBD), don’t put much stock in imprecise strain classifications like indica, sativa, and hybrid. These groupings can be misleading as (contrary to popular perception) they have little to no correlation to how much THC or CBD is in a product. If you have previous experience with marijuana, be sure to share that with your medical cannabis pharmacist. Based on many factors, most important of them being your input, they can help you find your ideal treatment, which may include more that one ratio.

Trust, but verify. If you’re not working with a Vireo physician or pharmacist, don’t just take the retail representative’s word for it. Ask to see lab testing that clearly shows how much CBD and THC are in the product.

If you’re sourcing your medicine through Vireo, all Vireo medications and required by law to be third-party tested. The Vireo Spectrum™ eliminates the mystery and makes identifying different ratios simple.

Dr. Dahmer explains:

Anyone that has dealt with medical cannabis quickly learns that this is remarkably individualized, and far more nuanced than any medication physicians have ever used. Person A, who weighs the same amount and is maybe born in the same year, and might even be the same sex as Person B, could have a very, very different therapeutic approach.

Our pharmacists are trained in cannabis-based medicine and have a lot of experience in helping patients find their ideal treatment by utilizing many tools. By incorporating the Vireo Dosing Algorithm, their own experience, as well as important patient and physician input, Vireo pharmacists then use the patent-pending Vireo Spectrum™ to help the patient identify the optimal ratio. When we find that therapeutic window as we guide a patient to that right sweet spot, they’re able to come back to our dispensary a week later, two weeks later, 30 days later, and get the exact same product at the exact same dose. We help our patients focus on what works for them while avoiding side effects.

The Vireo Spectrum™

The Vireo Spectrum™ is broken down into five color-coded medical cannabis product lines:

• Vireo Red products feature mostly THC and lesser amounts of CBD
• Vireo Yellow products feature mostly THC and moderate CBD
• Vireo Green is balanced, or a 1:1 ratio of THC to CBD. Green is the most common starting point for Vireo patients
• Vireo Blue products are mostly CBD and moderate THC
• Vireo Indigo products are high CBD and lesser amounts of THC

Vireo’s developed products for each medical cannabis product line containing a consistent and predictable amount of one—or both—of these two most common cannabinoids. Together, these chemicals work synergistically and can have a greater effect than if administered alone.

Step 2: Choose a Delivery Method That Best Suits Your Condition, Needs, and Comfort

Next, let’s talk for a moment about medical cannabis product delivery methods: In other words, how you’ll actually take your cannabis medicine.

Though some may previously have interfaced with cannabis by smoking it in “flower” form, that’s not an option Vireo offers (nor suggests) because of the potential for inconsistencies in both dosage and product. And, of course, smoking is a lung irritant, which runs its own potential risks. 

Here are a few of the most popular administration methods, including the pros and cons of each:

Vaporizers

Vireo offers oils and cartridges that can be administered with a slim “pen” that delivers inhalable vaporized cannabis oils. While it’s the fastest-acting method, the medical effect is also of the shortest duration. Vaporization, however, is great for providing instant relief. Also, because it affects you immediately, it’s the easiest method to self-titrate (adjusting your own dosage according to need).

Note that as vaporizing provides fast relief and effects, it is immediately acting on the brain’s reward pathways, so it is potentially more habit-forming than other methods. (Cannabis has a low potential for abuse, but some estimates show roughly 9% of users do develop dependency.) If a patient is at increased risk of dependence, they should feel comfortable sharing that with their physician and the Vireo team, and likely choose a different method.

Oral Solutions and Capsules

These products include a liquid or capsule made of cannabis-derived medicine. Oral solutions can be placed in the mouth and either swallowed or absorbed to some degree in the mouth itself. Capsules, of course, can be swallowed.

These medicines are longer-lasting than those delivered by vaporizers, but the onset—the time before the medicine takes full effect—is slower, sometimes up to two or three hours. It’s important to observe this waiting period before taking another dose.  

These methods may be unsuitable for patients with nausea, vomiting, or who have trouble tolerating oral (by mouth) medications for another reason.

Topicals

These are cannabis-infused creams and lotions applied directly to the skin to target pain areas. They are not intoxicating and are especially popular with seniors.

These products have been approved in New York, but are not yet available.

Topicals are gentle and efficient, and the onset of action takes place within minutes of local administration (e.g. creams applied to a joint), with the duration of effects lasting approximately one to two hours.

Vireo will work closely with you to determine which medical cannabis product type is the best match for you based on your condition and personal preference. For instance, if you’re concerned about the potential effects of THC on your performance at work, we’ll help you select a product and administration method to help minimize your side effects.

Step 3: Prepare for a Bit of Trial and Error

While the complexity of cannabis means there’s no single medical cannabis product and intake method that’s best for every person and condition, the Vireo Spectrum™ and intake methods eliminate much of the trial-and-error typically associated with finding the right cannabis medicine. Nonetheless, as we mentioned before, everyone is different, and it may take a bit of trial-and-error to find the ideal cannabinoid ratio and intake method that works best for you. Don’t be discouraged if you don’t see as much relief as you might expect on the first go.

Whatever product and intake method you choose, we’d like to remind you of a simple phrase:

“Start low. Go slow.”

This means that we advise patients to start with a very low dose and wait enough time for the effects to take hold. We understand that our patients are looking for immediate relief and we do our best to help them achieve that. However, it is preferred to underdose and increase until a patient feels the right effect, rather than rush ahead and cause both unwanted and unnecessary side effects. This safe approach to dosing is similar to many other traditional medications, and it will go a long way towards ensuring you get the safe, desired effects you’re looking for with cannabis medicine. One of the most important aspects of medical cannabis when compared to other accepted treatments, especially those for pain, is that there has never been a record of a death caused by medical cannabis overdose.