The medical benefits of cannabis (and its active ingredients like THC and CBD) are hard to deny. So if cannabis is working well for your medical conditions, you might think that the more cannabis you take the better it will work at relieving your symptoms. But is this true? In the midst of a cannabis market with increasingly potent cannabis options, some are choosing a different route. Instead of increasing their cannabis intake, they are scaling it back with something called “microdosing.”
What is microdosing? Microdosing is the practice of taking a much smaller dose of a medication than is normally used. It's a practice used with all kinds of compounds, but most often discussed with psychoactive substances such as LSD. Recently people have started to apply the practice to cannabis and its popular ingredients, THC and CBD. One recent clinical trial found that microdosing just 1 mg of THC, and even 0.5 mg, was effective at relieving chronic pain.
One reason for microdosing cannabis is that taking a small amount may help to access its helpful effects without engaging negative side effects like a psychoactive high. But microdosing cannabis is also helpful for those who are trying to avoid triggering the wrong side of something called a biphasic effect. When a substance (like THC) has a biphasic effect, it means that it can produce two opposing effects depending on the dose of the substance taken. Consider, for example, alcohol, which at low doses might make someone feel a bit energized, happy, and chatty but at high doses might leave them sedated, depressed, and antisocial. For many substances, these biphasic effects are important because the dose taken can drastically impact the effect it has on the human body. And with cannabis, multiple biphasic effects have been noted.
Cannabis' biphasic effects Cannabis' two most common and popular ingredients, THC and CBD, have been noted to have a variety of biphasic effects. One of the most commonly reported biphasic effects from cannabis is THC's effect on anxiety. While many report cannabis can help ease their anxiety, others say that it makes them more anxious and paranoid. The science supports these claims, showing that dosing can make a big impact on how cannabis and its components affect anxiety. Studies on both animals and humans have found that while lower doses of THC tend to relieve anxiety, higher doses can spike it. For example, in one animal study, mice given low doses of THC spent more time in open areas than controls (an indication of reduced anxiety), while those given high doses of THC spent less time in these stressful spaces (suggesting increased anxiety). In one human study, a group of 42 patients was given a placebo, a low dose of THC (7.5mg), or a high dose of THC (12.5mg). Then they were subjected to various stress-inducing tests and asked to rate their stress. Those in the low THC group showed reduced stress during these tests, but those who had the higher dose were more likely to have increased stress. In another human study, a group of incarcerated patients with PTSD were given even lower doses (4mg) of the synthetic cannabinoid Nabilone, which mimics THC's effects. Researchers found this low dose resulted in significant improvement in PTSD-associated insomnia, nightmares, general symptoms, and even chronic pain. Still, despite success in treating anxiety conditions at these lower doses, the average dosing for cannabis products is around 10mg, which might be too high for some. And it's not just anxiety that can benefit from microdosing. Biphasic effects from THC have been noted for pain, temperature regulation, motivational processing, appetite, novelty-seeking, and locomotion and exploration. Biphasic responses have also been found for CBD with effects like pain, sedation, nausea and vomiting relief, and immune responses. For many of cannabis' effects, a lower dose might be the most effective option.
How to microdose cannabis Microdosing can be very helpful for some, and the research on biphasic effects suggests it could be particularly helpful for patients dealing with pain, appetite, energy, or mood-related issues like anxiety and depression. As we've seen above, all of these issues are common reasons for cannabis use that have strong dose-dependent biphasic reactions. So microdosing can be a great way to hone in on an optimal dose. With microdosing, patients are advised to use the smallest dose that they can, which might be a small puff with an inhaled method like smoking or vaping, or a dose around 2.5 mg for edibles or sublingual options. There are few downsides to microdosing cannabis (when compared to taking larger doses) in terms of risk factors, but for some, microdosing might not be the best option. Some patients actually do need a larger dose to effectively manage their condition. Take for example, studies on migraines, which show that relief is usually achieved only after high doses (around 20mg). Still, in the process of finding the optimal dose, starting with microdosing can be helpful. By starting low, patients can slowly increase their dose until they find an optimal range. As they go up, they may find that the symptoms they are treating improve. But at a certain point, if they continue to increase, they are likely to hit a dose where the cannabis is actually causing negative symptoms. If this happens, they can return to the last dose that relieved their symptoms. For some, a microdose may actually be the most effective option. This is important because there can be big differences in how individuals respond to cannabis. In addition to condition-related differences in the cannabis needed, there are also differences in how sensitive individuals are to the effects of cannabis because of genetic differences and differences in previous cannabis experience (which can make you tolerant to its effects). So an optimal dose for one patient might be 2mg while for another patient it might be more like 20mg. Either way, if you aren't sure what your optimal dose is, starting low and slowly increasing is the best way to find out.