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Dear Nurse Susan

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Cannabis, Sleep and Choosing Products

October 16, 20234 min read

DNS – Help…I need something to help me sleep!

 

Dear Nurse Susan,

I went to a dispensary for the first time to get something to help me sleep, and was overwhelmed by the number of products to choose from! Can you narrow it down for me? Sincerely,

-Overwhelmed


Dear Overwhelmed,

The first visit to a dispensary is often overwhelming, and can create uncertainty when you’re not sure what you are buying. You’ll typically turn to the dispensary staff for assistance and some are definitely better informed than others, which makes things even more confusing. Whenever you are buying cannabis products, there are four things to consider:

1.     Safety: Ask to see the lab results to confirm the product is safe, without pesticides, mold or bacteria. Reputable companies lab test their products and will post the Lab Report on their website. If the company does not lab test their products, does not make tests readily available, or post expired lab reports, do not use that product! These are likely  low-quality products, especially over-the-counter CBD/hemp products. Buyer beware!

2.     Cannabinoid Profile: There are hundreds of cannabinoids and terpenes (therapeutic compounds) in cannabis, the most popular being THC, CBD, THCV, and CBN. Each cannabinoid has its own therapeutic effects, although their effects often overlap. For example, THC and CBD both alleviate pain, but for severe pain, you want to use equal parts THC and CBD.  It is a good idea to consult a cannabis nurse for education and consultation on cannabinoid and terpene profiles that best relieve your symptoms.

3.     Method of Administration: The method of administration is not just a personal preference. Each method has its own time to onset, duration of action, and bioavailability. Many times, a patient will use more than one method. For example, for immediate relief (rescue medicine) of nausea, pain, etc., vaping is the best method, because the time to onset is within 15 seconds, but lasts for only a couple of hours. Once the nausea is under control, utilize an edible or tincture for more sustained relief. For sleep, you may want to use an edible because, although they have a slower onset (up to 2 hours) they last up to 6-8 hours.

4.     Cost: Medical cannabis can be very costly, and insurance doesn’t reimburse. So, how do you know if a product is overpriced? Figure out how much you are paying per milligram of cannabis. For example, if a 30ml tincture has 500mg of cannabinoids (THC, CBD, etc.) and costs $50, you divide the cost by the number of milligrams, which in this scenario comes to $0.10/mg. The average cost per milligram for tinctures/sprays is between $0.10 - $0.20/mg. For full extract cannabis oil, the average cost is between $0.03 - $0.06/mg. Expect to pay more for CBD-rich products than for THC-rich products.

Back to your sleep issue, are you having a hard time falling asleep or are you waking in the middle of the night and can’t get back to sleep? Ideally, what I mention above regarding edibles can work for both. If you take an edible approximately ten hours before you want to wake up two things should happen. First, you should fall asleep in one – two hours after ingestion. Second, it should keep you asleep through the night.

Please note, this is where experimentation and proper dosing come into play. Both the amount of THC/CBD/CBN to take and the time until it impacts you differ for each of us. If it’s dosed appropriately, you will not be groggy when you wake up. Please be careful with edibles! Since they take a while to take effect, people often keep eating them, thinking they aren’t working. Don’t do this…it will not be fun!

For sleep, use Indica strains. Tahoe OG and Granddaddy Purple are two strains that are recommended for sleep. See this article for more sleepy strains… https://www.leafly.com/news/strains-products/the-best-cannabis-strains-for-insomnia

If you follow the steps above, you will considerably narrow down your options at the dispensary. Like any medication, cannabis works differently for each person. It takes some experimenting with different products, doses and methods of administration, plus some patience, to discover the best solution for you. In my opinion, it’s worth the effort!

Overwhelmed, I hope this simplifies your cannabis journey and gets you some sleep!

Warmly,

Nurse Susan

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Susan Edith Marks, MSN, FNP-C, PHN

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