There is no standard dose of cannabis oil for chronic pain. The FDA has not approved any cannabis oil for pain. Clinical trials use different doses. A common starting dose is 1 mg to 2.5 mg THC and 5 mg to 10 mg CBD per day. Increase the dose in steps over 1 to 2 weeks.
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Why no standard dose exists
Cannabis oil is not a single drug. It contains THC, CBD, and other compounds. The amount of each compound varies by product. The FDA has approved one cannabis product, Epidiolex, for seizures. It is not for pain. This lack of approval means no official dose for chronic pain.
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What clinical trials use
Trials of cannabis for chronic pain often use oral sprays or oils. One common product, nabiximols, has 2.7 mg THC and 2.5 mg CBD per spray. Trials allow up to 8 sprays per day. That equals 21.6 mg THC and 20 mg CBD per day. Other trials use 5 mg to 25 mg CBD per day. Doses above 25 mg are less common.
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THC and CBD ratios
THC and CBD have different effects. THC can cause intoxication, drowsiness, and dizziness. CBD does not cause intoxication. A 1:1 ratio means equal amounts of THC and CBD. A 1:20 ratio means more CBD than THC. For chronic pain, some people start with a 1:1 ratio. Others start with CBD alone. There is no proof that one ratio works for all pain types.
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How to start
Start with a low dose. Take the oil at the same time each day. Use a marked dropper or syringe. Measure the amount in milliliters. Check the product label for mg per milliliter. For example, a 10 mL bottle with 300 mg CBD has 30 mg CBD per mL. A 0.5 mL dose gives 15 mg CBD.
- Day 1 to 3: 1 mg THC and 5 mg CBD per day.
- Day 4 to 7: 2 mg THC and 10 mg CBD per day.
- Week 2: 2.5 mg THC and 15 mg CBD per day.
Stop increasing if pain drops or side effects appear.
Track effects and side effects
Keep a log. Write down the dose, time, pain score, and side effects. Pain scores range from 0 to 10. Side effects include dry mouth, red eyes, dizziness, and drowsiness. If side effects last more than 2 days, lower the dose. Do not drive or use machines after THC.
Risks
Cannabis oil can interact with other drugs. It can raise the effect of blood thinners, benzodiazepines, and opioids. It can lower blood pressure. Some people have anxiety or paranoia with THC. Long-term effects on memory and mood are not known in full. Do not use cannabis oil if you are pregnant or have a history of psychosis.
Talk to a doctor
Tell your doctor about all cannabis use. Your doctor can check for interactions. They can help you adjust your dose. In the U.S., cannabis is illegal under federal law. State laws differ. A doctor in a legal state may give guidance.