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What is THC tolerance?

What is THC tolerance?
April 29, 2024
7 min read

THC tolerance refers to the reduction in effectiveness of medical cannabis due to the regularity of its use. Tolerance is something that occurs across all drugs and prescription medications, as well as with non-drug-related stimuli such as food and pleasurable activities. THC tolerance is something that can be managed, provided that one understands how it works. In this article we aim to demystify THC tolerance and provide useful information for maintaining the effectiveness of plant-based medicine over time.

What is THC tolerance?

How does tolerance work?

Tolerance to THC is a desensitisation which happens with other stimuli too – a good example is with chilli. If chilli is eaten with every meal, you will find that soon enough more and more chilli is needed for it to taste spicy and feel satisfying. The same thing happens with drugs and medications like cannabis. It’s how our bodies maintain balance in a process called homeostasis.

When THC and cannabinoids are consumed regularly, the body attempts to maintain homeostasis and restore normal functioning. To do this, it decreases the amount of available CB receptors (cannabinoid signalling structures) in response to repeated stimuli, decreasing the effect of THC. This process is called receptor downregulation and results in the development of tolerance.

How to tell if tolerance is an issue

Patients often question if their cannabis tolerance is impacting their health outcomes. There are several tests you can apply to your cannabis use to assess if your tolerance levels should be a cause for concern.

The primary considerations regarding tolerance are:

Changes to frequency of dosing or duration of effect

An increased tolerance will result in needing more frequent dosing to achieve the desired result — perhaps experienced as a reduction in the duration of effects from vaporised flower, diminishing from 4 hours to 2 hours.

Changes to size of dose

As with the frequency, tolerance leads to requiring a greater dose to achieve the same effect. Patients may start on a fraction of a gram per day only to find some months later that they require a gram or more to experience the full effect.

Reduction of relief

Tolerance doesn’t just affect the frequency and size of doses — it can also affect the effectiveness of the medication in general, even when large and frequent doses are taken.

Quality of life changes

Keeping track of quality of life changes is a good way to measure cannabis tolerance. Consider keeping a diary of your use, mood, and health outcomes to compare your current quality of life with the changes you experienced when first switching to medical cannabis.

What are tolerance breaks?

A tolerance break refers to an intentional break from cannabis for the purpose of reducing tolerance. Tolerance breaks are often associated with the recreational use of cannabis, as medical cannabis patients typically require daily dosing. However, tolerance breaks may still be beneficial for those experiencing reduced efficacy if they are able to take a break from their medication. However, consult with your prescriber before making changes to your dosing regimen.

How long does it take for tolerance to reset?

Exactly how long it takes to lower your tolerance is down to individual chemistry and metabolism. Generally, tolerance begins to decrease around 48 hours after the last use of THC. In order to experience a near-complete reset of tolerance, a break of three or more weeks is necessary. 

Unfortunately, once tolerance has been built, the body will revert to prior tolerance levels much more quickly when the break is over. This is why the best way to avoid experiencing tolerance issues is to work with your prescriber to proactively manage your cannabis use in a manner that is sustainable. There are various methods of “tolerance hygiene” that may help you to continue to experience the benefits of medical cannabis long-term.

Exercise may be a helpful way to speed up the clearance of THC from the body.

Flower rotations

A flower rotation is a selection of prescribed strains that patients rotate through daily. Patients may use a flower rotation for various reasons, typically to manage tolerance, or side-effects such as tiredness and lethargy. 

Some strains of flower are better suited for certain times of day as they promote wakefulness or sedation. To manage this, a common round-the-clock rotation might be:

  • Morning flower (minimally psychoactive, energetic)
  • Day flower (energetic and active, ‘sativa’)
  • Afternoon flower (‘balanced hybrid’)
  • Night flower (heavy ‘indica’)

Flower rotations are often used to reduce tolerance by rotating through several similar flowers to prevent tolerance buildup to a specific product. The same is true for cannabinoid and other receptors – because cannabis is more than just THC, even small changes in the chemical profile of your prescribed strain may result in newfound sensitivity. 

If you have any questions about managing your rotation, speak to your prescriber at your next consultation.

Other ways of managing tolerance

Medical cannabis patients who require continual use of cannabis often employ other methods to manage tolerance.

One such method is the use of CBD flower. CBD flower only contains trace amounts of THC, and still provides some of the medical benefits of cannabis (depending on the medical condition of the patient). This means that briefly replacing THC flower with CBD flower (under the supervision of your prescriber) could lead to the reduction of tolerance without the need for an extended break.

Despite still containing THC, patients often find that tolerance to THC oil and THC flower can be somewhat separate. If a patient is used to vaporising cannabis regularly and consumes even a small dose of THC oil, they may experience unexpectedly strong effects.

Dr. Dustin Sulak’s Cannabis Sensitisation: 6-day Protocol

Dr. Dustin Sulak is a Maine-based integrative medicine physician, internationally regarded as an expert on medicinal cannabis.

This Cannabis Sensitization 6-Day Protocol was developed by Dr Sulak to quickly reduce or reset cannabis tolerance without requiring a several week-long break.

The full protocol can be found through the above link, but here is a simplified version:

It is important to remember not to make changes to your medication regimen without consulting with your doctor. If you have any further questions on tolerance or your prescribed medication, please consult with your doctor at your next appointment.

 

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Disclaimer

Please note that this blog was not written by a licensed medical practitioner and therefore is not providing medical advice. We do not endorse the use of cannabis or any other illicit drugs. Like any medication, cannabis has potential negative side effects and should only be used under the guidance of a qualified medical professional. For the latest information on cannabis prescription and use, please visit the TGA website. If you are considering cannabis as a treatment option, we encourage you to consult with a licensed healthcare professional.

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