An In-Depth Practitioner’s Guide on THC Tinctures

An In-Depth Practitioner’s Guide on THC Tinctures

 

THC tinctures are cannabis products in liquid form. They’ve risen in popularity as reputable options for various medical conditions. Their therapeutic potential is clearer today thanks to modern research capabilities.

 

Prescribing medicinal cannabis in Australia has become easier since legalisation. Many patients have experienced positive results, but the landscape is still controversial.

 

It’s vital as a medical practitioner to practise providing evidence-based prescriptions. Your decisions should always keep patient well-being in mind.

 

Our prescribing guide covers all you need to know to make informed decisions. We explore the science behind THC, why tinctures are viable options, and how to dose them. You’ll also find resources to help you keep updated with the cannabis landscape.

 

Understanding THC: Key considerations for medical practitioners

 

Tetrahydrocannabinol (THC) is a prevalent cannabinoid in cannabis plants. It’s responsible for the well-known psychoactive effects but also provides therapeutic benefits.

 

Cannabidiol (CBD) is also a cannabinoid but isn’t psychoactive like THC. It doesn’t alter an individual’s perception or cognition and is more accessible. CBD ointments, creams, capsules, tinctures, and edibles are available in general health stores.

 

THC tinctures aren’t available for recreational use in Australia. The country only legalised medicinal cannabis in 2016, with strict regulations. There are several legal considerations for medical practitioners to keep in mind.

 

Knowing the fundamentals of medical cannabis is the first step in understanding THC. Many concerns still surround the cannabinoid. Education is the best way to break down the stigmas that exist.

 

Appropriate dosing of medicinal THC is vital when adhering to the country’s laws. It’s also important to follow correct prescribing practices and patient monitoring protocols. These factors help minimise potential risks and prioritise safety.

 

The Therapeutic Goods Administration (TGA) is the Australian Government’s regulatory agency.1 It provides extensive resources for medical practitioners. Stay updated with the site in your journey toward prescribing THC tinctures. It’s a handy tool to have in your arsenal.

 

Below are seven recognised THC benefits.

 

  • Pain relief. THC has analgesic properties. It may help alleviate pain, particularly from conditions like neuropathy, arthritis, and cancer. A 2015 review found chronic pain patients experienced a 40% reduction in symptoms.

 

  • Nausea reduction. THC has antiemetic properties. It may reduce nausea and vomiting in individuals undergoing chemotherapy. It could have the same effects in patients with other medical conditions.

 

  • Improved sleep. THC may provide relaxing effects. Its soothing properties could help patients with insomnia or restlessness. Patients may fall asleep faster and experience fewer nightly disturbances.

 

  • Muscle relaxation. THC may provide relief for patients who experience muscle spasms and spasticity. It could relieve stiff joints and symptoms of conditions like multiple sclerosis (MS).

 

  • Appetite improvement. THC tinctures may stimulate hunger. It could benefit individuals undergoing cancer treatment or facing an HIV/AIDS diagnosis. These conditions typically cause appetite loss or wasting syndrome.

 

  • Mood improvement. Patients with mental health or mood disorders like depression or anxiety may benefit from THC. It could help regulate emotions and thoughts, particularly in low doses.

 

  • Neuroprotective properties. Patients with neurodegenerative disorders like Parkinson’s or Alzheimer’s disease could benefit. Low-dose, short-term THC use may provide neuroprotective effects.

 

Nabiximols (Sativex) and CBD (Epidyolex) are the only TGA-registered cannabis-based medicines.2

 

Sativex is an oromucosal spray formulation with equal doses of CBD and THC. Its approved indication is for treating spasticity from multiple sclerosis.3

 

Epidyolex doesn’t contain THC. It has 100 mg of CBD per millilitre of sesame oil. The TGA approved it for treating intractable childhood epilepsies. Patients take it orally via syringe.

 

Other cannabis-based medicines fall under “unapproved products.” They’re only available through the TGA’s Special Access or Authorised Prescriber Schemes.

 

THC tinctures and other products containing the cannabinoid are Schedule 8 controlled medications. You must get approvals from state or territory health departments to prescribe them.

 

The science behind THC tinctures

 

 

 

Tinctures are cannabis extracts containing THC in liquid form. Patients typically take them orally by applying drops into the mouth. They’re convenient and discreet, providing easy methods for specific dosing and titration.

 

Manufacturers use solvents like palm oil, coconut oil, or food-grade alcohol to make tinctures.4 They steep cannabis leaves in the base liquid for several days. The cannabinoids and terpenes dissolve into the mix, resulting in the final product.

 

Factors influencing THC dosage in tincture form

 

It’s vital to consider your patient’s needs when prescribing THC tinctures. Approach each individual uniquely, as cannabis isn’t a one-size-fits-all medicine.

 

The Minimum Effective Dose (MED) is the smallest working dose for THC. This amount is the minimum necessary to achieve the desired outcome. It changes between individuals depending on various factors. Below are six to remember.

 

  • Patient characteristics. Age can influence the best THC dosage for your patient. Older individuals have different chemical balances and metabolisms. Young adults may tolerate cannabis better than middle-aged people.

 

  • Tolerance. Regular THC users may get used to the effects of the cannabinoid. Your seasoned patient may need higher doses to achieve the same results as a beginner.

 

  • Weight. Patients with more fatty tissue may take longer to experience the effects of THC. Those with faster metabolisms and less fat could feel them sooner.

 

  • Health status. Patients with underlying health conditions may react to THC differently. Those with kidney or liver issues could take longer to process it. Colds and flu can also affect the onset and efficacy of benefits.

 

  • Severity of the medical condition. More serious illnesses may require higher THC doses. Less severe symptoms usually only need a small amount.

 

  • Desired therapeutic outcomes. Therapy goals may differ depending on what patients need from the treatment. For example, the THC dosage for pain relief is unique from the amount needed to boost moods or appetite.

 

The bioavailability of THC tinctures also affects dosing. Different metabolisms and product formulations can impact how the individual’s body responds.

 

Dosing methods and considerations for THC tinctures

 

Tinctures are convenient dosing methods for medical cannabis. They allow for precise and quick application.

 

Oral administration involves dropping the liquid into the mouth and swallowing immediately. The digestive system then needs to absorb it, which may take up to an hour.

 

Sublingual administration is more popular. It enables faster absorption of THC into the bloodstream. It involves dropping the liquid under the tongue and keeping it there for 30 seconds to a minute. Your patient may feel the effects in as little as 10–20 minutes.

 

The effects of oral administration may last longer than sublingual application. Delayed onset also occurs when adding the tincture to food or drinks.

 

THC dosage recommendations and treatment plans will differ between your patients. Tinctures typically have specific cannabinoid measurements on the label. For example, a 10 ml bottle with 100 mg of THC provides 10 mg/ml. A 2.5 mg dose will be 0.25 ml.

 

Below is a standard guideline for THC tincture dosage titration.

 

  1. Start your patient on the minimum dose once daily. Maintain it for two or three days to ensure stability. Inform them they may not feel prominent effects in the beginning.

 

  1. Increase the dose by 1 mg, then monitor the response for another 2–3 days.

 

  1. Repeat this incremental dosage increase until your patient reports the desired outcome. Maintain this amount for several weeks. Tell them to reduce the dose slightly if they experience any side effects.

 

The best advice to give your patients is to “start low and go slow.” The duration of dosage titration depends on how they respond to the treatment. It’s essential to ensure you both align your expectations and goals.

 

Personalising THC prescriptions

 

 

Tailored treatment plans are vital for meeting your patient’s needs and circumstances. It includes thorough assessments, open communication, and vigilant progress monitoring.

 

Patient assessments for THC tincture prescriptions

 

Thorough patient assessments are crucial for THC tincture prescriptions. You need a comprehensive medical history and current medications from them. This information helps determine the best individualised treatment plan.

 

Some health conditions or medications may pose a risk or interact with THC tinctures. They could lead to adverse effects or reduced effectiveness. Common contraindications include a history of psychosis, cardiovascular disorders, or substance abuse disorders.

 

Start by gathering information on your patient’s complete treatment history. Were over-the-counter medications, other prescriptions, and lifestyle or diet changes ineffective?

 

The Special Access Scheme (SAS) lets anyone get medicinal cannabis if other treatments were ineffective. Patients don’t need to exhaust all other options before getting a THC prescription.

 

The TGA has approved over 130 conditions for treatment as of 2022.5 Patients must have a chronic diagnosis to be eligible for medicinal cannabis. It must be ongoing for over three months, and you must provide a valid reason for their script.

 

THC tinctures may have contraindications and potential interactions. Knowing your patient’s treatment and medication history helps keep them safe.

 

Most drug interactions include the Cytochrome P450 Enzymes. These are medicines metabolised in CYP3A4 and CYP2C9 pathways. They also include drugs that interact with CYP1A2.6

 

Avoid prescribing cannabis to your patient if they’re taking any of these drugs. They could inhibit the metabolism of phytocannabinoids and make the treatment ineffective.

 

Below is a list of precautions to note. It may be best to find alternatives to THC if your patient exhibits any of them, or is undergoing any of the treatments listed.

 

  • Sensitivity or allergy to cannabinoids or hemp oil 
  • Hepatic or renal impairment
  • Cancer immunotherapies
  • Bipolar disorder
  • Immunosuppression therapy, like tacrolimus
  • A history of substance abuse
  • Unstable cardiovascular disease and risk factors
  • A history of psychosis

 

Remember to weigh the risk vs. benefit of prescribing THC tinctures to your patient. Each of these precautions could influence the treatment or finding alternatives.

 

Consultation and collaboration with other healthcare professionals

 

Collaborating with healthcare teams is vital when prescribing medicinal cannabis. Specialist consultations can help you and your patient gain extra expertise and guidance. Someone with psychiatric comorbidities or complex mental diagnoses may need psychiatric input.

 

Interdisciplinary collaboration includes working with other healthcare professionals. Pharmacists, primary care physicians, and mental health specialists can help. They facilitate proper plans involving monitoring strategies and medication adjustments.

 

Pharmacists can also provide valuable input on personalised THC prescriptions. Collaborating with them can help optimise your patient’s treatment plan. They also help ensure safe and effective dosing, medication use, and care management.

 

You may also refer your patient to a mental health professional while you’re treating them. Counselling addresses underlying psychological factors in individuals with depression, anxiety, or mood disorders.

 

Monitoring and adjusting THC treatment plans

 

THC treatment monitoring is essential in ongoing care plans. Several factors influence the success of your prescription. These include precise dosing, symptom tracking, patient adherence, and titration management.

 

Regular and consistent patient follow-ups are necessary to ensure successful outcomes. Establish open communication during the first consultation. Explain the importance of discussing all details with you throughout treatment.

 

Monitoring and adjusting THC dosage is the primary focus during titration. Discuss potential adverse effects with your patient and set realistic expectations. Ask them to keep a journal and pay close attention to every benefit or downside they experience.

 

Encourage your patient to consult with you before increasing or decreasing their dosage. Rigorous tracking of their treatment can help you both achieve the optimal prescription.

 

Differences in individual responses to THC tinctures influence treatment customisation. Logging each subsequent prescription also helps you keep track of your professional care.

 

Remind your patient that the benefits may take time. It could take a few weeks of dosage titration to achieve noticeable effects. Don’t focus on a singular overarching goal. Rather, aim to reach a point where both you and the patient are satisfied.

 

Listen carefully to patient feedback. Try to understand their wants, needs, and expectations. Examine all risk factors and be prepared if they say the treatment is ineffective. Consider other medications and whether the dose they’re taking is correct.

 

Create a follow-up schedule for you and your patient to maintain. They allow for fine-tuning dosages, changing products, or combating adverse effects. More frequent reviews are crucial during the initial treatment stages. They may last months before achieving optimal results.

 

Follow-ups become less intensive once your patient is satisfied with the effects. The focus from there should be to ensure the stability of the treatment. Remind them to check in with you if they experience adverse effects or a return of symptoms.

 

Educating patients on THC usage

 

 

Patient education on THC ensures safe and effective treatment and positive outcomes. Comprehensive information is necessary for dispelling common concerns. It also encourages open and candid conversations with your clients.

 

Your patient may already be knowledgeable about THC usage. Remind them that medicinal cannabis varies and goes through rigorous regulations. There may be a significant difference in purity and potency from what they’re used to.

 

Ensure you understand the basics of cannabis, including the body’s endocannabinoid system. Explaining THC’s interaction with your patients can help them know what to expect. Depending on the diagnosis, it also sets a standard for what to expect from treatment.

 

Provide detailed instructions on how to use THC tinctures. Explain the administration methods and how to maintain accurate dosing. Ensure your patients are also aware of potential side effects during titration.

 

Set realistic expectations for your patients, so they understand the treatment goals. Education helps them to make informed decisions and manage their symptoms effectively.

 

Addressing THC misconceptions may be necessary with some patients. They might want to try medicinal cannabis treatment but have legitimate concerns. Explain that careful dosing can provide therapeutic benefits without psychoactive effects.

 

Outline the minor side effects of using cannabis. These include an increased heart rate, dizziness, or dry mouth. Inform your patient that these symptoms are mild and rarely last long. Remind them to tell you if they experience any concerning effects.

 

Informing your patient of THC legalities is also important. They need to know the correct avenues to gain lawful access to their medicine. Remind them they also need to fill their prescriptions at licensed pharmacies.

 

Regulated medicinal THC tinctures differ from unregulated cannabis. Remind your patient that their prescriptions are for high-quality, manufacturing-standard-compliant products. Tell them that the potential long-term adverse effects originate from recreational use.

 

Tell your patient about tolerance and that they should speak to you if their symptoms return. You may suggest a break before continuing treatment again.

 

Advise patients with angina or a previous myocardial infarction against using THC. It may cause worsened symptoms of their diagnosis or induce tachycardia. A Systematic Review and Meta-Analysis of THC reported diminished tachycardia effects with repeated dosing.

 

Encourage open communication between yourself and your patient. Remain objective when listening to and advising them. Listen attentively and offer non-judgmental responses that address their concerns.

 

Consistent communication, education, and follow-ups foster a healthy practitioner-patient relationship. It also improves the chances of achieving successful treatment outcomes.

 

Navigating legal and ethical considerations

 

Prescribing THC tinctures requires compliance with local regulations. Your treatments should align with current legal changes and guidelines to avoid issues. An understanding of the regulatory frameworks is crucial. These include dispensation and patient eligibility rules.

 

The TGA provides several detailed clinical guidance documents for practitioners. They include guides on treating various ailments, from epilepsy to pain and multiple sclerosis. You’ll also find legal considerations for prescribing THC.

 

Cannabis medications are still experimental, and studies on their effects are still ongoing. Keep this in mind to practise ethical THC prescribing. Respect your patients, ensure informed consent, and involve them in your treatment decisions.

 

You should also weigh the possible therapeutic advantages of THC against the downsides. Keep a journal for them and tell them to keep one for themselves. Cease or change treatment if persistent adverse effects occur. These practices help you maintain ethical treatment.

 

You may organise prescriptions for unapproved medicinal cannabis products.7 Several pathways exist, most notably the Special Access Scheme (SAS). It approves applications for many medical conditions, like neuropathic pain and refractory paediatric epilepsy.

 

The Authorised Prescriber Scheme is another avenue to access unapproved cannabis medicine. The TGA also has various clinical trials involving medicinal THC. You may apply on behalf of your patient once you have a satisfactory diagnosis.

 

Keep the following points in mind to ensure ethical and legal THC prescribing.

 

  • Comply with all conditions imposed on a TGA approval. Ensure you always get informed consent in writing.

 

  • Adhere to all the conditions of your licences and permits.

 

  • Ensure your scripts comply with the Departmental standards for monitored medicines.

 

  • Double-check all your scripts to ensure they align with TGA guidelines.

 

  • Report all adverse and severe reactions or events to the TGA.

 

Follow the prescriber responsibilities and conditions according to SAS Regulatory and Compliance. Take part in continuing training courses and education programs. Various options exist to stay updated on the standards of prescribing THC tinctures.

 

Diverse medical conditions for THC treatment

 

Are you curious about diverse medical conditions and patient demographics? Below is a list of successful THC treatments involving various diagnoses.

 

  • PTSD. Many patients with post-traumatic stress disorder have recounted positive THC success stories. More research is showing promise in regulating memory and memory retrieval. THC may also increase relaxation, lower anxiety, and improve sleep.

 

  • Dementia. A Geneva Pilot Study showcased real-life THC cases with positive results. Doctors prescribed a THC/CBD oral cannabis extract to dementia patients. They tolerated it well, with improved daily care, rigidity, and reduced behaviour problems.

 

  • Fibromyalgia. THC tinctures may aid patients with fibromyalgia-related sleep disruption, pain, depression, and anxiety. A 2018 fibro-cannabis study demonstrated symptom relief in all participants.

 

  • Paediatric patients. Treating children with epilepsy or other neurological disorders with THC is controversial. They may benefit from tinctures with a high CBD content. Close medical supervision is mandatory.

 

  • Age-related conditions. Elderly patients often experience arthritis, chronic pain, or insomnia. They may also experience neurodegenerative disorders, including Alzheimer’s or Parkinson’s. Low-dose, tailored THC prescriptions may help manage symptoms.

 

THC tinctures have diverse therapeutic applications across various medical diagnoses. The rise in research is uncovering more benefits and fewer risks. The future is bright for those seeking alternative treatments.

 

Discover a wealth of medicinal cannabis knowledge with PlantEd

 

 

THC tinctures are convenient ways of ingesting medicinal cannabis. They provide patients with precise dosing so you can help them with proper titration. The therapeutic potential includes pain relief, improved sleep, and treating various medical conditions.

 

It’s essential to understand THC prescribing best practices as a medical practitioner. The legal landscape in Australia encompasses various strict protocols. The Therapeutic Goods Administration (TGA) provides resources to stay adherent to the law.

 

Collaborative treatment and thorough patient assessments and monitoring are vital. Ensure you maintain open communication with them to find the ideal treatment.

 

We’re passionate about continuing education for medical practitioners at Planted. Discover a wealth of educational resources to boost your medicinal cannabis knowledge. Evidence-based practice also helps you find the ideal treatment plan for your patients.

 

Sign up for our courses and join the communities for extensive benefits.

 

 

References

  1. Office of Drug Control (ODC). Medicinal cannabis
  2. Centre for Medicinal Cannabis Research and Innovation. Cannabis Medicines
  3. MS Australia. Sativex® (nabiximols)
  4. WeedMaps. Cannabis Tinctures 101
  5. Honahlee. How to Qualify for Medicinal Cannabis
  6. European Journal of Internal Medicine. Is medical cannabis safe for my patients?
  7. Therapeutic Goods Administration (TGA). Guidance for the use of medicinal cannabis in Australia
Back to blog