Cannabis tolerance — the gradual acclimation to the sensory impacts of use — is usually framed in a negative light: something to be avoided or remedied. But being able to handle larger doses of cannabinoids can actually mean increased medical benefits.
Cannabis has a bad reputation when it comes to building up tolerance. Countless articles describe the problem: you start using cannabis and it works great, but after a few weeks you find you need more. You increase your dose, only to soon find that this new dose is also insufficient — it just doesn’t get you ‘high’ the same way.
The prescription for this problem is usually to go on a cannabis tolerance break, a few weeks where you stop using cannabis and let your system reset. When you go back to using cannabis again, your cannabis tolerance will be back down to where you started. The message being communicated is clear: cannabis tolerance isn’t something you want to have.
But developing a cannabis tolerance isn’t all bad. For many, especially medical patients, it is a crucial factor in their cannabis use. Many medical patients starting cannabis worry about side effects like difficulty thinking, problems with memory or lack of coordination. One of the great benefits of developing a tolerance to cannabis is that many of these side effects go away: Studies show chronic cannabis users do not suffer from the same disorienting effects that leave occasional users unable to do everyday tasks, such as driving).
I remember marveling at a close friend and classmate who could smoke throughout the day while remaining completely normal. He would go to class, have complex conversations about analytic philosophy, work on his doctorate — all while using cannabis.
When I asked him about it he explained that he had a high tolerance. He was just used it.
At that time, I was dealing with intense chronic pain and missing a lot of school and work due to these struggles. Cannabis helped, but I was only using it at night, when I didn’t have any work to do. It was like a time-out from the pain, but it didn’t help me with the real problem — my inability to work when I was in pain.
My friend suggested something that ran counter to everything I had read — I should build up my tolerance.
“Smoke right before you write that paper” he suggested. “It will be weird for a few days, but then you’ll be used to it”.
To my surprise, he was right. Within a week of starting to use cannabis during my regular work and school activities, I was no longer feeling the disorienting side effects. I was free. While I still got relief from my pain and anxiety, I was thinking clearly and felt… normal.
While I worried my tolerance building would lead to continual increases in use, at a certain point my tolerance increases seemed to plateau: I have been on a relatively stable dose for the last five years. If I use the same strain of cannabis for too long, I develop a tolerance to that strain and need to switch it up to keep getting relief. Otherwise I haven’t experienced any tolerance-related problems and always avoid taking tolerance breaks now.
While tolerance breaks are fantastic for recreational users or those with occasional medical needs, I never suggest them for medical patients who have chronic issues they are managing. Just like you would be unlikely to have a doctor suggest you take a few weeks off from an antidepressant or a heart medication, if you are using cannabis for daily medical needs, interrupting this can be disruptive and confusing for your body. And of course, any symptoms you were managing will no longer be getting the help they need.
Still, last summer, I was forced to take a tolerance break: I got a lung infection (unrelated to the cannabis) which was aggravated by smoke, so I spent months unable to use my medicine.
When I started to smoke again a few months later, my tolerance was back at its starting point and I experienced tolerance free cannabis use again. I was totally useless! So, I spent the next few weeks building my tolerance back up. Only then was I able to again use cannabis effectively as medicine.
I thought I might be able to use a lower dose after such a long break, but I quickly found myself back at that stable dose I had been using for years. For all the discomfort of the break, it turned out that I did best on the dose I had already been on.
While tolerance breaks are great for some (and there are certainly medical and recreational users alike who swear by them), for others developing and keeping a certain level of tolerance may be the better route. This can vary drastically from person to person based on their needs and biochemistry.
As a patient consultant, I often work with clients to track their cannabis experiences in a journal. Looking back over a few weeks of entries, many of them are able to better understand what is working for them and what isn’t.
Written by Dr. Emily Earlenbaugh is a cannabis patient consultant and wellness researcher. She is the author of the online course “The Mindful Guide to Cannabis” and has a doctorate in philosophy of science from UC Davis. Reposted from Cannabis Now