Cannabis Education

Introduction to Medical Marijuana
First Time User
Dosing Guide
Pain Management
–   Cannabis vs. Narcotics
An Introduction to CannabinoidsCBD, THC
How Cannabis Works
Current Legal Environment
Traditional Healthcare Situation

 

Disclaimer: This Product and information has not been evaluated by the Food and Drug Administration. This Product is not intended to diagnose, treat, cure or prevent any disease.  Although A patent was awarded to the U.S. Health and Human Services in 2003 (US6630507) that covers the use of CBD as a treatment for various neurodegenerative and inflammatory disorders; focused on oxidative associated disease states. That being said, the following information is anecdotal.

Visitors to Trokie.com acknowledge that the information on the Website is provided “as is” for general information only. It is not intended as medical advice, and should not be relied upon as a substitute for consultations with qualified health care professionals who are intimately knowledgeable about your individual medical needs.

http://www.google.com/patents/US6630507

An Introduction to Medical Cannabis:

Many patients have been achieving a higher quality of life as the result of using medical cannabis for a range of symptoms, most notably:

  • pain relief
  • relief from nausea and vomiting
  • relief from the neurological attacks and muscular spasms caused by a number of neuro-muscular disorders. Positive outcomes have been reported with epilepsy and MS patients.

The Cannabis plant has hundreds of active ingredients with THC and CBD, both cannabinoids receiving most of the attention. Terpenes and flavonoids are components of this important adaptogenic herb and have significant clinical physiologic effects. Cannabis has been used in medicine for over a thousand years. For more information on the History of Medicinal Cannabis use we recommend visiting: http://www.rimidya.com/med-cannabis-ii/history-of-medical-cannabis/

Using cannabis is not a not an instant solution to treating disease and injury. If used as a therapy it can provide a  sustainable solution. Most individuals starting a cannabis medicating program will hit certain milestones, 3 days, 14 days, 30 days, and again in 60 days. Even though the first sixty days produces the most substantial results, patients reported a perpetual increase in health and well being for up to 2 years.

The first 60 days is the most significant time frame when medicating with cannabis. The individual using cannabis will not see results until the 3 day.  In the first 14 days we know if the individual is on the right medicating program. The 14th day is when the individual will notice substantial relief.  The 30th day the individual will notice a 50% to 70% symptom relief. If the individual is not responding typically to cannabis, it will take up to 60 days for them to experience a 50% to 70% relief in symptoms.

Patients tend to follow a characteristic treatment program influenced by the treatment’s efficacy (while ‘ramping up’ dosages for positive effects) and the patient’s level of comfort with psycho-activity (small adjustments once desired efficacy has been reached).

 

First Time Users

50% of Patients receive relief with less than 15mg

What do I do if I am using Trokie for the first time?

GO SLOWLY, you can always increase the dose, you cannot go backwards. If you find yourself overmedicated, there is not much that can be done other than waiting for the effects to subside. To date, there has not been any deaths caused by Marijuana.  Keep in mind that edibles can be very strong in comparison to smoke therapy. In addition, the effect of ingesting medical cannabis will last 6 times longer than the effects of smoke therapy. Most of the Trokie packaging recommends starting with a quarter lozenge, for patients who have little or no tolerance to THC that might be too much. One aspect that makes the Trokie lozenge unique is that it is uniform, The Trokie™ can be cut into an 1/8th or smaller. We recommend first time users to start with 20:20 CBD:THC Trokie lozenge and start with a ¼ or (5mg CBD : 5mg THC), Most patients do not experience a “high” but receive symptom relief.

 

Start at Bedtime, patients benefited more from a bedtime dose than any other time of day.

Dosing at bedtime has been shown to:

  • Promote higher quality, deeper sleep –The quality of your sleep directly affects the quality of your waking life, including your mental sharpness, productivity, emotional balance, creativity, physical vitality, and even your weight. No other activity delivers so many benefits with so little effort!
  • Allows the patient to consume larger doses of cannabis while sleeping through the psychoactive effects of THC.

There are 4 traditional methods of marijuana delivery: inhalation, consumption, sublingual, topical. And now Buccal. Effects will vary depending on type of product, these are just averages.

Buccal Absorption / Trokie Inhalation / Smoking Consumption / Edibles Topical
Onset:  within 30 minutes Onset:  within 5 minutes Onset:  30 – 120 minutes Onset: within 30 minutes
Duration:  4-8 hours Duration:  2 hours Duration:  4-8 hours Duration:  1-4 hours
Symptom Relief:

Pain, Anti-inflammatory,  Neuropathic (Nerve) Pain

Symptom Relief:

Nausea and Vomiting,

Pain, Mental Health

Symptom Relief:

Pain, Anti-inflammatory,  Neuropathic (Nerve) Pain

Symptom Relief:

Acne and skin conditions, Pain

 

Dosing

The challenge in cannabis dosing is that like any other medicine, medical cannabis reacts different in each individual. Patients should be advised that it might take up to two weeks to find the optimal dose and that undesirable effects can occur during this time, most commonly dizziness. These undesirable effects are usually mild and resolve in a few days.

When treating patients with medical cannabis, one size does not fit all. In fact this is the case in most patients and patients need to start their treatment regimen slowly to experience what works best for them. We have found that over time as the patients tolerance to THC improves, a higher ration of THC to CBD has better medicinal effects.

Trokie 50mg Pure CBD Lozenge Dosing Guide
Day Dose in the morning (in mg) dose in the evening (in mg) Total dose per day (in mg)
6.5 6.5 13

The pure CBD lozenge cannot get you high, so there is no titration period. The goal is to find the lowest dose that produces the intended results.

 

Titration period:

A titration period is required to reach optimal dose. The number and timing of dosing will vary between patients. The size of the dose should be increased each week following the pattern given in the table below. The afternoon/evening dose should be taken at any time between 4 pm and bedtime. When the morning dose is introduced, it should be taken at any time between waking and midday. The patient may continue to gradually increase the dose by 1/8th of a Trokie per day, until they achieve optimum symptom relief.

Trokie 20:20 CBD:THC Lozenge Dosing Guide
Day Dose in the morning (in mg) dose in the evening (in mg) Total dose per day (in mg)
1-7 0 2.5 : 2.5 2.5 : 2.5
8-14 2.5 : 2.5 5 : 5 7.5 : 7.5
15-21 5 : 5 5 : 5 10 : 10
21+ 10 : 10 10 : 10 20 : 20

As Stated above, this is just a guide every patient has a different dose that achieves optimum relief. Depending on severity of ailments and symptoms, much higher doses are maintained on a daily basis. For example, some patients going through Chemo Therapy require upwards of 80:80 per day to relieve the symptoms associated with the treatment like nausea, and pain relief.

Trokie THC Lozenge Dosing Guide
Day Dose in the morning (in mg) dose in the evening (in mg) Total dose per day (in mg)
1-10 0 10 10
10-20 5 15 20
21-30 10 20 30

Refer to above dosing information about daytime dosing, our experience suggests that after a patient is titrated up to 20mg at night, they have been able to function during the day on low doses of THC without major cognitive impairment. We recommend using trokie 1:1 for most daytime use, although it ultimately depends on which cannabinoids relieve the patients ailments and symptoms.

 

Maintenance period:

Following the titration period, patients are advised to maintain the optimum dose achieved. The median dose in for patients with multiple sclerosis is eight sprays per day. Once the optimum dose has been achieved, patients may spread the doses throughout the day according to individual response and tolerability. Re-titration upwards or downwards may be appropriate if there are any changes in the severity of the patient’s condition, changes in their concomitant medication or if troublesome adverse reactions develop. Doses of greater than 12 sprays per day are not recommended.

 

 

 

Pain Management and Palliative Care

Cannabis has many medicinal effects that are a perfect match for pain management and Palliative (end of life) care. Healthcare providers of today are quick to prescribe opiate based narcotics for pain relief which are heavily abused with many negative side effects.  That list includes addiction, constipation, nausea and extreme sedation. Medicinal Cannabis (CBD, THC, CBN) is an analgesic with pain relieving qualities and few side effects. Studies have shown MMJ can Reduce Opiate Use by 30%-100%.

Using the buccal delivery method, Trokie is positioned to be the leader for end of life comfort care and pain management. It has a quick onset of medicinal effects and long duration of action (4-8hrs). Most of the problems associated with administering pain management medications are eliminated with Trokie. The Trokie dosage design allows for Consistent, Repeatable, Controllable & Easily Adjustable Dosing.

 

              Narcotics                     Vs.                  Cannabis

(Norcos, Hydrocodone, Morphine, Fentanyl, Oxycodone, Hydromorphone)

Heavy addiction characteristics non-addictive
Constipation doesn’t effect the gastro region and used as a cure for IBS and Crohns
Suppress appetite appetite stimulant (THC)
Cause Nausea Reduces nausea and vomiting
Delivery methods: Many are given injections by needle, If the person can no longer swallow, no more needle pricks,  no more tough to swallow pills, no more IV PICC lines
 Allergic reactions Very uncommon
Extreme sedation: Confusion, Sleepiness and Breathing Problems. Improves Sleep and Recovery

 

An Introduction to Cannabinoids

There are at least 85 known cannabinoids in cannabis. The two most widely studied have been THC and CBD. THC is psychoactive, producing the “head high” by binding to CB1 receptors in the various parts of the brain, while CBD is non-psychoactive. Both compounds have medicinal therapeutic effects; they have a synergistic relationship and work best as a team. All Trokie THC products contain a relatively high level of CBD.  The 1:1 CBD:THC Trokie product is designed to deliver the medicinal effects of both cannabinoids without the high. These are powerful compounds so please read the dosing instructions and comply to get the best results.

 

CBD, or Cannabidiol is a non-psychoactive cannabinoid that has numerous medicinal effects as listed below. Several studies suggest that CBD actively works to counteract the psychoactive effects of THC. So CBD doesn’t get you high and could possibly be the answer to help bring overmedicated patients back down from the clouds.  CBD has many medicinal qualities, below are several we find to be most helpful:

Medical Properties of CBD Effects
Analgesic Relieves Pain
Anti-inflammatory Combats inflammatory disorders
Medical Properties of CBD Effects
Antiemetic Reduces nausea and vomiting
Anticonvulsant Suppresses seizure activity
Anti-Epileptic Reduces seizures and convulsions
Antispasmodic Suppresses muscle spasms
Antipsychotic Combats psychosis disorders
Anti-oxidant Combats neurodegenerative disorders
Anti-tumoral/Anti-cancer

Anti-proliferative

Combats tumor and cancer cell growth
Anxiolytic Relieves anxiety
Anti-depressant Combats depression disorders
Anti-Diabetic Reduces blood sugar levels
Neuroprotective Protects nervous system degeneration
Anti-bacterial Kills or Slows Bacteria Growth

A good article for more info about CBD is:

http://www.leafscience.com/2014/02/23/5-must-know-facts-cannabidiol-cbd/

 

THC, or tetrahydrocannabinol, is the primary ingredient in marijuana responsible for the high, but has several other therapeutic benefits listed below:

Medical Properties of THC Effects
Analgesic Relieves Pain
Antiemetic Reduces nausea and vomiting
Anti-Spasmodic Suppresses seizure activity
Appetite Stimulant Stimulates Appetite

A good article for more info about THC is:

http://www.leafscience.com/2014/03/16/6-surprising-facts-thc/

 

CBN, or Cannabinol is a mildly psychoactive cannabinoid that is the result of decarboxylation of cannabis oil and is the main cannabinoid responsible for marijuana’s  sleep aid.

Medical Properties of CBN Effects
Analgesic Relieves Pain
Anti-insomnia Aids Sleep
Anti-Spasmodic Suppresses seizure activity

 

Dosing factors to consider:

Severity of Symptoms – Some Patients have such severe symptoms that they must medicate more than once a day at high dose.

THC Tolerance – Some patients need strong relief but do not want to feel the psychoactive (stoned) effects of THC while other patients function better with the THC effects. If you have a good tolerance to THC you will want to experiment with day time dosing until you achieve the desired results. WARNING-THC rich MMJ can impair motor and cognitive function and must be used with caution when attention to detail is required.

Driving, operating machinery of any kind, being in situations where a person’s full attention is required should be advised to use extreme caution and/ or refrain from using THC rich MMJ during the day. If you do not like feeling the brain effects of THC (being high) you would do best with a strong MMJ dose at bedtime and enhance your symptom relief during the day by using low THC, high CBD products (a 1:1 ratio of THC and CBD is best). In fact this is the case in most patients and patients need to start their treatment regimen slowly to experience what works best for them.

Life Style – Some patients need symptom relief but cannot be impaired by THC because of their job, family commitments or daily tasks. This patient would do best dosing with MMJ at bedtime and enhance your symptom relief during the day by using products that are low in THC and high in CBD either the Pure CBD Trokie or the 20:20 CBD:THC Trokie.

Gender – Women can store more cannabinoids in their fat cells than men. Often men will have to dose twice a day to get the same result as a woman dosing once a day.

Weight – Cannabis is the ultimate time released medication. It is stored in the fat cells in the body and released into the blood stream over time, which varies from person to person. Extremely thin persons my need to medicate up to 3 times a day with mmj edibles to achieve desired medical results while heavier patients will receive symptom relief with a strong mmj edible dose at bedtime.

 

How Cannabis Works

Our body is pre-programmed to receive the cannabinoids in medical cannabis. Two types of endocannabinoid receptors in our body allow us to absorb the effects of medical cannabis. The first receptor is the cannabinoid receptor type 1, abbreviated as CB1. CB1. is a G protein-coupled cannabinoid receptor primarily located in our central and peripheral nervous system. It is activated by plant cannabinoids, such as the compound THC; and by synthetic analogues of THC, such as dronabinol. CB1 receptors are located in the brain, spinal cord, and periphery. In addition to CB1 we possess CB2 receptors. These are located in the immune tissues. When we consume cannabis high in THC, our body produces molecules (called endocannabinoids) that interact with these CB1 and CB2 receptors to dull our senses and produces euphoria. CBD, another key compound in cannabis, on the other hand, has little affinity for CB1 and CB2 receptors, but of the two, it has a greater affinity for the CB2 receptor than for CB1. In fact, it acts as an indirect antagonist of cannabinoid agonists. Because CBD acts as a receptor agonist, it acts as an antidepressant, anti-anxiety medication, which also has the beneficial side effect of being neuroprotective. Other benefits of high CBD concentrations include its recently discovered anti-psychotic effects, which may in time lead to its use in the treatment of schizophrenia.

 

Cannabis (marijuana) is a schedule 1 substance and the United States Federal Government has concluded that the drug has no medicinal purposes. Hopefully, re-scheduling from the Feds is coming soon.

There has been legislation fighting this categorization since the 1970’s. As of today there are 23 states that have declared MMJ to be a legal substance for medicinal use, many more are following suit. 2 states, Colorado and Washington, have legalized Marijuana for recreational use. Oregon and Alaska are in process now.

The Market is dictated by each State Medical Marijuana program. In California, patients receive a Letter of Recommendation from their physician that states “this patient has been diagnosed with a medical condition and the use of medical marijuana is appropriate”. After the patient obtains their “Rec”, they are allowed to visit dispensaries to donate in order to receive their medicine.

 

Conventional Healthcare Situation

Most people are not aware, that a synthetic version of THC has been legally prescribed and used in FDA-approved pharmaceuticals for decades in the form of Marinol.  In 1985, Marinol (dronabinol) received FDA approval as a treatment for chemotherapy-related nausea and vomiting. Synthetic THC.

GW Pharmaceuticals has created Sativex: a Marijuana derived pharmaceutical oromucosal spray containing equal proportions of THC and CBD (similar to the Trokie 1:1). Sativex has been approved in Europe and Canada for treatment of neuropathic pain and spasm in multiple sclerosis (MS) and for moderate-to-severe pain in advanced cancer. Numerous randomized clinical trials have demonstrated safety and efficacy for Sativex in central and peripheral neuropathic pain, rheumatoid arthritis and cancer pain. Sativex uses the same ratio that Trokie uses in our one to one (CBD:THC) lozenge. Epidiolex is another marijuana derived orally-administered liquid containing CBD created by GW pharmaceutical that has received orphan drug status in the US, for use as a treatment for Dravet syndrome and Lennox-Gastaut Syndrome.

As you can see: Cannabis (marijuana) is Medicine. Prohibition has created an information void and discouraged the best medical professionals and research scientists to get involved in the Taboo industry of medical cannabis. Because of this prohibition, there is a lack of research studies that are peer reviewed and widely accepted by the medical community as a whole. The Team at Trokie is working with healthcare organizations, clinicians and patients to help identify and collect data to support research and attempt to understand the importance of a whole cannabis extract.

Grotenhermen F. Pharmacokinetics and pharmacodynamics of cannabinoids. Clin Pharmacokinet. 2003;42(2):327-360.

Lohr L. Chemotherapy-induced nausea and vomiting. Cancer J. 2008;14(2):85-93.[PubMed 18391612]

Marinol (dronabinol) [prescribing information]. North Chicago, IL: AbbVie Inc; February 2013.