After a detailed consultation between the patient and one of our pharmacists- we decided the best course for this patient would be to start low and go slow. We suggested she begin with 0.25 mL of 440 mg 1:1 THC:CBD tincture every 6 hours as tolerated. After about 2 weeks, the patient reached out saying that she was up to 1mL of tincture (equivalent to approximately 14mg of THC and 14mg of CBD) three times daily and she had hoped for more of an improvement. Starting low and going slow can be frustrating. To quell the patient’s persistent pain in a more aggressive way, we recommended that she switch to half of a 220mg gummy once or twice during the day and add Rick Simpson Oil to her nighttime regimen.
What is Rick Simpson Oil, and why is it so popular with experienced and new cannabis patients alike?
Rick Simpson Oil (otherwise known as RSO) is a cannabis oil product developed by Rick Simpson, a Canadian engineer who turned marijuana activist after a work accident led him to have various health issues. In the late 90s, after a ladder fall, he developed ringing of the ears and dizziness, for which no prescribed medicine seemed to help. Despite it not yet being legal and against advice from his doctors, Simpson started to use marijuana to treat his persistent issues with great results. Years later, he was then diagnosed with basal cell carcinoma. At this point, medicinal cannabis had been legalized in Canada, but he still had a difficult time finding a doctor that supported its use. A 1975 study of “Antineoplastic activity of Cannabinoids” in The Journal of the National Cancer Institute showed that cannabis and its compounds inhibited tumor growth in mice- this inspired him to create RSO. The extraction process is complex, but RSO contains ALL the cannabinoids, terpenes, and compounds of the entire cannabis plant- and it is very potent —making it near-black in color and rather strong in taste. Rick Simpson claimed that applying the oil to his cancer growth topically and leaving it bandaged for four days cured it- but this has not been substantiated. Unfortunately, scientific studies are still lacking in this area- but it’s a great potential topic for further research.
The two most common ways that RSO can be administered are orally or topically for skin ailments. It can also be added to flower, dabbed, or added to dressings, sauces and more.
Our patients commonly use small doses with great success (and less side effects). We usually recommend starting the oral dosing oil at ½ to a whole size of a grain of rice every 8 hours. As always, we stand by the mantra to start low and go slow so that your cannabis journey is pleasant and comfortable while finding the most appropriate dosing for your needs.
Patient Follow Up
Shortly after beginning with RSO and gummies, the patient was able to finally find some pain relief. The small amount of concentrate for her in the evenings and sometimes during the day is allowing her to manage her pain. She is considering tapering some of her regular prescription pain medicines as her sleep improves. Since the patient is still relatively “new” to the cannabis concentrate world, she has chosen to supplement her RSO regimen with a high-dose CBD tincture, which can help her manage the cerebral effects of higher concentrated cannabis options and has the benefit of helping with inflammation and anxiety as well.
Have questions about using cannabis? You can reach out to our pharmacist team to find the right combination for your condition by calling our dispensary line or reaching out through our website.
At FRX Health, our pharmacists are on call daily to work with patients at no charge. We provide an individualized patient plan based on your current medication and health needs. Contact us at 234-718-8767 or at https://frxohio.com/ to meet with one of our pharmacy team members. We are here to find the best individualized options for your situation!