Methods of application and dosage


By far the most common way of administering cannabis is smoking dried female flowers. These flowers, or people’s sticks, contain the highest concentrations of active substances – cannabinoids (THC, CBD and others), terpenes, flavonoids and others. Doctors do not recommend this unhealthy way of consumption and as an alternative they offer their patients a modern healthy method of inhaling vapors from devices called vaporizers. Other modern forms of administration are also gaining more and more popularity – standardized extracts and individual medicinal products prepared from them such as ointments, gels, suppositories or tinctures and many others. In this text, we will introduce the basic methods of applying cannabis for medical use and their advantages and disadvantages.

Dry powder for inhalation

In the Czech Republic, roughly ten percent of cannabis patients use their medicine in the form of dried flowers intended for inhalation through so-called vaporization.

What is vaporization?

Vaporization is a modern method of applying cannabis for medical use, the main advantage of which is the rapid onset of effect. For that reason, it is referred to as a healthy alternative to smoking. Doctors usually recommend vaporizer inhalation to patients who need immediate relief from excruciating pain, to suppress nausea and increase appetite, or to relieve muscle spasms or tremors.

During vaporization, there is no harmful burning as in smoking, but only the heating of plant material (dried flowers, but also various extracts) to temperatures of a maximum of 220 degrees Celsius. This means that the patient inhales only vapors, not dozens of substances harmful to health as when inhaling smoke from burning plant material in so-called joints or pipes.

Today, there are even two vaporizers from a German manufacturer on the market, which are the only devices of their kind in the world certified for use in treatment as official health aids. The main obstacle for patients is their own high price – and not just these two certified devices, but in general all commonly available vaporizers made of quality materials. Another disadvantage is the shorter duration of action (two to three hours) compared to oral consumption of cannabis extracts or edibles, where the effect can last around six or more hours depending on the amount used and the specific form.

This means that they are using plant material that has not been modified in any way beyond the normal drying process. Distributors to pharmacies indicate the approximate content of THC and CBD on the packages of dry matter, and according to this, the doctor individually decides what ratio and content will be most appropriate for the patient.

Powder in capsules

Currently, around 90 percent of cannabis patients in the Czech Republic are treated using capsules, which are also prepared in pharmacies from dry matter. It is therefore the same plant material, only decarboxylated by heat and with added starch. Capsules prepared in this way are apparently used in the medical cannabis systém only in the Czech Republic as a kind of emergency response to a situation where doctors did not have extracts available and considered vaporization unsatisfactory for one reason or another.



Under the influence of heat, a molecule of carbon dioxide (CO2) is released from the cannabinoid acid and the neutral form of cannabinoids escapes.


THC content in relation to
the time and temperature
of decarboxylation

The graph shows the effect of time and temperature of decarboxylation on THC content. The values were measured for hemp extract placed on a glass surface in an open oven.


Source: Journal of Chromatography 520 (1990)



To prevent the resin from sticking to the tray or baking tray, spread baking paper over it. Spread crushed or hand-ground dried hemp on it.

We bake in the classic mode, without using hot air

Depending on the density of the dry matter, a temperature between 100 and 120 °C is recommended. The time required for decarboxylation decreases with increasing temperature (from 60 minutes at 100°C to 20 minutes at 120°C).

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Cannabis extract

Hemp extract or extract is, in short, a mixture of resin and essential oils extracted from the flowers of a mature female plant, most often using various solvents such as ethanol, tetrafluoroethane, using supercritical CO2 extraction or, nowadays, the so-called solventless extractions, where dried hemp is only presses and heats without using any solvents. Hemp extract usually contains high amounts of cannabinoids – it can be 30 to 90 percent THC or CBD, and smaller amounts of other cannabinoids, terpenes, and other substances.


Extracts are the most suitable for creating a safe medicinal product with a uniform content of cannabis substances. These are produced by separating biologically active substances from the plant matter of female flowers using different techniques, of which the most used today are extraction with gases such as carbon dioxide or tetrafluoroethane or extraction with liquid solvents such as ethanol, methanol or hexane.

In addition, there is a second group of so-called mechanical extractions where no solvent is needed. This includes both the “primitive” ancient production of hashish, for example by sifting, as well as the modern and increasingly popular method of pressing at high temperatures known as the so-called rosin press, or variants such as live rosin and others. These solvent-free cannabis concentrates are particularly popular in the United States among recreational users, but they are also increasingly being used by patients with chronic intractable pain.

The vast majority of extracts produced using various solvents are used in medicine. Each solvent and method has its advantages and disadvantages, however, it is beyond the scope of this article to go into greater detail. It is essential that every supplier of extracts to pharmacies must meet strict conditions of purity and standardized concentrations of THC and CBD. In the future, much attention will certainly be paid to the content of minor cannabinoids and terpenes, which, according to research from recent years, to a large extent complete and they multiply the possible therapeutic effect of the two main cannabinoids.

Extracts can generally be divided into three main categories according to the composition of the ingredients: full-spectrum, broad-spectrum or isolates. If the extract comes from the female inflorescence and no substances have been removed from it in any way, it is a so-called full spectrum extract (sometimes also full spectrum), which is a translation of the English full spectrum. Such an extract contains a higher amount of CBD and/or THC, but also a number of minor cannabinoids and many terpenes, flavonoids, essential oils and other substances. In contrast, the so-called broad-spectrum extract is essentially full-spectrum, only some substances have been removed from it by humans. This is most often done in order to reduce the THC content to a legal level, however, it is good to keep in mind that during this removal of THC there is very often a loss of other substances, especially terpenes.

Last but not least, there are the so-called isolates, which are nothing more than purified CBD, THC or other cannabinoids. Isolates are essentially the closest thing to modern medicine in the sense that it is a single isolated substance. However, in the case of cannabis, it seems that greater therapeutic potential they just have full-spectrum extracts, not isolates. Behind this is the concept of synergistic action of individual components known as the accompanying effect (entourage effect).

Hemp ointments and other preparations for external use

Hemp ointments and creams for external use can be made both from the dry matter by leaching it, and from extracts. The second option should be common practice in Czech pharmacies in the foreseeable future, thanks to the fact that the first extracts will be available in the Czech Republic from the second half of 2022. When topical application the active substances are absorbed by the skin and are thus used for the local treatment of various affected areas (for example, in case of allergic reactions, swelling, inflammation, burns, eczema, rashes, psoriasis and others). It is essential that the application of hemp ointments on the skin does not have psychoactive effects, which differs from inhalation or oral administration, whether dry matter in capsules or extracts or hemp foods with a higher THC content.

The future: sprays, suppositories, nanotechnology

Extracts can be used in pharmacies and laboratories to prepare not only ointments and creams, but also rectal or vaginal suppositories, sprays, tinctures and other individually prepared medicinal products. On the commercial market with CBD products today, the so-called are also commonly sold nano extracts soluble in water, which could bring a revolutionary change to the medical use of cannabis, however, there is still not enough scientific data on the safety of such preparations in this area. Intravenous administration is also used in preclinical research, but this method has not yet been properly tested in humans.

Home ways of consuming cannabis

Patients often use cannabis not only from a doctor, but also their own. For clarity, we briefly mention the main forms. The dry matter can be added to various heat-treated dishes that also contain some fat in which the cannabinoids dissolve. We most often see hemp cookies and cakes, but it can be part of sauces, milk drinks and so on.

Homemade ones are also very popular tinctures of at least 50% alcohol that can be drunk, applied in a spray sublingually or topically. A simple alternative to the demanding production of the extract is the so-called oil with hemp, where dried flowers are added to any vegetable oil (for example, olive is suitable) and this mixture is heated over a low heat and then strained.

Dosing cannabis for medical use

Dosage is highly individual and depends on a number of factors that play a role both in the patient himself and in the cannabis used and its form. When administering cannabis with a higher or high THC content to a patient, it is necessary to know whether he has psychological problems or genetic predisposition to psychiatric disorders, what other drugs he is taking, whether he has previous experience or is so-called cannabinoid naive.


The basic rule of dosage of cannabis for medical use is to start with a smaller amount – moreover, often distributed over several doses during the day – and gradually increase it (from the English “start low, go slow”) until sufficient relief from the treated difficulties is achieved. In addition, it is necessary to consider in advance whether it will be appropriate to take the cannabis medicine at bedtime or during the day, i.e. if the main goal is to help the patient sleep and rest or, on the contrary, to improve his functioning in everyday life. The time of administration, amount and form depend on this – during the day many patients are satisfied with smaller doses and varieties with a genetic dominance of the sativa species (energizing), while they take a more potent capsule with a sedative indica at bedtime. However, from this division into hypnotic indicas and stimulating sativas today’s science is retreating and rather attributes these properties to specific cannabinoid and terpene profiles in one or another variety.

THC overdose should not occur at all under the supervision of a physician and with careful titration. However, if this happens (for example, when the patient takes not only the prescribed dose, but his home-baked cookie), it is necessary for the affected person to know how to behave in such a situation so as not to harm himself. It is essential to explain to the patient that the toxicity of THC alone is extremely low and no matter how unpleasant the state of being dazed or, as people say, “smokey” is (accompanied, for example, by paranoia, dizziness, problems with motor skills and the perception of time and the surrounding world, etc.), it always subsides after a few hours. In the case of inhalation of smoke or vapors, it is about 2-3 hours, in the case of consumption of food or extracts it can be 6 to 8 hours, depending on the specific dose and the individual disposition of the patient.