Wednesday April 10, 2019
In our first Ask a Cannabis Nurse column, Natural Care’s director of patient care, Karen Newell, answers a reader’s question about cannabis for sleep.
Our readers ask:
I had a stressful job for decades, and a few weeks after I retired, I fell and broke my hip. Between work and pain from hip surgery, I haven’t had a good night’s sleep in years. I’ve tried sleeping pills, and they help a bit, but then I’m groggy the whole next day. My sister-in-law can’t stop raving about medical marijuana for sleep, but I smoked a few joints back in high school and they made me anxious and wired. I want to believe, but I’m skeptical – how do I know if cannabis will work for me?
-Sleepless in Sarnia
Our nurse answers:
As for cannabis as a potential treatment, I’ve got some good news and some complicated news for you. The good news is that the joints you smoked in high school are unlikely to predict how you’ll react to cannabis now.
Many factors influence how we respond to cannabis – hormones, time of day, what we’ve had to eat, etc – and those responses change as we age.
It’s also important to know that cannabis is not one medicine, it’s thousands! Different strains have different properties, depending on their exact balance of cannabinoids (such as CBD and THC) and the terpenes, or essential oils, they contain.
I can’t say for sure why the joints you smoked in high school made you feel anxious and wired, but my guess is that they probably contained more THC than your body likes, and potentially some energizing terpenes as well.
That’s the good news! The complicated news is that the only way to know what cannabis products might help you sleep better is to try.
In general, most of my insomnia patients have success with a low dose of THC before bedtime, but I’ve had some who see remarkable improvement taking CBD during the day. Since CBD is non-intoxicating, I’ll often start there, and add THC if needed. Of course, I’ll always look at a patient’s medical conditions, as well as any prescriptions they might be on before suggesting a starting dose, but the general rule of thumb is start low, go slow and see how it goes. In your case, I’d want to learn more about your hip surgery – if pain is the main thing keeping you awake, then I’d want to see what we can do to address that first.
Cannabis has a pretty good record with chronic pain and insomnia. I can’t guarantee it will help with your specific issues, but I can confidently say we’ve come a long way since high school!
To your health,
Karen Newell is Natural Care’s director of patient care, and a registered practical nurse with over 40 years’ combined experience in hospitals, specialized pharmacy and long-term care and retirement.
*Reader questions are lightly edited for space and coherence.