Tolerance Break 101 for Medical Cannabis Patients: Set Yourself Up For Success
Most people who consume cannabis know the feeling of building up a tolerance to THC. After a while, the same amount of cannabis just doesn’t affect you in the same way. Soon, it takes more and more to experience the same effects and symptom relief. Tolerance breaks are often used as a reset button for this problem. While anyone can take a tolerance break, patients considering a t-break have unique needs to take into account.
What is a T-break?
“A tolerance break is an intentional cessation of THC cannabis to assist in the reset of the CB1 receptors within the endocannabinoid system,” explains Jessica Dalziel, a registered practical nurse and director of clinical services at Canada House Clinics.
“Over time with THC usage, our body’s endocannabinoid system begins decreasing the amount of CB1 receptors available for THC to bind to,” says Dalziel. “They will still uptake THC, but the impact of THC will be much lower than it once was.”
THC binds to receptors in order to provide therapeutic effects like pain relief, sleep, appetite suppression or stimulation, and mood regulation. Dalziel explains that since patients use cannabis on a regular basis, they are likely to develop a tolerance to the cannabinoid. Typically, the solution for THC tolerance is what is known as a tolerance break.
But is it safe for patients to discontinue their physician-authorized medication cold turkey?
Prescription medication is simple. You take the instructed amount, at a certain time, for a period of time. Plant medicine isn’t always that simple, or at least it can feel that way. When a patient develops a tolerance to a prescription medication, they consult their doctor on how to move forward.
It’s the same with medical cannabis: you are never alone in making decisions about your medicine. The physician who authorizes your medical cannabis will be able to best advise whether adjustments need to be made to your regime.
When to Consider a Tolerance Break
It may be time to consider a tolerance break if you’re noticing that you aren’t getting the same benefits as you used to.
“As time moves on, you will need to continuously increase your THC intake for symptom relief, creating a costly care plan for the average patient,” says Dalziel.
“Patients experiencing brain fog, cost of your prescription increasing, increased symptoms of depression, decreased motivation and energy, or leaving the country for travel should consider a tolerance break.”
According to Canada House Clinics, patients who use cannabis on a daily basis might benefit from taking regular tolerance breaks. They recommend patients take one week off of THC every two to three months as required. Taking a break from THC use will assist in replenishing the CB1 receptors and save medical users from more costly care plans.
Patients May Have Unique Needs
Taking a tolerance break as a patient can feel daunting. It isn’t the same as cutting out the occasional joint. Patients are discontinuing a therapeutic treatment and it should be treated as such. Always consult your physician, as they understand your individual medical history and can advise on how, when, and why a tolerance break is needed.
Patients who take a tolerance break may experience insomnia, increased pain, irritability and mood fluctuation, nausea, lack of appetite, increased depression, night sweats, and headaches.
According to Dalziel, “patients could experience psychological symptoms during their tolerance breaks, with the worst experience during day three and four after their last dose.”
There is no ‘right’ way to take a tolerance break. Some patients benefit from a week off, and others pick one day a week.
“We suggest selecting a day where your [cannabis] activity levels are much lower than the other days,” says Dalziel. “Leveraging alternative therapies and coping mechanisms are highly recommended for optimal success. Self-care is key.”
Tolerance Break Tips
Set yourself up for success when taking a tolerance break. Remember, a t-break is only the cessation of THC. You can still use other cannabinoids and terpenes to ease any adverse symptoms. Dalziel suggests taking CBD to ease symptoms of THC cessation like irritability, anxiety and depression.
“Terpenes are what provide cannabis its smells and flavour. They also contribute a large portion to the therapeutic effects cannabis provides,” says Dalziel. “Look for the terpenes in everyday food and nature to potentially assist with symptom control during your tolerance break.”
During your tolerance break, think of self-care as a requirement rather than a recommendation. Exercise can help accelerate getting THC out of your system, as well as ease any psychological symptoms of the tolerance break. Self-care means different things to different people and can be highly individualized. Meditation, yoga, hiking, reading, journaling, etc., can all be used as tools in your tolerance break toolkit.
After your tolerance break, Dalziel recommends abiding by the old adage, ‘start low and go slow’ because smaller amounts of THC will likely affect you more than you expect. “When re-starting THC, start with microdosing and titrate your way up. Utilize CBD at least once daily, this can help slow down your body’s speed of tolerance,” says Daziel. “Do not rush titration or you will end up where you left off, and the tolerance break would have served minimal purpose.”