Just What the Doctor Ordered

What Specific Strains of Marijuana are Right for my Symptoms?

What’s in a strain name? Would Blue Dream by any other name smell just as sweet?

More and more people are turning to medical marijuana for a natural alternative to pain medications, insomnia pills and other mainstream drugs with dangerous side-effects. While there is bulletproof scientific literature on the safety and efficacy of the active molecules in cannabis, little is known about which specific strains of cannabis might be right for what ailment.

For the first time, patient surveys of all sorts have begun putting together the pieces. Whether dispensary questionnaires, cannabis competition surveys or consumer data left on sites like Leafly.com—some broad trends in strain indications are starting to emerge and complement what has been mostly anecdotal information.

CANNABINOIDS

According to licensed Berkeley physician Frank Lucido, two molecules—THC and CBD—have been proven to relieve a number of broad symptoms. According to a 2005 research review by Dr Ethan Russo, THC is a pain reliever, muscle relaxant and anti-inflammatory, while CBD has anti-anxiety and anti-psychotic effects as well as anti-inflammatory and immuno-modulatory properties.

“Everything else is anecdotal,” Lucido says.

That’s partially true because the federal government blocks any research into the medical effects of smoked cannabis on humans. Even if the feds did allow it, marijuana has 70 different cannabinoids in it, plus varying levels of cannabinoid acids and terpenes (aromatic oils).

Also, every cannabis plant contains varying levels of cannabinoids. According to lab tests, the amount and ratio of cannabinoids in any given plant depends on its genetics (or strain) as well as how it was grown, processed and stored. THC levels can be anywhere from seven to 21 percent of the dry weight of medical grade cannabis, while CBD levels amount to anywhere from 0.1 percent to up to 16 percent of dry weight.

It’s cannabis’ intense variability that is responsible for its massive list of indications, but also responsible for how little we know about what strains are good for what. Everything might be anecdotal, but the anecdotes are strong.

SATIVA VS. INDICA

According to Rick Pfrommer, manager at Harborside Health Center in Oakland, medical marijuana strains can be divided into two loose categories, indicas and sativas. Sativas generally have a more energetic, cerebral effect, while indicas tend to create more lethargy and pain relief in the body. According to Dr. Kymron deCesare, laboratory manager for the UC Davis Department of Chemistry and laboratory manager at Halent Laboratories, calling something “sativa” vs. “indica” or even using its strain name is an “unreliable indicator” of its effectiveness on a certain ailment. There’s no clear line dividing sativa from indica—most plants are hybrids now—and strain names can be changed or misrepresented.

Each person’s body may be different, too, Pfrommer says. “Some people get the complete opposite effects,” he says.

That said, strong, solid indicas like Pure Afghan, Afgooey and Grape Ape are often recommended for neuropathic pain and insomnia. Also some sativas in the Jack Herer line have also been reported to treat back pain.

“[Generally], many people find sativas to help with depression,” Pfrommer says. They are good for a mood lift before creative work.

DRILLING DOWN

Pain, insomnia and tension are the top three reasons why patients seek medical cannabis, according to a 2006 RAND survey. Let’s take a look at strains right for each one:

—Halent is really bullish on strains high in CBD to treat neuropathic pain, and that includes Harlequin, Sour Tsunami, and Cannatonic. For musculo-skeletal pain, arthritis pain and age-related pain, Halent recommends juicing those same raw plants for their acids, as well as finding strains that test high in the terpene myrcene, b-caryophyllene and linalool.

—For insomnia, patients want to stay away from pure sativas like Green Crack and Trainwreck, which can be racy and cause an elevated pulse. Stick with indicas, and indica-dominant hybrids like Blackberry Kush, Blueberry, and King Louis Kush.

—For tension, stress and anxiety: hybrids tend to be the way people are going. Try blockbusters like OG Kush, Blue Dream and Jack Herer for starters.

—Halent reports that patients suffering from ADD and ADHD are using high doses of THC to get a clear-headed, project-oriented mindset. Strains like Super Silver Haze can be just what the doctor ordered.

Conversely, some patients can be made too anxious by ingesting high levels of THC, which can cause rapid heart rate, emotional hyper anxiety, dizziness and sometimes severe vomiting. Strains high in CBD like Harlequin can actually bring down a patient who has consumed too much THC, by reducing the psychoactivity of THC in the body and increasing its duration.

Halent also recommends strains high in THC-V, which is found mainly in South African sativas like Pineapple Purps and Durban Poison, because THC-V “effectively switches off the panic/fight-flight effect in the brain . . . [making it] highly effective in the treatment of PTSD.”

Scientists have also learned that myrcene—a terpene found in mango, Thai basil, lemongrass and beer hops—“speeds absorption of cannabinoids across the blood brain barrier, and increases the maximum concentration at receptors,” deCesare writes. You can get more medicated, quicker, by eating a whole ripe mango while eating cannabis or 45 minutes prior to inhaling it.

WARNING

People with a family or personal history of schizophrenia should stay away from cannabinoids, as they can precipitate a psychotic break in vulnerable individuals. Women trying to conceive, as well as juveniles should also avoid the plant, as it can affect conception and the developing brain.