As regular medical cannabis users can attest, tolerance can be something of an issue to those seeking deep, consistent relief. So what is tolerance exactly and do you really have to take a break?
In 2011, a study from the National Institute of Mental Health (NIMH) explained the mechanism of action for tolerance and dependence with marijuana use. As we explained in an earlier blog, cannabinoids attach to the body’s cells through a receptor, like a key in a lock. Once the cannabinoids bind to the receptor, a chemical reaction takes place. This triggers a message that tells the body to react in a certain way.
Previously, studies in rats showed that with repeated exposure to marijuana, the number of cannabinoid receptors in the brain reduced. If the cannabinoid has no place to bind, no reaction can take place, meaning the marijuana does not produce any effect.
The NIMH study (which can be found here), used PET scans to demonstrate that humans who smoke marijuana on a daily basis (“chronically”) have a reversible reduction in the number of receptors that are available to bind to the cannabinoids. This reduction is found to be correlated with years of marijuana smoking (meaning the longer one smoked, the less receptors available) and was also found to be correlated to one location in the brain (the cortex).
However, after the human subjects stopped using marijuana (being continuously monitored in a secure research unit) the receptors increased to normal levels in about 4 weeks. This proves that the reduction in receptors is reversible. Interestingly, a similar study using alcoholics showed that in contrast to cannabis abusers (who had regionally selective and reversible down regulation of cannabinoid receptors), patients with alcoholism had a global reduction of cannabinoid receptors that did not reverse after one month of abstinence.
Gimme a break, gimme a break…
If you are a medical marijuana patient who uses pot daily, it can be beneficial to take some time off to allow the cannabinoid receptors to open up again, if you are able. This allows your tolerance to drop and will help minimize any dependency symptoms that could arise, should you stopped completely. Many patients find that they only need to take 1-2 weeks off every few months, especially if they are not using the medication multiple times during the day (as opposed to using it just once a day). If you are using marijuana multiple times a day every day and tolerance is an issue, you may consider taking 4 weeks off to allow your receptors to return to normal.
It is completely understandable that many patients are simply unable to take a tolerance break. Many medical issues treated by weed are constant and can be extremely severe at times and many users prefer to take tokes throughout the day, rather than pop pain killers or mood stabilizers.
But not all is lost. Much anecdotal evidence has found that many patients find that simply changing strains once and awhile (say once a week, or every few days) helps keep the relief strong. Ask our bud tenders about different strains for daytime and night time use. Marijuana is as varied as tea and coffee. Each strain has a different bouquet, taste and overall affect on the body. If you need to toke throughout the day, try a sativa. Then switch over to an indica to relax you in the evening. The possibilities are endless. Others say that it’s beneficial to give yourself at least 4-6 hours in between sessions, to give yourself a chance to clear your head a bit before medicating again. Wake ‘n Bakers can attest to how great that first toke is in the morning (after sleeping a full night). Others even say something as simple as switching up your method of administering (smoking, vaping, eating, etc) helps immensely.
So, while tolerance is definitely a real issue, there are still many ways to continue medicating with marijuana and not encounter any issues with consistency or quality.
For a more in depth look at tolerance, we highly suggest this article published by the Marijuana Library in 1995. While a little outdated, it still explains the science behind tolerance in a more academic fashion.