Many anecdotal and formal reports support the idea that the effect of CBD is improved when THC is added, even when added in very small amounts. Various medical conditions respond to particular ratios of THC to CBD. THC:CBD ratios express through plant phenotypes. For example, the whole cannabis plant pharmaceutical nabiximols has a 1:1 THC to CBD ratio that been shown to benefit spasticity pain in Multiple Sclerosis. Through the work of Dr. Roger Pertwee, one can see a very complex, refined and competitive relationship between CBD and THC. CBD, for example, acts to reduce side effects associated with THC, while also prolonging its effect.
The hypothermic effect of THC has potential to be both pro-palliative and anti-palliative. Leker, Mechoulam & Ovadia (2003) discovered that THC’s hypothermic effect contributed to reduction of ischemic damage following a stroke. In the context of EOL care, the fluctuation of temperature is known to be disruptive to comfort. In order to minimize fluctuation, medical providers tend to order drugs impacting body temperature on an around-the-clock basis.
There is one suggestion in the literature that ultra-low dose THC is associated with a neuroprotective effect. Waldman et al. (2013) studied a 0.002mg/kg dose of THC to prevent myocardial ischemic damage in an animal model. This study was aimed at identifying a cardioprotective agent for potential administration prior to cardiac surgery and found ultra-low dose THC to have neuroprotective and cardioprotective effects.
THCA is associated with many of the same benefits as THC and is available in raw cannabis that has not been dried. THCA is theoretically non-psychoactive, provided the plant material is fresh. According to The United States Patent 7807711 B2 entitled “Medicinal Acidic Cannabinoids” (The United States 2011), THCA suppresses inflammatory response, and is useful in the treatment of encephalomyelitis and autoimmune disease. A study by Sulak et al. (2017) presents physician-gathered data on cannabinoids to treat refractory seizures. These authors describe one case of THCA effectively treating a patient where THC and CBD had failed, and also report that THCA is becoming more widely used for seizure disorders in U.S. jurisdictions allowing MC. Lee (2017) reports that THCA in very small amounts with CBD has been effective for refractory childhood seizures, according to anecdotal reports by parents.
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