Understanding cannabis tolerance

Understanding cannabis tolerance


Are you no longer getting relief from your smoked cannabis medicine? Should you smoke more flower? Try a higher THC flower? Both? Maybe, but in the long run, you will likely keep increasing your dose, THC concentration, and financial expense. Many patients chose their dried flower medicine based on the “highest tester,” or the strain with the highest percentage of TCH. This may lead to desensitizing your cannabinoid receptors and the downregulation of your endocannabinoid system (ECS), or what people commonly call developing tolerance. The experienced cannabis nurse consultants at 2 Leaf Nurses can assist individuals that have developed THC tolerance. Let’s discuss the ECS and how to keep it performing optimally to prevent tolerance.  

Several factors may be involved when your smoked cannabis medicine no longer provides symptom relief.

First, how optimized is your ECS? The condition of your ECS may determine your response to cannabis, perhaps more than the concentration of THC in your flower. Do you only smoke joints? Delivery methods can significantly affect the amount of TCH introduced in the ECS. Once the THC reaches your ECS, are enough quality receptors present to utilize cannabinoids? Did you know that you may be able to “reset” your ECS, optimizing your cannabis experience? 

The endocannabinoid system is a marvelous network of receptors present in all vertebrate species (living things with a backbone). Our ECS helps us interpret external and internal stimuli, then based on that information, biochemical adjustments occur to maintain a balance or homeostasis. Optimizing your ECS can influence the quality and quantity of cannabinoid receptors. 

Next time you are at the store, grab foods high in Omega-3 fatty acids such as hemp, chia, and flax seeds. Add these to smoothies, baked goods, or cereal to boost your ECS. Walnuts, cacao nibs, eggs, and sardines are also excellent choices. Omega-6 fatty acids are essential, but most individuals get plenty in the form of vegetable oils and meat. A 50/50 balance of Omega 3’s and 6’s is optimal. Exercises such as yoga and walking are excellent for your ECS. Any activity you enjoy is beneficial. Staying hydrated and getting enough rest will also optimize your ECS. An optimized ECS will provide quality receptors, enhancing the effects of cannabis medicine.

How do you smoke your cannabis flower?

Each method has its pros and cons, but did you know that it can also affect the amount of THC available? Cannabis joints deliver about 27% of available THC, and glass pipes provide around 50% (Clark, 2021). Also, contrary to popular belief, “holding” your smoke does not increase the amount of THC absorbed; it only damages your lungs. Your ECS is designed to respond to change and keep it on its toes by switching up delivery methods periodically.   


So, you have optimized your ECS and switched up your delivery methods, but you are still not getting the relief you once did. Before jumping to the “highest THC tester,” you may benefit from “resetting” your ECS. Many patients succeed in a relatively simple process called the Sulak sensitization protocol, as developed by Dr. Dustin Sulak. The process involves tracking your regular cannabis use through pre-day one and day 1. Days 2-3 are cannabis fasting days. Fasting is required to give sensitization a proper try, but remember those Omega-3s and exercise? Utilize these ECS enhancers throughout cannabis fasting, along with hydration and rest. On days 4-6, cannabis is slowly reintroduced. Resetting your ECS to respond to the smallest amount of cannabis with the most therapeutic effects is the goal and will lead you to your optimal dose. (Clark, 2021) If you have any concerns about cannabis fasting or the process in general, reach out to the cannabis nurses at 2 Leaf Nurses. We can coach you through the process and discuss if it is suitable for your situation.

Most patients who use less than 3 grams of flower per day will not develop a tolerance. The highest risk for desensitization is for patients who smoke more than 5 grams of dried flower daily. (Clark, 2021). If you find yourself needing more dried cannabis flower and higher levels of THC to achieve previous results, you may benefit (physically and financially) from boosting your ECS through diet and exercise, changing delivery methods, or following a sensitization protocol. 

Optimal dosing will be different for every patient. Some patients may need as little as one milligram of THC per day. Others may need much higher doses, even if they have tried desensitization. All patients have unique medical and personal histories and require personalized cannabis care. Reach out to the trusted cannabis nurse consultants at 2 Leaf Nurses to assist in navigating cannabis education, collaboration, and advocacy. Every cannabis patient deserves a nurse that cares.


Citation: Clark, C. (2021). Cannabis A Handbook for Nurses. Wolter Kluwer.

The information provided by 2 Leaf Nurses is for educational purposes only. Nothing contained within should be construed as, nor intended to be used for, medical diagnosis or treatment. This information should not be used in place of the advice of your physician or other qualified health care provider. Always consult with your physician or other qualified health care provider before embarking on a new treatment, diet, or fitness program. You should never disregard medical advice or delay seeking it because of any information on this website.


ERIKA FIELDS, RN, is an affiliate nurse for 2 Leaf Nurses providing assistance navigating the medical cannabis world for new and seasoned patients alike. 2 Leaf Nurses acts as a guide for patients, caregivers, and medical professionals in Missouri. Erika is now accepting patient consults, for more information visit 2 Leaf Nurses or follow Erika on Facebook and Instagram.