Safer use limits

A Doctor’s Guide to Cutting Down

Why cut down?

GDS2014 suggested about 1 in 3 cannabis smokers wanted to use less in the coming year. Most are motivated to reduce their by health concerns (over their mood, memory, motivation, respiratory health), while others report issues to do with work, their ability to study, the impact upon relationships or money worries. Cutting down is also a good thing to do if you are planning on stopping altogether since any withdrawal will less severe if you cut down first.

The potential benefits of cutting down vary between people but for most the sorts of problem that motivated them to want to sue less in the first place get much better. They lose tolerance, get more stoned on less cannabis and get more things done. Most feel sharper, brighter look better and notice improvements in their memory and chest. Most people sat their mental health gets better. But this is not always the case and for some people who might be suffering and self-medicating physical or mental health issues these might not get better- sometimes they might get worse. So I guess everyone has to make their own mind up about the benefits or not of cutting down.

How to cut down – most of this is common sense and can be summed up by less cannabis, less often, starting later in the day.

Less cannabis per joint/pipe/bowl - Getting more joints or bowls out of gram is an easy way to start making your cannabis go further and can be good way to start cutting down. Let the joint going out. Make smaller pipes that give fewer hits. Ration out what you are going to use each day and gradually edge this down.

Delay the time to first smoke of the day - For most people the joint that gets you most stoned is the first of the day so the later you leave it the more stoned you will get and the longer you feel stoned for from that first smoke. It also means you will get more stuff done during the day not stoned.

Increase time between smokes - Avoiding smoking spiffs back to back and leaving gaps between smokes mean you lower your tolerance, avoid getting so stoned you fall asleep and also get to nudge down your consumption.

Cut down on tobacco (if you mix with tobacco and start using NRT) - Smoking tobacco on its own or mixed in with your cannabis significantly reduces the lung harms associated with smoking cannabis, including the risk of cancer. It also reduces your chances of becoming a regular tobacco smoker. It’s easier to quit or cut down cannabis if you stop smoking tobacco as well – see next section on how to stop.

Reduce your caffeine intake - Coffee and other caffeine containing products can counter some of sedating effects of cannabis – as you cut down you might find you don’t need as much caffeine and that will make any effect on your sleeping of cutting down on cannabis less marked.

Increase not stoned activities especially exercise - As you spend more time less toned during the day you might find you have more time on your hands or you are get bored. So plan things – see people, do more exercise, and spend the money you save on weed (if you buy it) on yourself or other people you care for.

Spend more time with non-smoking mates - (you don’t have to stop being mates with those who smoke but you might need a few days away from them). If all your mates smoke cutting down can be really hard. Best tell them you what you are doing and explain you might be off doing other things with other people some of the time. If they are your mates they should support you in what you want to do.

Ration your daily use - Having a big bag of weed in front of you can make it hard to know how much you are using and can make knowing that you are cutting down hard. So some people, like to WEIGH out what they are using each day and after a week reduce that amount by lets say 25% – so they know they are cutting down. It works for some people but not for others. Chatting to your supplier OR mates about how they can help might be an idea as well.

Watch out for an increase in alcohol use - If you miss that stoned feeling be wary of topping up with booze. It can be a slippery slope for some.

Rate of cutting down: slower is better and associated with less severe withdrawal – that is disturbance of mood, sleep and appetite - Most people should be reduce their daily cannabis intake down by about ¼ each week without noticing much withdrawal –if they focus on not smoking during the day then they might find little difference in how stoned they feel at night and their sleep might also be unaffected.

If you want to stop

After cutting down - preferably to less than 1/2 gm/day you are probably ready to try and quit (if you want to!)

Withdrawal symptoms - which occurs in about 75% of daily cannabis users are worse in women, tobacco users, those who stop because they had to and those with mental illness,. The more you are smoking when you stop the more intense your withdrawal. They start on day 1 peak on days 2-4 and are over for most people after 5-10 days, though sleep problems and moodiness can continue for several weeks.

The most commonly reported symptoms are difficulty sleeping, weird dreams, irritability - (sometimes increased aggression), and restlessness, craving for cannabis and low mood last 4-10 days for most people.

It can be easiest to stop any drug if you are away from home - a change of environment can make it harder to score, easier to avoid bumping into people and places you associate with cannabis and the distraction and novelty of being away can help a lot. But that is not always an option and you live at home not away from it – some people say – hey better quit where you live than somewhere where you were going to stop anyway. So maybe thing to going away as a kick starter.

The biggest problem is sleep - people find it hard to get to sleep in the few days of not smoking and when they do they can get full-on weird and trippy dreams which sometimes can be very distressing.

Drink less coffee, tea and other caffeine containing products - Caffeine keep you awake, makes falling asleep harder and can make you feel anxious and restless. We suggest having no caffeine after 2pm in the afternoon and thinking about herbal sleep of few days of night sedation (either from your doctor) or over the counter. Don’t take any medication to help you sleep for more than 7-10 days. You delay the return to a normal sleep pattern and run the risk of starting to rely on them.

Exercise

There’s 3 reasons to do this apart the general fact that it’s a good way to stay healthy and feel good.

1. Exercise is a good way to distract yourself and fill in the time now you're not stoned all day. If its a group sport then you might make new networks of non cannabis people which can be useful.
2. If you were a smoker exercise is great way to motivate you to stay quit, since you will see a gradual increase in your fitness level and you'll start to feel healthier.
3. Exercising could help reduce your withdrawal symptoms! The breakdown products of can are stored in body fat. Recent research has shown that these cannabis products are released when you exercise - so they might help reduce withdrawal by effectively helping taper off the amount of cannabis in your body. Even if its just a theory for now - what's the worse than can happen? You get a bit fitter!

Avoid increasing your alcohol intake - Some people increase their alcohol use – while the odd drop at night might not be so unwise, alcohol actually make sleep worse and you need to watch that you don’t start drinking yourself into a stupor and becoming reliant on alcohol to get to sleep. You might try some relaxation tapes, progressive muscular relaxation (google it) and making sure the TV and all lights are off. And don’t nap during the day.

Cut out tobacco - coming off tobacco and cannabis at the same time is a good thing but can make withdrawal worse if you don’t use some form of nicotine to get you over the first few days of week or not smoking if you are a reregulate tobacco smoker or always mix your cannabis with tobacco. We suggest you consider using some form of nicotine replacement product such as gum or spray. If you use patches take them off before bed since they can make weird dreams even weirder.

Tobacco and caffeine - worth knowing: tobacco increase the breakdown of caffeine – so people who smoke tobacco tend to feel the effects of any caffeine less than nonsmokers. Many heavy cannabis users drinks lots of coffee/other caffeine containing products – in part to offset the sedating effects of cannabis. When you stop smoking cannabis not only will you be more alert (so need all the coffee) but if you have stopped smoking tobacco then your caffeine level can increase loads. Suddenly the amount of coffee that just kept you going suddenly becomes way too much – and it can worsen your withdrawal, sleep and make you way more restless and agitated.

Other problems - some people get headaches, lose withier appetite, feel sick, very sweaty, get chills or became very angry.

If you feel sweaty – take a shower and dress in light clothes; a headache take a simple pain killer, feel sick think about something for motion sickness you can get over the counter ( these can often make you feel sleepy – so make sure you ask for the right sort of one unless you’re after something to help you sleep). People can lose their appetite for a few days – some even lose a few kilos in weight. As long you avoid getting dehydrated then this is not a problem.

Anger - Some people especially men who already have a history of being angry and or violent can become very aroused and snappy and even sometimes aggressive when they come stop using cannabis. Make sure those around you now you trying to stop and might become more snappy or irritable. If this places other people at risk especially children then make sure you gets some professional help (and maybe some medication to calm you down) or ensure that that these people are not around. Sometimes even a few days in a detox unit can help.

What can my doctor do to help? - Cannabis be a cause of health problems (yes we know it can also help some conditions). If you are having difficulties cutting down or stopping or worried about how cannabis is impacting on your health or how it might be interacting with other medications, go chat to your doctor. Your doctor will probably know local specialists who might be able to help with problems that she / he is unfamiliar with.

When should I seek help? - If you can’t stop or cut down on your own or if your cannabis use is effecting your relationships, your ability to work and study or health in other ways – such your lung health (coughing, wheezing, short of breath) or mood then go have a chat and checkup.