You ingest a marijuana tincture which fails to respond to your pain. You go back to the dispensary and purchase an alternate tincture. This time the new tincture results in you sleeping for 24hrs. What happened? From your perspective everyone is telling you marijuana works quickly within 30-60minutes. What’s wrong? Like any other medication marijuana/cannabis sometimes doesn’t work. When pharmaceuticals do not work the medical term used is refractory pain refractory nausea or marijuana failure.

This article will describe some of the reasons cannabis fails to work. The most common is that marijuana is not a precise medication like a 500 mg tablet of Tylenol or 5 mg tablet of coumadin. Marijuana extracts were legally marketed by Merck, Burroughs-Welcome, Bristol-Meyers Squibb, Parke-Davis, and Eli Lilly in America at the turn of the 1900’s. Around 1920 prescriptions waned due to the ease with which pharmaceuticals came on the market to treat all the aliments that cannabis treated.   

There are over 4000 strains of the plant with various ratios of 9deltatetrahydrocanabinoid (THC) and cannabidiol (CBD), Extraction methods give rise to various formulations. CO2 extraction removes the terpenes which are then added similar to adding vitamins to milk after pasteurization.


Terpenes relieve inflammation, (black pepper, carrots, cloves, rosemary), fight bacteria, viruses, (pine), relax the GI tract (citrus, lemon), relieves stress, antidepressant, (linalool), acts as an anticonvulsant (lavender), and finally relieves pain and insomnia (mango, hops, lemongrass). Soil conditions, climate, temperature all affect the composition in the plant and it’s effectiveness.

The medium used to ingest cannabis can determine the effectiveness. Is it in olive oil coconut oil or alcohol? Cannabis is lipophilic meaning it needs a fat substance like avocado cheese ice cream or chocolate to activate. An alcohol base tincture will absorb more readily under the tongue than an oil base tincture.

Most nonresponses to a tincture may be from too little a dose or not using the cannabis on a regular basis throughout the day. A common practice of novice users is taking a dose, not feeling a response, then taking a second dose within thirty minutes. The cannabinoids build up in the liver and by the time they are activated a double or triple dose is felt. Generally, a repeat dose is not taken before two hours.

The best way to take medicinal cannabis is without the high. Not experiencing a high creates a false impression the medication is not working. Users who vaporize are surprised to find one toke is enough. The art of taking cannabis is to experience sleep or relief of pain without the high. 

Building up a tolerance after long term use is another reason for cannabis failure. Experienced cannabis physicians recommend a fast of 48 hrs. after six months of use to desensitize the endocannabinoid system (ECS). Dr. Sulak has a detailed protocol for desensitization. His protocol can successfully decrease daily dosage by up to sixty percent.

Cannabis is biphasic meaning it can relieve symptoms but too high a dose can create the opposite. Too much of the product can cause pain nausea insomnia or anxiety. If increasing the dose fails to produce relief try the desensitization protocol.

After taking cannabis consistently for three or six months the tincture no longer works. This may be an indication that the ECS response effected healing and it’s time to lower the dose. A different method of administration may be needed. Using a vaporizer or patch instead of a tincture.  Topicals do not penetrate the circulatory system. When the effect of topicals fades try adding a tincture as often getting the cannabinoids into the blood stream may be required.

Another failure may be caused by a hemp product which only has 0.3% THC. Some hemp products have no THC. THC is a very effective anti-inflammatory, analgesic, antianxiety and antiemetic medication.  Switching from a hemp product to a full flower product will bring a more entourage effect by combining THC with CBD.

If you or a family member has tried marijuana/cannabis without relief make an appointment with an experienced cannabis health professional at who can mentor your journey to holistic healing.

Ruth Hill consults clients on safe use of medicinal cannabis at