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The Art of Choosing A Medical Cannabis Strain

medical cannabis
Written by Sarah Friedman

With so many options out there, online shops and dispensaries with seemingly limitless variety in products, how exactly do we pick a cannabis or hemp strain? And how do we know which strain is best for anxiety, or pain…

At this point, most people are familiar with CBD (cannabidiol) and THC (tetrahydrocannabinol), and medical cannabis in general. Whether someone has personal experience with a form of it, knows a person who uses it, or is simply familiar with some of the information out there, the thought of these compounds has become rather ubiquitous.

If you asked people to describe what CBD is, you might hear answers like it’s a cannabinoid, or that its non-psychoactive, or that it’s found more heavily in hemp than other forms of cannabis. Same with THC: it’s found in cannabis, it gets you high, it’s good for glaucoma, etc. If you asked what cannabis in general does, you’d likely hear about some of its medicinal properties like as an anti-inflammatory, or to help with anxiety, as an aid in pain management, or to help regulate blood sugars.

But if you asked a more specific question, like, does any CBD or THC product or flower do all of these wonderful medicinal things? You might be left staring at a confused face. And if you asked which specific cannabis flowers are best for a particular issue, you’d be likely to get nothing but a blank face.

We might all know about the general medical benefits of CBD, THC, hemp flowers, and cannabis in general, but that’s just part of the story. The reality is that there is a massive variation between plants, and these variations often determine which type of flower is best for which ailment.

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How do strains differ?

Most cannabis users are already quite familiar with the idea that different plants can create vastly different experiences. While one strain might make a person feel light, happy, and motivated, another might make a person so tired and comfortable that the only thing they want to do is lay on their couch watching Netflix.

Still yet, another strain might make a person more anxious, or even create paranoia. Most cannabis users know that at the most basic level, plants are split into sativas or indicas indicating their general nature of leading to a more lively or sluggish high. Pretty much all strains at this point are actually some kind of mixture of the two, with wide variation in how they are mixed.

At one point the story might have ended there, but now we know there’s even more to cause even deeper differentiation. Like terpenes – a range of organic compounds that work in concert with cannabinoids to create synergistic effects.

The makeup of the terpene profile associated with a particular strain also plays into the effects the user will feel. As do flavonoids – plant metabolites that play into the overall medicinal attributes of a strain. So, what does all of this mean? It means there are an endless number of specific kinds of flowers out there, with new ones being made every day in nature and in laboratories, often with the specific purpose of encouraging a particular medical antidote.

While this example used cannabis, hemp is just as varied with a world of difference between hemp flowers and what they are able to do to help a person medicinally.

Hemp Flowers vs Cannabis Flowers

Now this is where things can get confusing for many people. Cannabis flowers have all the cannabinoids including THC, and is what you will often what you’d find in a medical cannabis dispensaries and recreational stores. Because they have THC, the do produce psychoactive effects. The intensity of these effects varies based on how much is consumed, the THC content in the strain that’s being used, and individual tolerance levels.

What’s The Difference Between Cannabis And Hemp?

Hemp, on the other hand, is classified as having less than 0.3 percent THC content and often used for more industrial purposes. Some hemp plants grow flowers similar to cannabis, but they contain only trace amounts of THC and no other psychoactive compounds. Most hemp plants are CBD-dominant, although an increasingly popular alternative is CBG-dominant buds.

For the purpose of this article, we will be discussing medical cannabis flowers, as that is where most of the existing research has been conducted.

What do we know?

While we know – and are constantly learning – plenty about cannabis as a whole, the benefits of different cannabinoids, and the roles of terpenes, flavonoids, and other compounds found in cannabis plants, it is still extremely difficult to point to a specific strain and say ‘this is best’.

As of yet, there is no definitive research into definitive strains for definitive problems. Any listings found online are merely subjective guessing by writers, though often based on oft repeated assertions, like that CBD heavy or 1:1 ratios are better for pain, or high THC strains can be bad for anxiety. Of course, even these assertions will not always prove true. This is twofold:

  • Even when two different entities offer the same strain, it is never going to be identical which, of course, creates issues with consistency between retailers, making it harder for customers to know what version of a strain they might be purchasing, and how useful it will be for them.
  • The often subjective nature of cannabis compounds. Truth is, a high dose of THC isn’t going to make everyone paranoid, and a strong 1:1 ratio might not be applicable for all kinds of pain. It is not uncommon in either the pharmaceutical world or the natural medicine world for a compound to elicit different effects in different people, meaning that a person’s needs might be specific to them, and not reflected in a more generalized overview.

The farther we get into what we DO know, the more it becomes relevant that simply being able to measure what we DO know is a task unto itself.

The start of measuring

One of the most popular uses of CBD and hemp flowers these days is for the treatment of anxiety. In a quest to find which strains were best at treating anxiety, this study investigated this topic by looking for correlations between cannabis chemotypes and the effectiveness of different kinds of cannabis to treat anxiety symptoms.

All plants have chemotypes, or chemically distinct entities

Chemotypes are subspecies of a plant or microorganism that are chemically distinct but show differences in the composition of their metabolites. The investigators looked at the reporting of cannabis patients, and then at the similarities or differences of the strains picked most. In doing the study the researchers essentially set a benchmark for future investigators looking to do the same thing.

After all, it’s great to ask the question, ‘what works best?’, but before it can be answered, there has to be a system for comparison and measurement. This study was very interesting in that it set what is likely the first groundwork for making real assessments into cannabis strains, rather than having endless articles written based on subjective reasoning.

The study was performed by way of survey. It included 90 questions that covered patient health, personal patterns of medical cannabis use, perceived effectiveness for symptom alleviation or management, and strain preference for different symptoms.

More than half of all participants reported using cannabis daily for anxiety management, while only 15% reported an actual diagnosis of anxiety or a related disorder. 14% of participants named anxiety as an unwanted reaction to cannabis. All participants were users of a specific brand to ensure consistency, with 25 common varieties to choose from. They were asked to explain which strain worked best for which symptoms, and which worked least.

In the event that they wanted to list a strain that was not a part of the 25, there was also an ‘other’ option. Participants were also allowed to name more than one strain if applicable. In this particular study, the following four strains were picked as the best for dealing with anxiety from most to least:

  • Bubba Kush
  • Skywalker OG Kush
  • Blueberry Lambsbread
  • Kosher Kush

The four least effective strains for dealing with anxiety were:

  • Chocolope
  • Blueberry Lambsbread
  • CBD Shark
  • Tangerine Dream

It is, perhaps, very telling of how different we really are from one another, that Blueberry Lambsbread showed up on both lists!

The researchers didn’t stop here though, because they wanted to know if there was a correlation between the chemotypes of these different strains and their effectiveness in anxiety treatment. In this way, the specific terpenes and cannabinoids could be weighted as per how their respective strains were voted, and then compared. When looking at the final analysis, it was found that the most abundant terpene in the most effective strains was nerolidol, and the most abundant terpene in the least effective category was myrcene.

The pain issue

Aside from anxiety, probably the most common reason people medicate with cannabis is for issues of pain. Once again, the question arises of which strains are best for dealing with pain. In 2018, this study came out to asses cannabis use for those suffering from migraines, headaches, arthritis, and other forms of chronic pain, and to see which strains they preferred to treat their symptoms.

The Role of Cannabinoids in Treating Chronic Pain

In this study, as well, the participants filled out a survey about their use, preferences, and experiences, with migraine sufferers filling out an ID Migraine™ Questionnaire. This study had 2032 respondents that covered 21 illnesses treated with cannabis. Among the respondents:

  • 42.4% pain syndromes
  • 29.4% chronic pain
  • 9.3% arthritis
  • 3.7% headaches

The general results relevant to this topic were as follows:

  • Hybrids were preferred across all pain subtypes
  • OG Shark was the preferred strain in migraine and headache groups

This second point is interesting in that OG Shark is a high THC, low CBD strain which makes it not the assumed answer for those trying to guess it. Its most prominent terpenes are β-caryophyllene and β-myrcene, and it could very well be its terpene profile that gives it strength, once again making the chemotype of the specific plant extremely important when looking at its capabilities.

How to pick your cannabis

Truth is, if you wouldn’t pick your own antibiotic, or blood pressure medicine, it might be good to get some input on your best cannabis option. When looking for a specific remedy, it’s a very specific chemotype that’s necessary, and it won’t always show up where we expect it to.

If your medical issue is very specific, I recommend speaking to your doctor, and if your doctor is not certified in dealing with cannabis (as no standard MD will be), then find one who is. A non-cannabis certified MD will not know anything about it, and could very easily provide the wrong, and even harmful, information.

This is not pharmaceutical medicine and when looking for guidance, understand where to look. While a naturopathic doctor is always preferable – as this is their specific field of study – an MD with active cannabis certification is a close second. If your medical issue is less specific, or you are already more informed on how to treat it, give our product reviews a read-through to see if anything sounds good to you.

While we are not medical professionals here at CBDtesters, we are happy to provide any information we can on the use of cannabis, CBD, and the newest and best products out there. We promote healthful ways of solving medical problems, and encourage our readers to find the right cannabis products for them. Please see our product reviews for further information.

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About the author

Sarah Friedman

I am a US born writer, travelling the world and doing the digital nomad thing.

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