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Cannabis for Concussions and TBI: The Best Cannabinoids

Cannabis for Concussions: The Best Cannabinoids
By Rachel Sims Published November 6th

Fact-checked by Alexandra Arnett, MS

Key Takeaways

  • CBD-dominant strains like Remedy and ACDC are popular for managing TBI symptoms.
  • Higher ratios of CBD might offer the most relief, depending on the severity of the TBI.
  • To find the best cannabinoids for a TBI: Start low and go slow > Pay attention to the cannabinoid and terpene profiles > Buy from a trusted source

The variety of cannabis products available with different cannabinoid concentrations can feel endless, especially for those new to the cannabis industry. However, finding the right blend of cannabinoids may be key to finding a cannabis product best for relief from symptoms of specific medical conditions, including traumatic brain injury (TBI).

Today, more patients are exploring cannabis for concussions, TBI, and a variety of other injuries. As the use of THC for brain injury gains attention, understanding cannabis’ impact on TBI recovery is essential to ensure safe and effective treatment options and to provide patients with well-informed guidance.

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Which Cannabinoids Help Most With Traumatic Brain Injury?

Chronic pain may affect between 43% and 75% of TBI patients. It's more common with mild TBI cases rather than more moderate or severe ones. Chronic pain also happens to be one of the most common conditions for medical cannabis patients. Studies show an increase in patients substituting opioid medications for medical cannabis. These findings include a sample of TBI patients, suggesting the plant may help with pain specific to the condition.1

Similarly, sleep disturbance may affect around 50% of TBI patients. As medical cannabis is regularly associated with sleep and relaxation, it's easy to see how it might help.1,2

But which cannabinoids might help the most?

CBD

According to current research, CBD may show promise for helping with a TBI. The strongest evidence points to products containing CBD or those that target the body's CB2 receptors as the most effective.3

THC

Is THC good for concussion recovery? At this time, the effects of THC as a treatment are less consistent. While the cannabinoid has the potential to ease some symptoms, research on its effectiveness for TBI recovery remains inconsistent, highlighting the need for further study to clarify its role in treatment.3

CBG

CBG is one of the most researched cannabinoids in neurological disease models. Its benefits in reducing inflammation, protecting nerve cells, and promoting neurogenesis suggest it may offer unique therapeutic relief, making it a possible option for patients seeking alternative approaches to neurological health.3

Entourage Effect

It may not be just any one cannabinoid that helps with a traumatic brain injury. Cannabinoids, terpenes, and flavonoids work together to enhance the overall effects of the cannabis product. For example, beta-caryophyllene shows the most evidence of a therapeutic effect from terpenes. This synergy is often referred to as the entourage effect, which indicates that different compounds in cannabis may work together to create a more therapeutic impact than any single compound alone.4

It's also important to note that not every TBI patient may experience positive effects from medical cannabis. An analysis of veterans with a TBI and cannabis use disorder (CUD) saw a negative correlation. Results suggest that patients with comorbid TBI and CUD may be at a higher risk for early-onset cognitive disorders like dementia.5

Which Cannabinoid Concentrations and Ratios Help Most With Traumatic Brain Injury?

cannabis for concussions

While some may benefit from individual cannabinoids, it's often a blend that best eases symptoms. As a result, finding the right cannabinoid concentrations and ratios is key. However, the effectiveness of cannabis for concussions can vary widely.

CBD-Dominant Ratios

CBD-dominant ratios are often considered to have mild effects and can be a safe starting point for TBI patients. They're also appealing to those seeking relief without THC's intoxicating effects.

Those newer to cannabis can help determine their appropriate starting dosage with a CBD dosage chart. Generally, with edibles or tinctures, start with low doses, typically 2.5mg to 5mg CBD. Over time, gradually increase by 2.5mg to 5mg as needed.6 When consuming via smokables like joints or vaping, start with one small inhale and wait a few moments to start feeling the effects. Then take more ‘hits’ as needed.

Starting low and going slow can ease you into the ideal serving size without overdoing it. It's recommended not to exceed 1,500mg of CBD per day (for those with an especially high tolerance).

Balanced CBD to THC Ratios

Some patients may benefit from a balanced CBD to THC ratio, such as 1:1 or 2:1. These ratios might be useful for CBD's benefits while also allowing for some of THC's effects.

However, it's important to monitor intake when using THC for concussion recovery, even in balanced ratios. Start low and go slow to avoid overconsumption, which may lead to greening out. "Greening out" is a term that describes consuming too much cannabis and experiencing adverse side effects from it.

THC-Dominant Ratios

THC-dominant ratios might be better suited for patients with severe pain or spasticity. The same as CBD, patients should start with 2.5mg to 5mg of THC and increase the dose gradually as needed.

For those using inhalation methods, starting with one inhalation is recommended. Wait 15 minutes before considering another puff, then increase by another inhalation until you achieve your desired level of symptom control. This approach may help better prevent adverse effects like anxiety or paranoia.

As with any treatment, the right concentration and ratio of cannabinoids will vary between patients. Consult with a healthcare provider and note how different cannabinoid ratios feel to find the most effective approach for your needs.

How to Choose Strains for Traumatic Brain Injury Based on Cannabinoid Content

Several key factors should be considered when choosing strains for a TBI based on cannabinoid content. Below are some factors to consider beyond a strain's cannabinoid content to find a suitable option.

Certificate of Analysis (COA)

It’s best to check a cannabis product's certificate of analysis (COA) before you buy it. The COA comes from a third-party lab that has tested the product for contaminants, potency, a cannabinoid profile, and sometimes a terpene profile. 

Cannabinoid Ratios and Concentrations

Those newer to cannabis or sensitive to THC might start with strains that have a higher CBD content. Patients can closely examine a cannabis product's packaging or COA to verify CBD and THC levels.

Higher CBD-to-THC ratios might be suitable for inflammation management and mental relief. Those considering THC for brain injury symptoms might find a balanced ratio with equal parts CBD more appropriate. Other patients may find the most relief from extreme chronic pain with a more THC-dominant product.3,4

Consumption Method

Different cannabis consumption methods can significantly affect how quickly and how well it works. Inhalation methods like vaping and smoking provide a quicker onset and can be ideal for those who need immediate symptom relief.

On the other hand, edibles or tinctures offer a longer-lasting effect and are preferred by patients who like the flavors or discreetness.

Ultimately, patients should consider which method best suits their lifestyle and symptoms.

Secondary Cannabinoids

CBG might be noteworthy for its potential neuroprotective benefits.3

The 5 Best Strains for Traumatic Brain Injury Based on Cannabinoid Content

CBD for brain injury

When choosing the best strain for TBI symptoms, it may be helpful to consider each one’s cannabinoid profiles. Below are five strains with varying cannabinoid content and ratios, each known for its potential to help with specific TBI symptoms.

Remedy

Remedy is a high-CBD strain that's also low in THC. It's prevalent among patients seeking relief without THC's intoxicating effects. With a CBD:THC ratio of 13:1, many find it effective at reducing inflammation, pain, and anxiety — all common among TBI patients. Remedy's high CBD content helps some patients feel relaxed without feeling groggy.

ACDC

Similar to Remedy, ACDC is a CBD-dominant strain with a typical CBD ratio of 13:1. It's favored by patients who seek relief from pain and spasticity without feeling overwhelmed by the effects of THC. ACDC’s high CBD content may help reduce anxiety and promote mental clarity. 

Twilight

Twilight has a balance of mostly CBD, some THC, and even CBC. It's popular among TBI patients for its ability to relieve pain and promote relaxation. Some patients report feeling energetic and creative. Its calming nature makes it ideal for managing physical discomfort and sleep disturbances. 

Maui Bubble Gift

Maui Bubble Gift has a near 1:1 CBD:THC ratio and often contains CBG. The blend may be what makes it a top choice for patients seeking pain and inflammation management while maintaining mental clarity. Its balanced profile provides some patients with effective symptom relief.

Lucy

Lucy is a CBD-rich strain, occasionally packing over 10% of each CBD. With about 1% CBG, it's known to boost mood without being overwhelmingly sedative. Patients often choose Lucy for its calming and anti-inflammatory effects, which can be helpful with TBI recovery. 

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References

  1. Hergert DC, Robertson-Benta C, Sicard V, et al. Use of Medical Cannabis to Treat Traumatic Brain Injury. J Neurotrauma. 2021;38(14):1904-1917. doi:10.1089/neu.2020.7148
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  2. Aychman MM, Goldman DL, Kaplan JS. Cannabidiol's neuroprotective properties and potential treatment of traumatic brain injuries. Front Neurol. 2023;14:1087011. Published 2023 Feb 2. doi:10.3389/fneur.2023.1087011 ↩︎
  3. Lins BR, Anyaegbu CC, Hellewell SC, et al. Cannabinoids in traumatic brain injury and related neuropathologies: preclinical and clinical research on endogenous, plant-derived, and synthetic compounds. J Neuroinflammation. 2023;20(1):77. 
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  4. Szaflarski J, Szaflarski M. Traumatic Brain Injury Outcomes After Recreational Cannabis Use. Neuropsychiatric Disease and Treatment. 2024;20:809-821.
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  5. Esmaeili A, Dismuke-Greer C, Pogoda TK, et al. Cannabis use disorder contributes to cognitive dysfunction in Veterans with traumatic brain injury. Frontiers in Neurology. 2024;15. doi:https://doi.org/10.3389/fneur.2024.1261249
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  6. MacCallum CA, Russo EB. Practical considerations in medical cannabis administration and dosing. European Journal of Internal Medicine. 2018;49(49):12-19. 
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The information in this article and any included images or charts are for educational purposes only. This information is neither a substitute for, nor does it replace, professional legal advice or medical advice, diagnosis, or treatment. If you have any concerns or questions about laws, regulations, or your health, you should always consult with an attorney, physician or other licensed professional.

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