Intros New patient - hello! - looking for some strain advice.

[Kieran84]

Hello all,

I have recently started trialing medical cannabis as a potential alternative to opioid painkillers - specifically: exploring cannabis as an alternative to tramadol for managing breakthrough pain while retaining Fentanyl patches for baseline pain management - and I would appreciate some advice re: strain selection.

I am very new to cannabis - I smoked during my late teens and very early twenties however I am now 41 and haven't touched it, or any other illicit substances, in the circa 20 years since - and my first prescription was for 10g of a strain called: Pennywise. Pennywise has provided quite effective pain management, albeit at the price of significant intoxication (ie 'getting high' - something I had hoped to avoid during the daytime) however every now again a stimulant effect seems to kick in and when it does some ADHD related problems which I am also trying to keep a lid on flare-up quite unpleasantly.

I believe it may be the terpenes (possibly the Pinene) that are causing this stimulant effect, however, as I am very new to cannabis, I feel it would wise to seek the advice of those with far more relevant knowledge and experience than I have - can any fellow forum users help me to identify the cause of the unpleasant stimulant effect which I'd prefer to avoid? and moreover can any forum users suggest some good daytime options which: relieve pain; won't bring about the above-mentioned stimulant effect; allow me to remain reasonably clear-headed and focused; and aren't sky-high in THC (while I'd probably have a fairly low tolerance in any event, using cannabis alongside Fentanyl patches makes the effects of both the cannabis and the Fentanyl stronger)?

On a separate note: this site has genuinely been very helpful and informative so thank you to all those who've contributed to its creation and upkeep!

 

[Dooby Doo]

Hello all,

I have recently started trialing medical cannabis as a potential alternative to opioid painkillers - specifically: exploring cannabis as an alternative to tramadol for managing breakthrough pain while retaining Fentanyl patches for baseline pain management - and I would appreciate some advice re: strain selection.

I am very new to cannabis - I smoked during my late teens and very early twenties however I am now 41 and haven't touched it, or any other illicit substances, in the circa 20 years since - and my first prescription was for 10g of a strain called: Pennywise. Pennywise has provided quite effective pain management, albeit at the price of significant intoxication (ie 'getting high' - something I had hoped to avoid during the daytime) however every now again a stimulant effect seems to kick in and when it does some ADHD related problems which I am also trying to keep a lid on flare-up quite unpleasantly.

I believe it may be the terpenes (possibly the Pinene) that are causing this stimulant effect, however, as I am very new to cannabis, I feel it would wise to seek the advice of those with far more relevant knowledge and experience than I have - can any fellow forum users help me to identify the cause of the unpleasant stimulant effect which I'd prefer to avoid? and moreover can any forum users suggest some good daytime options which: relieve pain; won't bring about the above-mentioned stimulant effect; allow me to remain reasonably clear-headed and focused; and aren't sky-high in THC (while I'd probably have a fairly low tolerance in any event, using cannabis alongside Fentanyl patches makes the effects of both the cannabis and the Fentanyl stronger)?

On a separate note: this site has genuinely been very helpful and informative so thank you to all those who've contributed to its creation and upkeep!

Welcome to the Community @Kieran84 and for sharing your experience so far with Medical Cannabis. It sounds like you need a balanced strain with a lower THC level. A 10/10 mx maybe THC/CBD. It could be a particular Terpene triggering these unpleasant effects. Someone here will be able to guide you more on this subject who mix or use lower THC or avoid a particular terpene. Good luck on the rest of your journey hope to see you in the forums sometime.

New post automatically merged: 10th Jun, 2026

Welcome to the Community @Kieran84 and for sharing your experience so far with Medical Cannabis. It sounds like you need a balanced strain with a lower THC level. A 10/10 mx maybe THC/CBD. It could be a particular Terpene triggering these unpleasant effects. Someone here will be able to guide you more on this subject who mix or use lower THC or avoid a particular terpene. Good luck on the rest of your journey hope to see you in the forums sometime.

If still unsure speak to your Consultant

 

[Joint Account]

Hello all,

I have recently started trialing medical cannabis as a potential alternative to opioid painkillers - specifically: exploring cannabis as an alternative to tramadol for managing breakthrough pain while retaining Fentanyl patches for baseline pain management - and I would appreciate some advice re: strain selection.

I am very new to cannabis - I smoked during my late teens and very early twenties however I am now 41 and haven't touched it, or any other illicit substances, in the circa 20 years since - and my first prescription was for 10g of a strain called: Pennywise. Pennywise has provided quite effective pain management, albeit at the price of significant intoxication (ie 'getting high' - something I had hoped to avoid during the daytime) however every now again a stimulant effect seems to kick in and when it does some ADHD related problems which I am also trying to keep a lid on flare-up quite unpleasantly.

I believe it may be the terpenes (possibly the Pinene) that are causing this stimulant effect, however, as I am very new to cannabis, I feel it would wise to seek the advice of those with far more relevant knowledge and experience than I have - can any fellow forum users help me to identify the cause of the unpleasant stimulant effect which I'd prefer to avoid? and moreover can any forum users suggest some good daytime options which: relieve pain; won't bring about the above-mentioned stimulant effect; allow me to remain reasonably clear-headed and focused; and aren't sky-high in THC (while I'd probably have a fairly low tolerance in any event, using cannabis alongside Fentanyl patches makes the effects of both the cannabis and the Fentanyl stronger)?

On a separate note: this site has genuinely been very helpful and informative so thank you to all those who've contributed to its creation and upkeep!

Hi @Kieran84

Welcome to MedBud, thank you for sharing your journey with us and I hope medical cannabis does turn out to be fruitful for you.

I think the first I'll say is that if you've not touched anything in 20 years you will need to build a tolerance, even the balanced strains will have some effect on you because your endocannabinoid system is getting a bit of a shock. After a few weeks you should see things really calm down - well thats the hope.

Pennywise is a balanced flower, that means it has higher amounts of CBD and less amounts of THC. the CBD helps keep the THC at bay. That is why you've been prescribed it, to ease you in. If you can purchase OTC CBD Cannabis, carts, hash, etc. (I would recommend flower) then you can dilute things further and create a more dominant CBD effect.

Many in the community use CBD products for this reason and can recommend some if you like.

The dominant terpenes in Pennywise are Myrcene, Caryophyllene and Humulene.

Myrcene - sedative properties; pain relieving, muscle relaxant, anxiety relieving
Caryophyllene - pain relieving, anxiety relieving, gastroprotective, antibacterial, antidepressant, antioxidant, neuroprotective, antifungal
Humulene - anti-inflammatory, antibacterial, and appetite suppressant

A flower with Myrcene, Caryophyllene, and Humulene is heavy, sedating, and physical, not stimulating. It's good for pain, muscle tension, insomnia, and evening use. It also tends to kill appetite instead of increasing it.

Cannabis as a medicine is something we're still learning about and its very complex. Emotional state, sleep, diet, terpenes, THC, CBD, CBG, CBN all play a huge role in how cannabis effects us, even their relationship with one another changes how the overall experience can effect you. so I think its really important to know that we don't quite know why everything with cannabis is the way that it is and any number of factors and factors interacting can create a billion different effects.

with that said, I'll put my house on it being the THC that is giving you the stimulant effect. I think its just a natural case of needing to build a tolerance before things balance out for you. If you're able to ride it out for a while, that's certainly one option, but I would really recommend some good CBD flower/tea to back you up. I tend to go for the horrible cheap stuff but @Lank72 may well be able to recommend some quality for a good price.

 

[Kieran84]

I would really recommend some good CBD flower/tea to back you up.

Hi @joint_account, thank you very much for your helpful and informative reply! Apologies if this is a daft question but re: the CBD flower: how should I consume it? Should I mix it in with my existing flower? vape it separately? or something else? I have, at the cannabis clinic's suggestion, some CBD gummies which I have been consuming, albeit at a fairly moderate rate as there doesn't appear to be any readily available clear guidance re: CBD dosing and I'd like to avoid inadvertently taking too much.

 

[Joint Account]

Hi @joint_account, thank you very much for your helpful and informative reply! Apologies if this is a daft question but re: the CBD flower: how should I consume it? Should I mix it in with my existing flower? vape it separately? or something else? I have, at the cannabis clinic's suggestion, some CBD gummies which I have been consuming, albeit at a fairly moderate rate as there doesn't appear to be any readily available clear guidance re: CBD dosing and I'd like to avoid inadvertently taking too much.

No daft questions around here mate!

Actually a good question - we tend to mix it in. The ratio is a bit self dependent but many start on 50/50 and adapt it depending on effects.

The great thing about CBD is that there isn't really a to much dosage. It's not a psychoactive compound so it doesn't feel like anything, what you feel is just the relief from pain itself. 300mg per day is verging into heavy use but we're still just talking about feeling tired as the worst effects. I bet your gummies get nowhere near that 300mg in the entire pack lol.

Im not an edibles guy, I find them a bit hard to dose and they're a little unreliable for trying to get them to kick in. That said, if you took them regularly you may feel the benefit in the same way you would with flower.

The reason I recommend flower is mainly because it's easier to divvy up with your THC flowers for an immediate effect.

I personally use 3:1 ratio of THC:CBD flowers in the morning but I think 1:1 is a smart starting point.

 

[Kieran84]

Thank you! You're right re: the gummies - 10mg CBD/gummy which equates to 250mg/pot. I will order some CBD flower and try mixing it with my THC flower.

 

[Joint Account]

Thank you! You're right re: the gummies - 10mg CBD/gummy which equates to 250mg/pot. I will order some CBD flower and try mixing it with my THC flower.

Looking forward to seeing how you get on.

I've just looked at some old threads and Bud Bros is typically a good place to get some CBD flower. Sometimes it's called tea.

 

[Dooby Doo]

Looking forward to seeing how you get on.

I've just looked at some old threads and Bud Bros is typically a good place to get some CBD flower. Sometimes it's called tea.

I was surprised how many sites use tea as its use

 

[Raggamuffin]

Hi @Kieran84

Welcome to MedBud, thank you for sharing your journey with us and I hope medical cannabis does turn out to be fruitful for you.

I think the first I'll say is that if you've not touched anything in 20 years you will need to build a tolerance, even the balanced strains will have some effect on you because your endocannabinoid system is getting a bit of a shock. After a few weeks you should see things really calm down - well thats the hope.

Pennywise is a balanced flower, that means it has higher amounts of CBD and less amounts of THC. the CBD helps keep the THC at bay. That is why you've been prescribed it, to ease you in. If you can purchase OTC CBD Cannabis, carts, hash, etc. (I would recommend flower) then you can dilute things further and create a more dominant CBD effect.

Many in the community use CBD products for this reason and can recommend some if you like.

The dominant terpenes in Pennywise are Myrcene, Caryophyllene and Humulene.

Myrcene - sedative properties; pain relieving, muscle relaxant, anxiety relieving
Caryophyllene - pain relieving, anxiety relieving, gastroprotective, antibacterial, antidepressant, antioxidant, neuroprotective, antifungal
Humulene - anti-inflammatory, antibacterial, and appetite suppressant

A flower with Myrcene, Caryophyllene, and Humulene is heavy, sedating, and physical, not stimulating. It's good for pain, muscle tension, insomnia, and evening use. It also tends to kill appetite instead of increasing it.

Cannabis as a medicine is something we're still learning about and its very complex. Emotional state, sleep, diet, terpenes, THC, CBD, CBG, CBN all play a huge role in how cannabis effects us, even their relationship with one another changes how the overall experience can effect you. so I think its really important to know that we don't quite know why everything with cannabis is the way that it is and any number of factors and factors interacting can create a billion different effects.

with that said, I'll put my house on it being the THC that is giving you the stimulant effect. I think it’s just a natural case of needing to build a tolerance before things balance out for you. If you're able to ride it out for a while, that's certainly one option, but I would really recommend some good CBD flower/tea to back you up. I tend to go for the horrible cheap stuff but @Lank72 may well be able to recommend some quality for a good price.

Hi @Kieran84

Welcome to MedBud, thank you for sharing your journey with us and I hope medical cannabis does turn out to be fruitful for you.

I think the first I'll say is that if you've not touched anything in 20 years you will need to build a tolerance, even the balanced strains will have some effect on you because your endocannabinoid system is getting a bit of a shock. After a few weeks you should see things really calm down - well thats the hope.

Pennywise is a balanced flower, that means it has higher amounts of CBD and less amounts of THC. the CBD helps keep the THC at bay. That is why you've been prescribed it, to ease you in. If you can purchase OTC CBD Cannabis, carts, hash, etc. (I would recommend flower) then you can dilute things further and create a more dominant CBD effect.

Many in the community use CBD products for this reason and can recommend some if you like.

The dominant terpenes in Pennywise are Myrcene, Caryophyllene and Humulene.

Myrcene - sedative properties; pain relieving, muscle relaxant, anxiety relieving
Caryophyllene - pain relieving, anxiety relieving, gastroprotective, antibacterial, antidepressant, antioxidant, neuroprotective, antifungal
Humulene - anti-inflammatory, antibacterial, and appetite suppressant

A flower with Myrcene, Caryophyllene, and Humulene is heavy, sedating, and physical, not stimulating. It's good for pain, muscle tension, insomnia, and evening use. It also tends to kill appetite instead of increasing it.

Cannabis as a medicine is something we're still learning about and its very complex. Emotional state, sleep, diet, terpenes, THC, CBD, CBG, CBN all play a huge role in how cannabis effects us, even their relationship with one another changes how the overall experience can effect you. so I think its really important to know that we don't quite know why everything with cannabis is the way that it is and any number of factors and factors interacting can create a billion different effects.

with that said, I'll put my house on it being the THC that is giving you the stimulant effect. I think its just a natural case of needing to build a tolerance before things balance out for you. If you're able to ride it out for a while, that's certainly one option, but I would really recommend some good CBD flower/tea to back you up. I tend to go for the horrible cheap stuff but @Lank72 may well be able to recommend some quality for a good price.

Hi Joint account , Interested in your description of effects of terpene’s in this post. Can I get a full list of terpene’s and there effects anywhere?

 

[Joint Account]

Hi Joint account , Interested in your description of effects of terpene’s in this post. Can I get a full list of terpene’s and there effects anywhere?

If you click on any of the terpenes above, or say click on Myrcene here, it'll take you to medbuds terpene breakdown.

There's literally 100s but it covers the major 20-40.

New post automatically merged: 28th Jun, 2026

Or have a gander here - https://canavape.co.uk/a-to-z-terpene-encyclopaedia-uk/

 

[Raggamuffin]

If you click on any of the terpenes above, or say click on Myrcene here, it'll take you to medbuds terpene breakdown.

There's literally 100s but it covers the major 20-40.

New post automatically merged: 28th Jun, 2026

Or have a gander here - https://canavape.co.uk/a-to-z-terpene-encyclopaedia-uk/

Excellent thank you.

 

[Joint Account]

Excellent thank you.

Sent you the wrong link in that post! I meant this one - https://loudspectrum.com/en/blog/terpene-temperature-chart?from=medicalterpenes

 

[Delta 9]

CBD Negative alosteric modulator , changes shape of opiod receptor so can clear fentanyl from site so could be good to take in prevention on overdose, Got its positive in brain.

CBD world a bit crazy so tread carefully , fsa recommend used to be 35mg daily i think but think brought it down to 10mg daily which is nuts compared to epidiolex lol , I dont know recommended dose in MC or fsa really. Elevated liver enzymes is the issue and think thyroid. Uses p450 enzymes which metabolise most drugs , CBD and fenynal use cyp3a4 and there might be an interaction with this and maybe causing more fentynal in blood.

To be safe i always take CBD 3-4 hours after pharma tabs so no interactions with meds.

Look into CBD 1st n take at the right time. Although very sedation 2 close together could create a euphoric onset that seems stimulatory but theres THC and terpenes to look at but look at interaction and timing. THC euphoric CBD should tame. Joint pointed out sedation type profile.

A hell of alot of CBD flower is terp sprayed so tread carefully .

If patches is slow release then it will use cyp3a4 longer , CBD is a cyp3a4 inhibitor , Get advice just to be sure. Vaping might n prob wont have the same effect as oral CBD but just keep this in mind and not overlook.

 

[Kieran84]

Thank you for the information, I will endeavour to tread carefully when buying CBD flower.

For what it's worth: @joint_account's recommendation worked well - adding CBD flower didn't make the issue of the unwanted stimulatory effect disappear entirely, but it did ameliorate the issue very significantly (thank you @joint_account !).

The issue seems to have been strain-related: I mentioned it to my doctor at the clinic and she was a tad sceptical but I switched to the Green Joy Mango Cheese and haven't had an issue since. Out of curiosity I put the question to ChatGPT and it was surprisingly helpful - according to ChatGPT, while Pennywise doesn't have a record of aggravating ADHD symptoms one of its parent strains, Jack the Ripper, does and it was probably the presence of those particular genetics which set me off. I'd usually add a caveat that one shouldn't place too much faith in AI however, in this particular instance, it appears to have been quite helpful. Going forwards, I am apparently going to have to exercise some caution around energising cerebral strains, particularly Haze strains and the delightfully named 'Durban Poison' strain.

 

[Delta 9]

Thank you for the information, I will endeavour to tread carefully when buying CBD flower.

For what it's worth: @joint_account's recommendation worked well - adding CBD flower didn't make the issue of the unwanted stimulatory effect disappear entirely, but it did ameliorate the issue very significantly (thank you @joint_account !).

The issue seems to have been strain-related: I mentioned it to my doctor at the clinic and she was a tad sceptical but I switched to the Green Joy Mango Cheese and haven't had an issue since. Out of curiosity I put the question to ChatGPT and it was surprisingly helpful - according to ChatGPT, while Pennywise doesn't have a record of aggravating ADHD symptoms one of its parent strains, Jack the Ripper, does and it was probably the presence of those particular genetics which set me off. I'd usually add a caveat that one shouldn't place too much faith in AI however, in this particular instance, it appears to have been quite helpful. Going forwards, I am apparently going to have to exercise some caution around energising cerebral strains, particularly Haze strains and the delightfully named 'Durban Poison' strain.

Terpinolene is the main terpene you need to stay away from , i didnt think it was in there but just showing main 3 terpenes so terpinolene more than likely 4th , usually sedative in smaller amounts but look at high silver profile , i wouldnt like to think Curaleaf hasnt shown it but could still be a good % in there. I have been very vocal about that terpene and how stimulatory it can be , i think there should be a warning sign to warn users esp patients who can have adverse effects to it.

 

[Joint Account]

Thank you for the information, I will endeavour to tread carefully when buying CBD flower.

For what it's worth: @joint_account's recommendation worked well - adding CBD flower didn't make the issue of the unwanted stimulatory effect disappear entirely, but it did ameliorate the issue very significantly (thank you @joint_account !).

The issue seems to have been strain-related: I mentioned it to my doctor at the clinic and she was a tad sceptical but I switched to the Green Joy Mango Cheese and haven't had an issue since. Out of curiosity I put the question to ChatGPT and it was surprisingly helpful - according to ChatGPT, while Pennywise doesn't have a record of aggravating ADHD symptoms one of its parent strains, Jack the Ripper, does and it was probably the presence of those particular genetics which set me off. I'd usually add a caveat that one shouldn't place too much faith in AI however, in this particular instance, it appears to have been quite helpful. Going forwards, I am apparently going to have to exercise some caution around energising cerebral strains, particularly Haze strains and the delightfully named 'Durban Poison' strain.

Very pleased to see you get some relief mate. Funnily enough I was thinking about you earlier wondering how you'd been getting on.

 

[Bayo]

I find oil gives the most opioid type relief.

I make my own but the prescribed stuff is effective and much easier to dose.

It’s longer lasting but more predictable without the rushes of a flower hit.

 

[Kieran84]

Yes, I have a balanced 10/10 oil in my prescription too and I have been very pleasantly surprised by how effective it has been. That said, my fentanyl patch, which I hope to reduce down to a lower dose alongside an increased oil dose (as a sparing drug) in the near future, is my principle source of background pain management — my cannabis prescription’s raison d’être is replacing Tramadol, which can also cause a bloody unpleasant stimulant effect, for breakthrough pain management and flower is significantly better suited to breakthrough pain management than oil as it is both fast acting and short lived.

 

[Bayo]

Tramadol is a horror drug for me as it took me weeks of withdrawals to get off it. It’s marvellously effective though.

It sounds like you’re getting a good toolkit together to act quickly on your symptoms. Please share how you get on!

 

[Hazy-Haze]

Tramadol is and isn't a horror drug. It's a pretty decent low to mid level synthetic opioid, but you have to be ruthless with how you use it and if you have sustained pain with no chance of recovery, it's not a good choice. Just like benzos once or twice a week is fine, but if you pop 3-4 a day for months, it's not fun to come off. it is also described as a horror drug, but if used in moderation, it is a good short term hack for dealing with a number of conditions.

Caveat, the longest I was on Tramadol was two months and I was running a heavy opioid saturation protocol (termed by an anaesthetist I was talking to at A&E about pain management) to keep on top of my pain relief (two tram every eight hours, then two max strength co-codamol four hours after the Tram, rinse repeat indefinitely). I wanted to avoid the seizure possibility with the Tram, but I still had a broken shoulder and bruised back that were giving me 8-9/10 pain level and 4-5/10 on that protocol, 1-2/10 with BM weed as an addition. At two months i removed the Tram and tapered off the codeine over a few weeks. (5 for 1 day, 4 for 1 day, 3 for 3 days, 2 for 4 days, 1 for 5 days and off). I don't 100% know if I needed to taper, but it seemed wise. If there was an issue, tapering the codeine lessened any withdrawal issues, since it metabolises to morphine and given the half life of morphine is 2-3 hours, you are forcing your body to be less and less dependent on it.