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Working with the Heavy Cannabis User


If you are a practitioner working with heavy daily users of Cannabis, whether medical or recreational, or if you are a heavy user yourself, this course will:

  • Review the scientific literature behind a dozen of the most common approved conditions for medical Cannabis.

  • Describe forms and dosing strategies to increase effectiveness or reduce side effects for various approved medical conditions.

  • Describe the process of down-regulation, dependence, and withdrawal symptoms which can occur with daily use.

  • Describe the most common chief and secondary complaints of the heavy user in detail.

  • Describe the most common side effects and withdrawal symptoms, according to our case experience and surveys in the scientific literature.

  • Describe a strategy to delay or minimize down-regulation and withdrawal symptoms.

  • Offer a basic nutritional protocol and dosing strategy to minimize the effects of down regulation.

  • Review the effects of long term heavy daily use on cognition.

  • Review the effects of heavy use on the male and female reproductive systems, with case studies.

  • Describe the pattern of appetite loss, daily cyclic vomiting, and Cannabis emesis commonly occurring in heavy users – about 1/3 of our heavy users described such issues in their chief complaints or histories.

  • Review the typical pattern of effects in patients with post-traumatic stress disorder, with initial benefits but eventual loss of benefit and aggravation after down regulation and dependence, with case studies.

  • Describe nutritional and herbal strategies and formulation for the heavy user attempting withdrawal.

In our teaching clinical at the North American Institute of Medical Herbalism in Boulder, Colorado, we began to see an increasing number of heavy Cannabis users as patients after the legalization of Cannabis dispensaries in 2010. This course is based on a review of the cases and histories of more than 40 patients using between 4 and 10 doses of Cannabis per day, or using highly concentrated forms more than once a day. We began to recognize a consistent pattern of complaints and side effects in these patients which were consistent with side effects and withdrawal symptoms reported in the scientific literature and by such groups as Marijuana anonymous. About 1/3 of these patients were seeking assistance to cut down or quit Cannabis use after repeated attempts on their own to do so, and we got hands-on experience with different strategies. Beginning in 2016 we did a thorough scientific literature review of issues surrounding tolerance, dependence, side effects and withdrawal symptoms, and updated this review in 2021. In this course, we include example case reports, and also present more than 35 fully referenced scientific articles and literature on the topic, as well as specialized intake forms and educational materials for patients.

We are vigorous advocates for the complete legalization of Cannabis, but we feel that the safety insert on a package of medical marijuana should say more than “But its safer than alcohol.” Practitioners and patients should know what to expect and how to recognize the common effects, side effects, and withdrawal symptoms.



With this course you receive 5 hours of audio files for the 10 lessons, more than 180 slides to accompany the lectures, supplementary notes, readings, and more than 30 full-text scientific articles and clinical intake forms. The course comes with a Study Guide and Continuing Education questions. Students enrolled in our courses are also eligible for a 10% discount on purchases at Mountain Rose Herbs.




Lesson 1  Adverse Effects

Lesson 2  Dose and Srength

Lesson 3  Tolerance and Dependence

Lesson 4  Adverse Effects II

Lesson 5  Psychosis Symptoms

Lesson 6  Adverse Effects III

Lesson 7  Natural Therapeutics

Lesson 8  Pain

Lesson 9  More Approved Conditions

Lesson10  Support for Withdrawal

Further down on this page you can find Faculty Biographies.


Enrollment for Credit 


To enroll in the course, receive a faculty mentor, and to earn the Continuing Education certificate, follow these steps:

  1. Purchase the course materials in our online store. The materials may be purchased for self-study without further enrollment in the course or tuition. 

  2. When you receive materials, print out the application form or scan it to email. Send it in with the $75 tuition, or make the payment at the school store. 

  3. This entitles you to assignment of a faculty mentor for 12 weeks after we notify you that your enrollment is accepted. You may also request and extension. 

  4. Read the instructions for obtaining CE credit in the read-me-first file with the notes.

  5. Look over the CE questions and review them before listening to the audio. 

  6. Complete any assignments or readings and answer the CE questions for each lesson.

  7. You will receive a certificate reflecting 21 hours of CE credit.


The recorded lectures were delivered by NAIMH Director Paul Bergner in classroom settings, edited and supplemented with studio portions. If you enroll, you will also be assigned a faculty mentor. All our faculty are fully qualified clinical nutritionists as well as medical herbalists. Click here to see Faculty biographies. 


About This Course
  Hours:    15 CEU
Term:      12 weeks
Materials:     $79
See School Store for discounts

Tuition:    $75 (optional)

This course may be taken stand-alone, or as a  course in the Advanced Clinical Skills Certificate

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