BY RUTH HILL R.N.
Most people who do not use cannabis believe everyone smokes and gets high. The modes of administration are the same as any pharmaceutical: inhalation, oral ingestion, sublingual, buccal, topical, transdermal, and suppositories (rectal & vaginal). Recent studies have highlighted the challenges associated with cannabinoids’ formulation like low ability to dissolve in water, how quickly it is converted in the digestive system, how much of the dose is actually utilized in the body, and erratic activity of Δ9-tetrahydrocannabinol (THC) or cannabidiol (CBD) in the body over time, how is it absorbed, distributed in the body, localized in the tissues, and excreted. – all of which contribute to the limited efficacy of cannabinoids.
Unfortunately, smoking is the most inefficient form of adult use and not the most appropriate for medicinal use. Let us look at why. When smoking a joint at high temperatures much of the terpenes and 60% of the cannabinoids get evaporated. However, it is the most immediate response thus it is used medicinally for breakthrough pain, nausea, or anxiety. The effect can last one to two hours. A cleaner more efficient way to inhale is a vape pen (30% is lost) or through a volcano (54%) is gained, similar to using an Albuterol (ProAir) as a bronchodilator. Presently there is no way to measure the exact dose when inhaled.
The sublingual mode is using tinctures or sprays. Onset is quick in 15 minutes, similar to when a heart patient takes a nitroglycerin tablet for chest pain. Duration lasts 4-6 hours. Cannabis is lipophilic meaning it needs fat to metabolize. So, if no relief in an hour, take a fat snack like cheese, or avocado. If you do not like the taste, take it on a cracker. Tinctures are the best way to determine sensitivity to THC or CBD. Start low (2mgs) and build up slowly (10mgs) and space out the dosing.
The edible form is infused with the CBD or the THC molecule. It can be pills, capsules, gummies, tea, coffee, water, soda, pops, or chocolate. The edible follows the same path of digestion as food with the onset of 30-90 minutes and the duration is up to 12 hours. Edibles can be cut into smaller squares to lower the dose ingested. Some cultivators fill the capsules with broad-spectrum oil instead of just the infused molecules.
There are individual genetic differences that result in the dose taking 2-3 hours. This is because THC is turned into a metabolite by the liver that is stronger than THC. (11-Hydroxy-Δ9-tetrahydrocannabinol). For this very reason, tinctures are the recommended mode of administration for individuals using marijuana for the first time.
FECO (full extract cannabis oil) and RSO (Rick Simpson Oil) are highly concentrated forms of cannabis in which the whole plant is extracted and ingested orally. This process offers a broad spectrum or full-spectrum representation of the full cannabinoid and terpene profile found in that cannabis strain or cultivar. These products are usually used for cancer patients or children with seizures.
Topicals are CBD or THC rich in creams, balms, or liquids. Apply after a shower and 2-3x/day depending on the intensity of the pain. Onset is in minutes duration is up to four hours. Most topicals do not enter the bloodstream. Transdermal patches do penetrate the bloodstream for a slow-paced relief of up to 48 hours. Individuals with sensitive skin may get a rash when the patch is removed. It is not the marijuana that is the culprit, but the adhesive used to adhere to the skin. Patches are expensive because one is needed every 48 hours. Some users cut the patch in 2’s or 4’s.
Suppositories vaginally or rectally are used for severe pain with menses or cancer. Dabs—also referred to as wax, shatter, amber, honeycomb, or budder—are concentrated versions of butane hash oil (BHO) which contains highly-concentrated levels of THC. These can be very irritating to the throat, and are not suggested for medical use.
Learn more about how to use Marijuana Without the High on the 2nd and 4th Thursday of the Month from 11 AM to 1 PM at the Vault Dispensary Lounge. Call 760-866-9660 or send comments to cannaangel16@gmail.com
