Cannabis Consumption Methods and Bioavailability
In the rapidly emerging medical and adult-use world of cannabis, technology has advanced to take us far beyond the days of smoking dry cannabis flower. While each delivery method has its pros and cons, there are options for every want and need a person may have. Oftentimes, one person will utilize several delivery methods for the overall desired treatment effect. Please keep in mind that in this article, cannabis refers to both tetrahydrocannabinol (THC) and cannabidiol (CBD). Bioavailability is defined as the degree and rate at which a substance is absorbed into a living system or is made available at the site of physiological activity.
The most recently heard of and highly controversial method of delivery is vaporizing or “vaping” concentrated cannabis oil (Full Extract Cannabis Oil or FECO) or dry cannabis flower. Vaping FECO or other concentrates is either done by using a pre-filled, disposable cartridge or a device with a reusable reservoir. Another vape delivery method is using a device such as Volcano that can vape dry flower material and/or concentrated cannabis products (wax, shatter, budder, hash, dabs, etc.) The method of dry herb vaping heats the flower material at a lower temperature which reduces any byproducts. A vaporizer achieves the decarboxylation required to activate the cannabinoids by heating them just enough to be inhaled. By choosing to vaporize your dry cannabis flower or oil, as the lungs inhale the cannabinoids, they process the molecules and redistribute them through the bloodstream. This quick method of absorption results in the cannabinoids taking a more immediate effect, especially for relief of spasticity, anxiety, and severe pain flare-ups. The level of bioavailability with vaping cannabis oil is much better than with smoking cannabis cigarettes; at a comparison of vaping 50-80% and cannabis cigarettes at around 30%. The largest difference between vaping dry herb and smoking dry herb in cannabis cigarettes is that vaping uses low-temperature vaporization and cannabis cigarettes use combustion which can add harmful byproducts. Portable vaporizers are more discreet than smoking with minimal odor, which dissipates quickly.
Cannabis-based tinctures were a staple in American medicine in the late 1800s to early 1900s but due to prohibition, cannabis had been eliminated from western/modern medicine until recent years. These tinctures are available in a wide variety of cannabinoid formulations and dosages. Tinctures are typically taken sublingually, so the cannabinoids are delivered directly to the bloodstream which explains the 40-50% bioavailability of tinctures. Sublingual means applying directly to the pair of small salivary glands located beneath the tongue. Patients will find relief and treatment effects quicker than with edibles but not as quickly as inhalation methods. The lasting effects of tinctures depend on the patient’s tolerance and can be anywhere from a couple of hours to 4-6 hours.
By far, the most stigmatized and historical way of delivery is smoking cannabis in various forms; pipes, cigarettes, joints, blunts, bongs, and hookahs. The benefits of smoking as your method of delivery is quick-acting effects, many times within seconds. The effect tends to peak around thirty minutes and then will diminish within 2-3 hours; however, much THC/CBD is wasted due to the low bioavailability of smoking. The biggest pro of using raw cannabis flower is the patient’s ability to control the strain, source, and cannabinoid content. The largest drawback to inhaling cannabis with combustion is that of inhaling after combustion, which can create irritation in the lungs and the coughing experienced by many cannabis smokers. Another con to note is that flowers with the same strain name may vary in potency based on source and genetics. Some studies have promising results showing that the therapeutic effects of cannabis may directly counter any lung irritation to the point there is no link between smoking cannabis and lung cancer. It is important to note that in no way is smoking cannabis comparable to smoking cigarettes. Researchers in one study said, “Any attempt to try to equate cigarettes and cannabis exactly is probably a fool’s errand.”
Cannabis in edible form has been a popular method of consumption in the United States since the 1960s. The cannabinoids reach the cells by way of the liver, which converts THC into another, more potent chemical, 11-hydroxy-THC. The market is saturated with a variety of these items; baked goods, brownie & cookie mixes, beverages, cooking fats (butter, coconut oil), and treats such as lozenges, gummies lozenges, cookies & chocolates. The one major downfall of edible cannabis products is the lack of bioavailability at 4-20%, followed by a second major downfall of the time needed for effects to be felt by the patient, which will greatly vary from person to person. Edibles do have a huge benefit of being easily dosed and micro-dosed for patients that need a steady consumption amount. Edibles tend to onset in a wide variety of timeframes from 15 minutes to 2 hours; dependent upon the patient’s metabolism and whether or not the patient has an empty stomach (which may accelerate absorption). The effects of edibles are longer lasting than smoking and vaping, at around 4-6 hours for some patients; higher doses may result in effects lasting up to 24 hours. Edibles must always be consumed responsibly as it is very easy for patients to become impatient waiting for the effects and take high enough additional doses to create less than desirable effects. Always remember that if you are experiencing overwhelming THC effects, try consuming some CBD to reduce those effects.
Eastern medicine, or ayurvedic, practitioners have used cannabis-infused lotions, salves, balms, and other topical preparations for many thousands of years. The cannabinoids are absorbed into the skin and provide a much more focused, therapeutic effect that can last upwards of 12 hours. The onset of benefits may take five minutes for some patients and up to a couple of hours for others. It is important to note that topical applications (EXCEPT transdermal patches) negate the psychoactive effects of THC contained within the product. Topicals may aid in fighting bacterial skin infections, heal burns faster, reduce inflammation and arthritis, keep skin youthful, alleviate skin issues such as psoriasis and eczema, enhance sexual pleasure, and provide localized pain relief. Transdermal patches infused with cannabis are the exception to negating the psychoactive effects due to the fact that these patches worn on the skin deliver cannabis straight to the bloodstream. One thing to be cautious of with topical applications is any fragrances or additives that you may be sensitive to; always remember to test new topicals in a small area prior to applying over large areas of your skin.
Overall, there are options for every patient with all varying levels of treatment needs. Always remember to ask for independent lab tasting, always watch out for ingredients you may be allergic to, and never stop taking medications without the direction of your physician. Start small and work your way up in dosing, regardless of what consumption method(s) you choose. Cannabis can be a miraculous aid in improving a patient’s quality of life.
Disclaimer: As with any product you choose for your treatment, be aware of the product’s origins, additives, fillers, carrier oils, and chemicals, and be sure to ask for third party independent lab testing for any product you did not source or make yourself.
Please keep in mind it is illegal in the state of Missouri to use any combustible gasses or other dangerous materials in a home extraction process.
Nothing contained within this article is to be taken for expert medical advice; always consult with your physician before making changes in your treatment regiment.
