Cannabis is a plant that’s been used for medicinal and recreational purposes for nearly 6,000 years. It contains over 500 different kinds of compounds including over 100 different cannabinoids and 60 terpenes, the aromatic molecules that give cannabis its unique effects. While the full extent of interactions between these compounds is still unknown many of them are currently being studied for their potential health benefits.
The known medical benefits of cannabis entail the use of cannabis to treat pain, relax muscles, reduce inflammation and manage nausea/vomiting. Conditions that benefit from the use of medical cannabis include PTSD, muscle disorders like Parkinson’s disease, epilepsy, IBS and anxiety disorders like OCD.
With the passing of new cannabis laws an increasing number of people are now turning to cannabis as a source of medicine. But just how exactly do you take cannabis medicinally?
We provided a comprehensive guide outlining how to take cannabis for medical purposes below. This includes a brief introduction to the main therapeutic compounds in cannabis (cannabinoids). We’ll also breakdown the different methods of medical cannabis consumption along with their pros and cons.
The best way to maximize the therapeutic benefits of medicinal cannabis is to learn which cannabinoids are best suited for your condition/symptoms. You can then use this information to determine what types of cannabis (strains) are best for you.
The cannabinoid you’re probably most familiar with is THC (Tetrahydrocannabinol). THC is a psychoactive molecule known for the distinct psychoactive high it produces. While some susceptible groups may not benefit from THC its therapeutic potential as a medicinal compound is not to be understated.
“Despite the conventional wisdom, both in the popular press and much of the scientific community that only CBD has medical benefits while THC merely makes one high, our results suggest that THC may be more important than CBD in generating therapeutic benefits," says Jacob Miguel Vigil, Associate Professor in the Department of Psychology at The University of New Mexico.
THC currently shows promise when it comes to relieving pain, reducing muscle spasms, improve coordination in MS (Multiple Sclerosis) patients, treating atherosclerosis, reducing tics in Tourette syndrome (TS) patients and delaying progression of neurodegenerative disorders.
Two different types of THC exist. The first is Delta 9 THC. This is the THC you typically associate with a conventional high. The other type of THC is Delta 8 THC, a THC analogue “with antiemetic, anxiolytic, appetite-stimulating, analgesic, and neuroprotective properties.” Delta 8 THC is often favored by medical patients as it has a lower psychotropic potency (psychedelic effect).
The second most well-known cannabinoid is CBD (Cannabidiol). Unlike THC, CBD is a non-intoxicating compound, meaning it doesn’t get you “high”. This makes it a subject of great interest for patients and medical professionals, especially those who can not consume THC. CBD can also reduce the negative effects of THC.
CBD has an extensive list of health benefits that include anti-inflammatory, antioxidant and anxi-anxiety effects as well as promise as an analgesic and anti-epileptic. Health conditions that may benefit from CBD include chronic pain, diabetes, cancer and neurodegenerative diseases such as Huntington’s disease.
Patients taking certain medications such as blood thinners should exercise caution when using medicinal cannabis as these medications can have significant drug interactions with CBD.
Another compound that shows medical promise is CBG (Cannabigerol). CBG is the precursor from which all other cannabinoids are synthesized. As a result it can be very powerful medicine.
CBG is an anti-inflammatory and neuroprotectant. It’s currently being studied for treatment of several conditions including Hunginton’s Disease, Parkinson’s and IBS. CBG is also a powerful anti-fungal/anti-microbial agent that can fight infections like MRSA (antibiotic resistant bacteria) and is thought to be able to regulate mood thanks to its ability to block the reuptake of anandamide (your natural “bliss” molecule). In addition, research is currently being conducted to see if CBG may have future uses in the treatment of cancer.
CBN (Cannabinol) is a mildly psychoactive cannabinoid that’s produced when THC degrades. It’s thought to have a gentle sedating effect which is why some patients report using it to help manage conditions like insomnia or loss of appetite. Like CBG CBN is also thought to be a potential neuroprotectant with anti-inflammatory and anti-bacterial properties. It’s also thought to amplify the intoxicating effects of THC.
The other set of compounds to consider for medical cannabis use are terpenes. Terpenes are the aromatic molecules found within cannabis that give it its distinct effects. There are currently over 150 different kinds of terpenes, with known potential medical benefits ranging from bronchodilation to anxiety relief. Understanding your strain’s terpene profile is one of the best indicators of how it will affect you.
You may be able to view a strain’s profile by examining its Certificate of Analysis (CoA). A CoA is a third party analysis that details the cannabinoid and terpene content of your strain.
The first part of using cannabis medicinally entails knowing which cannabinoids and terpenes are best suited for your condition. Once you have an idea of this you can begin to think about which method of consumption is best for you.
Vaping is short for vaporizing, a process in which starting material like cannabis is heated up just below its boiling point without directly igniting it. The indirect heat releases the therapeutic compounds in cannabis as vapor that’s inhaled and released back into the air as a fine mist.
Many medical patients find vaping to be a much friendlier, healthier consumption method that is less irritating on the throat and lungs. Vaping also doesn’t produce smoke, reducing your exposure to potentially harmful byproducts of combustion. It’s also a highly discreet way to consume that’s portable and doesn’t leave a bad smell behind.
The effects of vaping can be felt almost instantaneously and reach peak effect 15 to 30 minutes after consumption. These effects can last up to three hours.
Patients seeking to use vaping medicinally should take great care to ensure there are no additives or thinning agents in the products they buy.
Oral consumption (edibles)
Another popular method of consumption is eating foods that are infused with cannabinoids (edibles). Oral consumption is also popular with patients as it is very discreet and edibles are fairly accessible. You can often find edible products sold online and in dispensaries as brownies, cookies and gummies.
There are distinct pros and cons to using edibles medicinally. While edibles are fairly popular oral consumption of cannabis subjects it to the first pass effect in the liver, resulting in the breakdown of additional cannabinoids. Edibles also have a delayed onset time that can range from as little as 20 minutes to a full two hours. As such patients should always wait a full two hours before consuming additional edibles.
Effects following oral consumption reach maximum effect two to three hours after consumption and can last anywhere from four to twelve hours. Bioavailability (the amount of drugs absorbed) of oral cannabis can vary, ranging from 4-30%.
Another type of oral consumption is sublingual. Sublingual consumption means under the tongue, and is used when consuming products like cannabis tinctures (concentrated alcohol or oil based solutions), lozenges or cannabis infused drinks.
This method of consumption is often preferred by patients as it circumvents the breakdown of cannabinoids through first pass metabolism and allows for accurate dosing. Cannabis is then absorbed directly into the bloodstream via mucosal membrane linings in the mouth, speeding up onset time. The effects of sublingual administration can be felt almost immediately and can last for several hours.
A special class of sublingual edibles based on nanoemulsifying technology are also available. These formulations are even faster acting than sublingual administration as they improve oral bioavailability of drugs with poor solubility.
Some patients treat physical pain with topical or transdermal applications of cannabis. A topical is any lotion, balm or oil infused with cannabinoids. These are generally used for localized pain relief and applied directly onto the skin. Due to the low porosity of skin it’s recommended that patients use highly concentrated topical formulations. The effects of topicals are generally felt within a few minutes of application. Conditions that benefit from topical cannabis applications include arthritis, joint and muscle pain and back spasms.
Transdermal cannabis patches operate in a manner comparable to nicotine replacement patches. They contain cannabinoids and are applied directly to the skin, thereby also bypassing first pass metabolism. Cannabinoids are then directly absorbed through the skin for a gradual period over time. Transdermal patches are a good option for patients who don’t want to re-up their dose several times throughout the day.
Highly potent versions of cannabis are available as concentrated solutions that can be vaporized. These include iterations of cannabis like hash, wax, budder and shatter and can contain up to 90% THC. The medical benefits of these concentrations can vary widely depending on the type of solvent used. Some forms of concentrates, like live resin, use cannabis that’s been flash frozen, thereby preserving valuable terpenes. Others include distillate products. These are highly potent isolated cannabinoids that often come as powders.
Due to the potency of concentrates this method of consumption is advised for patients with a very high tolerance to cannabis. Onset time is nearly instantaneously, with effects lasting 1-2 hours on average.
Patients with digestive issues can also opt to use rectal methods of cannabis administration. Cannabis suppositories enter through mucosal membrane in the anus, meaning they aren’t subject to the first pass effect and result in a shorter onset time. This method of administration also minimizes the psychoactive properties of THC which can be helpful for patients sensitive to its effects. One research paper found the bioavailability of THC used in rectal applications was nearly twice that of THC administered orally.
One of the most common types of medical cannabis use is smoking cannabis flower. While this is an oft practiced application it isn’t recommended for patients who may have lung issues including bronchitis or COPD (Chronic Obstructive Pulmonary Disease).
Cannabinoid absorption via inhalation ranges from 10–60%. Effects can begin within a few minutes of inhalation, with peak potency at 10 minutes and an overall duration time of 3 to 5 hours.
Cannabis use can come with unwanted adverse effects. The most common include dry, itchy or bloodshot eyes, changes in mood/appetite, impaired short term memory/judgment, drowsiness and paranoia. Chronic use is also associated with bronchitis and an increased risk of psychosis in susceptible groups predisposed to such illnesses. Other, more severe side effects can include hyperemesis syndrome or cannabis use disorders.
Consult your doctor if you have any questions on how cannabis may affect you.
Cannabis has been used in medical applications for thousands of years. The best way to determine the ideal cannabis for you is to understand what the unique properties of cannabinoids and terpenes are. This will help you determine what strain and consumption method is right for you.
Several different consumption methods are available for medical cannabis users. These include vaporization, oral consumption, topical applications and inhaling concentrates or cannabis flower. Each method of delivery comes with its own unique pros and cons. These usually include bioavailability, onset time and overall duration. Understanding your unique medical needs can help you determine which method of consumption is right for you.