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Every Type of Cannabis Oil, Explained

Cannabis is a remarkably versatile plant. You can smoke it, eat it or even infuse it into topical skincare products. You can vaporize it, drink it as tea, indulge in an extra potent cannabis concentrate or even get it in an inhaler. 

This article will focus on cannabis oils and helping you navigate the various types.

Cannabis oils are often placed under the tongue (sublingually) where they are then absorbed through the mucous membrane lining in your mouth and enter the bloodstream much faster. 

Sublingual absorption also bypasses the gastro-intestinal tract, where compounds can broken down before they are metabolized. It also boosts how much cannabis is absorbed by your system (bioavailability), thereby amplifying its effects.

The following is a guide to the most common cannabis oils.

Hemp Seed Oil

The terms CBD, hemp, and hemp seed oil are not interchangeable. While the terms may be colloquially used this way each one denotes a very specific, unique part of the cannabis plant.

Hemp seed oil is not hemp, nor is it CBD oil. It’s the oil extracted from the seeds of hemp plants. Be wary of brands that claim to sell CBD products that list “hemp seed oil” as the sole ingredient. This is a misleading practice used to trick consumers into believing they’re purchasing CBD oil, a much more expensive product.

Humans have been using hemp seeds as wellness products for thousands of years. Hemp seeds have been used in Chinese medicine to relieve constipation. They’re also full of beneficial compounds such as α-linolenic acid, an omega-3 fatty acid that may prevent coronary heart disease.

Hemp seed oil (also called sativa seed oil) is made by cold-pressing hemp seeds together. You can use hemp seed oil in cooking or even in beauty products. 

Hemp Oil

The most common question surrounding hemp oil is whether or not that is the same thing as “CBD oil.” 

Hemp is, in simplistic terms, a CBD-rich cannabis plant. The only difference between the two is that the amount of THC in hemp is federally regulated. In the US, hemp must contain no more than 0.3% THC. 

Hemp oil, therefore, is derived from hemp plants and alongside CBD and other elements, contains trace amounts of THC. It can be made in one of several different ways. We’ll learn a little more about how hemp oil is made further down when we discuss CBD oil.

Like CBD oil, hemp oil can be full or broad spectrum. The term full spectrum means that all of the hemp plant’s compounds (cannabinoids, terpenes and many more) are preserved in the final product. Broad spectrum products contain all of the plant’s cannabinoids except for THC. 

Full spectrum oils are often recommended for patients as they provide the most potent health benefits. This is due to the “entourage effect,” a theory states that the full spectrum of compounds found in the cannabis plant are more powerful when they work together — as opposed to extracts containing only one isolated cannabinoid.

The most refined version of hemp oil available is made with an isolate, a lone, extracted cannabinoid (in this case CBD). Some manufacturers may dissolve CBD isolate, into carrier oils for easy use.

Cannabis Oil

The term ‘cannabis oil’ is incredibly broad. Without any additional context it can be used to denote any type of oil made from any part of the cannabis plant. This can include anything from hemp seed oil to hemp oil as well as CBD based oils. It can also be used to loosely denote high-THC oils like RSO (Rick Simpson oil). 

Cannabis oils can have different absorption rates depending on how they’re consumed, which is why many patients favor sublingual absorption. You can, of course, also consume cannabis oil that’s been incorporated into food (an edible). While the bioavailability of edible THC is 4-12%, edibles tend to last a little longer (6-8 hours) than sublingual oils (4-6 hours).

Some cannabis oils may even be made with lesser-utilized parts of the plants like stems, or may contain a mix of oils, such as hemp seed oil blended with another carrier oil. A few common carrier oils include coconut/MCT oil, sunflower oil, and olive oil.

There are several different ways you can make cannabis oils. These include:

CO2 extraction

Manufacturers can use CO2 to extract cannabinoids from the plant. This method is often considered to be one of the safest ways to extract cannabis as it does not require the use of an additional solvent. 

CO2 extraction can be supercritical or subcritical. Supercritical CO2 is carbon dioxide that’s been heated and or pressurized until it exists in a state between liquid and gas. This type of extraction is very useful as it produces a large yield of CO2, but the extreme temperatures can destroy volatile compounds like terpenes. Subcritical CO2 extraction uses lower temperatures to preserve the plant’s compounds.

Lipid-based extractions

Lipid-based extractions infuse fats, usually carrier oils, with cannabis until cannabinoids are absorbed. While less precise than CO2 extractions they tend to preserve more of the plant’s cannabinoids, making this an ideal extraction method for patients.

Ethanol-based extraction

Another way to make cannabis oils is to extract the plant’s cannabinoids with ethanol. This technique soaks cannabis flowers in ethanol, a process that strips the plant of its cannabinoids. The resulting mixture is then subsequently processed. 

Ethanol based extractions are often more cost effective than other extraction methods. However, the polarity of ethanol means it has a proclivity to bind to water soluble parts of the plant such as chlorophyll, which can produce a bitter flavor if not removed.

THC Oil

THC (tetrahydrocannabinol) is one of at least 140 cannabinoids found in the plant. It is often the primary constituent found in cannabis, which means that breeders have typically focused on cultivating plants with high THC yields. Flowers today can express THC concentrations of up to 35%

Unlike CBD, THC is psychotropic. It has a wide variety of applications and can be used as an analgesic, an anti-epileptic, or as an antiemetic. 

THC oil is oil made from THC-rich cannabis flowers. It can be made in several different ways and infused into several different types of carrier oils. You can buy (and make) full spectrum THC oils as well. 

You may have also heard the term “hash oil” used before. This is a slight misnomer as the term is actually referring to a resin extract derived from cannabis. Hash oil is made by stripping the plant’s cannabinoids with alcohol. The alcohol is cooked off, leaving a sticky residue oil behind. 

CBD Oil

One of the most popular cannabis oils is CBD oil (cannabidiol). This oil can be made from the flowers of hemp plants or CBD-rich strains. Like THC oils, it can also be made using a variety of techniques including CO2 extraction and ethanol-based extraction methods. It can be bought or made as a full- or broad-spectrum product. 

The amount of THC is regulated for hemp (generally between 0.3 and 1% THC). As such, CBD oil made from hemp contains a minimal amount of THC (less than 1%). CBD oil made from CBD-rich cannabis flower, but it can contain larger amounts of THC. 

BHO Oil

BHO (Butane Hash oil, also sometimes called Butane Honey oil) is a resinous oil extracted from cannabis plants. This is usually done using butane as the primary solvent. 

BHO oil can take on several different consistencies depending on the heat and humidity used. These include: budder, shatter, pull, and snap, wax, crumble and sap, among others. BHO oils are a type of concentrate that can be consumed in a variety of different ways, primarily through dabbing or vaporization.

This technique has grown decidedly less popular with time as BHO is flammable and prone to igniting when exposed to a spark during the manufacturing process.

RSO (Rick Simpson Oil)

Rick Simpson Oil is another resinous oil left behind when cannabis is extracted with alcohol. It’s one of the most highly concentrated forms of cannabis you can get today. The creator of this type of oil, Rick Simpson, claims to have used it to successfully treat his skin cancer.

RSO is made by stripping the cannabis plant of its terpenes and cannabinoids via isopropyl alcohol. The plant is stripped and the mixture is cooked off until nothing but the resinous oil remains. As such you can find CBD-only RSO, THC-only RSO, and RSO that contains a mixture of both THC and CBD.

Ideal administration of RSO is sublingual as it maximizes bioavailability. However many find the taste of RSO to be extremely bitter and may opt to consume it orally instead. Its effects are extremely strong.

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Why Less Is Often More With Medical Cannabis

Cannabis can relieve anxiety, but it can also cause it. Cannabis can make you sleepy, but it can also give you energy. Cannabis can relieve pain, but in some cases it can worsen it. 

Some of these opposing effects may be due to differences in the chemical composition of a particular cannabis product — or by differences in the individuals using cannabis. But there is also another explanation — the biphasic response of cannabis.

What is a biphasic response? And what does it mean for finding the right cannabis dose for you?

When a chemical has a biphasic response, it means that the single substance can produce two opposing effects, one at a lower dose and one at a higher dose. 

Consider the effects of alcohol, a common substance with a biphasic response. Have a single drink, and the low dose might leave you feeling happy, full of energy and ready to be social. On the other hand, take a high dose like say 10 drinks, and you are more likely to become tired and sad. 

This kind of effect is usually represented with a biphasic response curve. If you were to graph it on a chart, on one side you would see how an effect (like the positive mood you experience with your first drink) starts at your baseline and increases as your dose of alcohol increases. But at a certain dose, this effect actually reverses. After this point, as the dose continues to go up, the curve of your positive mood goes back down — getting worse as you continue to drink. This creates a bell shaped curve — or a biphasic response curve. 

Biphasic Response Curves and Finding the Right Dose

In terms of dosing, this means that to achieve the effect you are looking for you need to know what the optimal dose is — and specifically what dose is right for you. As we all know with alcohol, sensitivity can vary. One person may feel nothing from a single drink and only reach the happy social part of their response curve after a few drinks. Someone else might take a few sips to reach their ideal point, while a drink or two might send them past their ideal dose and leave them too drunk for comfort.

In other words, the ideal dose for any drug with a biphasic response will vary by individual — but each individual will have an optimal dose at the curve’s peak, just before any further increase sends the effect back in the other direction. 

This kind of biphasic response curve has been studied in a wide variety of substances such as alcohol, nicotine, amphetamines, psychedelics like ayahuasca, and many pharmaceutical drugs. But it can also be found with cannabis’ two most plentiful and medicinally-utilized cannabinoids — THC and CBD. 

Evidence for Biphasic Responses with Cannabis

One of the most commonly reported uses for medical cannabis, anxiety, also happens to have a highly reported biphasic effect. Some say that cannabis has a calming effect and can relieve their anxiety, while others say cannabis makes them feel more anxious and can create a feeling of paranoia. This is primarily attributed to the biphasic effects on anxiety exhibited by THC, and has been shown experimentally in a few ways. 

In a study on mice, scientists gave mice subjects different doses of THC and then watched whether they avoided open spaces (a sign of increased anxiety in mice). Those who had lower doses spent more time exploring the open area than controls, while those with higher doses spent less time there. This suggests that lower doses reduced anxiety while higher doses increased it. 

This was also replicated in a human study, where 42 patients were administered either a placebo or low (7.5 mg) or high (12.5 mg) doses of THC. After being given a variety of stress-inducing tests they were asked to rate their own stress. Like with the mice, those who took the low dose reported lower anxiety than those who took the placebo, while those who took the high dose experienced an increased anxiety response. While 7.5 milligrams isn’t an exceptionally low dose, in other experiments, doses of THC as low as 4 milligrams have also been effective at reducing anxiety symptoms in patients with PTSD. 

THC’s biphasic effects have also been noted for temperature regulation, pain, appetite, motivational processing, novelty seeking, and locomotion and exploration

But THC isn’t the only chemical in cannabis with biphasic effects. Similar effects have also been noted in CBD, a medicinal cannabinoid without THC’s mind-altering high. Animal studies on CBD and pain, for example, show that pure CBD reduces pain responses at lower doses, but then at a certain point can actually increase pain responses. Interestingly, when the same dose of CBD is left in a full spectrum cannabis extract (which includes other chemicals found naturally in the cannabis plant) this dose dependant curve disappears. CBD continues to increase pain relief as the dose increases, with no observed ceiling on the effect. Thus other compounds in the plant may offer a protection against this biphasic effect of CBD.  

Biphasic responses have also been noted with CBD for nausea and vomiting relief. In animal studies, CBD decreased nausea and vomiting measures at low doses but seemed to enhance them at high doses. Other biphasic effects such as sedation and immune responses have also been found from CBD. 

Working with Biphasic Responses

While the biphasic nature of cannabis might be intimidating at first, understanding it can help you better utilize your medicine. 

This is especially important for conditions related to the studied biphasic effects mentioned above, such as anxiety and depression, sleep or fatigue issues, nausea, pain, immune health, or obesity and eating issues. But, it’s also something that should be taken into account anytime you are treating a condition with cannabis — since these effects are relevant even if they are just side effects. 

The moral of the story is that dose matters. While you might think more is better, instinctually, the science shows that sometimes a smaller dose is more effective. To find your ideal dose, work with a practitioner who specializes in cannabinoid medicine. They can help you to hone in the right dose for you. By starting low (around 2.5mg) and gradually increasing, you can find your optimal dose and avoid ending up on the wrong side of that biphasic response curve.

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Cannabis Vaping: Benefits and drawbacks

The cannabis vaporizer seems poised to overtake more traditional methods of cannabis use in the near future. Even today, vaporizers are the smokable cannabis market’s most popular accessory.

There’s at least one good reason for that. Let’s take a deeper look at what makes vaping so popular, and how you can use the vaporizer to complement your medical cannabis regimen. There are also, however, risks involved, and a mystery illness has led authorities in the United States to recommend against vaping — for the time being.

The Health Benefits of Vaping

Vaping entails the smokeless vaporization of cannabis, in order to inhale the plant’s active ingredients. The health and wellness-promoting qualities of medical cannabis shine through this delivery method, as they always seem to do. Yet consumption of cannabis by vaporization carries several unique health benefits of its own. 

Reduced Carcinogens: Ingesting or inhaling burnt materials is almost never a healthy idea. Because it circumvents any type of combustion, vaping is safer for the lungs. Keeping your vape at a low-to-moderate temperature may also be a good idea, of course. As one 2016 study on the therapeutic potential of vaping put it, vape pens  “should be carefully designed to minimize potential overheating.” Optimal temperatures for vaping are in the 160-180°C (320-356°F) range. 

Fast-acting: Vaping, like smoking, is the fastest way to get the effects of medical cannabis into your system. Often the “peak value” of your experience happens around 10-20 minutes after inhalation and may last for up to three to five hours. Some patients tend to prefer non-psychotropic CBD vapes for anxiety, while others may find more relief with THC. It appears as though CBD has a broader therapeutic index than THC does. So while overdoing CBD probably won’t cause anxiety, overdoing THC just might.  

Enhanced Dosing: While dosing with edibles can be messy or imprecise, optimizing your vape dose is usually easier. Many vapes can be ‘loaded’ with pre-filled cartridges containing a measured amount of cannabis products. If you goe through a lab-verified vape cartridge containing 300 milligrams of cannabinoids every 10 days, for example, then you know that you’re averaging 30 mg of total cannabinoids a day. 

Bioavailability, Pharmacology, and More: The bioavailability of vaping can vary quite wildly depending on how deeply you inhale, how long you inhale for, and more. Studies indicate that the absorption rates of inhalation are normally between 10-60%. Some of the factors that could affect the absorption rate are the amount and type of cannabis, duration of vaporization, and the temperature used for vaporizing. One notable study found that the most efficient delivery occurred at 439°F / 226°C. 

While high-tempurature vaping may seem best, it’s not necessarily that simple. Many of cannabis’s more-than-540 ingredients are heat-sensitive. Terpenes, for example, begin to vaporize at 258°F. Cannabinoids, on the other hand, require a much higher temperature point around 315°F or more. 

Vapes: One Delivery Method, Many Moving Parts

Modern vaporizers often come in the form of thin, pen-shaped devices. Tiny internal coils heat up a vape’s cannabis content to just the right temperature, at which point users can take a “draw” off the device and inhale its vapor. 

There are four main components of the typical cannabis vape pen:

  • The atomizer: a heating element that directly vaporizes cannabis.
  • The tank: a container or cartridge that holds cannabis oil or, in some cases, flower material. Tanks may be refillable or disposable. 
  • The mouthpiece: The small piece on the end of a vape pen that the user inhales through. 
  • The battery: A rechargeable battery that provides power and heat to the vape pen. 

There are several different types of vaporizers available in today’s market. Here are some of the most common ones:

Conduction vaporizer: Conduction vaporizers were the first type to reach the market. They are often less expensive and more user-friendly than other alternatives. They’re also more efficient. That’s because conduction is a process in which heat is transmitted directly from one substance to the next; in this case, from coil to cannabis oil. 

Water-cooled vaporizer: Also known as the “liquid filtration vaporizer,” this type of vape is one of the newest on the market. It combines the smoothness of vaping with the additional filtration of a water bong. 

Portable oil vaporizer: These vaporizers are called “vape pens” because of their size and shape. Portable oil vaporizers are often inexpensive, even though many of them contain high-quality, CO2-extracted cannabis oil. Just be aware that some vapes may use untested, unregulated fillers — so look for quality-controlled products. As always, lab verification is important. 

Portable Flower Vaporizer: Similar to the option above, portable flower vapes contain a chamber for cannabis flower as opposed to a container for melted cannabis oil. 

Tabletop Vaporizer: Many vaporizers in this category are expensive, though they often have extra features like precise temperature control. Users who opt for a low-temperature setting may find that the delicate flavors of the cannabis plant are perfectly preserved. Pharmacological effects may be better preserved, too, as intact terpenes and cannabinoids work together to provide a powerful entourage effect. 

Potential Health Risks

The scientific community is generally in consensus about vaporization being a safe and effective delivery method. All the way back in 2008, a study in The Journal of Psychopharmacology called vaping a “suitable method for the administration of THC.”

Just because vaping is generally safe, however, does not mean that everything is safe to vape. Many vape products use harmful ‘cutting agents’ to improve their viscosity. One cutting agent used by some producers is polyethylene glycol (PEG). When PEG overheats, it can produce cancer-causing molecules called carbonyls. One of the better-known carbonyls is formaldehyde.

As harmful as long-term exposure to PEG may be, vaping presents even more pressing issues. In 2019, a mystery vaping-related lung illness began to appear across the United States. Hundreds of people have been hospitalized and at least nine have died from the illness across the United States, which health authorities have not definitively found a cause.

Some reports have pointed to another diluting agent, vitamin E acetate, as a possible culprit. Most of the cases of the mystery vaping illness have involved THC products, although it is believed they are largely black-market products. Vitamin E acetate was not, however, present in the vapes of all those who have fallen ill.

Until the cause of the mystery illness is found, health officials in the United States have recommended people not use vaping products. Some states and cities have banned them outright.

Vaping Safely and Effectively

One of the keys to vaping correctly is treating your cannabis well. Avoid vaping the same cannabis material again and again, and avoid vaping on very high heat settings. Some studies show that polyethylene glycol converts too quickly to formaldehyde at around 215°C / 419°F. 

Medical cannabis patients are encouraged to seek out the strain or concentrate of their choice, so long as it comes from a reputable source with reputable lab testing. Look for tests that ensure your product is freedom from mold, mycotoxins, aflatoxins, heavy metals, and residual solvents. 

Customers should also be aware of their cannabis’s strength — these numbers should be made readily available via lab testing, too.  Use caution with ultra-strong concentrates (over 80% THC) and ultra-strong cannabis flower (over 25% THC).

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Vaporizers vs Smoking: What’s the Difference?

Vaporizers have become a popular way to consume medical cannabis in recent years. Many users prefer using vaporizers, commonly referred to as vaping, because it doesn’t leave lingering smells, is smoke-free, and can be more convenient.

Yet people have been smoking marijuana flowers for at least hundreds of years, and despite its drawbacks, old-fashioned smoking also has its benefits.

Vaping and smoking both involve drawing heated cannabinoids into one’s airways, but that’s where the similarities end. Depending on your particular health and lifestyle needs, either could be ideal for you. 

Different Ways of Smoking Cannabis

The delivery methods one can use for smoking cannabis are pretty diverse. They include joints, pipes, bongs, bowls, and more. The most established and well-known of these mediums is probably the classic cannabis cigarette — or joint.

Cannabis Joints

The simplicity of the marijuana cigarette is part of what makes it so effective. Cannabis cigarettes generally consist of flowers from the user’s strain of choice wrapped in a specially made rolling paper. 

According to the World Health Organization, the average joint contains anywhere from 250-750 milligrams of cannabis. In some parts of the world, marijuana is often sprinkled onto tobacco inside a joint or cigarette.   

Pipes

Pipes are another delivery vessel that goes way back. Pipes have three major components: a receptacle to hold burning plant matter, a stem to hold, and a mouthpiece through which to inhale the cannabis smoke. Many traditional cultures have their own trademark version of the pipe. In Morocco, for example, a narrow clay and hardwood pipe called a sebsi is most common. 

It’s worth noting that pipes come in all shapes and sizes, the smallest of which is often colloquially referred to as a “one-hitter.” One-hitters may be ideal for patients who are new or especially sensitive to cannabis, as they often only hold one-tenth of a gram of marijuana (that’s 10-30 milligrams of active cannabinoids in most cases).

Many of the simpler pipes out there are called bowls, which refers to their marijuana -holding component. Medical marijuana users who partake in this fashion can be said to be “smoking a bowl.”

Bongs

Think of the bong like a more sophisticated version of the pipe. This medium has a specialized water-filled chamber that the cannabis smoke travels through prior to inhalation, serving to cool down the smoke. 

Many users report that this makes using a bong easier on the lungs than other smokable options. 

Bongs may also have a detachable bowl that allows users to remove their cannabis from heat sources immediately post-draw. Out of all the smoke-friendly delivery vessels, the bong might just be the one that gives its user the most control over temperature. 

The Vaporization Method

Vaping is a way to heat up marijuana without actually burning it. Vaporization calls for a gentle heat that releases cannabinoids and other compounds into the air, producing a fragrant vapor which is then inhaled. No smoke is created in this process, so users are usually spared of lung irritation.

Vaporizers themselves usually come in the form of thin, pen-shaped devices. Tiny internal coils heat up a vape’s marijuana content to just the right temperature, at which point users can take a “draw” off the device and inhale its vapor. 

For obvious reasons, the whole process is much more discreet than smoking. Many users also find vaping to be much gentler on the throat and lungs than smokable products are. 

Unlike smoking, though, vaporizers can accommodate all sorts of products above and beyond regular cannabis flower: vape-specific oils, regular cannabis oils, live resin, and more. 

It’s worth noting that certain types of vapes are especially popular. In California, most cannabis is purchased in the form of concentrate — and most of this concentrate is vaped. Last year the amount of concentrate sold in the Golden State comprised 37% of total marijuana sales, as opposed to 33% of sales coming from cannabis flower, according to 2018 data from BDS analytics. Of that 37%, more than 70% of it is coming from vape-fueled purchases. 

CBD-specific vapes are also rising in popularity. In Colorado, Oregon, and Washington, their sales grew 203% in the first 10 months of 2017 alone. It’s likely these trends towards vaping will only grow more pronounced with time. 

The Bioavailability Question

Much of the available research says that CBD is more bioavailable when vaped than when taken through any other delivery method. The vaping advantage is there for THC, too, according to a double-blind, crossover study at Johns Hopkins University, which found that “vaporized cannabis produced greater pharmacodynamic effects and higher concentrations of THC in blood compared with equal doses of smoked cannabis.”

While more research in the area of vaping vs. smoking would be helpful, most of the available literature seems to say the same thing

Pros, Cons, and Things to Keep in Mind

No method of cannabis consumption is perfect — but with a little research and a good amount of intention, it’s possible to decide what’s best for you.

Smoking: The Pros

Despite the apparent health benefits of vaping, it seems like the most popular method in many areas is still smoking. That’s true in Canada, at least. Of all the Canadians who reported consuming marijuana in the first half of 2019, 77% reported smoking it while only 19% said they had used a vaporizer.

There’s something about smoking — perhaps its multisensory experience of fire, smoke, scents, and sounds — that remains attractive to many people. 

Smoking: The Cons

Now for some less favorable news: the act of smoking cannabis comes with surprising levels of carcinogens. Users may be unwittingly exposed to tar, ammonia, benzopyrene, benzanthracene, and hydrogen cyanide. There’s also carbon dioxide. And while some studies hint that the anti-cancer qualities of cannabinoids may counterbalance the carcinogens that smoking them comes with — perhaps it’s better to be on the safe side. 

Vaping: The Pros

Here’s a practical plus to vaping: it’s discreet. Surprisingly enough, a study in the Journal of Substance Use and Misuse identified this quality as the primary motive for vaping, above even convenience or the vaping experience itself. 

Most people who vape medical cannabis tend to view it as being safer than alternatives like smoking. They’re probably right. All else being equal, vaporizing a quality cannabis product won’t produce the carbon dioxide or harmful carcinogens that smoking will. 

Then there’s the already-mentioned absorption advantage. Vaporized cannabis seems to shuttle more cannabinoids into the bloodstream and produce stronger effects than an equal amount of smoked produce. 

Vaping: The Cons

While generally very safe, even vaping isn’t immune to risk. In fact, those who vape cannabis concentrates may be faced with bigger potential dangers than any other group. 

As of late September 2019, over 500 people had become ill from what the American Center for Disease Control described as “lung injury associated with e-cigarette use, or vaping.” At least seven people have died.

Authorities have been unable to pinpoint the cause of the illness, with the CDC suggesting consumers refrain from using e-cigarettes until their investigation is complete, and the FDA warning Americans to stay away from THC vaporizers for the time being.

The message here is clear: be careful with dubiously-produced vape oils, especially if you live in an area where their THC-rich varieties are illegal. Those without access to high-quality, lab-verified vape oils can instead opt to smoke cannabis flower with a special herbal vaporizer. Of course, ensuring the quality of one’s cannabis flower is important, too. 

Smart Shopping

With such pressing issues of quality in mind, what’s one to do? 

The best solution is an obvious one: get your vape or smokable products from a reputable medical cannabis dispensary or trusted online retailer. Look for brands with transparency that have their lab results readily available both online and in-person. Patients may also consider selecting companies that have organic certification, FDA-approved facilities, or other certifications. 

If one is seeking out clean, pure vape cartridges, a little extra care may be needed. Brands that exert full ownership over their entire supply chain — from seed to sale — will be able to have full confidence in the purity of their products. Brands that utilize in-house testing (in addition to third-party verification) may also have an easier time regulating each and every batch of products produced. 

Obtaining a premium-quality cannabis flower is a bit easier. Not to say that lab reports and pesticide analysis shouldn’t be requested (they should), just that discerning impurities in cannabis flower will be exponentially easier to discern than those in a vaporizer cartridge.  

Perhaps the best overall product is one that draws on elements from both smoking and vaping: the dry herb vaporizer. The most well-known of such devices are table-top machines, but handheld dry herb vapes are readily available today, too. These devices allow one to effectively get the best of both worlds, by vaping pure cannabis flower.  No solvents, oils, fillers, or emulsifiers needed — just a medical cannabis patient and their strain of choice.

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Can You Overdose on Cannabis?

Cannabis is legal for recreational use in Canada, Uruguay, and 11 US states. It is legal for medical use in dozens more countries and 33 US states. So the question of overdose is bound to come up. In fact, if you’re reading this, you’re probably wondering the same thing—is it possible to overdose on cannabis? The short answer is no, but it’s important to understand why. 

The fact is that cannabis is one of the safest substances on the market. That alone is one of the main reasons it is so attractive as a therapy, as opposed to other drugs that cause harmful side effects and can lead to an overdose if too much is used at one time. 

Has Anyone Ever Died From a Cannabis Overdose?

There is no scientific proof that anyone has ever died from overdosing on cannabis. Yet, there are many articles discussing “cannabis overdose,” and the steps to take to avoid it. Several news outlets have also been quick to report on suspected overdoses of THC, one of the active elements in cannabis, but are their stories credible? Many experts think not. 

Keith Humphreys, a former senior policy adviser for the White House Office of National Drug Control Policy weighed in: “We know from really good survey data that Americans use cannabis products billions of times a year, collectively. Not millions of times, but billions of times a year. So, that means that if the risk of death was one in a million, we would have a couple thousand cannabis overdose deaths a year.”

Most professionals attribute the few reported cases where THC is attributed to death either to respiratory failure, or the presence of other drugs. 

Is There a Lethal Dose of Cannabis?

Skeptics are quick to point out that just because there hasn’t been a proven death from overdosing on cannabis doesn’t mean it’s not possible. But don’t be so quick to believe that. According to the National Cancer Institute, cannabinoid receptors are much different than, for example, opioid receptors. Unlike opioid receptors, there are no cannabinoid receptors located in the parts of the brain that regulate respiration. If cannabis does not cause respiratory depression, then there should be no cause for concern. 

A person would have to take close to 1,500 pounds of cannabis within a 15-minute time period for the drug to have fatal consequences, one United States judge wrote in a ruling on the matter. That’s 20,000-40,000 times the amount most people use in one session. It simply is not possible, which means the idea that it’s possible to overdose on cannabis is false. That being said, it doesn’t mean that using too much of the drug at a time can’t have its share of harmful side effects and risks. 

What is Cannabis Toxicity?

Cannabis toxicity is a much more appropriate term to use than cannabis overdose simply because it is possible to use too much at one time and suffer negative effects. When a person consumes too much cannabis, there can be repercussions. 

According to the CDC, the effects of cannabis toxicity are likely very similar to its usual effects—only more severe. Some of the signs of cannabis toxicity include: 

  • Paranoia
  • Bouts of confusion
  • Severe anxiety or even panic attacks
  • Delusions and/or hallucinations
  • A faster heart rate than normal
  • Increased blood pressure
  • Nausea with or without vomiting

In addition, people who use too much cannabis at once put themselves at risk for injury. These individuals have a much higher chance of motor vehicle accidents, poisoning, and falls. 

Additional Cannabis Toxicity Risks

Anyone who consumes cannabis should always ensure that they are getting it from a reputable source. Some street dealers might cut the drug with other substances. In these cases, it is possible to overdose, but not because of cannabis. 

When cannabis has been cut with hallucinogens or other, more dangerous drugs, the following side effects can and often do occur:

  • Chest pain
  • Headaches
  • A sudden spike in blood pressure
  • Seizures 
  • Stroke
  • Heart attack
  • Problems with heart rhythm
  • Violent behavior

If you suspect that you are using cannabis that isn’t pure, it’s important to get medical treatment right away if you experience any of the symptoms listed above. While it is virtually impossible to overdose from cannabis, this is not the case with other substances, so immediate medical care is paramount.

Are You Experiencing Symptoms of Cannabis Toxicity?

Most people are very aware of how much cannabis is appropriate for them to use. But occasionally, people do use too much at once and experience signs of cannabis toxicity. If this is the situation you or someone you love is facing right now, it’s important to seek medical attention right away. Go to your closest emergency room for an evaluation and the appropriate treatment. 

It’s very important to be completely forthcoming with emergency room staff about your condition. Tell them how much cannabis you used, if you know the amount. You may even want to consider bringing them a sample for testing purposes. They will be able to find out if it was cut with another drug without your knowledge. Knowing as much as possible about your situation will allow them to prescribe the appropriate treatment right away. 

Common Treatments for Cannabis Toxicity

Many medical professionals refer to cannabis toxicity as a “green out.” Getting the appropriate type of treatment is the best way to feel better as soon as possible. If your symptoms are really severe, it may be best to call an ambulance. EMTs have the ability to offer some forms of treatment before you even get to the hospital. 

Paranoia is a very common symptom of cannabis toxicity, and EMTs can administer medications to help you calm down. They may also be able to give you medications to help with nausea or administer fluids if you are becoming dehydrated. 

Once you’re at the hospital, emergency room staff may do any of the following: 

  • Take the appropriate precautions to prevent you from injuring yourself. 
  • Give you activated charcoal to induce vomiting if you have eaten cannabis. 
  • Collect blood and urine samples for testing purposes.
  • Offer oxygen for breathing support. 
  • Order an X-ray, ECG, or other diagnostic testing. 
  • Administer IV fluids. 
  • Administer medications to help alleviate other symptoms you may be experiencing. 

Proper treatment can provide significant relief. Unless your cannabis was cut with another drug, you probably won’t need to remain in the hospital for any lengthy period of time. 

Tips for Responsible Cannabis Use

Now that you know overdosing on cannabis isn’t actually possible, it is imperative to understand the importance of responsible use. Responsible cannabis use will allow you to continue to reap the benefits of it without having to worry about negative side effects. 

Tip #1: Start low

If you have never used cannabis before, the amount needed to feel its effects can be quite small. If you’re using it with an experienced friend, don’t try to match their dose.

Tip #2: Go Slow

Take your time. It’s best to choose a time to consume cannabis when you’re not in a rush. Using too much in a short period of time can quickly lead to problems, as we mentioned earlier. Take your time and allow it to work in your body. If you’re smoking it, that means taking frequent breaks to allow your body to adjust and see how it is impacting you.

Tip #3: Know Your Source

It’s best to get your products from a dispensary that you know and trust. That way, you can be certain that it was not tampered with, or cut with another drug. Street cannabis may be readily available and relatively inexpensive, but when you don’t really know where it comes from, you’re taking a major risk in using it. 

Tip #4: Avoid Mixing Drugs

If you’re currently taking a prescription medication, it’s a good idea to ask your doctor or pharmacist about any known interactions with cannabis products. It’s best to avoid mixing cannabis with other drugs like alcohol or opioids. The resulting effects can be dangerous and can result in an overdose on the added drug if you use too much of it. Also, other drugs tend to interfere with cannabis, causing it to be less effective than if it were used on its own. 

By following these tips, your cannabis experience will be memorable, and you’ll get to experience the relief that so many others have found when trying cannabis for various medical conditions. As far as overdosing goes, that’s a concern you no longer need to have.

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Inhalation Methods for Consuming Medical Cannabis

Of all the methods humans have created for taking cannabis, the most traditional and time-tested is inhalation.

The reason perhaps lies in what we have learned about the pharmacology of cannabis. Science has shown again and again that the inhalation delivery method produces more immediate (and often, more powerful) effects than any other method.

Once inhaled, the smoke from combusted cannabis is absorbed through the lungs and its cannabinoids directly enter the bloodstream. From there these cannabinoids circulate into surrounding areas of the body, quickly passing through the blood-brain barrier, binding to CB1 receptors, and modulating the chemical status of the brain. 

By inhaling marijuana, the slower hepatic metabolism that comes with marijuana edibles or tinctures is avoided, resulting in a faster yet slightly more inefficient delivery method. 

These days, inhalation is similar to its fellow oral and sublingual delivery methods in one exciting area: product variety. The medical marijuana industry has been churning out all sorts of inhalable products and devices. Of these products, there are two primary categories: smokables and vape-ables. 

Smokable Products

Smokable cannabis products, as you might expect, include anything one can smoke in order to get cannabinoids into their system. That includes everything from joints and pre-rolls to mediums like pipes and bongs.

The Pros

Smoking cannabis is fast and convenient. It may also expose users to slightly greater amounts of fully degraded cannabinoids like CBN; some studies have indicated that this cannabinoid may have anti-cancer qualities. Overall, smoking is a valuable addition to the medical marijuana patient’s therapeutic arsenal. 

On a more experiential note, smoking also gives patients the opportunity to see, smell, and touch their medical marijuana for themselves. It can almost be like aromatherapy, and some people describe touching the plant itself as feeling more natural.

The Cons

While smoking is convenient and fast-acting, it does have some medical downsides. Smoking can result in inconsistent dosing, as varying amounts of ignited cannabis may or may not actually make it into one’s lungs. 

Cannabis smoke has been shown to contain, on average, five times more hydrogen cyanide and 20 times more ammonia than tobacco smoke. It does have lower levels of polycyclic aromatic hydrocarbons than tobacco smoke, however. And, of course, smoking anything means exposure to carcinogens. 

Thankfully, this is likely worse in theory than in practice. A longitudinal study published in 2015 followed habitual cannabis smokers for 20 years and found no link between lung cancer and medical marijuana use.

A 2006 population-based study also found no correlation between cancer rates and cannabis smoking. 

The Options

If you’re ready to experience the benefits of smokable marijuana, there are several different products to consider. Of course, the timeless joint continues to be a good option. 

Hand pipes of virtually every shape and size are also available. Smoking cannabis through a pipe requires no rolling paper or burnable medium of any kind, so it may contain slightly fewer carcinogens than other options. Smoking via hand pipe may also result in a smoother, less “harsh” mouthfeel and overall smoking experience. 

Another way to smoke is with marijuana cigarettes or pre-rolls. Just make sure they don’t contain any artificial flavoring or other additives. 

Vapable Products

Though one of the newest products in the marijuana industry, vaporization devices, commonly known as vape pens, have quickly risen to prominence in recent years. Now they stand to eclipse more established types of cannabis products. Based on some reports, they already have

The Pros

Some find that using a vape pen distances them from the stereotypes that sometimes surround the act of smoking cannabis. Vaporization can also have a more sterile, medical feel. A 2018 study found vape use tied to two interrelated factors: concealment and convenience.

Even more importantly, because vaporizers don’t produce smoke, there’s virtually no exposure to the type of carcinogens that result from smoking. The vaping experience is smooth and gentle, and it’s often flavorful because the low heat of some vaporizers may preserve delicate terpenes.

This gentleness belies what science has shown to actually be a very high absorption rate. 

A study from Kentucky’s University’s College of Pharmacy described CBD’s “great potential” before reporting that vaporization may provide bioavailability of up to 30 or 40 percent (smokable products were found to be only around 20% bioavailable).

It’s likely that some terpenes could match this absorption rate through vaporization, at least according to Dr. Ethan Russo…yet others might not be so lucky. A study that looked at the byproducts of “dabbing” also found that heating vape-specific oils could convert their terpene content to harmful byproducts like isoprene, methacrolein, and benzene. To safeguard against this effect consider selecting a vape oil that doesn’t contain extra terpenes—and then avoid overheating it.  

One double-blind, placebo-controlled study affirmed vaping’s efficacy, revealing how it produced good results even from low-cannabinoid (1.3% THC) cannabis. Patients with neuropathy reported “significantly better” pain levels, including reduced “sharpness, burning, and aching pain levels.” 

Thanks to the increasing popularity of pre-filled vape cartridges, vaporization also makes cannabis easier to dose. With a standardized vape pen, patients don’t need to measure out or weigh the marijuana or tincture drops. Exact dosing is still not possible using most vape pens, but doses can be easily dialed in at a more macro level. 

The Cons

Yet even this near-perfect delivery method is subject to potential drawbacks. Many commercial vapes use thinning agents like propylene glycol to produce their e-liquid base. 

A 2017 study found that propylene glycol could break down within the body, leading to carcinogen exposure and pulmonary stress. If you’re like other vaporizer enthusiasts, carcinogenic compounds were probably what you wanted to avoid in the first place. Another additive, called polyethylene glycol 400, is even worse; it has been shown to produce formaldehyde when exposed to high heat. 

The solution here is simple: prioritize quality. Patients should find a cannabis company that provides better thinning alternatives (like terpenes or MCT oil) to their consumers. Thankfully, many such conscientious companies are out there. 

In mid-2019, doctors in a number of US states began reporting a mysterious lung illness in hundreds of people who reported vaping, many but not all of them with products containing THC. Health officials are unsure of the causes—one direction being investigated is the addition or presence of a bad ingredient.

The Future

Many users think vaporization is the future of medical cannabis—and they just might be right. Vape pens today can pair with your smartphone, have their temperature settings precisely adjusted, and be drawn on sans any pressable buttons. Others release controlled amounts to make dosing easier.

Look for future technological advancements to cater to medical cannabis patients. Just imagine: doctors could upload patient prescriptions to a specialized app, to be shared with the patient and their “smart-vape.” The vape could then dispense its medical cannabis oil accordingly, holding perfectly to the prescribed schedule. It could even have an auto-reminder feature for busy patients. 

Of course, this is only one example—but hopefully it serves to illustrate that the sky’s the limit for medical cannabis.

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The Many Ways to Consume Medical Cannabis

The most important aspect of your medical cannabis intake, by far, is its quality. 

Ensuring that your cannabis is pure (organically grown, ethically extracted, cleanly processed, etc.) is paramount for anyone who wants to take the plant in order to feel their best. When these elements are in place, cannabis is able to do what nature intended it to: communicate with the endocannabinoid system and its receptors to promote homeostasis and health. 

As effective as medical cannabis can be, however, it has one potential downside: bioavailability

If you smoke a gram of cannabis, for example, you may only be getting the active cannabinoids from one-tenth of that gram into your bloodstream. In other words, the bioavailability of smoking cannabis is often only 10%, but it can vary wildly between “2 [and] 56%, due in part to intra- and inter-subject variability in smoking dynamics.”

That’s not necessarily a bad thing. Delivery of cannabis’ active ingredients via smoking has its own set of benefits. But for patients who require large, specific doses, there may be better options. 

Delivery Methods: 3 Categories, Endless Products

There are three major categories that delivery methods fall into. Medical cannabis can be inhaled, ingested, or applied topically. Each of these three methods has its own pros and cons, and each provides an opportunity to utilize various products. 

Inhalation

Inhalation is the most popular delivery method, perhaps for good reason. It’s convenient, simple, and very experiential. Indeed, the experience that goes along with merely burning something has been enjoyed since ancient times

When cannabis is inhaled, its gasses directly enter the lungs en route to absorption into the bloodstream. This whole process happens almost instantaneously—a convenience that makes inhalation almost universally popular. 

Inhalation products: Because inhalation is so popular, there are lots of different inhalation-specific products. These products can be divided into two major categories: smokable products and vaporizing products. 

Smokable products are the older of the two categories, and they’re also perhaps more diverse. Cannabis can be smoked in many ways: it can be wrapped with rolling paper into a joint or blunt, placed in the ‘bowl’ of a pipe or a bong, and more. Usually, cannabis flower is broken up into small pieces (either by hand, with scissors or with a specialized grinder) prior to being placed into the medium of choice and combusted. 

Smoking cannabis can become too harsh on the lungs over time. Unlike tobacco, cannabis smoke hasn’t been definitively implicated as a risk factor for lung cancer, though one study did find a strong correlation. While the carcinogens in cannabis smoke may be counteracted by THC’s anti-tumor properties, there are probably still healthier choices. That’s where vaporization comes in. 

In the past decade or so, vaporizing cannabis has exploded in popularity. Today one can find large, portable vaporizers, as well as much smaller handheld vaporizers called vape pens. Both types function almost like a small oven, gradually heating cannabis flower to a temperature that’s high enough to liberate cannabinoids, terpenes, and plant compounds — but low enough to avoid rapid combustion. Compared to smoking, vaporizing cannabis results in a gentler overall experience.   

Another possible option: cannabis concentrates can be smoked and/or vaped, too. Indeed, an entire product market has emerged for this very purpose. Water bongs are often topped with heatable plates designed specifically for burning cannabis oils and waxes.  

Inhalation’s Pharmacology: While the experience may be gentle, vaporizing is actually the most bioavailable inhalation method. Several studies show that vaping may deliver at least 34% of medical cannabis’ active ingredients (i.e., cannabinoids and terpenes) into the bloodstream. According to Dr. Ethan Russo’s book Cannabis Therapeutics in HIV/AIDS, the bioavailability of many terpenes is roughly equivalent to their cannabinoid counterparts. In the world of cannabis pharmacology, these are excellent rates. 

Once this 30-50% makes it into the bloodstream it quickly crosses the blood-brain barrier, where cannabinoids like THC and CBN cause an uplifting, cerebral effect. Increased binding to CB1 receptors in the brain may cause feelings of calmness and bliss. It’s no wonder that inhalation, whether by smoking or vaping, is such a relaxing experience. 

Ingestion 

Ingestion is the second of the primary delivery methods. The cannabis is absorbed through the GI tract. It includes two options of its own: eating medicinal cannabis and its derivatives or taking them sublingually. Because of that, ingestion is probably the most diverse of all delivery methods. 

Both types of ingestion are subject to the slow-burn of human metabolism, so they kick in slowly and provide lasting health benefits. Yet both methods are also subject to hepatic liver metabolism, which greatly reduces their absorption rates. More on that below. 

Ingestible products: This delivery method includes edibles, pills, capsules, powders, and tablets. Cannabis edibles, in particular, have come into their own in recent years. Today everything from THC-rich brownies to cannabinoid-infused drinks is available—the combinations are nearly endless. 

While psychotropic edibles are often used recreationally or for pain relief, there’s a growing market for ‘gentler’ CBD-centric edibles, too. Cannabidiol-rich health foods are starting to emerge as their own niche. With pro-athletes testifying to the benefits of CBD (and even starting their own CBD brands) this market seems poised to only grow with time.

When it comes to THC-rich edibles, some caution might be needed. Don’t forget that edibles of any type kick in very slowly—meaning it’s virtually impossible to dose based off of initial effects. Edibles are correlated with increased emergency room visits. The best safeguard is simply to check your edible’s nutrition label for cannabinoid content and make sure you don’t exceed your normal dose. As the State of Colorado encourages: “start low, go slow.”  

One way to safeguard against dosing inaccuracies is through the use of pills, capsules, and tablets. These delivery methods come prepackaged with their individual dosages specified; for example, one brand might make cannabis oil capsules that contain 4 mg of THC and 1 mg of CBD each. Though the longer onset times of these products make dosing by feel difficult, their standardization more than makes up for it. Cannabis-infused capsules and tablets also have the potential advantage of reaching the digestive system more intact, so they may be ideal for patients with IBS, Chron’s disease, SIBO, etc. 

Of course, you can also ingest cannabis products a little more directly. Eating raw cannabis leaves is a time-tested way to get trace cannabinoids into your system. Though compounds like CBDA and THCA aren’t all that active within the endocannabinoid system, they carry their own sets of health benefits. 

For example, studies have shown that CBDA (the unheated acid form of CBD) may directly activate the type of serotonin receptors that reduce stress and anxiety. Raw cannabis is also strongly antimicrobial. Unfortunately, current restrictions on cannabis cultivation mean that raw cannabis leaves and flowers aren’t available to everyone. If you have access to them, though, go for it. 

Cannabis concentrates can also be eaten directly; in fact, this type of ingestion might just be history’s most established. Across India, Egypt, and the Middle East, a concentrated plant resin called hashish was especially popular. Smoking cannabis, while commonplace today, didn’t actually become standard until the 1500s.  

This mode of delivery is somewhat less common today. But ingestion of concentrates like hash, crystalline cannabis powders, or even Rick Simpson Oil can still be beneficial to patients who want a very simple—but very strong—health solution. A 2013 case report documented how RSO-style cannabis resin worked as “an effective treatment for ALL” (acute lymphoblastic leukemia) in a “rapid dose-dependent” manner. Though all patients experienced side effects such as increased alertness, decreased memory, and increased hunger, cannabis repeatedly lowered blast cell count, a marker of leukemia. 

Don’t forget about the second type of ingestible products: sublinguals. This category includes tinctures, oils, and sprays that are made with some combination of cannabis extract and carrier oil. As you might expect, tinctures are meant to be taken sublingually, i.e. held under the tongue. 

As of 2019, cannabis oils are more popular than ever. That’s no truer than in the case of CBD oils, which themselves are projected to hit $22 billion in annual sales by 2022. THC + CBD blends are also available on today’s market. 

You can even get CBD: THC blends with specific ratios.  From a medical standpoint, this emergence is pretty exciting. It’s likely that different ratios work best for different health conditions; for example, a 20:1 CBD: THC ratio appears efficacious in cases of pediatric epilepsy, while a 1:1 ratio appears promising for autoimmune conditions like MS. 

Ingestible pharmacology:  Let’s look at the sublingual variety of ingestibles and their pharmacology first. The history of tinctures is surprisingly rich; alcohol-based tinctures first made their way onto pharmacy shelves over a hundred years ago. And now sublingual products are experiencing a resurgence, likely for one simple reason: because they work.

The longer an oil is held under your tongue, the higher its absorption rate rises. That’s because the mouth itself contains blood vessels which serve as targets that cannabinoids can easily access. That allows the bioavailability of tinctures to reach 30-40%. 

Some patients may find that they prefer an alcohol-based, sprayable cannabis tincture over conventional oil-based cannabis oils. These alcohol-based formulations are likely to be higher in cannabis’s water-soluble ingredients (like chlorophyll and glycosides) than other options, which could be better for certain patients’ biochemical needs.  

For those who want an even higher absorption rate, cannabis oil can be taken within a suppository. While unconventional, this method provides both the fast absorption of vaporization and the lasting relief of edibles. 

Medical cannabis suppositories may be an ideal delivery method for cancer patients, who find that this method allows ultra-high THC dosages to be taken without ultra-high psychotropic effects. According to MD and cannabis expert Dr. Allan Frankel, the efficacy of cannabis suppositories is unproven, but patient experience is pointing to distinctive health benefits. 

The pharmacology of edible products, on the other hand, is much lower. Edibles are fully susceptible to the slower hepatic metabolism that comes when ingested cannabinoids are processed through the digestive tract and liver. That means their absorption rates are drastically lower, hovering around 10%. 

But edibles are still a great choice for some. They’re convenient and discreet, and with practice, they’re actually very easy to dose. Edibles may be ideal for those with gut health issues like SIBO, Crohn’s Disease, or IBS. There’s even some initial evidence that cannabinoids can help strengthen and ‘seal up’ damaged gut linings. 

Topical Application 

Topical application is the third and final delivery method on the list. Though slightly more straightforward than the other two categories, even the world of cannabis topicals has diversified in modern times. Topicals have also taken a quantum leap forward in their technology. 

Topical products include balms, salves, and creams. Generally, these types of topicals are made by combining a cannabis extract/concentrate with a base like beeswax, shea butter, or coconut oil. Topicals vary in strength and consistency; often they come in a 1 oz jar with ~250 milligrams of total cannabinoids. That’s great for the average person, but those with intense pain may have trouble finding something strong enough.

For these patients, getting medical cannabis in the form of a transdermal patch may be the best option. Recent advancements in technology have seen these cannabinoid-rich transdermal patches double the normal efficacy of topicals. 

The pharmacology of topicals: Topicals have low absorption rates and don’t generally pass through dermal layers into the bloodstream. However, they do activate CB2 endocannabinoid receptors in the skin to provide powerful localized relief. This is especially true of time-release transdermals, which may saturate endocannabinoid receptors more and more over time. There’s also some evidence, courtesy of a 2004 study, that CBD topicals absorb better than ones containing THC. 

Keep in mind that topicals, just like other ‘uncombusted’ delivery methods, need to be decarboxylated prior to use. Topicals also commonly combine cannabinoids and specific terpenes from essential oils to boost absorption. It’s possible that the low molecular mass of certain terpenes helps them better permeate the skin — bringing cannabinoids like THC and CBD with them—in what’s known as the entourage effect.   

Overall, topicals are ideal for those who don’t want intoxication to impact their day-to-day life. Their ability to provide relief without euphoria may also be a boon for patients who already find themselves ‘maxed out’ on their current CBN or THC dose. 

Indeed, virtually anyone can use a topical in conjunction with their normal cannabis regimen. Even athletes are beginning to acknowledge their usefulness when it comes to reducing muscle soreness and pain. Maybe it goes without saying that topicals are also great for the skin, but this benefit deserves a mention, too.

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Oral Delivery Methods: Pros, Cons, and Choices

In the quest to optimize health and wellbeing, you may be wondering: what’s the best way to get cannabis into the system? 

There’s no universal answer—it depends on your unique medical and biochemical needs. Finding the greatest overlap between western science’s recent advancements and the human body’s more ancient pathways continues to require patience and intuition—and it likely always will. Likewise, cannabis dosing is highly individualized, and it still draws upon equal parts art and science.

Yet the oral delivery method is a common denominator, a type of dosing strategy within which many medical cannabis patients will find their best results. It’s not a one-size-fits-all solution—but it is a one-size-helps-many way to deliver cannabis into the body so the plant can do its best work.

The Oral Delivery Method: Highly Diverse, Highly Effective 

The oral delivery method includes anything that can be eaten or otherwise administered via the mouth. While cannabis edibles have risen in popularity (and creativity) in recent years, the oral delivery method encompasses more than edibles alone. 

Today the options within this category are nearly endless—everything from cannabinoid-infused drinks to THC-rich capsules is available. In other words, there’s sure to be something that works for everybody. 

Adding to the complexity, different product types often have different therapeutic effects—those will be touched on in the next section. For now, though, just know that the following types of products fall within the oral delivery method:

  • Edibles
  • Concentrates
  • Pills, capsules, tablets
  • Powders
  • Juicing
  • Sprays

Medical Cannabis Edibles

Medical cannabis edibles usually have two parts: their normal food ingredients, and their cannabis component. Often the cannabis component of edibles is a concentrated cannabis oil or cannabutter. The non-cannabis components are often common food ingredients like flour and sugar.

Of course, healthier options are also available. Whether you’re gluten-free, sugar-free, vegan, or paleo—there’s still an edible out there for you. Many edibles use healthy coconut or MCT oils as their fat source, also, as opposed to canola or grapeseed oil.  

Compared to other medical cannabis products, edibles kick in slowly (i.e, they have a long onset time) and provide long-lasting effects. That’s because they’re subject to hepatic metabolism, a process where ingested cannabinoids are filtered through the liver before hitting the bloodstream. This same process lowers the bioavailability (i.e, internal absorption) of edibles to around 10%. If you take an edible with 10 mg of cannabinoids, for example, expect to actually absorb and benefit from only one or two milligrams of it.

Even then, edibles are an ideal delivery method for many. They’re especially potent, sometimes more so than their given cannabinoid content implies. They also provide the body with metabolized cannabinoids, like 11-Hydroxy-THC, which may have distinct benefits compared to “normal” THC. Medical cannabis users who prefer the psychotropic experience may find it with 11-Hydroxy, seeing as the cannabinoid easily crosses the blood-brain barrier. 

Cannabis edibles may also be useful to individuals with SIBO, IBS, or other systemic gut health problems. Why? Because this method carries a greater proportion of cannabinoids directly into the digestive tract. More research is definitely needed in this area: one study’s author reports being certain that “other anti-inflammatory compounds of the Cannabis plant are still waiting to be explored […] in human IBD.”

Like many cannabis products, edibles come in a variety of concentrations and cannabinoid profiles. To ensure you don’t surpass your normal dose, carefully read and quantify your product’s label before ingesting anything. Also, keep in mind that one can’t dose edibles by feel because of their 30-120 minute onset time—maximum effects may not be experienced until three hours (or more) have passed. 

Users who rush into edible use risk panic attacks and even psychosomatic issues. In states such as Colorado, edible use is correlated with increased emergency room visits. No wonder the state published billboards  urging users to “start low and go slow.” Thankfully, cannabis’s LD50 (lethal dose) is almost impossibly high, with no recorded overdoses. 

One more thing: taking your medical cannabis in edible form may actually improve cannabinoid absorption rates if the edible was sufficiently fatty. That’s according to new research from the University of Minnesota, which found that CBD’s absorption was aided by a fatty meal. The same concept likely holds true for other cannabinoids and is attributable at least in part to the fact that cannabinoids are fat-soluble. Even endocannabinoids use fatty acids as their precursors. 

Medical Cannabis Concentrates

Not a fan of eating calorific cannabis edibles? Don’t worry. That’s because medical cannabis concentrates can also be ingested. 

Simply stated, cannabis concentrates are products derived from the oiliest, resinous parts of cannabis and then processed into a more concentrated form. They include extracts like hash oil (BHO) and solventless concentrates like live rosin. Usually, concentrates are smoked with a specialized device, but not always—thus their placement here.  

Historically speaking, concentrates were eaten in the form of a concentrated cannabis resin called hashish. Hash was incredibly popular in medieval-era Arabia and shows up in stories like “1001 Arabian Nights”.

Also, keep in mind that some cannabis products are versatile enough to double as ingestible products. Rick Simpson oil, for instance, is both a topical and ingestible product. While cannabis concentrates may not always taste good (RSO, for example, often tastes earthy and bitter), the upside is that one only has to eat a small quantity to hit their daily dose. 

Medical Cannabis Pills, Capsules, Tablets

The medical cannabis capsule or pill is a simple invention—often just a cannabis concentrate placed into capsule form. The primary advantage of this delivery method? Specificity. Cannabis-infused capsules can be dosed very precisely, and often contain exact amounts of THC, CBD, and more in each and every capsule.

Another plus: with capsules and pills, the sometimes-overbearing taste of cannabis concentrates is masked. Patients averse to the taste or smell of cannabis might be more likely to take their ideal dose if it comes prepackaged in this convenient form. Along similar lines, patients who are more accustomed to using prescription drugs may feel perfectly at home with this type of encapsulated cannabis.

Medical cannabis capsules aren’t able to hit the highly permeable sublingual regions, however, which likely lowers their bioavailability. Patients in need of a rapid dose of cannabinoids (those with epilepsy or acute anxiety, for example) may be better served relying on faster-acting delivery methods. 

Medical Cannabis Powders

Medical cannabis powders are a somewhat rarer oral delivery method. Often these powders are isolated cannabinoids that come in crystalline form. Both CBD and THC can be taken via cannabis powder, as both form large crystals when highly purified. 

Just like with other types of medical cannabis, it’s important to know what’s in your cannabis powder. The proper purification process for isolates is long and exacting and not all manufacturers follow it precisely. 

For this reason, it’s important to be diligent and request lab testing before you buy. If a manufacturer claims that their CBD isolate is 99.99% pure, for example, they should be able to quickly verify things with independent lab testing. Also keep in mind that some cannabis powders may not be fully decarbed, though most do meet this standard. 

Medical Cannabis…Raw

One of the most underrated delivery methods, the idea of merely eating or juicing raw cannabis calls one back to simpler times. Don’t let the simplicity mislead you, however. A huge subset of medical cannabis patients could stand to benefit from this ancient oral delivery method.

Why? Because the nutrient profile offered by raw cannabis is very, very different than what’s present within most commercial cannabis products. 

For example, raw cannabis doesn’t contain appreciable CBD or THC. Instead, it contains the ‘acid forms’ of these cannabinoids — CBDa and THCa. Raw cannabis is also likelier to contain rare cannabinoids like CBG and CBGa than the processed forms of the plant. Further, fresh cannabis comes with delicate terpenes, like the monoterpene pinene, fully intact. 

Raw cannabis

Most conventional cannabis products are lacking in the carboxylated cannabinoids — the ones that end with an “A”. Courtesy of “Cannabis sativa L. and Nonpsychoactive Cannabinoids…”

From the chemistry standpoint, ‘raw’ cannabinoids are slightly larger and heavier than conventional ones, which means they generally aren’t able to bind directly to endocannabinoid receptors. And yet these raw cannabinoids have distinctive health benefits of their own. 

CBDa, for example, is especially useful as an anti-nausea and anti-anxiety (anxiolytic) agent. Kalant et al confirm: “one of the oldest pharmacological remedies for nausea and vomiting is the plant cannabis.” 

CBDa’s antiemetic qualities remain almost unmatched to this day. Cotter et al concluded that “cannabis-based medicines have been found to be effective anti-emetics and even surpass some modern treatments in their potential to alleviate nausea.”

CBDa has also been shown to reduce the inflammatory marker COX-2 in those with breast cancer. According to the study, this implies that “CBDA may possess the ability to suppress genes that are positively involved in the metastasis of cancer cells in vitro”. 

A final oral delivery method is the cannabis spray. This involves a cannabis oil or tincture placed in a spray bottle for convenient ingestion. Often the viscosity of the oil is changed to make it more sprayable. Alcohol-based sprays may be an ideal option for patients with fat malabsorption problems who wish to avoid cannabis oils that are oily. The cannabis-derived pharmaceutical Sativex utilizes this delivery method, too.

Ingestible Cannabis = Convenient Cannabis

In short, there have never been more ways to orally ingest cannabis than there are now. 

Technological advancement is also making cannabis more widely available—and more convenient—than ever before. Cannabis delivery services are on the rise worldwide, at least in areas where such services are legal. 

Progress is being made on the education front, too. Researchers continue to learn more about oral delivery methods and how they can be better matched with human metabolism to improve the patient experience. While more work is yet to be done, we’re happy to help push medical cannabis towards its rightfully bright future. 

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