Between vaping and edibles and everything in between, consuming cannabis as a medical patient can be confusing and overwhelming. In this blog, we will look in detail at all of these ingestion methods, in hopes of making it easier for patients to decide which methods may work best for them. As always, speaking to the pharmacist at your dispensary is very helpful in making this decision.
There are four primary ingestion methods: inhalation, oral, sublingual, and topical (Drug Policy Alliance, 2020).
Let’s start with the most well-known consumption method – inhalation. With this, cannabinoids enter the lungs and then directly enter into the bloodstream. Due to this, the effects of inhaling cannabis are almost immediate and typically last around two hours. It is also fairly easy to judge dosing through inhalation. Inhalation is performed by smoking or vaping, and one can smoke or vape cannabis flower or cannabis concentrates. Moreover, concentrates can be added to flower, increasing the effects of the flower.
On the other hand, vaping offers patients a convenient and smoke-free manner to consume their medication. Vaping differs from smoking in that it does not involve combustion, lending way to a “cleaner” inhalation. Vaping flower and concentrates can be done through the use of vaping devices. Conveniently, Connecticut’s dispensaries tend to be stocked with prefilled cartridges that already contain cannabis concentrates. This requires the purchase of a battery, too. HPO or pure cannabis oil syringes (explained below) can be used to refill these cartridges. In addition, dispensaries contain disposable vape pens, which do not require an additional purchase of a battery and are pre charged.
Between smoking or vaping cannabis flower or concentrates, it is important to note that most of Connecticut’s flowers range from 15-30% THC levels, whereas concentrates tend to range from 70-90% THC, making concentrates much more potent. There are, however, certain products that contain higher CBD levels and lower THC levels for patients seeking these options. Connecticut’s dispensaries carry many forms of concentrates from CR (concentrate with a crystalline look and smooth consistency) to BD (concentrate with a soft and buttery texture) to SH (concentrate with a pure and transparent appearance and is hard to the touch). If you think concentrates may provide the relief you are seeking, speak to the pharmacist at your dispensary to see which product will be the most beneficial.
Next, oral ingestion of cannabis medication is another popular consumption method among patients. Orally consuming one’s medication generates a slower and stronger onset than that of inhalation (Americans for Safe Access, 2020). The effects can begin after 30 minutes or up to two hours after ingestion, and they often last around six hours! Patients will notice individualized effects based on their own physiology, what they’ve eaten beforehand, etc. It is also important to note that patients should begin with small doses when orally ingesting their cannabis medication and wait around two hours before consuming more.
Orally ingested products come in a variety of forms. If you are looking to mix your medicine with food, Connecticut’s producers have become extremely creative in offering patients this option. For example, dispensaries tend to carry products such as cookies, brownies, granola bites, peanut butter, crackers, honey, tea, and even infused baking mix! On the other hand, some patients prefer a more traditional way of consuming their cannabis medication. This can be done through the use of capsules and tablets. Capsules contain active cannabinoids and may range from 3 to around 200 mg of THC per capsule. Tablets also contain active cannabinoids, and they may range from 2.5 to 50 mg of THC per tablet. Certain tablets can be split into halves or quarters, for patients seeking smaller doses. Tablets and capsules can also contain CBD and range from 5 to 50 mg per capsule or tablet. Moreover, a newly emerging mildly psychoactive cannabinoid, cannabinol (CBN), can be found in tablets and cookies. CBN is thought to promote sleep and reduce pain and inflammation (Breus, 2019).
Oral consumption of cannabis medication can be personalized through the use of syringes. Syringes may contain pure cannabis oil, marijuana oil standardized in medium chain triglycerides (MCT), highly potent marijuana oil (HPO), or whole plant extracts/full spectrum (360X or RSO). MCT syringes can contain terpenes, are medium strength, and are best administered through swallowing or mixing with food. HPO syringes contain terpenes, are high strength, and are best administered through swallowing, vaping, or topical application. RSO/360X syringes contain terpenes, are high strength, and are best administered through swallowing, mixing with food, or topical application. These products can also be dispensed into capsules, allowing patients to personalize their dosage.
Cannabis medications can also be orally administered through oral solutions, oral drops, tinctures, and nano-tinctures. Oral solutions contain super refined cannabis and MCT oil, or pure cannabis oil, and they can range from 300 – 900 mg of THC per bottle. They can also contain up to 975 mg of CBD, and some contain a combination of CBD and THC. Other oral solutions may contain up to 300 mg of THCA, a lesser known non-psychoactive cannabinoid thought to contain anti-inflammatory and neuroprotective properties (Rahn, 2015). Oral drops are cannabis extract solutions mixed with natural fruit flavors, and they can contain up to 200 mg of THC or 200 mg of CBD per bottle. Certain bottles contain a combination of both THC and CBD.
Interestingly, some oral drop bottles contain up to 200 mg of a newly emerging cannabinoid, cannabigerol (CBG). This non-psychoactive cannabinoid is believed to provide therapeutic effects for glaucoma, inflammatory bowel disease, Huntington’s disease, and cancer (Havelka, 2017). Similarly, CBGA can be seen in oral drops products, and it is thought to be beneficial for diabetes and cardiovascular disease (Havelka, 2019). Tinctures are alcohol-based cannabis extracts that contain terpenes and up to 50 mg of THC or 50 mg of CBD per bottle. On the other hand, nano-tinctures are water-based cannabis extracts that do not contain terpenes and contain up to 200 mg of THC. All of these products bear self-administered droppers, making them fairly easy to use.
Sublingual ingestion of cannabis medicine is unique in that one is orally consuming their medication, yet the onset of therapeutic effects is rapid. Most of Connecticut’s dispensaries carry two products that can be ingested sublingually – sublingual slips and sublingual sprays. Sublingual slips can contain 3 mg of THC and 17 mg of CBD per slip, or 20 mg of THC per slip, whereas sublingual sprays can contain 3 or 4.5 mg of THC per spray. All of the products mentioned in the previous two paragraphs can also be consumed sublingually. It is important to note that sublingual products should be placed under the tongue, not on the tongue! This allows the medication to directly enter the bloodstream and bypass the gastrointestinal system, producing a similar effect to inhalation (Drug Policy Alliance, 2020). In contrast, products such as edibles often produce a stronger effect because they do pass through the gastrointestinal system.
Topicals offer patients a very safe way of consuming their medication, while producing no psychoactive effects. Patients can see a rapid onset of effects lasting one to two hours. These products work well on localized pain. Conveniently, Connecticut producers have become extremely innovative in creating these products, offering patients a wide variety of options. For example, products can range from lavender topical lotions, bath bombs, relief roll-ons, personal lubricants, transdermal creams, and massage oils containing THC, CBD, or both! HPO and RSO syringes can also be applied topically.
Although the list of medical cannabis products appears to be endless, Connecticut’s producers continue to innovate and add onto this list. Patients can stay up to date on new product releases by adding themselves onto producers’ mailing lists or following them on social media. Also, it is important for patients to track the medical products they try through the use of a journal. This allows patients to better understand what products work best for their symptoms, and which products do not. Fortunately, we will write about maintaining a journal to keep track of your medication intake in a future blog post. Stay tuned!
Americans for Safe Access. “Cannabis 101.” Americans for Safe Access, 2020, www.safeaccessnow.org/using_medical_cannabis.
Breus, Michael J. “Research Shows 9 Potential Health Benefits of CBN.” Psychology Today, Sussex Publishers, 8 Aug. 2019, www.psychologytoday.com/us/blog/sleep-newzzz/201908/research-shows-9-potential-health-benefits-cbn.
Drug Policy Alliance. “How Marijuana Is Consumed.” Drug Policy Alliance, 2020, www.drugpolicy.org/drug-facts/10-facts-about-marijuana/how-marijuana-consumed.
Havelka, Jacqueline. “What Is CBG (Cannabigerol) & What Does This Cannabinoid Do?” Leafly, 22 Mar. 2017, www.leafly.com/news/cannabis-101/what-is-cbg-cannabinoid.
Havelka, Jacqueline. “What Is CBGA (Cannabigerolic Acid) & What Does This Cannabinoid Do?” Leafly, 9 Sept. 2019, www.leafly.com/news/science-tech/what-is-cbga-cannabigerolic-acid-marijuana-cannabinoid.
Rahn, Bailey. “What Is THCA & What Are the Benefits of This Cannabinoid?” Leafly, 25 March 2015, www.leafly.com/news/cannabis-101/what-is-thca-and-what-are-the-benefits-of-this-cannabinoid.