Not all vaporizers are the same

Many of us have heard of vaporizers, and instantly we think of ‘e-cigarettes’ or ‘vape-pens’. However, these are not the only types of vaporizer available.

This article discusses the topic of administering cannabis flos by vaporization and inhalation into the lungs. It explores several aspects of vaporization, highlighting the importance of using medical grade administration devices in combination with standardised, pharmaceutical quality cannabis flos.

Not all vaporizers are the same. Vaporizers (as medical devices) for the administration of cannabis flos are in fact quite different from ‘vape-pens’ or ‘e-cigarettes’. The vapour does not contain nicotine, or carries agents such as liquid propylene glycol, glycerol, or synthetic flavours. The large, socially intrusive vapour clouds of ‘e-cigarettes’ do not apply for the medicinal use of cannabis flos by vaporization. It should be considered that currently none of the ‘e-cigarettes’ or ‘vape-pens’ for inhalation of cannabinoids have been subjected to any scientific or clinical testing.

Vaporizer medical devices offer patients an effective, safe, and easy to use delivery system for cannabis flos. The inhaled vapour contains THC, CBD, and terpenes in consistent, measurable quantities. This is something not otherwise possible via oral administration. Importantly, the use of a vaporizer medical-device avoids the respiratory disadvantages of smoking, by virtually eliminating exposure to toxic compounds linked with cannabis smoke.

Fully standardised, pharmaceutical-quality cannabis flos provides a suitable medicinal product for vaporization and inhalation into the lungs.

The vapour of cannabis flos contains therapeutic levels of cannabinoids and terpenes. Harmful compounds are virtually absent, making it suitable for use by immune-compromised patients.

The vapour content is rapidly absorbed by the lungs, improving the ability to adjust dose and therefore minimize side effects. There are no pyrolytic compounds that constitute a risk for secondhand exposure.

Pharmaceutical quality cannabis flos

Not all vaporizers are the same. This also applies to medicinal cannabis. For vaporization to be truly effective, the cannabis product used with it must be of pharmaceutical quality. Fully standardised cannabis flos assures dosage composition, repeatability and the ability for patient and prescriber to effectively adjust dose by titration. A critical factor to build the evidence-base of medicinal cannabis, it is essential to be able to compare findings from different clinical trials and studies across time. That means the exact quality and dose of the cannabis, used for different conditions, should be known.

Finally, pharmaceutical quality cannabis flos is required from a public and patient safety perspective. Cannabis flos must be free of contaminants such as microbes, pesticides and heavy metals, qualities that make the vapour safe for inhalation into the lungs.

An efficient administration route

The most efficient administration route of medicinal cannabis is by inhalation. Indeed, administration by inhalation is a rapid way to induce measurable serum levels of cannabinoids.

“The most efficient administration route of cannabis is inhalation …the use of a vaporizer medical device avoids the respiratory disadvantages of smoking.”

A vaporizing medical device, compared to smoking, dramatically lowers concentrations of toxic compounds such as carbon monoxide, ammonia and polyaromatic carbohydrates (PACs). Compared to smoking, higher therapeutic levels of THC and consistent, reproducible THC extraction and delivery is possible. The vapour is quickly absorbed by the lungs, permitting patients to effectively titrate to optimise their dose based upon symptom severity, tolerability and avoidance of side-effects. The rapid onset of effects of inhaled cannabinoid use allows easier titration of dose, while standardised cannabis products enable patients to administer an exact dose.

In practice, with prescriber guidance, patients initially focus on ﬁnding a dose range that works for their speciﬁc condition. On average, patients in the Dutch medicinal cannabis program use only 0.7 grams of cannabis flos per day, divided over multiple doses.

Smoking cannabis in the form of cigarettes (joints) is still the most common way of consumption today, for medical as well as recreational users internationally. The advantage of vaporizing over smoking is obvious with regard to irritation and respiratory complication resulting from smoking. The presence of non-THC constituents, including anti-inﬂammatory terpenes that protect the lungs from irritation, are present in the cannabis flos vapour. This makes vaporizing the obvious and healthier choice for administration of the full range of therapeutic compounds present in the cannabis plant.

Not all vaporizers are the same. Patient perspectives and providing options

The importance of vaporization is underlined in patient use surveys. The majority of survey respondents report higher satisfaction (approval) scores with the inhalation route. In general, whole plant, herbal cannabis-based medicines received higher scores than other products containing isolated cannabinoids.

While smoking may be a popular administration method internationally, it is evident patients are looking for alternatives to smoking. Patients seek a reliable, affordable and portable vaporizer for administering cannabis flos. Presently there is research dedicated to advancing administration technology. An example of major developments in vaporizer medical devices, using standardised cannabis flos, include the Syqe® Inhaler (Syqe Medical). This device has relied on Bedrocan standardised cannabis flos for its quality testing and clinical trials.

Vaporizer medical devices, delivering standardised doses, underline quality assurance, safety, and efficacy. With these administration technical advancements, smoking of cannabis flos can soon be a thing of the past. Backed by proper scientific studies, medicinal cannabis flos will become an acceptable therapeutic among patients, prescribers, and regulatory authorities.

Second hand exposure

The content of exhaled cannabis vapour contains no pyrolytic compounds for second-hand exposure. However, it is not exactly known how exhaled vapour is dispersed in the air, and whether there may be significant levels of cannabinoids present in the exhaled vapour. No vapour cloud dispersion studies have yet been conducted. As a result, it is undetermined if passive intake of cannabinoids would present an occupational hazard to health professionals and other carers. While the levels are not likely critical to health and safety, this is an important future research to be undertaken.

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Vaporizer

Administration
Absorption via the lungs may reduce total daily intake.

Dose Type
Cannabis flos and granulate. A vapour of cannabinoids and terpenoids.

Onset
Highly efficient and fast acting. Between 2-10 minutes.

Duration
Between 2-4 hours.

Not all vaporizers are the same. See also:

At Bedrocan we are often asked about the different routes of administration – the ways medicinal cannabis is taken for therapeutic purposes. There are various ways in which patients administer medicinal cannabis. The typical route is through inhalation, but most patients who cannot inhale choose to use it orally. A survey conducted among patients shows the most common modes of delivery. Read all about it here.

Updates

Metered dose cannabis inhaler enables precise cannabis treatment. Update July 10, 2020.

Precise cannabis treatment dosing remains a major challenge, leading to physicians’ reluctance to prescribe medical cannabis. A recent feasibility trial demonstrates that a metered dose cannabis inhaler, produced by Syqe Medical and containing processed Bedrocan cannabis, enables individualisation of medicinal cannabis regimens. Not all vaporizers are the same… An update.

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