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 that the five most common modes of delivery are:
Bedrocan cannabis can be prepared in a specific administration form in a compounding pharmacy. Many compounding pharmacies can prepare products such as tablets, oils, capsules, sprays, or ointments, depending on the prescribed administration form. However, it needs to be noted that these products are considered compounded medicines, not registered medical products. As such, the lack of coherent regulations results in the lack of standardized compounding methods and, as a consequence, variability of cannabinoid content between different preparations and pharmacies.
Mode of administration
For each mode of administration, we compare the common dose type, the onset of action, the duration of the effects and relative safety (especially compared to smoking). Please note that many of these preparations have never been examined in rigorous medical studies; therefore, most of what is known about them is based on experiences by actual patients.
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.
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, consistent, reproducible THC extraction is possible, delivering higher therapeutic levels of THC.
Bedrocan has worked with highly specialised companies on the development of more sophisticated vaporization devices such as:
- Volcano Medic® – allows the inhalation of dried cannabis flowers and liquids dissolved in alcohol.
- The miniVAP® – an easy to use portable system to vaporize. The vaporization occurs only when the user inhales by convection heating.
- The Syqe Inhaler ™ – a new type of vaporizer developed for professional healthcare use in hospitals or by licensed patients. It differs from traditional vaporizers by using single inhalation doses of standardised cannabis flos. Bedrocan is Syqe’s preferred producer of cannabis flos for this purpose. The Syqe device, including Bedrocan cannabis flos, is currently sold in Israel.
The most common mode of administration among self-medicating patients is cannabis oil. The oil is often obtained by solvent extraction of the flowers or leaves of the cannabis plant. It is not actually an oil, but derives its name from the oil added to the extract in order for it to be consumed more easily.
A patient survey showed an incredible 97.3 % of the respondents using oil to treat cancer and its symptoms. Most of these patients use it without a prescription. Some patients firmly believe that cannabis oil is capable of curing cancer, a claim often backed up with patient anecdotes of such treatment success. Laboratory studies do indeed show a potential effect of cannabinoids on isolated cancer cells in a petri-dish and in lab animals, but it is too early to claim that consumption of medicinal cannabis may cure human cancer.
Cannabis tea is a very common way of consuming cannabis orally. Tea is relatively easy to make without the need of additional specialised equipment. Cannabis tea does not look like cannabis, nor does it produce smoke or vapor. Therefore, it allows the user to consume it in public (e.g. at work, family visit) without drawing much unwanted attention.
Studies have shown that an average cup of cannabis tea contains about 5 times more THC-acid than THC. The reason is that the temperature of boiling water is not as high as the temperature of cannabis when vaporized or smoked. Contrary to popular beliefs, the concentration of THC and CBD in fresh or dried cannabis plants is very low. Instead, cannabis mostly contains cannabinoid acids. When sufficient heat is applied to the plant, THC-acid will convert into THC, and CBD-acid will convert into CBD.
Due to the high amounts of acidic cannabinoids and low amounts of converted cannabinoids, it is likely that cannabis tea works in a different way. However, at this point it is not clear what the effects are exactly, as this has never been tested.
Edibles (cookies and brownies) are another common way of consuming cannabis orally. Unfortunately, there are currently no scientifically approved methods available for the analysis of cannabinoids and/or terpenes in edibles containing herbal cannabis or extracts. As a result, no good scientific data is available on the potency, composition or consistency of edibles. Theoretically, issues that are likely to occur with edibles include proper mixing (ensuring one edible has the same potency as the next), and stability of these products during storage. Consequently, the use of standardised recipes and procedures is very important for edibles.
Worldwide, smoking is the most common method of intake, either as a straight herbal product or in combination with tobacco. It is certainly not the healthiest one. Inhalation of toxic compounds may pose serious health risks due to release of highly noxious by-products such as tar, ammonia and carbon monoxide.
In many countries, the stigma attached to smoked cannabis poses a major obstacle for approval of herbal cannabis as a medicine by public health authorities.