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.
Pharmaceutical quality cannabis flos
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.
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. Some examples of major developments in vaporizer medical devices, using standardised cannabis flos, include the Volcano® Medic vaporizer (Storz & Bickel), the Syqe® Inhaler (Syqe Medical), and the Bedrovape® vaporizer. All devices have relied on Bedrocan standardised cannabis flos for their 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.
Absorption via the lungs may reduce total daily intake.
Cannabis flos and granulate. A vapour of cannabinoids and terpenoids.
Highly efficient and fast acting. Between 2-10 minutes.
Between 2-4 hours.