In our previous article on Top Reasons to use Inhaled Cannabis , we addressed how there are lots of new ways to use cannabis, but that these are mostly about selling new products.  We also noted that many of these new items are not effective or safe. 

When it comes down to use for medical treatment, there are really only two ways that are effective and reliable: inhalation and oral ingestion.  

In this article we’ll explore the top reasons you might consider taking cannabis by mouth.  We’ll explore the top reasons why you might want to use less cannabis in the next article – stay tuned. 

1) Slow Onset

Okay, this isn’t really a selling point for oral ingestion.  I can’t really think of a reason that being slow to start working is an advantage.  However, the extended duration that we’ll discuss next is really to key feature.  

Oral cannabis is slow for several reasons.  The obvious is that it has to get absorbed in our gut, and that takes time for digestion and the actual absorption.  Once the cannabis medications are absorbed, they are carried to the liver whether a really cool thing happens: the THC, ore more properly called delta-9 THC is converted into 11-hydroxy THC.  11-hydroxy THC is actually a different medicine, and as such, it behaves differently

2) Extended Duration of Action

Once the 11-hydroxy THC is created, it goes via the bloodstream to the tissues, including the brain, where it interacts with our endocannabinoid receptors to create the effect we’re expecting.  Since this is the 11-hydroxy form, it simple works longer – about 8-12 hours. 

11-hydroxy THC is also removed from the blood and broken down by enzymes in the liver which, by their nature, explains the relatively longer duration of action. 

3) Chronic Problem

While the length of time it takes for orally ingested cannabis to start working is a bummer, it’s similar to most conventional medications.  The extended relief is what we’re after.  

Any chronic problem like pain management, where the patient has symptoms nearly all the time, is best addressed with oral cannabis.  We know from research on pain management that chronic pain is poorly treated with short-acting medications.  In fact, short-acting medications can actually make pain worse!

Using short-acting medications for pain typically leads to a “yo-yo” effect: you feel better for a short while, then it wears off and you feel bad again.  Over time, your brain can actually learn from this that that pain will come back and will anticipate the return of the pain by actually making the pain come back worse.  This yo-yo effect needs to be avoided.  This is where long-acting meds are superior.  

For examples, typical osteoarthritis knee, back, shoulder, hip pain are best treated this way.  

Furthermore, the risks associated with cannabis medication, like all medications, are dependent on the overall dose.  Using 10mg THC via inhalation 4-5 times per day leads to an overall use of 40-50mg per day, whereas the same 10mg THC used orally only twice a day leads to 20mg overall exposure.  Less is more, and certainly safer.  

All Manner of Products

OMG there are so many oral products now.  However there are some general guidelines that you should know.  

First, don’t go for products that are high in calories, fat, or sugar.  Most of us just don’t need that in our, already too caloric, diets.  Don’t forget you’ll be taking these twice a day.  Don’t overlook your weight or diabetes or other medical conditions when thinking about cannabis medicine.  I tend to favor small gummies as they are easy to use and not excessive in the food portion.  With really small gummies, you can even swallow them whole if you don’t like the flavor.  

Second, get products that are just cannabis.  In the current market brands are struggling to set themselves apart from their competitors – which can be difficult if all the products are similarly good ol’ weed.  Many manufacturers are turning to condition or “feeling” specific formulations.  These are often pretty unclear about what they do and what’s in them.  

I don’t know what I’d expect in a product called “Inspire” or “Midnight Drops”.  As it turns out, there can be all sorts of things in these products.  They might contain caffeine, or melatonin, or L-theanine, or other stuff.  Caffeine can cause jitteriness and heart palpitations.  Melatonin might help you sleep, but has also been shown to cause surreal, unpleasant dreams.  With these combination products, if there’s a problem, we’ll never be able to tell if it’s a cannabis reaction or something else.  I recommend pure products so we know exactly what you’re taking. 

A Word About Tinctures:

If you’ve been following me for a while, you probably already know that I’m not a great fan of tinctures.  I use them for patients in some circumstances – like a feeding tube – but it’s rare.  The problem with tinctures is two-fold.  One, the put it under your tongue advice from the dispensary is complete rubbish.  It doesn’t get absorbed in your mouth, is unpleasant and foul-tasting.  There are some pharmaceutical products that can be used that way, but not garden-variety tinctures.  

Second, and more important, tinctures are liquids and are just more likely to cause dosing errors.  Dosing is the key to getting the right and reliable treatment.  Why use a product that doesn’t support that?  For those times with a tincture is all we have, I have approaches to address these concerns, but they’re second-choice. 

Consult with a Qualified Boston Medical Marijuana Expert Today 

Those considering using THC, CBD, or any type of medicine found in cannabis to help manage their condition should consider speaking to a trained medical expert who is knowledgeable about using cannabis therapeutically. Massachusetts medical marijuana doctor Jordan Tishler, M.D. sits on the faculty of Harvard Medical School and has years of experience helping patients treat pain and other ailments using cannabis. He and the team at InhaleMD stand ready to assist patients in determining whether medical marijuana is right for them. For more information, or to set up a virtual consultation with the team at InhaleMD, call us at (617) 477-8886 today.

Now Offering Virtual Telemedicine Consultations

Now Offering Virtual TeleMedicine Consultations

Due to COVID-19, and for the foreseeable future, all of our appointments are being done by telemedicine. As it turns out, this has been wonderfully successful — patients love not having to take time away from work, fight traffic, or worry about parking. For us, telemedicine is like doing old-fashioned home visits — we get to see people in their own environments. What started out as an adaptation to the current crisis has transformed into a better way of providing healthcare.

Telemedicine, using Zoom, is easy to do with just a few clicks. It's also safe and secure.

Schedule a Telemedicine Visit