Date Modified: October 26th, 2020
Date Published: January 27th, 2020
Author: Paul Caluori
9:48 mins to Read
Generally, there are four ways to use cannabis:
- Under the tongue,
- On the skin.
- Eating it.
- Inhalation, through smoking or vaping.
1. Sublingual Absorption (under the tongue)
Consuming cannabis sublingually means placing the oil under the tongue. This consumption method involves taking cannabis oil from a bottle, drawing it up into a syringe (without the needle) or dropper and dispensing the oil underneath the tongue. The oil should be held under the tongue for 30-60 seconds and then swallowed.
By holding the dose under your tongue, some absorption will take place at that site. Once swallowed, the rest of the oil enters the stomach and begins absorption there. A detailed description of the processing of cannabis through the stomach is contained in the ingestion section.
Although sublingual oil has a slower onset of effect than inhalation, sublingual oil provides relatively quick results. Effects may start to be felt within 20 minutes, but usually 60-90 minutes, and last for 4-6 hours. This type of administration allows for the treatment of symptoms present a lot or all the time. An example might be anxiety. Administration of cannabis oil sublingually may keep your anxiety in control for large parts of the day with one or two doses.
Sublingual dosing allows for greater accuracy in your medication dosing. Because the oil is drawn up with a dropper or syringe, an accurate dose can be administered. This also lends itself to titrating your dose. Titration is a method of adjusting your dose based on your symptom relief. You can alter the amount of cannabis taken quite accurately to focus in on an optimal dose based on how you feel.
Be sure to hold the oil under your tongue for 30-60 seconds. This is for two reasons: For CBD, it will increase the amount available to provide therapeutic effects. For THC, any absorption that occurs in the mouth reduces the THC that reaches the liver and is converted into a more potent form. (More on this in the ingestion section)
Although theoretically, bypassing the stomach and absorbing CBD directly from under your tongue should result in better absorption, it seems there is no consensus on just how significant this difference is.
Another way to potentially increase THC or CBD available for therapeutic effects is to consume cannabis with a fatty food before or immediately following a cannabis oil dose. An animal study showed this increased the THC amount available by 2.5 times and CBD by 3 times.
At WeedwellTM, we often recommend sublingual cannabis oil as it usually provides a repeatable dose and a long duration of action. Also, this method of taking your medicine does not cause the lung problems that may be seen with smoking or vaping cannabis.
Cannabis oils are extremely concentrated products. As a result, it is often mentioned with dosing to start low and go slow. It is better to inch closer and closer to the desired effect than to take a large dose and suffer from some unwanted side effects.
2. Topical (on the skin)
Topical application is a cannabis consumption method that involves putting cannabis-infused creams or balms on the skin’s surface. This application is often useful for joint issues like pain or skin conditions like eczema or acne.
Creams and oils with cannabis can be effective on the skin. They can penetrate to some degree to reach deeper tissues. However, there is an issue with absorption across specific layers of the skin. This can limit its effectiveness because the THC and CBD remain trapped on the outer layer of skin and cannot penetrate.
New technology is aimed at improving penetration. Patches are also available that can release medicine slowly to an area. Many people like to make their own remedies and find this helpful, and it is usually quite safe.
It is possible that smaller joints and tissues that are close to the skin surface may benefit more from topical administration. It may be simply too far for the THC or CBD to penetrate deep into, say your hip joint, which may be 2-3 inches from the skin surface. On the other hand, your knuckles are close to the skin surface. This may make topical application of cannabis to arthritic hands and fingers more responsive to treatment. Keep in mind also, that applying THC to widespread areas of the body, such as your whole back and chest, could theoretically result in enough absorption to cause impairment or even to cause someone to fail a drug test. As always, even when using THC topically, start low and go slow.
At WeedwellTM, some patients have reported great success with topical application. It is important to note that there is not much research in this cannabis consumption method and trying it may be trial and error. Because of this, it is impossible to discuss the onset and duration of action. As well, it is not easy to assess what dose you have applied.
3. Ingestion (eating your medicine)
Eating your medicine or oral administration results in a very slow onset of action. Ingesting your cannabis can be done in 2 different ways. The first method involves taking gelcaps or capsules filled with cannabis oil. The second method will have you consuming food or drink infused with cannabis. These are referred to as edibles.
For gelcap or capsule ingestion, this is a straightforward process. Take the gelcap and swallow. The limiting factor is that there are only specific doses available. For example, a gelcap may contain 2.5mg THC or 5 mg CBD. You cannot open the gelcap up and accurately take a half dose. This method does hide the taste of cannabis oil from your tastebuds as the taste can be a deterrent for some people.
For edibles, you can purchase food or drink infused with cannabis, or make the product yourself. Common foods infused with cannabis are chocolates, gummy bears or brownies. People will also add cannabis oil to their tea or other drinks.
Whether gelcap or edible, ingesting cannabis brings THC or CBD to the stomach. Once in the stomach, it is moved to the liver for processing. The amount and type of food in your stomach also affect the rate and amount of absorption. Once processed at the liver, the cannabinoids are ready to enter the bloodstream to produce therapeutic effects.
When consuming edibles, the onset of action is usually 2 hours and the effects can last 6-8 hours, sometimes even longer for some people. Edibles are an effective way to provide a dose of medicine spread out over a long period of time. A condition of chronic pain which is present all or nearly all the time may respond well to a long acting dose of edible THC or CBD.
A few words of caution:
Ingesting your CBD can be a tasty way to consume medicine, but the amount of medication available after the liver completes its process is greatly reduced. Some literature suggests from 6-20% of the initial dose.
For THC edibles, the liver converts the THC to a more potent form that has the potential to create more significant effects. The THC effects may not be felt for 2-3 hours, so do not take a second dose because you feel nothing.
A couple of other considerations:
Making your own edibles can be reasonably simple. There are many resources and recipes available. Keep in mind that dosing may vary from piece to piece, like in a pan of brownies. In general, we recommend against this method of consumption. The main reason is that we want our patients to have a consistent and repeatable dose each time they take their medicine. Professionally produced, regulated, and tested edibles may reduce these inconsistencies, but for now, we feel that sublingual administration has many advantages over ingestion. Finally, as with other dosing methods, always remember to start low and go slow with edibles or gel caps.
4. Inhalation (vaping or smoking)
Vaping or smoking your cannabis is a consumption method that involves inhaling cannabis directly into your lungs. From there, the THC and CBD can quickly enter the bloodstream. Consuming cannabis by inhalation provides the quickest onset of action, but its effects last the shortest amount of time.
Dosing by inhalation is fairly accurate. You can measure the amount put into your joint or vaporizer. However, there is a wide range of medicine available once the THC or CBD has passed the lungs. There are variables such as depth of inhale, amount of time breath is held, cleanliness of vaporizer or relative dryness of the flower. While a specific dose is difficult to measure, the person who inhales their cannabis can alter their intake based on how their symptoms responded to previous inhalations. This is easier to do with inhalation because the effects are much more immediate.
If your condition needs immediate relief, then inhalation might be right for you. Migraines, panic attacks, and severe breakthrough pain are conditions that might be best treated by inhalation. As of today, there are no other methods to get quicker relief.
Inhaling cannabis involves one of three methods:
- Vaporizing dried cannabis (traditional vaping)
- Vaporizing oils (vape pens)
Smoking cannabis involves burning the dried flower and inhaling the smoke. The most common image that comes to mind when consuming cannabis is smoking. Various methods of smoking include joint, bong or pipe. At Weedwell™, we generally do not recommend smoking cannabis because we believe vaping dried cannabis is safer for the lungs
What exactly is vaping?
Vaping is the act of inhaling and exhaling the aerosol produced by heating a substance. Instead of burning cannabis (which occurs in smoking), the vaping device heats the material (can be liquid/oil or wax extracts, or dried flower/herb) into a vapour, which then condenses into an aerosol (a fine spray of particles) that you inhale.
Vaping dried flowers versus vaping oils
Vaping dried flower has been around for a long time. This involves inhaling the vapour of the dried cannabis flower that has been ground up. The THC and CBD concentrations of the flower do not exceed 30%. On the other hand, a relatively new method of administration allows for vaping oils. Vape concentrates are extremely concentrated and potent. THC concentrations of these products can be up to 70-80%.
Do not try to vape concentrates which are not formulated especially for vaping. If you have a dried cannabis vapourizer, do not try to vape cannabis oil. They may contain dangerous additives. This can cause severe damage to your lungs. Remember, cannabis oil may be safe to put under your tongue but not to vape.
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There are all kinds of vaping devices. All of them heat dried cannabis to just under the temperature where it will burn. Generally, the range for vaporizing cannabis is around 180-210oC. This results in a medicine rich vapour with minimal unwanted substances. After consumption, you will know if the temperature is too low if the remaining cannabis has green streaks in it. Alternatively, if your cannabis has burn streaks in it, the temperature may be too high. The proper temperature will leave a light brown product in the filling chamber after consumption. Vaporizers contain a temperature control, heating element, filling chamber and mouthpiece.
Desktop vaporizers are relatively large units that plug into a power source and are not portable. The largest tend to be more expensive but are of higher quality. They also offer precise temperature control. Some desktop vaporizers use a fan to deliver your medicine into a plastic bag. You can then inhale from this where you wish, creating a somewhat portable experience.
With portable vapes, you usually need to inhale directly on the mouthpiece. Most of these vaporizers have temperature settings. They are often rechargeable and are good for travelling. Filling chambers can be pre-filled and capped to prevent medication loss and used during your day as needed.
Portable ‘oil vapes’, often referred to as vape pens, administer oil instead of dried flower. These can be open (allowing loading of oils) or closed (using cartridge pens). These products tend to use extremely potent and highly concentrated oil. There is a place for these devices in cannabis treatment; however, it is not recommended that a new person initiate their treatment with this consumption method.
Recommended action for patients
There are many ways to take your cannabis medicine. At Weedwell™, we tend to prescribe oil under the tongue to eliminate any concerns about the lungs. This method is also great for long action and consistent dosing. Still, there are situations where vaping may work better for some people. Good temperature control is important, as is high-quality dried cannabis or concentrate. If you decide to vape, read and understand how your vaporizer works. Be sure to use products that are to be used specifically with your vaporizer.
The Weedwell™ Team