For those medical marijuana patients looking for alternatives to smoking or vaporizing their medicine to relieve various ailments, thankfully several safe and highly effective options for delivery exist and are available to choose from.
Let’s take a quick look at two such methods of cannabis delivery; sub-lingual (under the tongue) and oral ingestion. Also check out some effective ways to administer each method and look at the unique characteristics and the benefits for patients looking to go this route.
Discovering the most effective and satisfying method for medical marijuana patients involves experimentation of course, but several key features and characteristics distinguish the application methods and may help patients make more educated choices prior to dosing, ultimately achieving better results for desired relief of pain.
Oral Ingestion
Today, there are various ways ingest cannabis. Patients can medicate in pill or caplet
form, a liquid or medical edibles (medibles), all common ways to orally self-medicate with cannabis.
Orally ingested cannabis is absorbed in a very different way than the methods of smoking, vaporizing or sub-lingual delivery.
The GI tract gradually absorbs cannabinoids, including cannabidiol (CBD), one of at least 60 active cannabinoids identified in cannabis to possess significant medical benefits. Orally delivered cannabis requires four to ten times the amount of the smoked version in order to achieve the same effect. The reduced psycho-activity of CBD-rich cannabis may make it an appealing treatment option for patients seeking anti-inflammatory, anti-pain, anti-anxiety, anti-psychotic, and/or anti-spasm effects without the high or euphoric feeling.
On the downside, absorption rates will be slowed and less predictable, with the onset of action taking roughly 30 minutes or longer, depending on one’s metabolism, for example. This can present confusion determining the proper dosage. In addition, the medication gets metabolized through the liver before getting into the bloodstream, further altering and degrading CBD and its medicinal qualities and effectiveness*.
One advantage of the oral route is that it will last much longer, so a patient does not have to medicate as frequently once the proper dose is determined. Today, many dispensaries offer edible cannabis products such as baked goods, candies and beverages with variable dosage for patients. Another benefit…the variety of amazing choices and improved taste and quality are making them irresistible nowadays, even without the munchies! Lasagna, ice cream, meatballs, pizza…the healing goodies product varieties are boundless.
Some “medibles” contain a single dose, while others contain much more so please make note when trying new products! The products dosage should be labeled as such and considered carefully prior to consuming.
Another commonly used versatile product is cannabis butter, obviously great for cooking in so many favorite recipes or as a spread for favorite breads.
Sub-lingual Ingestion
The sub-lingual method or oromucosal (in the oral cavity) delivery method of an oil or
tincture, provides rapid onset of action. The medication is readily absorbed into the bloodstream. Cannabis tinctures are an excellent way to utilize the plant’s medicinal ingredients, and a perfect alternative for those who find smoking difficult. “A tincture is a medicinal extract prepared in a base of alcohol, oil or glycerol solution. The solution is used to extract and preserve the resins and other soluble material from the plant. **
A tincture is designed to address the problems of rapid medicine delivery and consistent dosing.” ***
Many concentrated tinctures are flavored and taken by dropper under the tongue and within minutes the patient will feel the effects of the cannabis. Titration or dose control is very easily controlled by the number of drops the patient administers under the tongue.
One trick is to not swallow the dose as, if swallowed; absorption will be in the GI tract reducing the effects.
Other tinctures are available in flavored spray form, sprayed into the mouth and absorbed in the oral cavity entering the bloodstream rapidly. However, the most effective method of administering tinctures is sub-lingually.**
Medicine is rapidly absorbed then dispersed into the arterial system and transported to the brain and body. Therefore, tinctures are designed to address the problems of medicinal delivery and consistent dosing posed by other methods.***
As is always the case, choosing the correct medications and methods in which to use them are an important personal decision for good health. Choosing medical cannabis and its various methods for usage meet those requirements of responsibility. Proper research, careful and safe experimentation of medical cannabis will help determine which method of medicating is best for you and your specific medical needs.
Stay informed and stay safely medicated!
References:
*(1) Mary Lynne Mathre RN, MSN, CARN; International Nurses Society on Addictions Published in A Train Education
**(2) Stan Czolowski – Cannabis Culture -10/2/03
***(3)Dr. Allan Frankel M.D. – GreenBridge Medical/Patients for Medical Cannabis
I’ve bought a few tinctures and have been trying to medicate sublingually but it doesn’t seem to work.
I started with taking 1mg under the tongue with no results then 2mg all the way up to 10mg with spitting the solution out after 20 mind of holding it under the tongue. It only works if I swallow the solution after.
1 mg is a sub-clinical dose For most people. 10 mg _delivered_ is more typical. But the method of delivery can make a big difference.
Because only some fraction of the cannibinoids ever make it to your bloodstream (you’ll be spitting most of it out) you have to use much more to begin with. For example, if 10 mg is your ideal dose when eaten, you’ll probably need 25 mg under the tongue. But if you try this, _dont swallow_ the rest or you’ll get over medicated.
So why would anyone do sublingual? For me, the effects are very different. Sublingual is more energizing and doesn’t impede my thinking or short term memory hardly at all. I much prefer this to the feeling when eaten where a much lower dose makes me stupid and worthless for accomplishing anything for the rest of the day.
There is scientific backing for the difference. Eaten, the thc is metabolized by the liver and converted to a different chemical form before entering the blood. People respond differently to the liver-metabolized version and for me, I don’t care for the result after eating.
Everyone reacts differently, so your mileage may vary.