Cannabis is becoming a popular medicine in the United States for patients wanting to fight a wide variety of diseases and disorders. Cannabis and derived products are used to treat conditions such as multiple sclerosis (MS), cancer, inflammatory disorders, autoimmune disorders, and a wide variety of psychological disorders, ranging from depression and anxiety to schizophrenia. The majority of medical benefits cannabis consumption provides are due to the presence of cannabinoids that interact with the human endocannabinoid system.
ROUTES OF ADMINISTRATION
Cannabis consumption is quintessentially perceived by the public in the form of a “joint”, a cannabis-flower cigarette. People more familiar with cannabis are also aware of dry pipes, water pipes, vaporizers, dabbing rigs, and more. These methods are all variations on administration via inhalation, because they all introduce cannabinoids into the lungs.
Another common route of cannabis administration is oral ingestion, whereupon the consumer ingests edible products that have been infused with cannabis or one of its extracts. Although edibles come in a wide variety of forms, they all introduce cannabinoids into the gastrointestinal (GI) tract via the stomach.
Other, less common routes of administration include:
- Dermal absorption (through the skin)
- Anal and vaginal suppositories
- Intravenous solutions
Inhalation and oral ingestion represent a large majority of traditional medical cannabis consumption, therefore comparing their effects on patient health will be the focus of these articles.
When comparing the effects of inhaled and ingested cannabinoids, it is important to also examine the differences between the stomach and the lungs.
The lungs contain a large amount of blood vessels that quickly absorb cannabinoids. Blood from the lungs is pumped directly into the heart and is subsequently pumped into the brain, where many endocannabinoid receptors are present.
In contrast, cannabinoids that enter the body via the stomach take a longer journey to reach the brain. Ingested cannabinoids start in the stomach, which cannot absorb cannabinoids into the bloodstream directly. After entering the stomach, cannabinoids pass into a region in the small intestines called the duodenum. Stomach contents are mixed with bile, allowing water-insoluble substances such as fats, oils, and cannabinoids to dissolve. The dissolved cannabinoids are then absorbed into the blood by the intestines.
However, blood from the intestines is not heading directly to the brain. Instead intestinal blood is pumped into the liver, otherwise known as the body’s natural detoxification center. The liver attempts to detoxify the blood’s contents before releasing it into circulation. As part of the detoxification process, the cannabinoids are metabolized into new compounds.
The liver transforms THC, or tetrahydrocannabinol, into 11-hydroxytetrahydrocannabinol, abbreviated as OH-THC, a psychoactive cannabinoid distinct from THC. The brand new OH-THC cannabinoids leave the liver, passing into general circulation, eventually reaching the brain. This long route of administration also explains why edibles often take over an hour before effects are visible.
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About the Author
Marco Troiani is one of the founding members of Digamma Consulting and the laboratory manager. He was also the laboratory manager of DB Labs from its founding 2015-2016. His responsibilities included developing detection methods for terpenes and solvents (GC-MS), metals (ICP-MS), pesticides (GC-MS-MS), and Total Yeast and Mold, Total Aerobic Bacteria, Total Coliform Bacteria, and Salmonella spp. in cannabis and associated products.