MEDICAL CANNABIS
Consumption Methods

This section explores the various methods of ingesting medical cannabis. Each patient is unique in his or her requirements and responsiveness to cannabis. Journaling is HIGHLY recommended to ensure your patient is receiving the benefit of Medical Cannabis as an alternative treatment.

VAPORIZING DRIED CANNABIS:
Vaporization is the optimal delivery method for dried flower cannabis. Unlike smoking, vaporization is achieved by heating the cannabis to a temperature that vaporizes, but does not burn the cannabinoids, virtually eliminating the health risks associated with smoking. The effects of inhaled cannabis – whether smoked or vaporized – will be felt in a matter of minutes. It is recommended that your patient pause between inhalations to let the dose be fully realized.

• "Vaping" can extract up to 70-100% of cannabinoids.
• It is an effective method for breakthrough pain.
• Fast acting (typically within 5 minutes)
• NOTE: Quality vaporizers are upwards of $400. However, due to the high extraction level, the vaporizer will pay for itself over time due to its high extraction rate.

EDIBLE CANNABIS OILS:
When ingested, cannabis oil is processed through the liver, thus has a much slower onset time with effects that will last longer. It can take anywhere from 1-1.5 hours before your patient will begin to notice the effects and can take 2-4 hours to reach its peak effect. To avoid overconsumption, ensure your patients waits 4 hours after the first dose before taking a second. Patients who are new to edible cannabis oil should begin their therapy with a dose less than 0.5 ml, increasing the dose very slowly. Patients should follow extreme caution when dosing cannabis oils for the first time.

• Slower onset of action
• Easy to titrate
• Less stigma and barriers to use
• Convenient for patients in LTC settings
• Dosing should be thought of in mg/mL of THC and CBD and not g/day
• Dose VERY slowly and conservatively (i.e. 0.6mL may be perfect and 0.7mL may be too much)

SMOKING:
• Not recommended due to risk for lung cancer
• High stigma attached to this method
• Burns up to 50% of cannabinoids (costs patients more money)

MIXING TOBACCO & CANNABIS:
• Considered polydrug abuse
• Risk of developing nicotine dependence and increasing amount of cannabis used
• Possible risk of COPD
• Addictive due to nicotine
• Advise patients who combine to STOP.

CONCENTRATES (DABS/POPPERS):
• High THC (60-90%)
• No medical value to concentrates (even though it is commonly used on the street)
• Does not contain CBD or any of the other cannabinoids
• None of the other cannabinoids
• High risk of tolerance and dependence
• Often produced using solvents (butane/naphtha) which can be carcinogenic

TOPICAL:
• Not available in Canada
• Anecdotal evidence supportive
• Current evidence lacking
• DENY patient request for topical




Respiratory hazards of smoke are due to toxic by-products of combustion, not the active ingredients in the plant. Combustion creates smoke, which is the prime cause of lung cancer and many respiratory disorders.

By smoking the cannabis approximately 50% of the medicinal properties go up in smoke, thus losing half of the benefits of it of the medicine.

Vaporizing marijuana emits a vapor that is 95% smoke and carcinogen free. Vaporizers heat a substance to a precise temperature, releasing active ingredients in vapor form without ever igniting the substance.

It’s both better for your patient’s health… and their pocketbook.