The basics of medicinal cannabis formats
Medicinal cannabis can be used in a variety of ways, depending on the desired outcome. From vaporising to using capsules or oils, each product type has its own unique characteristics. From onset time to duration of action, these differences are important when evaluating medicinal cannabis choices.
Below is an overview of some of the differences between common medicinal cannabis formats. Please note that patients should always consult with their doctor to find the most suitable option for their needs.
Inhalation has been shown to provide rapid relief for patients. Studies have shown vaporising medicinal cannabis to be highly effective with patients often feeling its effects within minutes. Although inhalation can provide quick relief for patients, its relatively short duration means that patients may need to re-dose in more regular intervals when compared to other product types.
Medicinal cannabis should never be combusted (smoking or other smoking paraphernalia) and should always be vaporised. Smoking cannabis can pose a risk to patient health and may contribute to lung and throat disease. Patients should always use a TGA-approved vaporiser.
In Australia, TGA-approved vaporisers require dried medicinal cannabis flower to be loaded into the vaporiser before each use. Unlike combustion, vaporisation creates a vapour that is then inhaled instead of smoke. Vaporisers do this by gently heating rather than burning the medicinal cannabis, creating a cannabinoid-rich vapour which is less harmful relative to combustion.
Medicinal cannabis capsules can vary in their contents, with some containing cannabinoid-rich oils and others in refined powder form. Medicinal cannabis capsules can not only vary in the carrying vehicle (oil or powder) but can also vary in the type of cannabinoid included, the specific ratio of cannabinoids and cannabinoid strength.
Capsules can provide a convenient and easy way to get accurate dosing for medicinal cannabis patients, relative to other formats such as vaporisation where it may be difficult to ensure consistent dosing. Although capsules have a slower onset time, patients generally benefit from a longer duration of action and its predictable onset time and convenient standardised dosing allows for patients to have scheduled dosing timetables.
Sublingual administration has demonstrated the potential to be more efficient at delivering quick relief to patients relative to capsules. This is primarily attributed to the fact that oils when administered sublingually bypass first-pass metabolism and enter the bloodstream via membranes under the tongue. Additionally, oils enable granular control over serving sizes making dosing easier to control than in formats such as vaporisation.
The topical applications of medicinal cannabis in creams, balms and transdermal patches have steadily been growing in use within recreational markets, however their use within the medicinal context has yet to catch up. The research into onset times and duration of action with regards to medicinal cannabis topicals is still being developed, however anecdotal reports from patients and consumers have been shown to hold the potential for some localised pain relief.