Medical cannabis patients often expect different effects from products with different cannabinoid contents and ratios (active compound in cannabis, such as THC and CBD). However, they may not realize that the format of the product also has an impact on its effects.

Aphria currently offers a variety of product formats including dried flower, vape concentrate, oil with syringe, oral spray and capsule. These products are intended for either inhalation or ingestion.

 

Product Formats:  Dried Flower Vape Concentrate Oil With Syringe Oral Spray Capsules
Route of Administration

Inhalation

Inhalation Ingestion Ingestion

Ingestion

Onset of Effects1

Seconds to Minutes

Seconds to Minutes 0.5  – 2 hours 0.5 – 2 hours

0.5 – 2 hours

Time to Feel Full Effects1

10 – 30 mins

10 – 30 mins Up to 4 hours Up to 4 hours

Up to 4 hours

Duration of Effects1

1.5 hours

(up to 6 hours)*

1.5 hours

(up to 6 hours)*

6+ hours

(up to 12 hours)*

6+ hours

(up to 12 hours)*

6+ hours

(up to 12 hours)*

*Residual effects can last up to 24 hours

 

What are the cannabis products intended for inhalation?

Dried cannabis flower is available in two formats: whole flower or pre-milled. Whole flower products will need to be ground into a fine powder before use. Alternatively, pre-milled flower is ready for immediate use. All dried flower products need to be activated through application of heat and are consumed through smoking or vaporizing. Since dried flower vaporizers apply lower levels of heat to cannabis, these devices can help limit the amount of combusted product inhaled 2. For this reason, Canada’s Lower-Risk Cannabis Use Guidelines suggest vaporizing dried cannabis as an alternative to smoking.

Vape Concentrates are a highly concentrated cannabis extract and provide an alternative, convenient and discreet method for consuming THC and CBD. Our vape concentrates are pre-activated and are available in a variety of aromas including: Lemon, Lemon Eucalyptus and Floral cannabis aroma

 

What are the cannabis products intended for ingestion?

Oil with Syringe gives patients full control over the dosage of their medication. This means that it’s a good option for those who dose at low or high amounts, or those who are slowly and gradually increasing their dosage until a level that maximizes therapeutic effects and minimizes potential unwanted side effects is found. The syringe also makes it convenient to apply the oil under the tongue.

Oral Sprays allow for easy transportation of patients’ medication and allows for convenient and discreet to consume on the go. They allow patients to take their medication in low, regular doses, a practice referred to as “micro-dosing”.

Softgels provide a consistent, pre-measured amount of oil for those who know their effective dose. They allow for easier and more discreet transportation as well as consumption of cannabis oil. Finally, because the oil is sealed within the gel capsule, the softgels are flavourless and odourless.

DID YOU KNOW? Dried flower can be incorporated into recipes by infusing cannabis into butter or olive oil, or by steeping in hot water to make cannabis tea. Learn how.

 

The difference Between Inhaling and Ingesting Cannabis

A product that’s inhaled through smoking or vaporizing, will have different effects from a product format that’s ingested 1. Patients may find these differences beneficial depending on the type of symptoms they are treating, or the desired length of the effects. Before using any new product, it’s always important to first speak with your health care practitioner so that an appropriate treatment plan can be established.

DID YOU KNOW? CBD dominant products still contain small amounts of THC. This means individuals working in worksafe positions may still test positive for THC during random drug screening and should speak with their employer before using cannabis 9.

 

The Different Cannabis Product Formats 1

 

Inhaling Cannabis Delivers Rapid and Short Effects

When patients inhale smoked or vaporized cannabis, the effects are felt rapidly taking seconds to minutes to feel initial effects. This is because the cannabinoids (such as THC and CBD) are absorbed quickly into the bloodstream through the lungs. Once there, the cannabinoids can travel throughout the body to produce varying effects1.

The fast effects of inhaled cannabis are beneficial for patients looking to treat symptoms that have a sudden onset, such as nausea and vomiting 3 or breakthrough pain.

 

Ingesting Cannabis Delays and Prolonged Effects

The effects from ingesting cannabis through the mouth, such as when taking cannabis oil products, are much slower and may take up to 4 hours to feel full effects 1. The effects are slower because swallowed cannabis oil needs to be absorbed through the digestive tract, once absorbed THC and other cannabinoids are metabolized by the liver, eventually entering the bloodstream 1.

Inhaling cannabis vs. ingesting cannabis effects on lungs, liver, stomach and heart

Caption: Ingesting cannabis will allows for THC to be converted into a more potent form (11-OH-THC) which helps prolong effects1.

 

Cannabis oils can be taken under the tongue (sublingual) to try shortening the amount of time needed to feel effects. This method is not perfect, and in all likelihood, a part of the dose will end up being swallowed and absorbed by the digestive tract 5,6. Whichever way one chooses to use oils, the existing literature suggests that absorption of THC and CBD during oral delivery (i.e. swallowed or under the tongue) is comparable 5,7,8.

Whether you ingest cannabis oils by placing under the tongue or swallowing, effects will typically last much longer than inhaled cannabis (up to 12 hours)1. For this reason, formats such as cannabis oils may be better for treating chronic conditions (symptoms that develop over time and are persistent), such as chronic pain and arthritis because of its long-lasting effects3.

DID YOU KNOW? You can improve absorption of ingested cannabis oils by ingesting on a full stomach.

 

How to Find the Right Cannabis Format?

The format of your medical cannabis product can contribute different effects and serve your medical needs in different ways. If a patient needs fast relief, inhaling cannabis will lead to a faster onset of effects, whereas ingesting cannabis products can provide longer-lasting effects for chronic ailments. It’s important to remember that the therapeutic effects of cannabis are highly individualized, meaning what works for one person may have different effects for another.

For instance, patients suffering from respiratory diseases wanting to treat acute symptoms through inhalation of cannabis should first speak with their doctor and weigh the pros and cons of this method as cannabis inhalation can negatively impact lung function 9.

Additionally, certain individuals may not want to inhale smoke or vapour from cannabis for a variety of reasons including health concerns or stigmas associated with the smell of cannabis. In these instances, cannabis oils are a good option as one is able to dose more discreetly while also avoiding concerns that they are inhaling byproducts from heating cannabis.

Compared to smoking, vaporizing dried cannabis produces fewer toxic byproducts (although not completely removed by this process)2. Thus, inhalation of cannabis can still be considered, but may not be suitable to everyone and should be evaluated case by case. We’ve prepared an article about the best ways to select medical cannabis products.

Talk to your healthcare practitioner to determine what is the most appropriate method of cannabis consumption for you.

If you have questions about the formats available at Aphria, feel free to contact our Patient Care Team.

 

References

1 Health Canada (2019) What you need to know if you choose to consume cannabis. Electronic document, https://www.canada.ca/en/health-canada/services/drugs-medication/cannabis/resources/what-you-need-to-know-if-you-choose-to-consume-cannabis.html, accessed February 2020.

2 Pomahacova, B., Van der Kooy, F., & Verpoorte, R. (2009). Cannabis smoke condensate III: the cannabinoid content of vaporised Cannabis sativa. Inhalation toxicology21(13), 1108-1112.

https://www.tandfonline.com/doi/abs/10.3109/08958370902748559

3 MacCallum, C. A., & Russo, E. B. (2018). Practical considerations in medical cannabis administration and dosing. European journal of internal medicine49, 12-19.

https://www.sciencedirect.com/science/article/abs/pii/S0953620518300049

4 Musty, R. E., & Rossi, R. (2001). Effects of smoked cannabis and oral Δ9-tetrahydrocannabinol on nausea and emesis after cancer chemotherapy: a review of state clinical trials. Journal of Cannabis Therapeutics1(1), 29-56.

https://www.tandfonline.com/doi/abs/10.1300/J175v01n01_03

5 Millar, S. A., Stone, N. L., Yates, A. S., & O’Sullivan, S. E. (2018). A systematic review on the pharmacokinetics of cannabidiol in humans. Frontiers in pharmacology9, 1365.

https://www.frontiersin.org/articles/10.3389/fphar.2018.01365/full

6 GW Pharma Ltd (2015) Product Monograph for Sativex. delta-9-tetrahydrocannabinol 27mg/mL (from Tetranabinex – Cannabis sativa L. extract) and cannabidiol 25mg/mL (from Nabidiolex – Cannabis sativa L. extract), Buccal spray, Cannabinoid Analgesic. GW Pharma Ltd, Cambridge, UK. Control No:149598.

7 Health Canada (2018). Information for Health Care Professionals: Cannabis (marihuana, marijuana) and the cannabinoids. [online] available at:

https://www.canada.ca/en/health-canada/services/drugs-medication/cannabis/information-medical-practitioners/information-health-care-professionals-cannabis-cannabinoids.html

8 Karschner, E. L., Darwin, W. D., Goodwin, R. S., Wright, S., & Huestis, M. A. (2011). Plasma cannabinoid pharmacokinetics following controlled oral Δ9-tetrahydrocannabinol and oromucosal cannabis extract administration. Clinical chemistry57(1), 66-75.

https://academic.oup.com/clinchem/article/57/1/66/5621130

9 Tetrault, J. M., Crothers, K., Moore, B. A., Mehra, R., Concato, J., & Fiellin, D. A. (2007). Effects of marijuana smoking on pulmonary function and respiratory complications: a systematic review. Archives of internal medicine167(3), 221-228.

https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/411692