Cannabis contains a rich profile of cannabinoids (113 identified so far) that interact with our bodies in unique and sophisticated ways via the human endocannabinoid system. Cannabis also contains some non-cannabinoid substances.

The main compounds found in cannabis are:

• ∆⁹-tetrahydrocannabinol (THC)
• Cannabidiol (CBD)
• Cannabinol (CBN)
• Terpenoids

Chances are you've heard about THC and CBD, as they are the most well known cannabinoids (also the most prevalent compounds) whose precursors are found in the cannabis plant.

The average person probably knows that THC gets you high and CBD doesn't, but there's actually far more to these cannabinoids than this over simplification would suggest.

While cannabinoids have gotten much of the glory over the years, terpenoids are now the rising stars amongst cannabis researchers and cannabis consumers as well.

Medical marijuana can be administrated by:

• smoking
• vaping
• eating cannabis edibles
• oral consumption of capsules, pills, lozenges, tinctures or sprays
• sublingual drops
• topical sprays, creams or ointments
• dermal patches

Medical hemp products consist primarily of extracts infused in oil for oral use and pure extracts for vaping.

CBD can also act in concert with opioids to reduce pain

• opioid meds are required in smaller amounts if taken with CBD (opioid sparing)
• chemo therapy is required in smaller amounts if taken with CBD
• can also help overcoming opioid addiction

THC is not required for CBD to work, but these two cannabinoids do work together synergistically:

• in pain releif
• in activity with glioblastoma cancer cells

NSAI drugs relieve pain by upregulating the ECS with this same mechanism as CDB deploys, but . . .

• unlike CBD, NSAI drugs can have side effects: ulcers, heart attacks and strokes

The reason THC gets you "high", while CBD does not, is because unlike THC, CBD is exceedingly bad at activating the CB1 receptor. In fact, evidence suggests that it actually interferes with the activity of the CB1 receptor, especially in the presence of THC. When THC and CBD work together to affect CB1 receptor activity, users tend to feel a more mellow, nuanced subjective high and have a much lower chance of experiencing paranoia compared to the effects felt when CBD is absent. That's because THC activates the CB1 receptor, while CBD inhibits it. The presence of both cannabinoids balances the effects.

In the United States, the CBD drug Epidiolex has been approved by the FDA for treatment of two epilepsy disorders. Side effects of long-term use listed on the Epidiolex label include somnolence, decreased appetite, diarrhea, fatigue, malaise, weakness, sleeping problems, and others.

The U.S. Drug Enforcement Administration has assigned Epidiolex a Schedule V classification while non-Epidiolex CBD remains a Schedule I drug prohibited for any use. CBD is not scheduled under any United Nations drug control treaties, and in 2018 the World Health Organization recommended that it remain unscheduled.

Terpenes are not unique to cannabis. Other plants also contain terpenes. Being the primary components of essential oils (created by plants), terpenes help protect the plant against herbivores, insects, and other environmental dangers. They're also responsible for a plant's regeneration, oxygenation and immunity defense, which is why cannabis researchers are investigating if terpenes may serve as immunity boosters in humans.

Chemically, there really is no difference between specific terpenes extracted from different plants. When it comes to function, what's more important than the specific terpene, is the other specific compounds present along with the terpene. In the case of cannabinoids, which are uniquely found in cannabis, terpenes interact with and influence the effects of cannabinoids.

Terpene preservation has never been more important to the cannabis market than it is now. Growing, harvest, and curing conditions all have an effect on terpene expression, and they can all contribute to the terpene-heavy cultivars that today's cannabis consumers are looking for.

In order to get a rich terpene profile, cannabis plants should neither be harvested too early nor too late. Harvesting too early may cut trichomes off from full cannabinoid and terpene production, while harvesting too late may produce trichomes that have decreased in chemical potency, or broken off entirely. Properly ripe trichomes will be bold, distinct, and translucent on the plant's surface, and they'll be rich in terpenes. Cannabis emitting a strong pungent fragrance is commonly referred to as being "skunky", which is very desirable and considered an indicator of high quality.

Other factors that influence terpene production include growing at sufficiently cool temperatures (77-80℉, or 25-26.67℃, during the day and roughly 7-10 degrees colder at night) and drying under sufficiently cool temperatures (between 65-75℉, or 18.33-24℃) to reduce terpene evaporation. Lastly, being as gentle as possible with cannabis flower in every step of the cultivation process will increase a grower's chances of coming up with a terpenoid-rich final product.

A huge factor in the cannabis industry's current terpene boom is the growing popularity of "dabbing" (the act of inhaling vaporized cannabis concentrates through a temperature-specific heating method such as a dab rig, e-rig or vaporizer). Dabbing concentrates at high temperatures typically results in a smooth, tasty cannabis vapor-rich in terpene flavors. What many dabbers may not be aware of is the possibility that terpenes produce toxic chemicals when super-heated. According to a study from Portland State University, vaporizing terpenoids at the high temperatures required for dabbing may produce the toxicants methacrolein and benzene, which have been linked to certain cancers. So, if you want to enjoy a flavorful dab without heating the terpenoids to toxicity, dab at as low a temperature as possible.

Although hundreds of different terpenes have been found in cannabis, only a select group of them are sufficiently present. These are the 11 most prominent terpenes in cannabis, along with their aromas, boiling points, and potential health benefits as shown in experiments on animals.

• Myrcene and Caryophyllene
• the two most prominent terpenes in cannabis. (most cultivars are dominant in one or both.)
• Myrcene (a monoterpene) carries the signature "earthy" aroma found in most cannabis plants.
• has a boiling point of 332.6℉ (167℃)
• an effective anti-inflammatory
• may also alleviate pain
• Myrcene accounts for the sedative effect (falsely attributed to "indica") and contributes to the "couch lock" (tired effect)
• Caryophyllene carries an "herbal" aroma.
• has a boiling point of 266℉ (130℃)
• also found in hops, cloves, and rosemary
• Like myrcene, caryophyllene has both anti-inflammatory and pain relieving properties.
• Pinene
• Pinene is one of the most commonly expressed terpenes in nature.
• responsible for the" piney" aroma of certain cannabis cultivars
• found in pine trees and other conifers
• has anti-inflammatory properties
• may help to protect from ulcers
• may help improve airflow to the lungs
• has a boiling point of 311℉ (155℃)
• Limonene
• In addition to being found in cannabis, limonene is commonly found in citrus fruits.
• provides the classic citrus smell
• has a boiling point of 348.8℉ (176℃)
• Limonene is commonly used in a wide variety of products, from cleaning supplies to fragrances.
• may boost immune system function
• may alleviate heartburn symptoms
• can be used as a solvent to dissolve gallstones rich in cholesterol
• uplifting on mood
• can effectively reduce or eliminate the classic THC-induced short-term memory impairment
• Terpinolene
• Terpinolene has a fresh herbal-citrus aroma.
• has a boiling point of 361.4-365℉ (183-185℃)
• commonly found in plants known for pleasant fragrances (i.e. rosemary, conifers, lilacs, apples)
• Human studies have identified terpinolene as a potential antioxidant, and animal studies have found it to have sedative properties.
• Terpinolene might eventually be used to decrease cell proliferation associated with cancer.
• Humulene
• Humulene is common cannabis terpene that's also predominant in hops.
• also present in sage, clove, basil, black pepper, and ginseng
• carries the signature "hoppy" aroma
• may be an effective topical anti-inflammatory and pain reliever
• has a boiling point of 222.8℉ (106℃)
• Linalool
• Linalool is a terpene found in rosewood, bergamot, coriander, rose, jasmine and lavender.
• has a boiling point of 388.4℉ (198℃)
• carries a very pleasant floral aroma, and is often used in soaps and perfumes.
• In addition to potentially reducing inflammation and inflammatory pain like several other terpenes, linalool has several unique potential health benefits.
• inhibits the growth of fungal infections outside the human body, particularly as they arise from the yeast infection candida.
• It also has anticonvulsant and sedative properties.
• Ocimene
• Ocimene has a strong, sweet, herbal scent.
• has a boiling point of 212℉ (100℃)
• found in a wide variety of plant life, including mint, mangoes, basil, and orchids
• Omicene can act as an anti-inflammatory, and may have antiviral and antifungal properties.
• Nerolidol
• Nerolidol is characterized by a singularly woody aroma
• used in a wide variety of cosmetic and cleaning products has been studied for its potential as an antifungal, antioxidant, anti-microbial, and anti-inflammatory agent.
• Nerolidol may even help other drugs penetrate the skin for more effective topical delivery.
• has a boiling point of 251.6℉ (122℃)
• Bisabolol
• Bisabolol has a mild floral scent, and is frequently used in fragrances and cosmetics.
• has a boiling point of 307.4℉ (153℃)
• Bisabolol has long been thought to heal the skin.
• Animal studies have confirmed that bisabolol may specifically reduce skin inflammation.
• Guaiol
• Guaiol is found in guaiacum and cypress pine.
• has a quintessentially piney aroma
• has a boiling point of 197.6℉ (92℃).
• has been identified as a potential antimicrobial, as well as an inhibitor of lung cancer cell growth.
• Guaiol is also a central component of essential oils in Xylopia sericea fruits that have potential antibacterial and antioxidant properties.

According to what I call the "species-folklore fallacy":

• the effect of sativa is characterised as
• uplifting, energetic, creative, euphoric, spacey, cerebrally-focused, and better for day use
• the effect of indica is characterised as
• calming, relaxing, sedative, full body - "body buzz", and better for night use

There are several reasons why this "species-folklore fallacy" exists and persists:

• The Indica/Sativa taxonomy was originally adapted to describe a cannabis plant's physical traits (morphology) and geographic origin (landrace), NOT its chemical makeup (chemotype).
• This very much outdated convention was established long before:
• we knew anything about cannabis terpenoids and the interaction they have with cannabinoids.
• aggressive hybrid breeding vastly diversified cannabis chemotypes
• Marketers in the cannabis industry perpetuate the "folklore out of ignorance and/or sales hype.

Research suggests these effects are not likely due purely to CBD:THC ratios, as there are no significant differences in CBD:THC ratios between Sativa and Indica strains. Rather these different subjective effects are likely due to varying ratios of major cannabinoids as well as minor cannabinoids, terpenes and probably additional phytochemicals

Understandably, many cannabis cunsumers are confused, but here's the bottom line:

• When it comes to predicting cannabis effects . . . the chemotype is far more important than the species.
• what ratio of cannabinoids are present
• which terpenes are present (and in what proportion)

Different strains do have different chemotypes and can be classified by their cannabinoid dominance:

• THC-dominant strains
• primarily chosen by those seeking a potent euphoric experience.
• chosen by those with: pain, depression, anxiety, insomnia, and more.
• best for cancer, neurological disease, gut issues
• better for glioblastoma cancer patients
• Example:
• Bedrocan® (THC:CBD ratio of 22:1)
• CBD-dominant strains
• used by those highly sensitive to THC or patients needing clear-headed symptom relief
• best for anxiety, spastics, seizures
• preferred by neuroblastoma cancer patients
• Examples:
• ACDC, Ringo's gift, Valentine X, Remedy, Harlequin, Cannatonic, Sour Tsunami(THC:CBD ratio of of 1:10)

• Balanced THC/CBD strains
• provides mild euphoria alongside symptom relief.
• good choice for novice consumers seeking an introduction to cannabis' signature high.
• Example
• Jamaican Lion, Omrita RX, Blue Jay Way (THC:CBD ratio of 1:1, or 3:2)

Its worth noting that cannabis buds can be THC rich or CBD rich

• This has nothing to do with the plant's strain
• Rather it has to do with when the buds are harvested
• CBD matures before THC.
• An early harvest will favor a CBD rich product (even if the strain is THC dominant)

Its also worth noting that medical cannabis can come from marijuana or hemp plants.

• Many people incorrectly think THC comes from marijuana, while CBD comes from hemp.
• The actual difference is that marijuana is a high resin plant, while hemp is a low resin plant.
• marijuana plants:
• contain as high as 20% CBD or THC
• extracts do not need thinning agents, viable "as is"
• industrial hemp plants
• contains less than .3% THC
• contain 3.5% CBD (by dry weight)

As important as cannabinoid profile is in predicting effect . . .
the importance of the terpenoid profile can not be understated.

A recent study
Variations in terpene profiles of different strains of Cannabis sativa
L. Acta Horticulturae 925:115-121

demonstrated that:

• strains which were considered "mostly indica" were characterized by dominancy of β-myrcene, present in high relative contents, with limonene or α-pinene as second most abundant terpenoid,
• while strains that were said to be "mostly sativa" were characterized by more complex terpene profiles, with some strains having α-terpinolene or α-pinene as dominant terpenoid, and some strains having β-myrcene as dominant terpenoid with α-terpinolene or trans-β-ocimene as second most abundant terpenoid.
• Breeding for specific terpenoids in plants is a fascinating research topic.
• Terpenoids analysis, combined with cannabinoids and flavonoids analyses, are essential for the metabolic fingerprinting of pharmaceutical cultivars, which could lead to the selection of chemotypes for specific medical effects.

The most common pharmaceutical medical marijuana drugs include:

Epidiolex

• an FDA approved drug for for seizures associated with:
  • Lennox-Gastaut syndrome
  • Dravet Syndrome
• the first CBD (single molecule isolate) drug approved by the FDA (in June 2018).
• GW Pharmaceuticals holds the patent for Epidiolex
• requires a large dose that must be determined precisely (on an individual basis) to be effective
• formulated as a liquid to be administered oral mucosally, using a syringe
• Side effects include:
• sleepiness
• decreased appetite
• diarrhea
• increase in liver enzymes
• feeling very tired and weak
• rash
• sleep problems
• infections

Nabiximols (Sativex):

• for the treatment of spasticity, neuropathic pain, and other symptoms of multiple sclerosis
• GW Pharmaceuticals holds the patent for Sativex
• a balanced oil (1:1 ratio of CBD:THC ) derived from botanical marijuana
• under-the-tongue spray (tincture)
• may be most effective pharmaceutical cannabis based drug for pain
• Side effects include:
• abdominal (stomach) pain
• appetite changes (increase or decrease)
• balance problems
• burning sensation in the mouth
• constipation
• cough
• diarrhea
• dizziness
• drowsiness
• dry mouth
• forgetfulness or poor concentration
• mood changes
• nausea
• panic attacks
• sore throat
• soreness or stinging sensation in mouth
• spinning sensation
• tiredness
• trouble sleeping
• trouble urinating
• unusual taste in the mouth
• weakness

Dronabinol (Marinol and Syndros):

• synthetic THC
• approved by the FDA, as safe and effective for:
• HIV/AIDS induced anorexia
• chemotherapy induced nausea and vomiting
• appetite stimulant, antiemetic, and sleep apnea reliever
• Solvay Pharmaceuticals holds the patent for Dronabinol
• formulated as an oily resin in capsules
• most users who have reported that the effect is not at all fun (like marijuana).
• not likely to penetrate the recreational market
• Side effects include:
• drowsiness
• cotton-mouth
• euphoria
• tachycardia
• postural hypotension
• lethargy
• slurred speech
• decreased motor coordination

Nabilone (Cesamet):

• another synthetic THC
• a cannabinoid agonist with superior bioavailability to dronabinol
• has a more predictable dose-response relationship
• has less individual variability in drug response
• used as a treatment for nausea and vomiting associated with cancer chemotherapy
• formulated as a capsule for oral administration
• Side effects include:
• dizziness
• drowsiness
• euphoria "high"
• ataxia
• anxiety
• disorientation
• depression
• hallucinations
• psychosis
• tachycardia
• orthostatic hypertension

• When smoking or using a vaporizer, patients should wait a few minutes between inhalations to let the dose be fully realized in order to gauge the strength of the effect.
• The average dose of medical marijuana is 1 to 3 g/day when smoked or vaporized.
• In one recent Canadian study, 25 mg of pharmaceutical-grade cannabis with a THC content of 9.4% was effective in reducing intensity of pain, improved sleep and was well tolerated when smoked as a single inhalation 3x/day for five days.
• With edible oils, patients should exercise caution when dosing for the first time.
• allowing at least an hour for the product to work through the digestive track and take effect,
• then waiting at least four hours before taking a second dose.
• High doses of CBD are not always more effective than lower doses.
• A CBD dose of as little as 2.5 mg combined with a small amount of THC can have a therapeutic effect.
• Full-spectrum CBD-rich cannabis oil (with a small amount of THC) is efficacious at much lower doses and has a much wider therapeutic window than pure, pharmaceutical-grade CBD.
• Cancer patients who received 21 mg/day of Sativex experienced significant reductions in pain,
• more so than cancer patients who received 52 mg of Sativex,
• while those who were given 83 mg of Sativex reduced their pain no better than a placebo.
• In clinical trials of epidiolex, children with catastrophic seizure disorders were given up to 50 mg of epidiolex per kg of body weight. Such high doses caused interactions with other anticonvulsant medications, requiring adjustments of the latter to avoid a toxic overdose.
• Dr. Bonni Goldstein (author of Cannabis Revealed), typically starts with a much lower dose of full spectrum CBD-rich oil (1 mg CBD/kg of body weight) for epileptic children - with the understanding that the dose may have to be lowered or raised depending on the initial response. If necessary, Goldstein increases the dose of CBD by increments of 0.5 mg/kg until a threshold of 5 mg/kg of body weight is reached. And that amount may also need to be adjusted.
• Kids, adults and animals metabolize drugs differently.
• It may seem counterintuitive, but young children can actually tolerate higher doses of cannabis oil concentrates, (including THC-rich formulations) than adults can. Thus, it's not a good idea to calculate dosage for an adult based on what works for a child.
• If 1 mg/kg of CBD is an appropriate starting dose for a child, and an adult weighs 15 times more than the child, one should not assume that the correct CBD starting dose for the grown-up is 15mg/kg of body weight. That could be way too high a dose. While CBD has no known adverse effects at any dose, an excessive amount of CBD may be less effective than a moderate dose.
• Similarly, it's not a good idea to devise a dosage regimen based on data from animal studies, which usually involve high doses of single-molecule cannabinoids. Human metabolism differs from mice and rats, and data from animal models doesn't always translate to human experience.
• When ingesting THC-rich cannabis products (with little CBD), microdosing as little as 2.5 mg THC can provide symptom relief without making a person feel high.
• If well tolerated, the amount of THC can be increased to 15 mg (divided equally throughout the day).
• Doses exceeding 20-30 mg/day (or a single dose of 10 mg or more) may cause unwanted side effects.
• A balanced ratio of CBD and THC could have a greater therapeutic impact than either CBD or THC alone. so its good to adjust the amount of CBD and THC until you find the sweet spot.
• When using the full-spectrum hemp oil for insomnia, the 25-milligram range seems to be most effective.
• Medical marijuana does not need to be taken per some schedule, can be taken when needed:
• daily
• multiple times per day
• every other hour (not uncommon and not considered addiction)
• should be taken at least an hour or two before bedtime

When we look at the research on dosing, unfortunately, we must rely mostly on studies conducted by GW Pharmaceuticals, which were done with isolated, purified CBD.

• An alternative 2015 study, out of Israel, showed that a study group using full-spectrum oils had superior outcomes compared to the group taking the single molecule isolates.
• While the bulk of the dosing studies were conducted using doses in the couple of hundred milligram range, many clinicians who are using much smaller does- anywhere from 10 to 25 milligrams a day are reporting quite remarkably responses.

In 2014, the College of Family Physicians of Canada (CFPC) produced its first guideline for physicians, focusing on cannabis for the treatment of chronic pain or anxiety. In their document, the CPFC not only listed what sort of people might be inappropriate candidates for medical cannabis, but also rated the level of the research evidence for their recommendations. Their rating scheme consisted of three levels:

• Level I - evidence is the strongest (well-conducted controlled trials or meta-analyses),
• Level II - evidence is 2nd strongest (well-conducted observational studies),
• Level III- weakest evidence (consensus of the expert members of the committee writing the guidelines).

To summarize, in this document the CFPC advised doctors to not authorize medical cannabis to patients who:

• Are under the age of 25 (Level II)
• Have a personal history or strong family history of psychosis (Level II)
• Have a current or past cannabis use disorder or another active substance use disorder (Level III)
• Have cardiovascular or respiratory disease (Level III)
• Are pregnant, planning to become pregnant or are breastfeeding (Level II)

In addition, it said caution should be used in recommending cannabis for patients who:

• Have a mood or anxiety disorder (Level II)
• Smoke tobacco (Level II)
• Have risk factors for cardiovascular disease (heart disease and stroke) (Level III)
• Are heavy users of alcohol or take high doses of opioids, benzodiazepines (a class of tranquilizers) or other prescription or over-the-counter sedatives (Level III)

In 2013, the Canadian College of Physicians and Surgeons of Canada asked the federal government to develop explicit indications, precautions and contraindications for medical cannabis, so doctors could evaluate which of their patients should, or should not, be given access to medical cannabis.

Although they disclaimed any conclusions about the appropriate use of cannabis (marihuana) or cannabinoids for medical purposes, they did state that based on contraindications for existing synthetic cannabis medications (nabilone and dronabinol) and the cannabis extract dronabinol, Health Canada suggested the risk/benefit ratio of cannabis needs to be carefully and individually considered for people who:

• Are under the age or 18
• Have a history of hypersensitivity to any cannabinoid or to smoke (if the cannabis is smoked)
• Have severe cardio-pulmonary disease with occasional hypotension (low blood pressure), possible hypertension (high blood pressure), syncope (loss of consciousness) or tachycardia (rapid heart rate)
• Have respiratory diseases such as asthma or chronic obstructive pulmonary disease (COPD)
• Patients with severe liver or renal disease, including chronic hepatitis C
• Have a personal history of psychiatric disorders or a family history of schizophrenia
• Have a history of substance abuse
• Are women of childbearing age not on a reliable contraceptive, planning to become pregnancy, are pregnant, or are breastfeeding.
• In additional, it suggests medical cannabis should be used with caution in people who have mood disorders or are taking sedatives or other psychoactive drugs.

According to Dr. Ethan Russo, medical marijuana can adversely interact with other drugs (slows their metabolism resulting in much longer half lives)

• CBD inhibits the cytochrome P450 enzyme, which is involved in metabolizing many drugs. Compounds in grapefruit inhibit the same enzyme group, which is why physicians advice patients not to eat grapefruit shortly before or after taking a medication. By inhibiting cytochrome P450, CBD can either reduce or increase the effects of other drugs. In some situations, it may be advisable for a physician to monitor a patient's blood levels of other medications while taking CBD.
• In extreme doses when used in isolation, CBD can induce sedation in combination with other drugs (for example clobazone, used to treat seizure disorders)

• Intravenous (IV):
• 100% bioavailable, but not practical
• VERY few people (if any) utilize this delivery system.
• Inhalation (smoking or vaping):
• 34-46% bioavailable
• bypasses the (GI) tract and "first pass metabolism", which accounts for it high bioavailability
• The bioavailability of THC inhalation is reported to be as high as 56%.
• very little difference (if any) between bioavailability of vaping compared to smoking
• Difficult to accurately measure because of smoking/vaping variables -
  size and spacing of puffs, hold time, and volume of inhalation
• Fastest acting delivery system
• when smoke or vapor enters the lungs it quickly passes directly into the bloodstream.
• Health risks
• Smoking
• Lingering second-hand smoke may be undesirable for family members.
• can cause bronchitis (does not cause emphasema, COPD or lung cancer)
• Vaping
• Only high quality, pure "vape oils" should be used (not infused oils).
• safety concerns with flavors and aromas in many vape pen cartirdges
• important temperatures pertaining to the vaping of dried buds:
• decarboxylation takes place at 240℉-250℉ (115.6℃-121.1℃)
• THC vaporizes at 315℉ (157.2℃)
• CBD vaporizes at 356℉ (180℃)
• most terpenes vaporize between 311℉ and 388℉ (155℃ and 197.8℃)
• combustion occurs at 450℉ (232.2℃)
• optimal vaporization temperature is between 320℉ and 410℉ (164.4℃ and 210℃)
• 360℉ (182.2℃) is probably best
• Oral consumption:
• Sublingual (under the tongue):
• 12-35% bioavailability (best oral delivery system)
• absorbed through the mucous membrane under the tongue. Capillaries in the connective tissue diffuse the substance, facilitating its entry into the bloodstream.
• bypasses the digestive system and liver "first pass metabolism". preserving more of the actives allowing them to enter the bloodstream faster
• can be delivered with tinctures, concentrates, lozenges, and sprays
• Swallowing:
• 4-20% bioavailability
• popular due to its ease of use
• must go through the gastrointestinal tract and then into the liver, where it suffers further breakdown ("first pass metabolism") reducing bioavailability.
• can take as long as two hours to enter the bloodstream, but has longer lasting effects
• A study (Huestis, 2009-published by the U.S. National Library of Medicine) suggests that swallowing with fatty acids may bypass the "first pass effect" and increase absorption rates.
• can be delivered with capsules, edibles, oils and tinctures
• Capsules:
• Popular amongst doctors and patients because:
• elimination of measurement mistakes with dosages
• easier and more convenient than using syringes to measure dose
• no sugar
• not cultivar or strain-specific
• Infused Oils:
• cannabis extracts that have been infused into an oil
• liquid at room temperature
• already "active" (decarboxylated)
• don't need to be heated or vaporized . . . just ingested.
• different from vape oil (shouldn't be smoked or vaped)
• will change the compounds and potency of the cannabinoids
• Tinctures (aka green or golden dragon):
• extracts dissolved in ethyl alcohol (ethanol)
• Solvent concentrations of 25-60% are common.
• 15-45 minutes onset, peak effects at about 90 minutes
• Edibles:
• 10% bioavailability
• Edible snacks are fun, but are a not very effective delivery system.
• they're a nutritional disaster containing lots of sugar and salt
• Plus, sugar and salt both act against hemp actives
• Liposomes and Micelles:
• Liposomes and Micelles are similar (but different) delivery systems that involve the encapsulation of a nutrient (the payload) with a lipid to improve its bioavailability.
• Liposomes contain a lipid bilayer (similar to the makeup of cell membranes).
• most often composed of phospholipids (especially phosphatidylcholine)
• have an aqueous core
• most suitable for a water soluble payload
• normally a water soluble nutrient
  • can enter the blood system easily
  • has difficulty integrating with or passing through a cell membrane and into a cell
• theoretically, a liposome can facilitate the transport of its water soluble payload intact (through the digestive system) and then through the cell membrane of its target cell.
• Micelles contain a lipid monolayer
• improves water solubility of its payload
• theoretically delivers more payload to the blood stream, but not necessarily more to the target cell membrane or into the target cell
• The biggest drawback with both liposomes and micelles is stability.
• They have very short shelf lives and quickly degrade into emulsions.
• Manufacturers of both liposomal and mycelized medical marijuana products make many claims about how superior the bioavailability of their products are.
• They show impressive graphs, which supposedly demonstrate their superior bioavailability.
• None of these manufacturers was able to refer me to a single published clinical study to substantiate their product claims.
• I searched extensively on the pubmed website, but could not find ANY published studies to back up these claims.
• I don't know how they can even plot a graph with data that does not seem to exist.
• One product website shows a beautiful graph, but did not have any vertical "y"axis scale. When I inquired what the "y" axis scale was, I was told "its relative." Not exactly a professional response.
• Although liposomes and micelles may have some valid applications in pharmacology, I personally believe that those, who claim their liposomal and/or mycelized medical marijuana products have enhanced bioavailability, are just perpetrating a scam.
• Topical (application to the skin):
• Cannabis oils can be mixed with butters or other oils to create topicals, which can be applied to the skin.
• Topicals enter the skin and body tissues and allow for direct application and relief of affected areas for allergic skin reactions, muscle strain, inflammation, swelling, etc.
• Both THC and CBD are effective topicals, which reduce inflammation and provide pain relief.
• Topicals do not get you "high", because they do not reach the bloodstream.
• interacting with "local" cannabinoid receptors instead.
• Skin does not absorb cannabinoids very well, so its best to apply topicals very generously.
• Topical forms include: oils, creams, salves and transdermal patches
• oils:
• They do not absorb very well and are messy.
• Creams:
• cannabinoids heated into shea butter and combined with other ingredients.
• Salves (aka ointments):
• cannabinoids heated into coconut oil and combined with beeswax.
• Transdermal patches:
• The only topical CBD products able to penetrate the skin and enter the bloodstream are transdermal CBD patches. Transdermal, by its very definition, means able to cross the dermal barrier to reach the blood. The U.S. Library of Medicine discusses a study, (Hammell et al, 2016), proving the ability to CBD to be efficiently absorbed via transcutaneous methods.
• Rectal administration (suppositories):
• Many people laugh when they hear the phrase "cannabis suppository", but they are no joke.
• Suppositories are a very effective and easy to use delivery system.
• Suppositories work quickly, exerting systemic effects when they enter the rectal mucosa, spreading healing compounds quickly through nearby organs and into the bloodstream.
• Suppository users report a very diminished "high" effect.