How Best To Use Medical Marijuana: Smoking vs Edibles and Tinctures

Brandon March 3, 2012 60
How Best To Use Medical Marijuana: Smoking vs Edibles and Tinctures

Cannabis dispensaries are increasingly offering a wide variety of edible goods made from marijuana, in addition to a growing assortment of cannabis concentrates and buds. With all these options, medical marijuana users face some real choices about how best to use cannabis to treat their medical conditions.

Smoking Cannabis

Photo By: Shawn-Tron

Inhaling cannabis smoke from a joint, pipe, or bong is a quick and effective way to introduce cannabinoids into the bloodstream and the associated cannabinoid receptors in the brain. The psychoactive effects known as the “high” are usually noticeable within one to three minutes and generally last for two and three hours. Many medical cannabis users prefer smoking cannabis because the effects are so quickly noticeable making the dosage relatively easy to gauge. Laboratory testing enables dispensaries to accurately determine marijuana potency and help provide dosing estimates to patients.

Health Effects of Smoking Cannabis

Unfortunately inhaling smoke is not the most healthy method of consuming cannabis. While there is still no conclusive correlation between the effects of smoking cannabis and an increased incidence of lung cancer, this is likely due, in part, to the difficulty in finding subjects with a history of long term cannabis use but no history of smoking tobacco.

In September of 2011, the University of Colorado Cancer Center released a paper stating, “There is little direct evidence that THC or other cannabinoids are carcinogenic”. This means that THC on its own is not a cancer causing compound. The article goes on to state that, at least in rodent test subjects, “cannabis smoke is carcinogenic”. In other words, the smoke from burning cannabis is carcinogenic, not the plant itself.

While the debate over cannabis smoke and lung cancer is far from over, long term exposure to cannabis smoke is shown to accelerate the decline in pulmonary function. For some medical marijuana patients the increase in the quality of life associated with smoking cannabis is worth the long term risk of inhaling smoke. For others, especially those already experiencing throat and lung problems, cannabis smoke can cause irritation and exacerbate or complicate existing medical problems.

Luckily there are other options available to those who choose to use medical cannabis but wish to avoid or decrease exposure to cannabis smoke.

Hash, Kief and other Concentrates

One simple method of decreasing the amount of inhaled smoke is to increase the potency of the product. Hashes, kiefs, and other cannabis derived concentrates allow medical cannabis users to smoke less plant material while still consuming high levels of cannabinoids. Though this still requires the inhalation of smoke, one “hit” of hash may be equivalent to 6 or more hits of cannabis bud.

Pros:

  • Quick to take effect
  • Relatively easy to judge dosage
  • Predictable 2 to 3 hours of relief

Cons:

  • Inhalation of smoke, tar and carbon monoxide
  • Short 2 to 3 hours high requires continued use throughout the day or night.
  • Possible inhalation of mold spores
  • Marijuana smoke odor draws attention and limits the places you can medicate
  • Dangerous to travel with by car or air
  • May result in inhalation of butane from lighters or chemicals from burning matches

Vaporizing Cannabis

Many medical cannabis users have begun vaporizing cannabis instead of smoking it. Vaporization, or volatilization, is a process in which the cannabinoids are released in gas form through the application of heat without combustion. Because the buds or concentrates are never burnt, vaporization produces none of the byproducts of combustion like carbon monoxide and tar. The released vapor is also much cooler than smoke, making it less damaging to lung and throat tissue.

Cannabis Edibles

An increasing number of medical marijuana users are finding the advantages of cannabis infused foods known as “edibles” to treat their medical conditions. Unlike smoking cannabis, edibles are introduced to the body through the gastrointestinal tract and processed by the liver before entering the blood steam The liver changes the cannabinoid THC into the more potent 11-hydroxy-THC which tends to have a stronger more sedative effect. This makes cannabis edibles especially suitable for patients with sleep disorders caused by pain or general insomnia. Patients ingesting cannabis will often feel the effects within 45 to 90 minutes with a high lasting between 6 to 10 hours.

Edibles are generally sold as high calorie treats like cookies, candies and brownies made by infusing butter or cooking oil with cannabis. The cannabis infused butter is then added to a traditional recipe. Edibles made from marijuana leaf and bud often have a distinct taste and a green tinge from the plants chlorophyll. Edibles made from concentrates like hash oil often have a less noticeable taste and color. Medical marijuana users who prefer to keep the calorie count under control sometimes dip bread in marijuana butter or oil, or use it in healthy recipes.

Dosage

One of the most common complaints with cannabis edibles is their often unpredictable strength. Though one dose of an edible should contain about 20 mg of pure THC, the strength of an edible is determined by the quality and quantity of the marijuana used to create it. The slow onset of cannabis edibles can create even more confusion. Impatient users looking for relief from their symptoms often do not wait long enough and eat more before feeling the effects of the first dose. When in doubt, always start with a small dose and wait at least 90 minutes before eating more. To maintain a consistent dosage between batches, edibles should be made from a consistent source of laboratory tested marijuana with a known cannabinoid potency.

Health Effects and Cannabis Edibles

Because cannabis edibles are ingested instead of smoked, all of the harmful side affects associated with smoking are eliminated. Though some users have described feeling nauseous or groggy, and on rare occasions, vomiting. There are no known long term negative side affects from ingesting cannabis edibles.

Pros:

  • None of the known health problems associated with smoking cannabis
  • Can be consumed anywhere without being conspicuous
  • Edibles are easy to travel with since law enforcement rarely thinks to look for edibles
  • Longer lasting effects don’t require continued dosing throughout the day or night

Cons:

  • May not be suitable for patients experiencing nausea or lack of appetite
  • Edibles often contain large quantities of empty calories from sugar, fat, and other highly processed ingredients.
  • Long lasting effect (6-10 hours) may not be suitable for every situation
  • Edibles must be kept away from children or others who may unknowingly consume the cannabis.
  • Patients must wait for up to an hour before relief from their symptoms  
  • Slow onset can lead patients to eat more than is needed resulting in discomfort
  • Appropriate dosage is often unknown

Cannabis Tinctures

Cannabis infused tinctures became common in the 1840’s after an article was published by Dr. Walter O’Shaughnessy, “On The Preparations of the Indian Hemp, or Gunjah”. By the late 1800’s almost every major pharmaceutical company was producing cannabis tinctures. While not as popular today, cannabis tinctures are easy to make and offer a great alternative for medical marijuana patients.

Tinctures are usually an alcohol based solution of dissolved cannabinoids that can be taken as drops. If held under the tongue the drops are absorbed directly into the bloodstream and taken to the brain within minutes, much like smoking or vaporizing marijuana. Cannabis tinctures can also be added to food or drink so it can be processed by the liver in the same manner as eating cannabis edibles. THC is converted to 11-hydroxy-THC which takes more time to reach the brain, but delivers many more hours of relief.

It may take a bit of experimenting to figure out the proper quantity for treating your symptoms. Start out with only one or two drops and wait for the effects before taking more. Because tinctures are made of high proof alcohol they will evaporate if left uncovered. As the the percentage of alcohol to cannabis diminishes the potency of each drop will increase.

Pros:

  • Fast or slow onset depending on how it is taken
  • No calories like edibles
  • No throat and lung irritation from smoking
  • Easy to measure doses once the required number of drops is known
  • Easy to conceal and travel with
  • Can be used anywhere without notice
  • Does not attract accidental use like edibles might

Cons:

  • May conflict with some patients beliefs as it contains some amount of alcohol
  • Some consider the taste to be quite unpleasant
  • Alcohol can evaporate, increasing the strength of the the remaining tincture
  • Dosage must be determined by gradual dosage increases until a desired dosage is determined

There is nothing wrong with experimenting to find what form of cannabis works best for you. Likely you will find that a combination of methods is required to treat your symptoms. Many users find that smoking or vaporizing work best during the day and edibles work best at night before bed. However you take your medicine, be sure to get it from a safe and consistent source.

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60 Comments »

  1. Corrector March 7, 2012 at 7:55 am -

    Vaporizing is NOT the same as smoking.

    There should be no combustion product with vaporizers; no “smoke, tar, or carbon monoxide”. The vapors tend to be relatively low odor depending on quantity and the device used. And you’ll never be inhaling matches with a vaporizer, either; there are some butane powered ones, but there are also plenty of electric vapes.

    Vaporizing is widely considered one of the cleanest, safest and most effective forms of delivery, even safe enough for asthmatics.

    • Rambo March 7, 2012 at 8:49 pm -

      While I agree that vaporizing is much cleaner than smoking, you are still drawing a foreign gas into your lungs. I don’t know if I wouldn’t go so far as to say that it has no ill effects. I’m not a pulmonary specialist, and I’m not aware of any research done by one on users of vaporizers. If anyone finds this research, I’d love to see it.

      • tk October 12, 2012 at 7:27 am -

        @ Rambo – here’s a study.
        http://www.canorml.org/healthfacts/vaporizerstudy2.html
        Granted, one may question the unbiased nature of the organizations administering the study. However, MAPS is pretty damn trustworthy (and I think NORML is too).

  2. Corrector March 9, 2012 at 10:55 am -

    It’s true that there is still an intake of something into the lungs when vaporizing; but what’s being taken in is not at all the same as during smoking. Breathing hot combusted gas from *anything* is going to be bad for the lungs, be it tobacco or MMJ or anything else. Vaporizing means not breathing that hot combusted gas. It’s never formed in the first place: that’s really a part of the definition of vaporizing.

    User reports from vaporizing indicate that the overall medicating effect is different: stronger, shorter and “cleaner”-feeling than smoking, with less coughing and harshness in the throat and lungs as well.

    However, I should have said “reportedly safe enough for asthmatics” – Corrector stand corrected. Consult with a MMJ physician for more information.

    My point was more that lumping vaporizing and smoking together is doing a disservice to vaporizing, a unique way of taking in mmj that certainly has benefits and advantages over smoking, which from what I’ve seen has never been recommended by MMJ professionals.

    Some people reportedly also find that edibles can be overpoweringly strong and with too much psychadelic effect, whereas vaporizing in moderation does not; but plenty of people swear by edibles too. Personally, I’d recommend folks to try both if possible and see which they prefer, as you suggest towards the end of your article.

    Thanks for the article and the discussion, by the by.

  3. 45YrToker March 21, 2012 at 8:27 pm -

    A very nice article indeed, but I fear the folks living in San Francisco very nearly lost their access to concentrates, edibles & tinctures today (03-21-12), as the S. F. health Dept. was ready to9 ban them, but rescinded their decision this afternoon. Phew! What’s next?! Will the paranoia ever end?

  4. 45YrToker March 21, 2012 at 8:31 pm -

    Forgot the link. You can read about it here: http://blogs.sfweekly.com/thesnitch/2012/03/sf_medical_marijuana_clubs_ask.php

    Maybe somebody showed the S. F. Health Dept. Rambo’s article!

  5. Muriel December 18, 2012 at 12:47 pm -

    Hello Folks,
    Doing some research about medical marijuana for cancer/chemo patients. Do you have any information on medical marijuana causing anxiety? From my limited experience if you take too strong a dose of marijuana you might feel a bit anxious, paranoid or at loose ends with yourself. For a person who is already a bit anxious perhaps you’d need to try out small doses to start?
    The benefits of this drug are pain relief and overall relaxation, correct? Also, there is the benefit of not increasing your dependency on Western prescription drugs; cancer patients can use a lot of prescription drugs, all of which come with side effects.
    Thanks for your help.
    Sincerely, Muriel

    • Rambo December 18, 2012 at 5:21 pm -

      Medical cannabis can cause anxiety in some patients, but in others can be used to treat anxiety from PTSD . From those I have spoken with, strains that are higher in CBD content are less likely to cause aniety. Also, some say that indica strains produce less anxiety than sativa, though I am skeptical since I believe what is actually important is the cannabinoid and terpen ratios. You may be able to get some useful insight out of our fledgling strain review as it is based on the results of 14 medical patients. Cannabis actually has many benefits besides pain relief and relaxation. Among other qualities it is an anti inflammatory, helps with seizures has anti cancer properties, helps with sleep disorders, and helps with nausea and appetite something useful for people going through chemo. There is a ton of info out there, best of luck to you.

  6. Houston Sex Crimes Attorney January 19, 2013 at 10:47 pm -

    Quality details exactly about medical marijuana.
    Thanks so much for sharing.

  7. PeachMelba February 4, 2013 at 3:45 am -

    Hi Rambo.
    Hope you can help with my theory to a problem that occurs when smoking un cured marijuana.
    Looking for information on chlorophyll intake through smoking uncured bud .As in pulmonary irritation or muscle absorption in the lower back being caused by chlorophyll build up. As i think there could be a direct correlation for smokers with back pain .
    Any ideas on information above would be grateful

    • Rambo February 9, 2013 at 7:50 pm -

      Interesting idea but I’m not a doctor and know nothing about the subject. I am guessing there is nothing to it. There is a lot more chlorophyll in salad greens then there is in uncured pot and salads have never given me back pain. Then again I don’t smoke salads but I do eat them.

  8. cool dude July 29, 2013 at 1:45 am -

    I love this website and the insightfull articles. Never have cared for most of themj community as they usually just talk without backing up what they say with facts, not you guys, bravo! Medibles have always been a crap shoot. Ive seen them get better over the years but most still are not suitable for true.medicinal users as they cause upset stomachs. There is a lady in lane county oregon i know that somehow uses just shake and does amazing things. Very little taste of mj if any, so much soi thought i got ripped off after eating a what she called a coma brownie. It hit me fast, like 10 minutes and lasted for 4or 5hours. No bad taste, headaches or stomach aches. The thing was tasty as heck too. No pain the next day either, no high butno pain. Anyone heard of her or know how to find her. I prefer medibles since i hate smoking.

  9. laith August 16, 2013 at 2:01 pm -

    It is well known that smoking is dangerous in many different ways. Smoking over a period of time leads to many different health problems. Smoking is particularly damaging to the heart and lungs. Smoking can lead to a number of lung diseases or disorders including COPD (Chronic Obstructive Pulmonary Disorder), lung cancer, Emphysema, and shortness of breath. But exactly how can smoking destroy your lungs.

    Article source : http://1betteroff.blogspot.com/2013/06/what-are-damages-of-smoking-most-facts.html

  10. Butch Holland / Texas October 22, 2013 at 11:50 am -

    I really wanted to read your info but could not figure out how to get rid of the tweet/email floater thing that floats right on top of what you are trying to read. You went to a lot of trouble writing this, I would think you would want people to read it THEN tweet it.
    confused

    • Rambo October 22, 2013 at 6:38 pm -

      Interesting problem you are having. The facebook/tweet floater usually floats the left of the article and does not obscure the text. I have never seen in overlap on any devices I have used. How are you viewing the article?

  11. Doremi October 23, 2013 at 9:55 am -

    Rambo, can decarbing freshly harvested bud be considered the same as drying & curing? What if you plan on using it for a tincture or hemp oil?

    • Rambo October 29, 2013 at 7:08 pm -

      Decarbing and trying/curing are two totally different things. One is for making edibles that won’t be cooked, one is for prepairing your cannabis to be smoked or stored for later use.

  12. Doremi October 25, 2013 at 12:17 am -

    Re: the facebook/tweet floater on the left…it does interfere with the reading when I change the zoom level to 150% so my aging eyes can read the print.

  13. Barbara Moore November 5, 2013 at 10:41 am -

    I’m looking for cannabis candy to help me sleep.

    • Rambo November 19, 2013 at 5:26 pm -

      You should be able to find what you are looking for a dispensaries if your state has them. If possible go for something established and consistent so if it works you can get the same thing again next time. While I am not on board 100% with the way Cheeba Chews does things, there products are pretty strong and consistent and usually not hard to find. http://www.cheebachews.com/

  14. BCwoodcarver November 15, 2013 at 5:31 pm -

    with a tincture is it most effective medically diluted by alcohol, or does evaporating the alcohol make the tincture more potent?

    • Rambo November 19, 2013 at 6:04 pm -

      Evaporate for a stronger dose

  15. Anxious January 1, 2014 at 7:46 pm -

    I’m a stressed person. Started eating and smoking some herb 2 years ago but it caused sideache and nausea. Had to quit
    I Tried it again last year by inhaling a very quick sniff off my ceramic top stove. Works well, lowers my stress, no high, just a nice calm. Only problem is now I fear everyday use could cause cardio problems.
    So I made tinctures by the book but sideache is back. Anyone else this sensitive have a solution. Thanks for listening…….

  16. http://www.VaporizerWeedBlog.com January 19, 2014 at 2:34 pm -

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  17. Tworootles February 24, 2014 at 8:29 am -

    ANXIOUS:
    I also have an anxious personality. Since I have asthma and quit cigarettes 20 years ago, I do not want to smoke now. I was introduced to ‘legal’ tincture a few months ago.
    I have cervical disk issues and a bad disk in lower back. My experiences to date:
    If I take 3 drops in the morning, beside feeling sleepy, it doesn’t do much to alleviate my pain. I must be very careful to count 3 drops. 4 drops lead to panic attacks, rapid heart beat and a drop in my BP! It happened a few times and scares me to the brink of dialing 911′. Luckily me wife calms me during these psychotic episodes. Since I am not a fan of prescribed pain killers, I was hoping I had finally found a solution to my pain. Like I said; it doesn’t seem to be working in my favor. I don’t want to confess what 5 drops did!

  18. Martina Sidney March 25, 2014 at 8:22 am -

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  19. segun April 29, 2014 at 5:23 am -

    Am so happy for this site cos it may answer few questions i hav. I dont have any health conditions requiring its intake but i hav been smokin for somtims and lov de feelin i get. Am calm and my brain releases useful ideas that i need bt jst yesterday i decided to smoke nomore bt resolved to add it directly to my food,in very litle quantity,evryday. Pls can sombdy advise me on dis? Tanks.segun frm Nigeria.

  20. adomax April 29, 2014 at 7:39 am -

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    I honestly appreciate people like you! Take care!!

  21. felix Silvester April 30, 2014 at 7:32 am -

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  22. Jenni May 5, 2014 at 9:46 pm -

    I am thinking of using edibles to help with my chronic arthritis pain and I would like to thank you for having the most informative article I could find. I don’t want to get high, I just want to manage the pain. Thanks to you I now have enough information to make a balanced and informative decision. So thank you!

  23. zenny May 13, 2014 at 5:42 pm -

    Thanks to all the contributors When I gave up cigarettes after 30 odd years in addition to over 20 of smoking spliffs daily I suspected my addition was to nicotine and not cannaboids, thc etc.
    The press would have us believe otherwise, always associating Marijuana as a gateway drug .I can honestly tell you this is not the case. I now choose edibles to get high but have no desire to do so on a regular basis.
    Being an experimental home cook ive perfected the art of making edibles for both enjoyment and relief from work related pain, im a plasterer , and aside from massage I find edibles a good natural cure as opposed to downing tablets etc.
    I have a vap pipe which I use with hemp wick and find I have no real unpleasant effects to my lungs and even use the waste products in recipes, in fact it has adistinct nutty taste to it.
    As so many others have taken trouble to add thier comments I wished to do likewise. Demonisation of “weed” has existed way too long, who knows why, but from a very personal perpsective im certain that it is not as addictive as our so called peers would suggest. But if you are going to use it, deliver it in a way that has the least impact on your overall health.
    Be wise for each other, regards from Oz.

  24. steve kirchner May 15, 2014 at 5:56 am -

    I have 2 hip replacements and chronic joint pain (No pun intended:)…problem with me is that I am sober for 8 years and really don’t wish to be high so much, so I am interested to see if high CBD treats are available (or tincture) for me to send UPS to my residence in the UK. I am desperate, I cannot take codeine or tramadol or lyrica anymore, it is messing me up.
    Thanks

  25. zenny May 17, 2014 at 2:31 am -

    Thanks for that, I have found this to be a really cool site for constructive discussion, so im glad if someone else can perhaps identify with my expeiences.
    Regards From Oz.

  26. Cynthia May 31, 2014 at 3:44 pm -

    There is controversy about vaporizing vs. smoking. Vaporizing is no different than inhaling an herb for colds or bronchitis. Cannabis is not like cigarettes, no tar, no nicotine just pure medicine.

  27. tweedymom June 1, 2014 at 1:17 pm -

    Where can I find recipes for tinctures? I have not tried any canniboids yet, but this would be my preferred method as I will not smoke them. The medications that have been prescribed for my nerve damage shut down my kidneys. Not acceptable.

  28. Melissa June 4, 2014 at 7:06 pm -

    How long does an edible stay in ur system???

  29. fred June 22, 2014 at 7:44 pm -

    if you will bake the cannabis for 1 hr at 240 degrees it will remove most of the THC’s and leave the CBD’s. It kills cancer

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  31. StripeyCat July 29, 2014 at 5:45 am -

    I have fibromyalgia and I’m looking for methods of pain relief. I love the scientific approach and insight you offer here, it’s really what I’m looking for.
    Does anyone have experience of making tea from buds? I’ve got some 3 year old Thai, which I’ve just boiled up in water, with a teaspoon of olive oil, and it’s now resting. It is the first time I’ve tried making tea but I’ve got so much pain right now I’m willing to try anything!
    I live in Spain and I’m able to grow outdoors, although we’re at risk of being robbed, there’s no issue with the law, one of my plants; Cream Caramel, is already over 6′ or 2m tall! I’ve “topped” it at that and it just keeps growing! I’ve also got a Cheese and a Skunk plant that are also exceeding my expectations.
    Any advice regarding making tea [I can’t wrap my head around the decarboxylate issue at the moment to consider a tincture, fibro-fog is horrible.] or other simple things I can do to help myself, would be gratefully appreciated.