More delivery systems
INGESTION
Eating cannabis usually leaves you with a stronger, more deeply felt effect that will last for hours. It takes more plant material or concentrates to get the effect than smoking does though, up to three times the quantity. This sounds crazy given the cost of cannabis, but remember it lasts 2-3 times longer in the system, so that's really not as bad as it seems at first.
* Onset can be delayed up to an hour or two, if you do nothing to enhance the bioavailability. We have a plan for that on site that we're pulling together at the moment. It'll be posted on this thread as soon as possible.
* The effects will peak and be available for 1-6 hours, dependent on the severity of what you're treating and the strength of the patient's digestive system.
* The liver converts THC into 11-hydroxy-THC. This metabolite is in smaller concentrations when you smoke, because the cannabinoids go straight to the brain, bypassing the liver that first time. 11-hydroxy-THC is a potent psychoactive metabolite, but it's also effective as a sedative. It does, however, lack the same medicinal benefits that THC offers.
If you use techniques of competitive inhibition you can increase the number of THC molecules that make it through the liver unmolested and still medically beneficial. Here's a link to some good ideas on doing that.
Competitive Inhibition
* Bioavailability is pegged at 6-20%.
At 6-20% bioavailability 1 gram of cannabis will supply 20 mg of cannabinoids, only 1-4 mg of which will be THC.
* Edible preparations are a great option if you're dealing with a chronic condition, where you want high doses that will carry you through a 24-hour period.
* The cannabinoids that make it through the stomach and the liver are absorbed through the intestinal tract into the bloodstream.
* The canna foods you're using have to be digested too, so a big part of the effectiveness of this delivery method hinges on the health of the patient's digestive system.
DOSING CANNA FOODS
* Always precede your canna dose with a small oily meal. Something as small as a tablespoon of coconut oil will keep your liver occupied as the cannabinoids are squeaking through, allowing more medicinally valuable cannabinoids to get through without being metabolized.
* The effects begin somewhere within 2 hours of ingesting.
* It's easy to overdose on edibles, and once in, you can't get them out. They have to work through the system. Start small and increase slowly. Wait 12 hours between the initial doses and evaluate carefully. Utilize the Internal Inventory.
The Inner Inventory.
This is a self-awareness technique used by Dr. Dustin Saluk to teach his patients to increase awareness of their body in the early stages of dosing. It's a helpful tool at any time.
Before and five minutes after the dose sit and ask yourself these three questions.
1) Take a deep breath. How easy was that to do? Rate it on a scale of 1-10, 1 being "Ouch!" and 10 being "Ahhhhh....."
2) How comfortable is it for you to sit still? Again 1-10 with 1 being "difficult, if not impossible" and 10 being "no trouble at all."
3) How are you feeling mentally and emotionally? Rate as 1 being "Stressed to the max!" and 10 being "Peaceful and calm."
Write this down every time you dose during the early stages of setting the dose. After you find your optimal therapeutic dose, test it out for 2-3 dosing sessions. After that you don't have to wait five minutes between administrations.
* Use depends on the potency of the substance prepared, for example, 1/4 of a cookie, 1 tablespoon of butter, one capsule, etc. As such, doses for capsules can range from 0.1-0.5 gram/capsule, and ten times higher (10-50 gm/capsule) if those capsules have CCO in them.
* A typical capsule dose would be 3 x/day for 24 hour coverage.
* If the digestive system is compromised the effectiveness of the dose can suffer up to a factor of 10.
HIGH DOSE OPTIONS
This is for edible or rectal doses.
Capsules with CCO can be made to typically carry 25-100 mg of cannabinoids in each.
CCO is a thick and sticky concoction that's stored in syringes, and may hold up to 800 mg of cannabinoids/ml of oil. We have numerous places on site that can assist you in producing your own. I maintain a study hall dedicated to this very subject. Feel free to stop in and ask questions.
Cannabis concentrates with coconut oil can be cut with a knife into grains.
Some cancer patients use over a gram of CCO /day.
Advantages
* No smoke to deal with.
* This delivery system is long-lasting, bringing up to 8 hours of effect. It's one of the few delivery systems that'll get you through the night.
* It's food as medicine. It doesn't get any more basic than that.
* Prepared foods can easily be stored in frozen form for months.
* You can dose as with other oral meds, 3x/day.
Disadvantages
* Edibles have that slow onset, unless you bio bomb it. (See link above)
* It may be too long-acting for some. You can't turn it off.
* Preparing edibles takes more resources.
* It may cause stomach irritation, so be alert for that possibility.
* Precise dosing is challenging, given the wide variability of the foods and the strength and health of the patient's digestive system.
SUBLINGUAL (OROMUCOSAL) DELIVERY
Cannabis can be delivered through the mucosal lining of the digestive tract by using a tincture. Tincture are extracts of cannabis into an organic solvent, such as alcohol or glycerin. They're absorbed directly into the bloodstream in the mouth (under the tongue is an effective location) and as you swallow.
* It doesn't have to be digested.
* There are a number of products that will have submucosal absorption, including lozenges, lollipops, mouth strips, gum, mouth spray and tablets.
* Mucosal absorption has a more rapid onset of action, less than 30 minutes, but can last as long as 4-6 hours.
TINCTURE VS OIL
* Both products can be delivered by sublingual (oromucosal) absorption.
* Tincture is absorbed rapidly, while oil gets stored in fat cells and released over a longer span of time.
* Alcohol is an efficient extraction method, pulling out chlorophyll and all the cannabinoids and terpenes.
* Glycerin is less efficient than alcohol, with a lower yield. It doesn't retain chlorophyll, but does pick up the cannabinoids and terpenes.
* You can increase the potency of your glycerin tincture by doing a second round with fresh material. Strain and press out the original plant material and replace it with fresh. Follow your process once again, typically another 1-2 months.
* Oil extraction is very efficient in yield, retaining all of the cannabinoids. However, the process leaves the chlorophyll behind and the heat typically used in the process destroys the terpenes and flavonoids.
* Cannabis fluid extracts come in bottles with droppers for dosing.
Average concentrations of prepared tinctures:
- alcohol: 10-15 mg cannabinoids/ml
- glycerin: 3-10 mg cannabinoids/ml
- oil: 1-2 mg cannabinoids/ml. (Can be more with better extraction practices and a potent strain.)
SUBLINGUAL DOSING
* A moderate dose is required.
* There'll be a moderate onset in 15-30 minutes.
* Absorbed in the mouth, the dose is good for 2 hours. Swallowing, the dose will carry for 3-5 hours. Much depends on the potency of the meds.
* Mouthstrip dosing is every 2-4 hours. Canna strips contain 20 mg cannabinoids/strip.
* Start Low and Go Slow
- Begin with a few drops and gradually increase to several droppersful per dose.
* One dropper is approximately 1 ml.
* A typical tincture dosage is 3-4 x/day for 24 hour coverage.
* You're looking for 5-20 mg cannabinoids/dose.
Advantages
* There's a rapid onset, within 15 minutes.
* Products are easy to transport.
* There's no cannabis odor. This is a stealthy delivery method.
* It's easy to get a measured dose, and it's easy to repeat that measured dose. Consistency of dosing makes this delivery method a preferred one by many physicians.
* Most products have a long shelf life.
* The doses are moderately long-lasting at 5-6 hours.
Disadvantages
* Unless you make your own you can't choose the strain being used.
* Good products may be difficult to procure commercially, especially the invaluable mouth spray.
* There's a widely variable range of potency.
* Products can be more difficult to make at home.
* Most products don't taste very good.
RECTAL DELIVERY
There's no denying the fact that rectal delivery works. There's still a lot of controversy in the medical community concerning this, but we have members who can testify that the delivery method works, in that they're still alive and actively eliminating cancer from their own bodies. So the medical community can debate this point all they want. Until a believable study comes along to convince us that we're all spitting into the wind, we stand behind our belief that suppositories infused with CCO will indeed help your body guide itself back to homeostasis.
* Most of the meds will be absorbed directly into the bloodstream. This means no first-pass through the liver, a very desirable effect. If you incorporate competitive inhibition into the regimen, you can do better than average on the second time through the liver too. Worth looking into.
* Suppositories are effective vaginally too.
* Suppositories are made with cannabis infused cocoa butter. Delivery can also be done with a syringe using coconut oil.
* This method has been a good choice for delivery into the pelvic and lower abdominal areas. According to cajuncelt this has also been shown to benefit patients treating breast cancers, and I know other members have spoken of patients they've known who used suppositories to successfully treat lung cancer.
* The FORIA vaginal suppositories are 240 mg THC + 40 mg CBD. A good example of the potential.
RECTAL DOSING
This is an area of treatment in its infancy, so we're still learning as data accumulates. In the medical community it's a limited patient pool. This will change as the wave to legalize sweeps the country.
* Suppositories are typically made with cocoa butter or coconut oil. These carriers will help speed absorption.
* Effects can begin within 15 minutes and last 6-8 hours.
* Similar doses to those administered orally can be achieved, from a low of 10 mg to as high as 200 mg/dose.
* This route is suitable for those in need of high dose therapies but cannot or do not want to take the oral route, for example someone who can't swallow or someone who doesn't want to get the psychoactive effects.
Advantages
* You can target the local pelvic and lower GI areas.
* There's increased bioavailability, compared with oral dosing.
* It may be more cost effective for higher doses.
* You can achieve higher doses with less psychoactivity.
* The dose is moderately long-lasting.
Disadvantages
* The method is relatively new to the medical field, so supporting data is difficult to find at this time.
* There's little information available about dosing, because at this stage, most of it's being done at home, in private, in states and countries that enforce prohibition and tie the hands of the professional caregivers.
* Unless you make your own, strain-specific products are not available.
* This is not a popular choice for most patients. Most aren't familiar with the method and even more are uncomfortable with the idea.
Let me share with you the perspective of an actual patient who overcame this discomfort, speaking to another patient reluctant to try suppositories.
You've been a survivor for a long time. That's a blessing for sure. But just know that the chemo only kills/contains the weak secondary cancer cells leaving the root cancer to grow stronger. That's why the recurrence & the chemo not working & needing to be changed.
What bothers you more? Chemo, toxins, poison, hospital, infusion room, IV, port, side effects, needles, meds to"help"....
Or an all natural suppository 2" up your rectum causing very welcomed effects?
Easy choice for me.
Rectal delivery works. Enough said.
It was kinda yucky at first ... OK it was nasty! But the positive effects coupled with the earthy taste and odor eventually trained my brain to desire the BudChew. Certainly an acquired taste!
