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<span style="font-size: 24px;"><strong>[spacer height="6px"]Consumption Methods</strong></span>

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[spacer height="10px"]Under the ACMPR program in Canada, licensed producers are currently authorized by Health Canada to sell marijuana in the form of dried bud, fresh leaves, oils and capsules.  The marijuana plant and its extracts can be prepared and consumed in various delivery methods/systems to medicate, so that the active ingredients in marijuana can be absorbed into the blood stream and body.  Some of the most widely used consumption methods include: vaporizers, edibles, oils, beverages, transdermal (topical) treatments, sublingual sprays, tinctures and smoked marijuana.

Treatment decisions and consumption methods are best made in consultation with a licensed health care practitioner.  Before taking any action, please consult your own appropriate health care provider about the applicability of any opinions or recommendations with respect to your own symptoms or medical condition.

<span style="font-size: 24px;"><strong>1. Vaporizers</strong></span>

Vaporizers are becoming an increasingly popular method to administer marijuana. A vaporizer is a device that uses a heating process that reaches passed the boiling point to release the active ingredients, but not high enough to burn the plant material. The collected vapour is then inhaled.

Vaporizers often have various temperature settings, which can impact the amount of cannabinoids in the vapour.

The effects of Inhaled marijuana using a vaporizer may be felt within a few minutes of dosing and will generally peak within 30 minutes.  The duration of effects generally last between 2-4 hours.  However, duration can be shorter or longer depending on tolerance, amount and type of cannabis placed in the vaporizer, the vaporizing temperature and duration of vaporization.  Vaping can be effective for treating acute symptoms that need to be addressed quickly, such as nausea, vomiting, pain and spasms.

A good vaporizer at the right heat setting can release up to 95% of all available cannabinoids.  Cannabinoids (e.g. THC and CBD) are chemical compounds found in the marijuana plant, which when consumed, bind to the body’s cannabinoid receptors.  This process is known to have medicinal value and applications for various aliments.  (Please visit the review article <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3442177/" target="_blank"><em>The Therapeutic Potential of Cannabis and Cannabinoids </em></a>for more information on this topic.)<em>
</em>

<a href="http://www.hc-sc.gc.ca/dhp-mps/marihuana/med/infoprof-eng.php#chp2211">Vapourized Cannabis - Health Canada</a>
<p style="padding-left: 30px;">Vapourization of cannabis has been explored as an alternative to smoking. The potential advantages of vapourization include the formation of a smaller quantity of toxic by-products such as carbon monoxide, polycyclic aromatic hydrocarbons (<abbr title="polycyclic aromatic hydrocarbon">PAH</abbr>s), and tar, as well as a more efficient extraction of <abbr title="tetrahydrocannabinol">Δ<sup>9</sup>-THC</abbr> from the cannabis material. The subjective effects and plasma concentrations of <abbr title="tetrahydrocannabinol">Δ<sup>9</sup>-THC</abbr> obtained by vapourization of cannabis are comparable to those obtained by smoking cannabis, with absorption being somewhat faster with the vapourizer compared to smoking, according to one <a href="https://www.ncbi.nlm.nih.gov/pubmed/17429350" target="_blank">study</a>. In addition, the study reported that the vapourizer was well tolerated with no reported adverse effects, and was preferred over smoking by the test subjects.</p>
There is supporting evidence that vaping marijuana may be safer because the exposure to <a href="http://www.ncbi.nlm.nih.gov/pubmed/16128224" target="_blank">harmful toxins</a> that are emitted thru combustion, are <a href="http://www.cannabis-med.org/data/pdf/2001-03-04-9.pdf" target="_blank">reduced by using a vaporization device</a>.

There are <a href="http://www.canorml.org/healthfacts/Second-Study-Shows-Vaporizers-Drastically-Reduce-Toxins-in-Marijuana-Smoke" target="_blank">studies</a> and <a href="http://www.ncbi.nlm.nih.gov/pubmed/20451365" target="_blank">data</a> that suggest vaporizing may be a healthier, efficient and more practical alternative to smoked marijuana, because this method of consumption offers fast acting effects similar to smoking, provides better dosage control and potentially reduces health risks.

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<strong> [spacer height="15px"]<span style="font-size: 24px;">2. Edibles</span></strong>

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Medical marijuana patients can choose to consume marijuana, or the active ingredients in marijuana, by eating or drinking food products infused with dried/fresh marijuana or its extracts.

On June 11, 2015, the Supreme Court of Canada ruled to legalize marijuana oils and edibles.  This landmark decision makes <a href="http://www.cbc.ca/news/politics/medical-marijuana-legal-in-all-forms-supreme-court-rules-1.3109148" target="_blank">medical marijuana legal in all forms.</a>  This decision allows authorized medical marijuana patients the right to prepare, possess and consume any food products infused with marijuana or its extracts, such as cookies, brownies, muffins, teas, juices, smoothies, etc.

<strong>Medical marijuana can be prepared/processed, so it can be infused with food for cooking in the following ways:</strong>
<ol>
 	<li>Dried bud can be pulverized into a powder, known as canna flour.</li>
 	<li>Dried bud can be extracted into a fat or oil. The most commonly used fat is butter, and the final product is known as cannabutter.</li>
 	<li>Dried bud can be processed into a marijuana extract (caution, safety and knowledge/training are highly recommended before embarking upon this process.)</li>
 	<li>Dried bud can be infused with alcohol to make marijuana tinctures</li>
</ol>
<strong>In addition to this:</strong>
<ul>
 	<li>If fresh marijuana is used, it induces a non-psychoactive effect, as long as plant has not been heated via combustion, vaporization and cooking, or dried, ripened and/or stored over time</li>
</ul>
<a href="http://www.hc-sc.gc.ca/dhp-mps/marihuana/med/infoprof-eng.php#fnb273-ref" target="_blank">Oral Ingestion of Cannabis ~ Health Canada</a>
<p style="padding-left: 30px;">Whereas the central nervous system and physiological effects occur within minutes by the smoking route or by vapourization<a id="fnb285-ref" class="footnote-link" href="http://www.hc-sc.gc.ca/dhp-mps/marihuana/med/infoprof-eng.php#fnb285"></a>, these effects proceed on a time scale of hours in the case of oral ingestion. Oral administration results in a slower onset of action, lower peak blood levels of cannabinoids, and a longer duration of pharmacodynamic effects compared to smoking. The psychotropic effect or "high" occurs much more quickly by the smoking than by the oral route, which is the reason why smoking appears to be the preferred route of administration by many, especially recreational users.</p>
<strong>Please note: </strong>The ingestion of marijuana edibles are slower acting, and as such, this delivery method has a delayed onset effect which can be felt as quickly as 30 minutes, and as late as  3 to 4 hours after administration.  This variability in timing depends on a number of factors (e.g. amount of food in stomach). It is prudent to wait a minimum of 2 hours between administration of single doses of oral products to avoid possible overdosing.  Acute effects generally peak between 3 and 4 hours after dosing and can last up to 8 hours or longer e.g. 12–24 hours).<em> ~ <a href="http://www.hc-sc.gc.ca/dhp-mps/marihuana/med/daily-quotidienne-eng.php" target="_blank"><span style="color: #808080;">Health Canada guidelines</span></a>
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<em>It it recommended that patients use caution and start with a low dose and monitor the impact that dose has before consuming a higher dose.</em>

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<strong><span style="font-size: 24px;">[spacer height="15px"]3. Marijuana Oil Extracts</span></strong>

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Marijuana oil extracts are liquid concentration of marijuana that are consumed orally.  Some Canadian licensed producers currently provide marijuana oil extracts that are contained in capsules or in liquid form in a bottle.  The bottles come with a dosing syringe/eyedropper to measure dosage.  Marijuana oil extracts can be ingested via capsules, infused with food and drink to make edibles, or through <a href="http://www.ijppsjournal.com/Vol3Suppl2/1092.pdf" target="_blank">sublingual absorption/uptake</a>.

<strong>Ingestion:</strong> marijuana oil extracts' onset, peak and duration of effects are similar to that of edibles, if infused with food or drinks and ingested.  The ingestion of food infused with marijuana oil extracts have a delayed onset effect, which can be felt as quickly as 30 minutes, and as late as  3 to 4 hours after administration.  This variability in timing depends on a number of factors (e.g. amount of food in stomach).  It is prudent to wait a minimum of 2 hours between administration of single doses of oral products to avoid possible overdosing.  Acute effects generally peak between 3 and 4 hours after dosing and can last up to 8 hours or longer e.g. 12–24 hours).<em> ~ <a href="http://www.hc-sc.gc.ca/dhp-mps/marihuana/med/daily-quotidienne-eng.php" target="_blank"><span style="color: #808080;">Health Canada guidelines</span></a></em>

<strong>Sublingual:</strong> If marijuana oil extracts are absorbed under the tongue (sublingual), the effects are likely to be felt quite rapidly, sometimes within 15 minutes.  This method of consumption can induce a peak high that is reached rather rapidly, the effects of which can be felt for much longer than 4-6 hours.

<em>It it recommended that patients use caution and start with a low dose and monitor the impact that dose has before consuming a higher dose.</em>

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<strong><span style="font-size: 24px;">[spacer height="15px"]4. Marijuana Topicals / Transdermal
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Topical marijuana treatments are transdermal applications that are absorbed through the skin.  The active ingredients contained in marijuana infused creams, lotions, balms, salves, sprays and oils are absorbed through the skin and can provide localized relief of aches, pain, tension, itching and inflammation.

Transdermal delivery methods such as topicals are non-psychoactive, as the active (cannabinoid) ingredients can not reach the blood stream, and as such, can not induce an intense "high" compared to other delivery methods that enter the blood stream, such as inhalation and ingestion methods.

Patients who what the therapeutic benefits of marijuana without the effect of a cerebral "high"often choose this delivery method for certain conditions that are treatable via a topical application.

With topical application, it is not known how long it takes for potential therapeutic effects to appear, nor how long they last.  There have been reports of hypersensitivity reactions (e.g. rashes, itching) when skin has come into contact with cannabis.

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<strong><span style="font-size: 24px;">[spacer height="15px"]5. Beverages</span></strong>

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Beverages infused with marijuana or its extracts is an edible method of ingestion that is used to deliver the active ingredient in marijuana to the blood stream.

There are a wide variety of beverages that can be infused with marijuana or its extracts, such as water, carbonated drinks, tea, hot coco, fruit juices, smoothies, etc.

According to Ezra Pryor of the American Chemical Society’s <a href="http://dchas.org/cann/">Cannabis Chemistry Subdivision</a>, beverages infused with cannabinoids are just as effective as those found in solid edible food products.

“There really is no difference between the effects of oral dosing with cannabis, whether in an edible or drinkable form,” says Pryor. “With edibles, as with infused beverages, THC becomes 11-Hydroxy-THC after passing through the stomach and liver, rather than delta-9-THC entering directly into the bloodstream as with smoking, which will cause a completely different effect.”

<strong>Ingestion:</strong> Consumption of marijuana beverages have onset, peak and duration effects similar to that of solid food edibles.  The ingestion of marijuana infused beverages have a delayed onset effect, which can be felt as quickly as 30 minutes, and as late as  3 to 4 hours after administration.  This variability in timing depends on a number of factors (e.g. amount of food in stomach).  It is prudent to wait a minimum of 2 hours between administration of single doses of oral products to avoid possible overdosing.  Acute effects generally peak between 3 and 4 hours after dosing and can last up to 8 hours or longer e.g. 12–24 hours).<em> ~ <a href="http://www.hc-sc.gc.ca/dhp-mps/marihuana/med/daily-quotidienne-eng.php" target="_blank"><span style="color: #808080;">Health Canada guidelines</span></a></em>

If fresh marijuana is used, it induces a non-psychoactive effect, as long as plant has not been heated via combustion, vaporization and cooking, or dried, ripened and/or stored over time.

<em>It it recommended that patients use caution and start with a low dose and monitor the impact that dose has before consuming a higher dose.</em>

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<strong><span style="font-size: 24px;">[spacer height="15px"]6. Raw Marijuana
</span></strong>

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Fresh marijuana can be consumed raw in a salad, blended into a smoothie or juiced.  Much like other leafy greens, raw marijuana is loaded with vitamins, minerals and antioxidants.  It is also loaded with beneficial disease fighting cannabinoids, that when ingested raw, induces a non-psychoactive effect, since that plant has not been heated, dried, ripened or stored over time.

Marijuana in its raw natural form is not psychoactive.<strong>  </strong>Marijuana can be decarboxylated to activate psychoactive THC when it is dried, ripened and/or stored over time – or when it is heated through combustion, vaporization and cooking.

<em>Please use dosing and strain variety recommended by your healthcare professional.</em>

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<strong><span style="font-size: 24px;">[spacer height="15px"]7. Marijuana Tinctures</span></strong>

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Marijuana Tinctures are alcohol based liquid concentration of marijuana.  In other words, the active ingredients found in marijuana are infused with alcohol.  Marijuana Tinctures can be infused with food or drinks and ingested or through sublingual absorbtion (under the tongue).

<em>Please note: Marijuana tincture dosing, effect and duration are similar to that of edibles, if infused with food or drinks and ingested.  The ingestion of marijuana tinctures has a delayed onset effect that can take 30 minutes - 2 hours or longer.  Ingestion of tinctures can also induce a potent and long lasting effect, which can be felt for much longer than 4-6 hours.  So use caution when dosing.  </em>

<em>If marijuana tinctures are absorbed under the tongue, the effects are likely to be felt quite rapidly, sometimes within 15 minutes.  This method of consumption can induce a peak high that is reached rather rapidly, the effects of which can be felt for much longer than 4-6 hours.</em>

<strong>Ingestion:</strong> Marijuana tincture onset, peak and duration of effects are similar to that of edibles, if infused with food or beverages and ingested.  The ingestion of food/beverages infused with marijuana tinctures have a delayed onset effect, which can be felt as quickly as 30 minutes, and as late as  3 to 4 hours after administration.  This variability in timing depends on a number of factors (e.g. amount of food in stomach).  It is prudent to wait a minimum of 2 hours between administration of single doses of oral products to avoid possible overdosing.  Acute effects generally peak between 3 and 4 hours after dosing and can last up to 8 hours or longer e.g. 12–24 hours).<em> ~ <a href="http://www.hc-sc.gc.ca/dhp-mps/marihuana/med/daily-quotidienne-eng.php" target="_blank"><span style="color: #808080;">Health Canada guidelines</span></a></em>

<strong>Sublingual:</strong> If marijuana tinctures are absorbed under the tongue (sublingual), the effects are likely to be felt quite rapidly, sometimes within 15 minutes.  This method of consumption can induce a peak high that is reached rather rapidly, the effects of which can be felt for much longer than 4-6 hours.

<em>It it recommended that patients use caution and start with a low dose and monitor the impact that dose has before consuming a higher dose.</em>

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<strong><span style="font-size: 24px;">[spacer height="15px"]8. Smoked Marijuana
</span></strong>

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Marijuana can also be consumed using pipes, bongs and rolled joints.  When the plant material is burned, the active ingredients in marijuana (THC, CBD..) are absorbed by the lungs and enter the blood stream.

Inhalation of smoked marijuana is fast acting, the effects of which can be felt within a few minutes of dosing and will generally peak within 30 minutes.  The duration of effects generally last between 2-4 hours.  The duration can be shorter or longer depending on tolerance, dose, depth of inhalation, puff duration, and breathhold.  Smoking can be effective for treating acute symptoms that need to be addressed quickly, such as nausea, vomiting, pain and spasms.

<a href="http://www.hc-sc.gc.ca/dhp-mps/marihuana/med/infoprof-eng.php#chp2211">Smoked Cannabis ~ Health Canada</a>
<p style="padding-left: 30px;">Smoking cannabis results in more rapid onset of action (within minutes), higher blood levels of cannabinoids, and a shorter duration of pharmacodynamic effects compared to oral administration.  The amount of <abbr title="delta-9-tetrahydrocannabinol">Δ<sup>9</sup>-THC</abbr> delivered from cannabis cigarettes is not uniform and is a major variable in the assessment of absorption. Uncontrolled factors include the source of the plant material and the composition of the cigarette, together with the efficiency and method of smoking used by the subject.  While it has been reported that smokers can titrate their <abbr title="tetrahydrocannabinol">Δ<sup>9</sup>-THC</abbr> intake by adapting their smoking behaviour to obtain desired levels of <abbr title="tetrahydrocannabinol">Δ<sup>9</sup>-THC</abbr>, other reasons may also explain the observed variation in smoking topography.  <abbr title="tetrahydrocannabinol">Δ<sup>9</sup>-THC</abbr> absorption by inhalation is extremely rapid but quite variable, with a bioavailability of 2 - 56% through the smoking route depending on depth of inhalation, puff duration, and breathhold.</p>
Since there are many variables associated when inhaling smoked marijuana, it can be difficult to titrate dose (t<span class="hvr">he</span> <span class="hvr">continual</span> <span class="hvr">adjustment</span> of a <span class="hvr">dose until the desired effect is achieved</span>).

Some studies indicate that smoked marijuana can irritate and expose lungs to <a href="http://www.ncbi.nlm.nih.gov/pubmed/16128224" target="_blank">harmful toxins</a>  that are emitted thru combustion.

There are <a href="http://www.canorml.org/healthfacts/Second-Study-Shows-Vaporizers-Drastically-Reduce-Toxins-in-Marijuana-Smoke" target="_blank">studies</a> and <a href="http://www.ncbi.nlm.nih.gov/pubmed/20451365" target="_blank">data</a> that suggest vaporizing may be a healthier, efficient and more practical alternative to smoked marijuana, because this method of consumption offers fast acting effects similar to smoking, provides better dosage control and potentially reduces health risks.

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<strong><span style="font-size: 24px;">[spacer height="15px"]Marijuana Overdose Symptoms</span></strong>

Marijuana overdose symptoms are usually rare, but not impossible.

Signs of excessive marijuana consumption or overdose may include:
<ul>
 	<li>Hallucinations</li>
 	<li>Panic Attacks</li>
 	<li>Extreme Paranoia</li>
 	<li>Rapid Heart Rate (can increase risk of heart attack)</li>
 	<li>Mental Confusion</li>
</ul>
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<strong>DISCLAIMER:</strong> The material provided here is for informational purposes only, and is not intended to be a substitute for a health care provider’s consultation.  Before taking any action, patients should consult a licensed healthcare professional.

The information herein does not constitute health, legal or technical advice.

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