Updated: Jan 12
Most of us know someone with asthma or other lung conditions that benefit from the use of inhaled medication from a metered dose inhaler, a vaporizer, or a spray for the mouth or nose. Delivering medical marijuana using these same methods is growing in popularity for an increasing number of patients because of how easy they are to use as well as how quickly they work. Patients affected by medical conditions that cause acute pain, difficulty breathing, muscle spasms, or other symptoms can benefit from these delivery systems.
There are a variety of different ways to use medical marijuana. While people often think of routes like smoking, tinctures and oils, or edibles, researchers are finding new routes for delivering marijuana’s benefits most efficiently to the parts of the body that need it most. This is especially important to people with health conditions that cause sudden and strong symptoms like shortness of breath, muscle spasms, seizures, intense pain, migraine headaches, and the nausea and vomiting caused by cancer or chemotherapy. Being able to get relief in minutes or even faster can make a significant difference in a patient’s quality of life.
Bioavailability is defined as “…the relative amount of a drug administered in a pharmaceutical product that enters the systemic circulation in an unchanged form and the rate at which this occurs.” First- pass metabolism refers to how drugs taken by mouth are absorbed and processed through the digestive system before entering the circulation; this process often affects the amount and quality of the medication available to the body. These are important considerations to keep in mind when choosing a route for any type of medication, including MMJ. Certain routes provide more rapid effectiveness than others because of how the drug is processed and how quickly it reaches the area that needs to be treated. One such highly effective route is oral inhalation via smoking, vaporizing, or using some form of inhaler. As the medication is inhaled it goes to the lungs, where the majority of it is absorbed and made available to the body almost immediately. These concepts are important when deciding which route to use for your particular situation. Here are some examples of the bioavailability of different routes of marijuana administration:
Smoking a joint – approximately 30% THC
Vaping – 50-80% depending on the device and consumer
Edibles – 4-20% (the reasons for this are still being explored but may have to do with first-pass metabolism, what the patient has eaten, stress levels, activity, and a number of other factors)
Sublingual Tinctures – 40-50% (most likely due to sublingual absorption avoiding the first=pass effect)
Topicals – 5-10% (the skin acts as a barrier, preventing the psychoactive effects of THC while providing positive therapeutic outcomes)
Inhalers – these have effects similar to smoking or vaping with a couple of significant differences. They deliver pure, uncontaminated product without additives. In addition, an inhaler provides a way to determine a precise dose each and every time it is used. Inhalers tend to be more effective for rapid relief due to the purity and increased levels of THC or CBD delivered with each use.
Aside from bioavailability, there are other benefits to using an inhaler for MMJ. Because they don’t involve lighting or burning the plant matter, no carbon, other toxins, or irritants are released into the lungs. This can be especially helpful for people who experience lung irritation when using a method that involves burning the plant or extracting its beneficial components and adding thinners or solvents to them. Inhalers are discrete and give off no odor, which makes them easier to use in public. In the case of patients with COPD, bronchial asthma, or emphysema, the THC being delivered directly to the lungs enables it to help patients breathe easier almost immediately by relaxing and enlarging bronchioles (breathing tubes), which spasm and tighten when stressed. A study done in 1973 showed THC administered via a metered-dose inhaler had a dilating effect on the lungs of patients with bronchial asthma and may have a longer effect than other medications that work in a similar fashion.
Another item to be aware of is the Cannatol nasal rescue inhaler. This device was developed specifically for use by patients with seizure disorder, but is also being studied for use by patients with migraine headaches, cluster headaches, glaucoma, and shows promise in helping decrease self-harming behavior in autistic children. This inhaler interrupts the activity of overstimulated circuits in the brain, slowing or stopping the symptoms they produce. Someone having a seizure or migraine attack may be unable to take a pill, use a vape pen, or eat an edible; the bioavailability of MMJ through the nasal membranes is high and rapid so effects are often felt within minutes if not faster.
There are CBD-only inhalers also available in most states that can help with a variety of disorders including:
Seizures — while THC helps a seizure in progress, CBD oil taken as part of a daily routine can help decrease the amount, severity, and length of seizures on an ongoing basis.
Nausea – whether caused by chemo, antibiotic therapy, or other intestinal disorders, it can be effectively treated by an inhaler even when the patient is unable to tolerate oral meds.
Anxiety – CBD has been shown to have a calming effect on patients suffering from anxiety due to a variety of causes.
Depression – Cannabidiol has proven mood-lifting effects, which can be extremely beneficial for patients suffering from temporary or ongoing depression.
Diabetes – CBD helps moderate the need for supplemental insulin by boosting the efficiency of insulin produced by the body as well as helping increase the storage and usage of glucose in the bloodstream.
Weight Loss – Acting to help regulate insulin levels and maintain a healthy weight is a noted benefit of CBD.
Pain – One of the first uses of medical marijuana was for the pain associated with glaucoma. Since then, CBD has been used to relieve the discomfort associated with cancer, AIDS/HIV, MS and other autoimmune disorders, and many other chronic pain issues. (9,10)
MMJ patients looking to control their THC intake through the practice of micro-dosing may find using an inhaler is a good way to accurately and consistently get the precise amount of medication they need. Most edibles come in 10mg doses, and that may be too much for someone who only wants to use 2-3mg at a time; dividing a small edible can be difficult and the results can vary in size as well as dose. Vaping and smoking doses vary with the potency of the product. Tinctures can create portability and storage issues. Inhalers are small, portable, and easy to use while delivering a specific dose with each puff. Some of the newer products available in other states even have a dial that allow patients to determine their own dose.
While the availability of marijuana inhalers is still extremely limited, it is a growing trend in the US and worldwide. These devices offer discreet, precise, and rapidly bioavailable doses to patients who need and want this delivery system. The development of more ways to use and benefit from medical marijuana is an exciting thing to watch, and the positive effect it exerts on the lives of patients is noteworthy. Medical marijuana is a rapidly growing and important part of the healthcare market.