Cannabis is consumed through a variety of methods, most notably smoking, vaping, eating, and topical application. The effects, both in terms of medicinal benefits and risks, are different between each method used, but how different are they? Is one method safer than any others? Are the effects on the user any different between various cannabis consumption methods?
It may surprise some to find out that yes, it is not just the cannabis you are consuming, but how you consume it that will determine its effects in your body. In some cases, this may even explain why cannabis can both be considered an illicit substance or a valid medicine. In today’s article, we will compare and contrast the various routes of cannabis consumption, and try to provide the framework for you to make the best decisions for yourself when using the pant for both THC and CBD.
How is cannabis consumed?
There are generally four ways that cannabis is consumed: combustion, vaporization, ingestion, and topicals. We will go through each one in a bit more detail below, then in the next section describe the pros and cons of each.
Combustion is any process that uses high heat to burn the cannabis flower or extract for inhalation. This may include pipes, joints, bongs, or other methods of smoking. This method is traditionally used around the globe and provides a quick and effective means of accessing beneficial THC or CBD. It is not known at this time how much of the terpenes, flavonoids, or alkaloids of the plant survive the combustion process.
Vaporization is a process in which cannabis flower or extracts are heated to the boiling point of THC or CBD (THC is about 157°C while CBD is around 160-180°C), this causes those compounds to become a gaseous vapor that is then inhaled. This method greatly reduces the amount of unwanted byproducts consumed (tar, carbon, VOCs, etc.) and may be more effective at preserving the taste and benefits of terpenes, flavonoids, or alkaloids, however, there has been very little scientific investigation in this field.
Ingestion is a broad category to describe any oral administration routes, such as edibles, drinks, tinctures, oromucosal sprays, or oils. This category is unique in that, for THC, the flower or extract must first be heated to decarboxylate the THCa into THC. This is generally done prior to preparing the final product and is not of concern to the consumer, but it should be noted that you cannot directly consume cannabis flower to get the effects of THC. Consumption for dietary purposes may also include the leaves, seeds, or roots.
Topicals include balms, salves, transdermal patches, or creams made from the cannabis plant. Unlike other preparations, this category can also include the stalks and roots. For THC based topicals, decarboxylation is still necessary but for CBD topicals or root based topicals, it is not.
What are the most popular routes of cannabis consumption?
According to a new study just published in November of 2020 [ ] using survey data from 21,903 Americans aged 18 and over from all 50 states, it was found that combustion was the most common consumption route. According to the report, almost half of the users used combustion (42.08%), followed by topicals (28.65%), ingestion (19.66%), and vaporization (8.95%). The data was quite different between medical and recreational users, with medical users preferring topicals or smoking a pipe or joint, followed by edibles. Whereas the recreational users tended to prefer pipes and bongs, followed by joints, blunts, and edibles. The data clearly shows that medical users have a broader range of consumption methods, whereas with recreational users the preferred route is combustion.
What are the health effects of various consumption routes?
Although some may be tempted to reduce the argument to just getting THC or CBD into the body, how you do so will greatly change both the desired effects, and the side effects. As combustion is the most common consumption method, we will start there.
When smoking Cannabis, non-psychoactive THCa is converted into THC and absorbed directly through the tissues of the lungs, were it then directly enters the blood steam. It then moves throughout the body, affecting the CB1 type receptors primarily found in the body’s central nervous system. The effects can be more or less immediately felt, and tend to peak in about 4 to 8 minutes. The effects will last 3-4 hours, with a response cuve showing a rapid rise, short peak, and then steady drop in blood concentration. Some users report after-effects for 1-12 hours.
Smoking and combustion is undoubtedly the easiest and quickest method of consumption, as it requires nothing more than the dried cannabis flower, hashish, or an extract and a smoking device. The effects are immediate, and easy to control, users wanting more can smoke more, and those who may have taken too much will only have a few hours before returning to normalcy.
While being the most convenient and fastest method, combustion also carries the most health risks. Smoking any substance is bad for the lungs, and the effects of smoking cannabis may be as bad or even worse than the effects of smoking tobacco. Furthermore, smoking cannabis flower also has the added risk of inhaling mold contaminants. Some users believe that a bong or water pipe will filter some of the byproducts of combustion, however the effects of filtering with water have not been quantified in any known publications. If you do smoke, be aware of the dangers, including chronic bronchitis, increased susceptibility to viral infections, and even lung or throat cancers.
Vaporization is similar to combustion in that it is direct form of consumption that provides immediate absorption and action. As we have discussed previously in the largest studies to date, vaping to be about 95% safer than smoking, and is also less pungent and carries less of a risk of second-hand exposure. As we have discussed elsewhere the scare involving vaping products in 2019 that where attributed as Vaping Related Lung Injuries (VALI) was concluded to be an isolated event involving the additive Vitamin E Acetate. While that event does highlight the need for quality control in vaping products, it does not indicate that vaping is less safe than smoking.
Vaporization does require more equipment and preparations, either a device capable of vaporizing dried cannabis flower or one that uses liquid or solid cannabis extracts. The negative effects of vaping are similar to that of combustion, but much less in magnitude as vaping does not release the tar, carbon, VOC’s and many other toxins that are inherent with combustion and smoking. Like smoking, although the effects are immediate, the actual dosage consumed or absorbed will vary greatly, and is generally not used for medical applications where specific dose and dosage are of concern.
Ingestion of edibles or other forms of oral administration routes removes many of the health risks of combustion or vaporizing, and are thus the preferred route by the medical industry. With oral consumption, the THC or CBD is passed from the intestines to the liver, where it is then processed and introduced to the blood stream. We will focus primarily on THC consumption here, but if you are interested in CBD consumption please see our previous article on the best ways to consume CBD.
Unlike edibles, tinctures and oromucosal sprays are absorbed through the mucous membranes of the mouth, or sublingually (under the tongue), they have the advantage of absorbing directly into the blood stream for faster action than edibles. They can likewise deliver known amounts of cannabinoids without being metabolized by the liver, and are the preferred routs of medications such as Sativex and Epidiolex. Taking cannabis orally has the advantage of being able to closely titrate the dosage, use full spectrum extracts for the “entourage effect,” and patients are likely to comply with the treatment.
The problems with oral consumption include the reliance on metabolism by the liver, which can vary in individuals or be compromised due to comorbidities. The onset of action may be delayed anywhere from 10 minutes to 2 hours, and the effects generally last for about 6 hours. Often, users do not wait long enough to feel the effects before decided to consume more, leading to overconsumption issues.
Further compounding this issue, the psychoactive effects of consuming cannabis orally are different from smoking it. In a 2005 review paper, it was described how oral cannabis consumption produced a higher concentration of the primary metabolite of THC, also known as 11-hydyoxy-THC (11-OH-THC) in blood plasma than with smoking. The same study also suggested that oral consumption may produce more psychotomimetic metabolites (those which can produce a temporary psychotic state) of THC, and that the mechanism of absorption produced sustained plateaus in blood concentrations which could affect the way the compound is distributed throughout the body. Essentially, the effects of smoking and eating cannabis can be very different, as many long-time smokers can attest to when trying to consume orally for the first time.
And lastly, topicals are those which are all plied externally to the skin. There is little empirical evidence on the effectiveness of these routes of administration, but anecdotal user data shows that they can be effective. Although in theory it is possible for THC and CBD to be absorbed through the skin, no publications have been produced using blood serum levels to quantify this. The effects of topics may be more local, which is why they are generally used for pain relief and muscle or skin issues, rather than recreationally. The use of topicals seems to be quite safe, and no major side effects have been observed or described in the literature.
As you can see, there are multiple routes of cannabis consumption for you to choose from, depending on the resources you have available to you and the desired effects. The last piece of the puzzle however is your body’s unique chemistry and genetics, which also play a role in how you will react to cannabis consumption. For that reason, always start slow and be mindful of how you feel after consuming cannabis, and try to find the way the works best for you, with the lowest risk to your long-term health.