Does It Make Difference How One Consumes Cannabis?
Cannabis is most often inhaled - either through a cigarette (joint), pipe, water-pipe (also known colloquially as a 'bong'), or vaporizer. Consumers tend to prefer inhalation as a route of administration because they begin to experience cannabis' effects almost immediately after inhalation. This outcome allows them to moderate their dose as needed or in accordance with their particular preference, as well as to achieve immediate relief from pain, nausea, and other symptoms.
Regardless of whether a person is inhaling cannabis via a joint, pipe, or water-pipe, they are still subjecting their lungs to potentially noxious smoke. However, studies have, to date, failed to link cannabis inhalation - even over the long-term - to the sort of adverse pulmonary effects associated with tobacco smoking. According to a 2012 study published in the Journal of the American Medical Association (JAMA), lifetime, moderate cannabis smoking (defined as at least one joint per day for seven years or one joint per week for 49 years) was not associated with adverse affects on pulmonary function.[17] Cannabis inhalation is also not associated with increased prevalence of certain types of cancers, such as melanoma, prostate cancer, or breast cancer[18]. Nor has its use been associated with higher prevalence of tobacco-related cancers such as lung cancer.[19] In 2006, the results of the largest case-controlled study ever to investigate the respiratory effects of marijuana smoking reported that cannabis use was not associated with lung-related cancers, even among subjects who reported smoking more than 22,000 joints over their lifetime. "We hypothesized that there would be a positive association between marijuana use and lung cancer, and that the association would be more positive with heavier use," one of the study's primary researchers, Dr. Donald Tashkin of the University of California at Los Angeles stated. "What we found instead was no association at all, and even a suggestion of some protective effect."[20]
The use of a water-pipe filtration system primarily cools cannabis smoke. However, this technology is not particularly efficient at eliminating the toxic byproducts of combustion. As a result, some cannabis consumers utilize vaporizers, which heat marijuana to a point where cannabinoid vapors form, but below the point of combustion. This technology allows consumers to experience the rapid onset of the plant's effects while avoiding many of the associated respiratory hazards associated with smoking -- such as coughing, wheezing, or chronic bronchitis. In several clinical trials, investigators have concluded that vaporization is a "safe and effective"[21] cannabinoid delivery mode that "does not result in exposure to combustion gases."[22] Researchers also report that vaporization results in higher plasma concentrations of THC compared to smoked cannabis.[23]
Consuming moderate to high quantities of marijuana orally, such as in food or in a tincture (a liquid-based solution), will yield a different and sometimes more intense outcome. Consumers will typically not begin to feel any psychoactive or physiological effects of the plant for at least 45 minutes to 90 minutes after ingestion. This delayed onset makes it more difficult for subjects to regulate their dosage. Orally consumed cannabinoids tends to be stronger acting and last far longer (upwards of four to six hours is typical) than the effects of inhaled cannabis. This result is largely because of the way bodies metabolize THC. When cannabis is inhaled, THC passes rapidly from the lungs to the blood stream and to the brain. By contrast, when cannabis is consumed orally, a significant portion of THC is converted into the metabolite 11-hydroxy-THC before reaching the brain. (Inhaling cannabis produces only trace levels of this chemical.) Since this metabolite is believed to be slightly more potent than THC and possesses a greater blood-brain penetrability, the physical and psychoactive effects of substance may be magnified in some consumers.
Some users prefer these longer-lasting effects, particularly those seeking to treat chronic conditions. Other consumers, such as those seeking occasional symptomatic relief or those less experienced to cannabis' effects prefer the milder, shorter-lived effects associated with inhalation. Additional information regarding inhaled cannabis versus orally ingested THC is available here:
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