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Explanation of Ingestible Inconsistency in Medical Marijuana

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Cannabis Ingestibles and Edibles- A Brief Overview of Patient Considerations

Ingesting cannabis is the preferred method of medicating for many patients. This is for a variety of reasons. Long-lasting effects and a desire to avoid smoking are two of the primary reasons that patients cite for their preference to ingest rather than inhale.

In the mid 1800’s cannabis tinctures were popular and in wide use. Ultimately they fell out of use. A contributing factor was the fact that patients had highly variable experiences and dosage was difficult to determine and seemingly erratic. At the time, cannabinoids, the psychoactive and medicinal compounds in cannabis, had not yet been identified. Patients either experienced unwanted intoxication from too much, or insufficient therapy from too small a dose.

With the identification and research on the properties of THC, CBD, CBN and others, we now have a greater understanding of what influences the patient experience with ingestible cannabis. As a result we know how to ensure a more repeatable therapy level. Patients who have tried a range of commercially available ingestible cannabis generally report having experienced ingestibles with no perceivable effect, as well as those with unexpected and excessive intoxication effects.

There are two main considerations to ingesting cannabis that both the patient and medicinal baker should be aware of. These are #1, the activation of the cannabinoids present in the ingestible and #2, that the intoxicating effects of THC are magnified 10x when ingested versus inhaled.

When THC and CBD are in the plant material, they are in an inactive form, called the “acid form”. These are referred to as THCA and CBDA. They may also have medicinal properties, but are not well understood at this time. THCA is non-intoxicating and non-psychoactive. To “activate” the THC and CBD, cannabis is generally heated. This of course happens as a normal part of the smoking and vaporization process when flame or heat is applied to prepared plant material.

Depending on the type of ingestible that is being prepared different methods of activation can be used. As a general rule of thumb, heating cannabis at 212° F for 90 minutes achieves thorough activation of the THC, converting the THCA to THC and CBDA to CBD.

THCA + HEAT -> THC

In cases when an ingestible has little to no effect, it may be due to incomplete or zero activation of the THC and CBD. Butter and oil can be analyzed before it is used in a recipe to determine if activation has been achieved. If not, the mixture may be heated at the correct temperature for additional time to improve the activation level. This can also be a reason for batch to batch inconsistency in edibles. One batch may be made with activated butter, while the next batch may have been made with partially activated butter because temperature was not monitored, for example.

The second consideration for patients choosing to obtain therapy through cannabis ingestibles is the magnification of the intoxicating effects when THC is metabolized in our bodies. When we inhale combusted or vaporized cannabis delta-9-THC enters our bloodstream, interacts with receptors in our brain and eventually is broken down and excreted from our bodies. In the case of ingested THC, as it goes through “first pass metabolism” it is actually converted to a different substance called 11-hydroxy-THC. When it is in this form, it is 10x more psychoactive that delta-9-THC you experience with inhaled cannabis. This is one reason why it is so easy for patients to experience unwanted intoxication when using a new product. A little can go a long way.

It may be helpful to patients who prefer ingestibles to consider their dosage in “smoking equivalents”. For example, if a normal amount of inhaled cannabis for you is 0.5 grams to achieve your desired therapy level, 0.05 grams or 50 milligrams of ingested plant material of the same potency may have similar psychoactive effects. Stomach acids do break down cannabinoids, and this loss may also be a consideration depending on the time the ingestible resides in the stomach before it is absorbed into the body.

The total effect from an ingestible experienced by the patient is influenced by a variety of factors, from cannabinoid activation, first pass metabolism to how full their stomach is when the cannabis is ingested. Keeping these factors in mind as you prepare your own ingestibles or select a commercial product can help with success in achieving the desired level of therapy on a repeatable basis without unwanted or excessive intoxication.

The Pure Analytics Team

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