Choosing the Medicine
The medical values of THC, CBD and other Cannabinoids.
Which cannabis? There are two strains of cannabis; Cannabis 'Sativa' and Cannabis 'Indica'. Both contain large amounts of THC, but Cannabis 'Indica' contains other cannabinoids such as CBD and CBN. These are similar to THC, but have different effects on the body and can be used in different ways. THC causes the feelings of euphoria, creativity and a sense of well-being which are often called being ‘high'. It also reduces blood pressure and nausea, benefits cancer patients taking chemotherapy, AIDS patients who have reduced appetite and patients with uncontrolled glaucoma. CBN and CBD cannabinoids create a stronger sedative physical effect useful for pain relief and reducing muscle spasticity - helping Multiple Sclerosis patients, stroke victims and those suffering from chronic pain.
Our knowledge of these different cannabinoids can be used to target them specifically for the purposes they are most effective. However most cannabis currently available is a hybrid strain - somewhere in between the extremes of 'Sativa' and 'Indica'. The 'Sativa' plant is taller and sparcer, with bigger branches to unit length, while the 'Indica' plant is more compact, narrower, skinnier and shorter, with more branches spaced closer together. Cannabis resin (‘hash') is likely to be higher in CBD, while many strains of herbal cannabis (‘weed' or ‘skunk') can be very high in THC. One of the many strong arguments for legalisation is that it would require cannabis to be properly labled like any other mass consumer product.
Smoking/inhaling: Burning or vaporizing the cannabis and inhaling the smoke into the lungs is the fastest route to the blood stream. Conventional wisdom is that holding in the smoke increases the effects felt. Recent research shows the opposite; it causes more harm to the lungs without increasing the amount of THC absorbed. Studies done in Australia indicate that 95% of the THC in cannabis is absorbed in the first few seconds of inhaling. Holding in the smoke longer just allows more tar and other noxious chemicals to be absorbed. Take small, shallow puffs rather than deep inhalations.
Irritation of the throat and lungs is one of the most obvious adverse effects to the marijuana smoker as is the inevitable cough upon inhaling. The cough is the body's reaction to the irritation of the numerous constituents of the smoke. Prolonged and repeated exposure to these irritants can lower resistance to, and aggravate infections from viruses, bacteria, or fungi. The lesser coughing, the safer the smoke. The fewer puffs the better; the more potent the cannabis used is the fewer puffs required. For these reasons, it is preferable to use only the more potent flower tops, or high grade hash for smoking use.
Despite the obvious dangers of inhaling hot smoke, there is evidence that in some cases (ie. Asthma) smoking could be a beneficial medical use of cannabis. Another advantage of smoking is that it allows the user to control their dosage better as the effects are almost immediate, unlike when eating, or using THC in pill or spray form. In general however, smoking is not the best way to take cannabis, especially for pain, being a less efficient use of the herb than eating. However, many medical users find they appreciate the immediate and pleasurable effects of smoking cannabis and the harm of smoking can be reduced in various ways. One alternative to inhaling smoke is to release the THC through Vaporization; inhaling vapor rather than smoke, see vaporization.
Joints: Smoking cannabis in ‘joints' is one of the least harmful ways of smoking. A loose, fat joint is preferable to a thin one because the temperature of the smoke is lower in a thick joint. Mixing cannabis with tobacco counter-acts the positive effects of THC. Some research suggests that Cannabis may actually offset some of the harmful effects of tobacco but there is also evidence that the relaxing effects of cannabis on the lungs allows the toxins in tobacco to get in deeper. There is evidence that a thin joint gives a more stimulating ‘high', while a fat joint has a more sedative effect (due to different burn temp in ‘fat' or ‘thin' joints). Avoid rolling papers with 'strawberry' tasting chemicals and the like, 'rainbows' and any use of colored inks.
Pipes and Bongs: Many ingeniously designed products are on the market that claim to offer a cooler smoke but they are not all safe or efficient to use. Avoid wood, aluminum or plastic materials. Use glass, stainless steel or brass pipes and bongs.
Water pipes: Recent research suggests that water pipes are the most harmful and least efficient methods of smoking cannabis. The water absorbs a great deal of the THC in the smoke (up to 50%!), increasing the amount of tar the smoker must ingest to get the desired result. Using a water pipe with a mouthpiece less than 20cm from the water level can allow water vapor and water drops to enter the lungs.
Vaporization: Using a vaporizer which heats but does not burn the cannabis, is an alternative to smoking. The process involves releasing the THC as vapor which is inhaled rather than smoke. The effect is ‘clearer' and it is far more economical and reduces the exposure of the throat and lungs to products of burning. Vaporization works because THC, the active ingredient of cannabis, is a resin that vaporizes at a lower combustion (burning) point than cellulose. You can make your own vaporizer very cheaply or buy various types starting at around £35 up to £300+ for the 'hospital standard' 'Volcano'. High heat destroys some of the THC in smoked cannabis (estimates vary). Vaporizers heat it more gently; the THC molecules decarboxylate and evaporate in a whitish vapor. A problem with vaporizers is with correct use. Many users tend to overheat and consequently burn the stuff. They are now 'smoking' not 'vaporizing' the cannabis, often without realizing - and just as many toxic tars are released as smoking in a pipe. Vaporizers sometimes fail to satisfy longtime recreational smokers who associate burning lungs with getting high. They distrust the incredibly smooth taste of the vapors, and they don't like waiting 20 seconds to 1 minute for each hit. However they always like the fact that their supply seems to last up to four times as long because valorization wastes so little of the active ingredients lost through smoking. Some regular users of vaporizers have complained that they produce a fine dust along with the vapor. This can't be good and they should maybe be fitted with a filter system but vaporizers are still the safest way to consume cannabis using heat.
Eating or drinking: Simply sucking a small piece of hashish or eating cannabis prepared as a cake, drink or other food is a very effective and economical method of using cannabis. The effects take up to an hour and last 4-12 hours. Over dose is possible by eating too much (see ‘Over-Dosage'). This could result in an unpleasant ‘whirling-pit' feeling but no lasting physical damage. If in doubt ‘self-titrate' the dose; experiment with a little, and then a little more. More worrying are the dangers of adulteration and infection encouraged by the unregulated trade in cannabis. These include smuggling methods and profiteering practices which can make eating the resulting product totally undesirable. In general avoid eating most hash especially ‘Soap Bar' and ‘Manali' or 'Squiggie' black. Eating Hemp seeds (see 'Hemp Seed & Nutrition') or their oil (which have no THC content) is a very valuable source of nutrition; a quality which can have considerable medical value and contribute to general well being.
Creams and lotions: Applied on the skin to treat complaints ranging from muscle pain and/or tremors to ache. You can make these your self. The simplest way to do this is to put leaves and buds of cannabis into a bottle filled with surgical alcohol available in any chemist. Leave in a dark place for 1-3 weeks, shaking every day or as often as possible, then use to rub on area suffering from pain.
Tinctures: The active ingredients of the plant are extracted as oil and can then be used either as drops taken orally, or the ingredient for creams and lotions to be rubbed on the skin to relieve pain and other symptoms. Cannabis Tincture was available by prescription for medical purposes in Britain until 1971.