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This article teaches students the pros and cons of edibles, or cannabis ingestion, and exposes them to some of the most significant peer-reviewed research studies on the topic.
It is estimated that humans have been consuming cannabis via ingestion for thousands of years. Evidence also exists to indicate that humans have smoked or perhaps vaporized cannabis as far back as 5,000 BC. Modern ingested cannabis products are typically called edibles and sometimes medibles (implying their medicinal value).
Understanding Cannabis Edibles
According to author James Gaines writing for Knowable Magazine in 2021, "Many people still prefer inhaling cannabis—edibles make up roughly 11 percent of the cannabis market—but a growing number are eating their greens, so to speak. Edibles are more lung-friendly than smoking and more discreet—they don’t generate stinky secondhand smoke and can be consumed both in and out of the home.
Delayed Onset & Discreet Consumption
One disadvantage of ingestion of cannabis is the slowest onset of all consumption avenues. When eaten, cannabinoids and terpenes must be processed by both the stomach and the liver. This results in an onset period of between 45 minutes and two hours, with some patients waiting three hours for onset (the exact onset period if extremely variable and depends on a number of factors).
"Despite their sluggish onset, edibles—like tinctures—offer the advantage of discreet consumption in nearly any environment or situation (something not possible with inhalation)."
Despite their sluggish onset, edibles—like tinctures—offer the advantage of discreet consumption in nearly any environment or situation (something not possible with inhalation). However, bioavailability of cannabinoids and terpenes consumed via ingestion is lower than via other methods, including sublingual tinctures and inhalation, due to the digestive process involving the stomach and liver.
Some anecdotal reports and research data indicates that the duration of the effects of edibles may be exemplary compared to smoking and vaping, especially when dosed properly.
Understanding Cannabis Edibles: The Big Mistake
Understanding Cannabis Edibles. Many medical professionals and cannabis industry professionals preach the edibles mantra "start low and go slow" to patients and social media followers. This is due to the exceptionally long onset period of edibles.
The basic mechanism of the common dosing problem with edibles involves cannabis consumers assuming that they feature the same onset period as smoking or vaporizing (2-2.5 minutes; very different from two hours!). This makes sense as smoking and vaping are the most common form of cannabis consumption and the prohibition surrounding cannabis has made accurate information dissemination challenging at best.
The Infamous Maureen Dowd Overdose of 2014
Maureen Dowd, the Pulitzer Prize-winning columnist for the New York Times, in an infamous June 2014 article entitled "Don't Harsh Our Mellow, Dude," described how she visited then newly adult-use cannabis legal Denver, Colorado and decided on the consumption avenue of edibles.
Dowd made the common mistake of consuming the intended and officially recommended portion of her cannabis edible, only to wait 10 or so minutes and feel nothing (a period over which cannabis smokers and vapers necessarily are well into their onset period). This prompted her to falsely perceive that the dose she had consumed only minutes prior was too low to deliver psychoactivity, so she ate more.
"Sitting in my hotel room in Denver, I nibbled off the end and then, when nothing happened, nibbled some more."
"Sitting in my hotel room in Denver, I nibbled off the end and then, when nothing happened, nibbled some more. I figured if I was reporting on the social revolution rocking Colorado in January, the giddy culmination of pot prohibition, I should try a taste of legal, edible pot from a local shop," wrote Dowd in the article.
How did the edible affect Dowd? Below is her description of the experience as excerpted from the featured New York Times article:
"For an hour, I felt nothing. I figured I'd order dinner from room service and return to my more mundane drugs of choice, chardonnay and mediocre movies-on-demand. "But then I felt a scary shudder go through my body and brain. I barely made it from the desk to the bed, where I lay curled up in a hallucinatory state for the next eight hours. I was thirsty but couldn’t move to get water. Or even turn off the lights. I was panting and paranoid, sure that when the room-service waiter knocked and I didn’t answer, he'd call the police and have me arrested for being unable to handle my candy. "I strained to remember where I was or even what I was wearing, touching my green corduroy jeans and staring at the exposed brick wall. As my paranoia deepened, I became convinced that I had died and no one was telling me. "It took all night before it began to wear off, distressingly slowly. The next day, a medical consultant at an edibles plant where I was conducting an interview mentioned that candy bars like that are supposed to be cut into 16 pieces for novices; but that recommendation hadn't been on the label."
Dowd, regardless of how or why, had made the same mistake that millions of other novice cannabis consumers have made: Eating too much cannabis-infused food (in this case, chocolate).
Understanding Cannabis Edibles. A 2016 study entitled "Teen Use of Marijuana Edibles: A Focus Group Study of an Emerging Issue" that was published in The Journal of Primary Prevention noted that recent studies have revealed that "marijuana-infused food product (i.e., edible) use is becoming nearly as common as smoking marijuana where medical marijuana is available."
The study examined edible use among teenagers who lived in the San Francisco Bay Area and were aged 15 to 17. The teen subjects were divided by gender and whether they used cannabis. "Some teens mentioned edible use at school" noted the study, which said edibles were chosen instead of smoking "primarily to reduce the likelihood of getting caught."
"Females were more likely than males to prefer edibles over smoking because they desire to avoid smelling like marijuana smoke."
The researchers noted that edibles are also attractive to consumers who do not like to smoke or who "have concerns about smoking." The study revealed that, among the participants, females were more likely than males to prefer edibles over smoking because they desire to avoid smelling like marijuana smoke. "For some young women, edibles may be a way to avoid publicly presenting themselves as marijuana users," hypothesized the study.
The study noted that cannabis edibles are readily available to young people. "Youth reported that they can purchase edibles at school from other students who either make the edibles themselves or are reselling edibles obtained from dispensaries."
Female non-users "appeared to be more concerned than others about edibles and compared them to drinks that could be spiked with drugs," reported the study. The study concluded that cannabis edibles were readily available to the San Francisco area teens who participated in the study and that many of them, particularly the female subjects, chose edibles merely because they desired to avoid being identified as a cannabis consumer due to the lingering aroma of cannabis smoke.
Understanding Cannabis Edibles. A 2019 in vivo study involving rodent subjects entitled "Self-administration of Edible Δ9-Tetrahydrocannabinol and Associated Behavioral Effects in Mice" that was published in the journal Drug and Alcohol Dependence explored the potential medicinal efficacy of cannabis edibles.
"There are relatively few animal models of self-administration of the primary psychoactive component of cannabis, Δ9-tetrahydrocannabinol (THC), and almost all incorporate routes of administration other than those used by humans," reported the study's authors.
"Edible THC presents a viable alternative to other administration procedures for cannabinoids."
The goal of the study "was to develop a model of edible THC self-administration and assess its impact on CB1 receptor-mediated behaviors in female and male mice." Mouse subjects were given "a palatable dough which occasionally contained THC in doses ranging from 1 to 10 mg/kg," reported the study. Following their consumption of the dough, the mice were tested for "locomotor activity, body temperature, and analgesia [pain reduction]."
Interestingly, the study noted that the dough was "well-consumed," but that "consumption decreased at the highest THC concentrations." It noted that the edible containing THC "produced dose-dependent decreases in locomotor activity and body temperature in both sexes," but that effects were more pronounced in male subjects. The CB1 receptor in the animal's endocannabinoid system was found to play a role in this mechanism.
The study concluded that the data it collected from the rodent subjects demonstrate that "edible THC is relatively low in stress and uses a route of administration analogous to one used by humans." The study also concluded that "edible THC presents a viable alternative to other administration procedures for cannabinoids."
2021 Study #1
Understanding Cannabis Edibles. A 2021 study entitled "Effects of Cannabis Ingestion on Endometriosis-associated Pelvic Pain and Related Symptoms" that was published in the journal PloS One investigated the potential efficacy of ingested cannabis edibles for patients suffering pain resulting from endometriosis.
This study involved an "electronic record-based cohort study...with self-reported endometriosis." A total of 252 participants logged 16,193 cannabis consumption sessions between April 2017 and February 2020 using a mobile application and self-rated the efficacy of their experience. This included symptom clusters such as cramps, depression, gastrointestinal pain, low libido, nausea, and pelvic pain. Data captured for these sessions included consumption avenue ("form"), dose, and cannabinoid ratio information.
"A total of 252 participants logged 16,193 cannabis consumption sessions between April 2017 and February 2020."
Because it documented consumption avenue, the study was able to reveal the relative efficacy of different methods. "Inhaled forms had higher efficacy for pain, while oral (ingested) forms were superior for mood and gastrointestinal symptoms," reported the scientists. Of the more than 16,000 sessions analyzed, the average dosage for ingested cannabis was one mg/mL.
The study revealed that consumption avenue influences the efficacy gained by patients. "Cannabis appears to be effective for pelvic pain, gastrointestinal issues, and mood, with effectiveness differing based on method of ingestion," reported the study. The study theorized that participants favored inhalation of cannabis over other forms of consumption due to the "rapid onset of pain-relieving effects" relative to eating or even sublingual tinctures.
"Oral forms appeared to be superior compared to inhaled forms in the less commonly reported mood or gastrointestinal categories," concluded the investigation. The scientists stressed that full clinical trials that investigate "the tolerability and effectiveness of cannabis for endometriosis pain and associated symptoms" are necessary to begin making conclusions or forming treatment approaches.
2021 Study #2
Understanding Cannabis Edibles. Another 2021 study, this one entitled "Cannabis and Cannabis Edibles: A Review" that was published in the Journal of Agricultural and Food Chemistry explored cannabis and some of the effects of edibles specifically.
"Cannabis is an excellent natural source of fiber and various bioactive cannabinoids," reported the study. The study noted that cannabinoids are volatile, delicate molecules that are "especially vulnerable to oxygen, heat, and light."
The study noted that cannabinoids are volatile, delicate molecules that are "especially vulnerable to oxygen, heat, and light."
The researchers discussed "the recent legalization of edible cannabis" and how it "extends its application into the food industry." They noted that legal edible cannabis products are "relatively monotonous" due to a rigorous regulatory framework and the infancy of the industry.
The study's abstract emphasized that "patents/studies related to the safety and quality...of cannabis edibles are still rare and need to be developed." It further noted that this research must encompass not only cannabinoids such as CBD and THC, but also "many phytochemicals such as flavonoids, lignans, terpenoids, and polysaccharides [that] exist in the cannabis matrix and...may exhibit prebiotic/probiotic properties and improve the composition of the gut microbiome."
Understanding Cannabis Edibles: Conclusions
Understanding Cannabis Edibles. Among all cannabis consumption avenues, edibles feature the longest onset period--something that is unacceptable for a number of conditions, including severe anxiety and pain, that require fast treatment.
"Although edibles feature slow onset, they offer many advantages over smoking and vaporization."
Although edibles feature slow onset, they offer many advantages over smoking and vaporization. Chiefly, edibles can be consumed discreetly and in a number of environments and social situations where smoking and vaping are frowned upon or prohibited.
Ingested cannabis also features lower bioavailability than other forms of consumption, primarily sublingual tinctures, due to the detailed digestive process involving the stomach and the liver.
For lifestyle consumers and patients who wish to avoid smoking or vaporization, edibles offer a pleasant way to consume potentially large doses of cannabis. For those who can tolerate the long wait for onset, edibles offer a valuable alternative to the most common consumption avenue, smoking.
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