Methods for Consumption
Below we will outline the most common ways to consume cannabis and outline the typical time of onset and duration of effect. We will also address pros and cons in some cases, as well as summarize typical starting doses.
Smoking and/or Vaporizing
Typical onset: 2-10 minutes
Duration: 1-2 hours
Smoking is the most common way patients consume cannabis. It has a moderate bioavailability. Doses can be easily titrated to effect and its rapid onset are considered recognized benefits. Smoking can cause general lung irritation, so vaporizing is considered an easy and safer alternative to smoking. Many patients perceive effects within a few puffs, which allows patients to have a high degree of control over dosing.
Typical onset: 30-120 minutes
Duration: 4-8 hours or longer
Edible cannabis products have a delayed onset. This is where following the motto "start low and go slow" is imperative. Most cannabis naïve patients should begin with doses of 2.5-5 mg, and titrate dose based on effect after 2 hours. THC is converted by the liver to a much more psychoactive form following ingestion, which can cause patients to have considerable adverse effects if too high of a dose is consumed. See our next section on limiting side effects for more information on using edible products.
Typical onset: 5-45 minutes
Duration: 2-4 hours
Sublingual dosing has become a common way of ingesting cannabis products. The bioavailability is high. The effects start rapidly and last longer than smoking. The dosing is more reliable and more consistent than edible products. A proper starting dose would be 2.5mg and can be titrated based on effect.
Topical preparations of cannabis can be very helpful to some patients and cause no psychoactivity or "high". They can be used to help decrease pain and inflammation locally. They can be applied fairly liberally and often.
While not a dosage form used in the majority of patients, suppositories are a legitimate way to utilize cannabis. The bioavailability of cannabinoids is high, with most patients reporting little to no "intoxicating" effects. They can be utilized in patients who want to target the lower torso specifically, or by patients who have damaged or altered upper GI tracts.