Jay R. Cavanaugh, PhD
August 2002

One of the major criticisms of cannabis as medicine is the idea that it must be smoked. The vast majority of physicians and health care workers have been trained to discourage smoking wherever possible as part of the campaign against tobacco.

While smoked cannabis is not nearly as harmful as smoked tobacco it is important to recognize that there are both benefits and risks to smoking as a route of administration. The primary risk is respiratory inflammation including bronchitis. Much of the cannabis currently available is rather crude and produces a hot smoke that can irritate delicate lung tissues and aggravate existing respiratory problems. These problems alone are enough for the majority of physicians to refrain from recommending cannabis as medicine. Arguments detailing the expectorant, anti respiratory pathogen effect, and anti neoplasm effects of cannabis are insufficient for physicians and many patients to feel comfortable with smoking medicine.

The benefit from smoking as a route of administration is instant action and the ability of the patient to self titrate the dose needed for relief. Here we describe how patients can achieve similar quick acting relief and the ability to control dose without smoking. It is important that the medical community understand that whole cannabis products are available today that provide significant relief without smoking. We don’t have to wait for a pharmaceutical pill to be developed years in the future in order to have the benefits of cannabis. The present pill (Marinol) has proven very unsatisfactory due to a long delay of action time, poor absorption in the GI tract, and its failure to include many of the antioxidant and anti-inflammatory cannabinoids present in whole cannabis and its extracts. In addition, future pharmaceuticals will be wildly expensive.

The second (and newer) major method of non smoking cannabis delivery are vaporizers. All vaporizers essentially use a controlled heating element that raises the temperature of whole cannabis samples (flowers) just to the point where the cannabinoids vaporize. There is no combustion with vaporization and no chemical conversion from heat. There is no hot smoke to irritate the lungs and no annoying combustion byproducts. Vaporizing is far more efficient in delivering medicine than smoking so in the long run "vaping" is far cheaper than smoking as well as much healthier. Just as with smoking, a patient inhales a dose of vapor and waits one or two minutes to evaluate the effect. Patients can use only that amount that is necessary for the relief of symptoms. An added benefit of vaporizing is that there is little cannabis odor when vaping which can be important for both security reasons and general decorum. There are a wide variety of vaporizer systems that vary greatly in ease of use and cost. Here are links to some of the major vaporizers that our readers say work best for them:

Many of today’s medical cannabis patients utilize vaporizers, tinctures, and oral cannabis food products. Some patients have never smoked (either cannabis or cigarettes) and don’t have to in order to obtain the full benefit of cannabis medicine. Other patients maintain basic cannabinoid levels with tincture or food products and then only smoke when they experience acute distress from their illness. These patients could just as easily vaporize for these acute episodes.

Thus, inexpensive, healthy, and effective methods of cannabis drug delivery exist today. Patients and physicians do not have to wait for "better" delivery systems. Patients and caregivers are very adept at producing standardized and consistent products with known effects. While progress can and should be made in characterizing and researching cannabis medicines, they are available today for the relief of a wide range of illnesses and disorders.