As the legal environment for cannabis changes to a more open and tolerant framework for recreational users (in some countries, at least), clinical data are becoming more available. The increasing use and applications of medical marijuana across the developed world is opening up treatments for a wide variety of different conditions including nicotine addiction.
Unfortunately, the scientific literature on cannabis and its use is not as complete as legislators and prescribers would like. There are significant gaps in the knowledge of methods of administration, appropriate doses, and long-term safety profiles of cannabis products. The wide variety of different cannabis products and ways to take them presents those studying cannabis with a unique set of problems: how to compare and contrast use and effect.
Here is the full scientific article if you wish to download it.
This study was a self-report questionnaire on the internet with 21 structured questions. 953 participants from 31 countries took part, the largest ever of this kind of survey. Overall, the herbal non-pharmaceutical cannabis products were higher rated than the pharmaceutical options. Participants’ exposure to pharmaceutical cannabis products was low, even though a majority of participants were using cannabis for medicinal uses. The purpose of the study was to establish whether different forms of administration had different advantages and disadvantages.
Synthetic and isolated cannabinoids (CBD) like dronabinol (THC) and nabiximols were generally regarded as less effective, tolerable, and effective than herbal cannabis. The reasons for this are not thoroughly explored in this paper but seem to be because of familiarity, the lower doses required, faster onset and the significantly lower levels of side effects reported.
Even when prescribed alternatives were available, herbal cannabis still rated higher in almost every field except patient satisfaction, which was universally low. Vaping was the most side-effect free method of delivery, followed by smoking. Nabilone was the least satisfying. The presence of over 100 cannabinoids in the cannabis plant might be the reason for this higher tolerability compared to single cannabinoid use.
Some methods were more advantageous in some ways than others and more disadvantageous in other ways. Smoking cannabis was seen as the most effective delivery method and producing some of the best effects, however, it irritated the lungs, was often accompanied by tobacco and is known to be deleterious to health. While synthetic cannabinoids were easy to administer, they were less effective overall. The picture is a confused one.
Although most users reported that cannabis was at least partly successful in relieving their symptoms, none of the methods was rated highest overall in terms of satisfaction. Cost and the risks associated were thought to be the main reasons, even when they were covered by medical insurance.
Medical cannabis users would on average prefer a cannabis tincture containing a full spectrum of cannabinoids. This would eliminate smoking , enable vaporizing, cost less, and be more consistent than variable herbs.
While more surveys need to be carried out to address the large holes in the data, the picture this study presents is one of overall good satisfaction with whole plant preparations that are inhaled, less so with other methods.