Due to its wide range of medicinal applications, cannabis comes in various delivery forms to meet the demands of patients with a wide range of medical ailments. Cannabis affects multiple systems of the body, leading to a manifestation of different physical and mental effects. Different routes have different benefits and drawbacks that can delay or speed up the user’s experience. This paper looks at four common ways of administering cannabis, analyzing its advantages and disadvantages, including inhalation, oral ingestion, sublingual administration, and topical application routes. If healthcare workers and patients are aware of these distinctions, they can better advise patients on the best method of cannabis delivery for their specific needs.
Mechanism of Action
Cannabis, a plant with both medicinal and recreational uses, has piqued people’s interest for ages. The endocannabinoid system (ECS) regulates its complex interaction with the human body. Discovered in the 20th century, this biological network is essential to maintaining homeostasis. Cannabis affects the ECS by modulating a wide range of physiological processes through a complex interaction between receptors, endogenous cannabinoids, and enzymes (Schilling et al., 2020). Endocannabinoid deficiency syndrome (ECDS) can occur when the ECS is underdeveloped, underscoring the importance of this intriguing system.
The endocannabinoid system is an intricate network in almost all human tissues and organs. Cannabinoid receptors (CB1 and CB2), endocannabinoids, and metabolic enzymes responsible for their synthesis and degradation are its three essential components (Lu & Mackie, 2020). The central nervous system is rich in CB1 receptors, while the immune system and peripheral tissues contain a disproportionate number of CB2 receptors (Lu & Mackie, 2020). Anandamide and 2-arachidonoylglycerol (2-AG) are endocannabinoids that bind to cannabinoid receptors.
When ingested, cannabis introduces a wide variety of phytocannabinoids, the most well-known of which is delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD). CBD is non-psychoactive and is gaining popularity due to its possible therapeutic advantages, while THC is the principal psychoactive ingredient responsible for the euphoria associated with cannabis use (Schilling et al., 2020). Once within the body, these phytocannabinoids bind to and activate the CB1 and CB2 receptors, emulating the effects of endocannabinoids. The biochemical responses triggered by this activation include pain alleviation, altered mood, and stimulated appetite (Schilling et al., 2020).
The endocannabinoid system acts as a homeostatic regulator, maintaining homeostasis in the body despite disturbances from the outside world. Depending on the cannabinoid and the targeted receptors, the ECS’s interaction with ingested cannabis can stimulate or inhibit specific physiological processes (Schilling et al., 2020). CBD’s interaction with CB2 receptors in the immune system may reduce inflammation and alleviate pain, whereas THC’s activation of CB1 receptors in the brain results in altered perception and mood.
The endocannabinoid system has an exceptionally high concentration in the hippocampus and prefrontal cortex, suggesting that these brain regions play an essential role in memory, cognition, and emotion processing (Lu & Mackie, 2020). As a result, cannabis usage, particularly at high dosages or during critical developmental phases, may affect working memory and other cognitive processes. Cannabis may have medical applications, but it is essential to exercise caution when using it excessively or for an extended period because it can cause tolerance, dependency, and undesirable side effects. Over time, CB1 receptors in the body may become less sensitive to endocannabinoids, necessitating higher cannabis doses to get the same effects (Schilling et al., 2020). This demonstrates the adaptability of the ECS and its capacity to exert a moderating influence on the surrounding environment.
Recent research into the ECS and its functions in various illnesses led to the concept of ECDS. According to the ECDS theory, specific individuals may have insufficient endocannabinoid signaling, which can result in a wide variety of symptoms and various health issues. Even though it is not officially recognized, ECDS has been connected to physical disorders such as fibromyalgia, migraines and psychological problems such as sadness and anxiety.
According to Schilling et al. (2020), some individuals struggle to maintain control of their feelings and their levels of inflammation and discomfort. Cannabis use is one of the treatment techniques that scientists have developed that boosts the ECS. These approaches may be helpful for people who have ECDS. Marijuana has several negative impacts on cognitive performance. It has the potential to cause tolerance and dependence, so it is vital to use it sparingly and keep in mind the risks involved.
Routes of Delivery
- Inhalation (Smoking and Vaporization)
One of the quickest ways to feel the effects of cannabis is to inhale it. Cannabinoids in smoked or vaporized cannabis enter the bloodstream quickly through the lungs, causing the drug’s effects to become noticeable quickly, typically within minutes. Since it works so fast, inhalation is a good choice for people who need relief from severe pain, nausea, or anxiety right away (Richter et al., 2021).
Pros: Inhalation has practically instantaneous effects, making it an excellent choice for treating acute symptoms and delivering fast relief.
Cons: There are risks to respiratory health from smoking cannabis, such as inhaling toxic combustion byproducts.
- Oral (Edibles and Oils)
Cannabis edibles and oils are the most popular forms of ingestible cannabis. It takes significantly longer (30 minutes to 2 hours) than with inhalation for the effects to begin to take action (Richter et al., 2021). It is challenging to determine the optimum dosage because patients may overdose if they do not experience the effects promptly after taking the medicine.
Pros: The effects of cannabis products taken orally can last from four to eight hours. Therefore, they are ideal for those who require continuous relief but cannot take their medication often.
Cons: Due to the delayed onset, patients may mistakenly overdose if they take additional doses thinking they have not gotten the desired effect yet.
- Sublingual (Tinctures and Sprays)
The placement of cannabis tinctures or sprays under the tongue allows for the quick absorption of cannabinoids via the sublingual glands. The effects typically become apparent within 15 minutes, significantly faster than when taken orally (Dhein, 2020).
Pros: Sublingual delivery gives patients a faster-acting choice for relief than oral ingestion.
Cons: Some tinctures and sprays’ sour or gritty taste may put off some patients.
- topical products (creams and balms)
Topical treatments containing cannabinoids derived from cannabis can enter the body and bind to specific cannabinoid receptors. Some people may feel the effects in minutes, while others may need more time.
Pros: Patients who want to avoid systemic effects may prefer topicals since they provide targeted relief for pain, inflammation, and skin concerns.
Cons: While topicals can assist in curing localized symptoms, they may not be as helpful in treating systemic diseases.
The complex relationship between cannabis and the endocannabinoid system (ECS) has puzzled humans for centuries because of the drug’s therapeutic potential. Cannabis acts on the ECS, a network of receptors, endocannabinoids, and enzymes, to produce a variety of responses in the body because of the ECS’s role in regulating many physiological processes. The concept of endocannabinoid deficiency syndrome (ECDS) further emphasizes the role of ECS in homeostasis and health.
Dhein, S. (2020). Different effects of cannabis abuse on adolescent and adult brain. Pharmacology, 105, 1–9. https://doi.org/10.1159/000509377
Lu, H.-C., & Mackie, K. (2020). Review of the endocannabinoid system. Biological Psychiatry: Cognitive Neuroscience and Neuroimaging, 6(6). https://doi.org/10.1016/j.bpsc.2020.07.016
Richter, G., Hazzah, T., Hartsel, J. A., Eades, J., Hickory, B., & Makriyannis, A. (2021). Cannabis sativa: An overview. Nutraceuticals, 603–624. https://doi.org/10.1016/b978-0-12-821038-3.00038-0
Schilling, S., Melzer, R., & McCabe, P. F. (2020). Cannabis sativa. Current Biology, 30(1), R8–R9. https://doi.org/10.1016/j.cub.2019.10.039
Cannabis 101 for Nurses
Write a 1000-1500 word essay addressing each of the following points. Be sure to completely answer all the questions for each bullet point. There should be two main sections, one for each bullet below. Separate each section in your paper with a clear heading that allows your professor to know which bullet you are addressing in that section of your paper. Support your ideas with at least three (3) sources using citations in your essay. Make sure to cite using the APA writing style for the essay. The cover page and reference page in correct APA do not count towards the minimum word amount. Review the rubric criteria for this assignment.
Explain how cannabis works in the body by including information regarding the endocannabinoid system (ECS) and endocannabinoid deficiency syndrome.
Describe four different delivery routes patients may use cannabis, the onset of action for each, and one pro and one con of each route.
M5 Assignment UMBO – 1, 2, 4
M5 Assignment PLG – 2, 6
M5 Assignment CLO – 2, 5
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