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What's The Best Way To Take Medical Marijuana?

LdyLunatic

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USA -- Medical-marijuana users, take heart. So what if the Food and Drug Administration told the nation last month that marijuana has no medical benefits?
You've read about the widespread scoffing that followed, and the 1999 Institute of Medicine study that concluded marijuana might in fact ease some debilitating conditions. The ongoing debate is not just about whether medical marijuana works. It's about the best way to take it.

Choosing a marijuana delivery method involves weighing legality, safety and ease of use, and effectiveness. Back in 2004, when I was a staffer at the Marijuana Policy Project, an organization based in Washington, D.C., that works to legalize and regulate marijuana use, I met dozens of patients who used varying methods of marijuana consumption.

Since I don't have any medical training, I brushed up on the latest technology by speaking to medical-marijuana patients including Angel Raich, who will be forever remembered by first-year law students as the plaintiff in the Supreme Court case Gonzales v. Raich; Philippe Lucas, president of the Vancouver Island Compassion Society and one of about 1,200 legally registered medical marijuana patients in Canada; and Alison Myrden, another Canadian patient. The reviews of the various delivery methods are based on what they told me about their experiences.

METHODOLOGY

Security (10 possible points): Will using this product land you in jail? A legally prescribed product gets a 10. Everything else is rated based on the chances of getting arrested.

Safety (5 possible points): Might this product give you lung cancer or a respiratory ailment like bronchitis? Because many medical-marijuana patients already have cancer or seriously debilitating illnesses, this won't matter to everyone.

For more on attendant health risks, here's the medical journal BMJ's take. -- http://bmj.bmjjournals.com/cgi/conte...l/327/7416/635

Portability and Ease of Use (10 possible points): Can a sick or disabled person easily carry the product around or out of the house? And is preparation doable if you have a limited range of motion? Products that must be taken orally lose 5 points since many medical marijuana users suffer from nausea, which makes swallowing a pill or eating a brownie decidedly unappealing.

Medical effectiveness (25 possible points): The most important measure—How well does the product reduce pain and nausea, increase appetite, or enable sleep? Do the side-effects outweigh the benefits? Points are awarded for the nature of the beneficial effect, and how rapidly and predictably it sets in.
 

LdyLunatic

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RANKINGS (worst to first)

Marinol (dronabinol)

Marinol, a synthetic version of Delta-9-Tetrahydrocannabinol, or THC, the main active ingredient in marijuana, is legal with a prescription. It's also resoundingly unpopular. First off there's the problem of taking a pill if you're throwing up. ("I felt nauseated but was hungry at the same time, which is a stupid concept," Raich reports.) Worse, Marinol takes a long time to kick in, often more than an hour. And once it does take effect, the feeling patients get can be an overwhelming high that leaves them disoriented and unable to function. Marinol's manufacturer warns of "dizziness, feelings of exaggerated happiness, paranoid reaction, drowsiness, and thinking abnormally."

"Marinol doesn't work," says Raich. "I took the lowest dose possible and I got really, really sick from it. My heart felt like it was beating so hard I called my doctor." According to Lucas, the intensity of the effect comes from taking the pill orally. In the kidney, he says, the THC converts to a form four times stronger than when it's inhaled. "That's why people get so bloody stoned."

Security: 10
Safety: 5
Portability and Ease of Use: 5
Medical Effectiveness: 2
Value: 22


Pot Brownies

For the same reason that Marinol disappoints, many patients have reservations about brownies and other baked goods made with marijuana. Effects are often delayed for more than an hour, and like a pill, brownies are an inconvenient remedy if you're nauseated. On the other hand, patients I met while at the Marijuana Policy Project were adept at controlling dosages; cooking marijuana with butter and spreading it on toast or muffins was one way to consume small amounts.

Though medical marijuana is legal under state law in 11 states, even in those jurisdictions a patient can be arrested by the feds. The patients I knew appreciated baked goods for their discretion; it's a rare cop who will collar an elderly woman for a batch of brownies.

The patients I interviewed generally described baked goods as similar, but superior, to Marinol. Whereas Marinol is only synthesized THC, baked marijuana contains all the active ingredients of marijuana. "I eat it and drink it in tea," says Myrden, who lives with muscular dystrophy and a painful facial malady. Tea takes effect more quickly, but "eating lasts a lot longer. I can be up and running for six to eight hours."

Security: 8
Safety: 5
Portability and Ease of Use: 5
Medical Effectiveness: 11
Value: 29


Sativex

Putting marijuana into pill form eliminates the advantages of absorbing the drug through inhalation, which include increased dosage control and rapid onset of effect. The British-based GW Pharmaceuticals has devised a compromise by creating a full marijuana extract—THC and everything else—that is sprayed under the tongue. It is available on a limited basis in Britain and Spain but has been fully approved only in Canada, where Myrden says she was the first patient to use it. But not so happily. "Within a month, I was up to 50 sprays a day and still not getting relief for the pain in my face," she says. At about $3 a spray—51 sprays per vial—such use adds up. Another downside: Savitex is made from only one strain of marijuana, while doctors and patients find that different strains work best for different ailments.

Overall, patients gave the maker of Sativex an "A" for effort but felt the product fell short. Though onset of effect was faster than with brownies and Marinol, the method still lagged behind inhalation.

Security: 10 (in Canada—it's not available in the United States)
Safety: 5
Portability and Ease of Use: 10
Medical Effectiveness: 15
Value: 40 for Canadians. For U.S. patients, it won't be available for at least a few years—and, sorry, Rep. Barney Frank, D-Mass., doesn't bring any back with him.
 

LdyLunatic

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Pipes, Bongs, and Bubblers

Pipes, bongs, and bubblers have attractive qualities that come with the benefits of inhalation, such as easy control of dosage and quick onset. At the same time, they can be cumbersome. Myrden says she uses pipes occasionally with the help of a partner, but because she has lost use of her right hand, she has difficulty manipulating them on her own.

The conventional wisdom about bongs and bubblers—which draw smoke through water before it reaches the lungs—is that the water acts as a filter of unwanted tar and other noxious chemicals. Not so, says Lucas. "It cools down the smoke and nothing else. There really is no filtering effect." For those patients who thought they were getting cleaner, purer smoke by pulling tubes instead of smoking a joint, well, sorry.

Security: 7
Safety: 3
Portability/Ease of Use: 8
Medical Effectiveness: 23
Value: 41


The Volcano

The June issue of the Journal of Pharmaceutical Sciences will include a study on the medical effectiveness of the Volcano, a vaporizer that patients use to get the beneficial elements of marijuana while avoiding the smoke. Marijuana need not be burned to release its medicinal components. When the plant is heated to a degree short of combustion, its active ingredients become vapor and are released without the accompanying smoke. The Volcano traps those vapors in a bag, which patients can then inhale from. The device takes the traditional vaporizer—basically a heat-gun, a metal plate or bowl, and a tube—to another level of safety, mechanization, and price. At $539, it's far and away the most expensive marijuana-delivery method.

According to the journal article, with a Volcano, "The final … uptake of THC is comparable to the smoking of cannabis, while avoiding the respiratory disadvantages of smoking." You would think that would be good news for the Volcano's manufacturer, Storz & Bickel, a German company. Officially, at least, you'd be wrong. The Volcano may be "a safe and effective cannabinoids delivery system" according to the researchers. But according to the company, it is not a "medical device" at all. The lead American sales representative for Storz & Bickel said he hadn't heard of it.

Regardless, the patients I spoke to all had good things to say about the Volcano. "It's patient friendly. It's easy to maneuver," says Raich. "If you're someone who is fairly disabled and somebody who has mobility problems, the Volcano is right for you."

Security: 7
Safety: 5
Portability and Ease of Use: 6
Medical Effectiveness: 24
Value: 42


The Joint

The joint is the delivery method of choice Alison Myrden and Irvin Rosenfeld, a Ft. Lauderdale stockbroker. Rosenfeld, 53, doesn't have to roll his joints: Every 25 days the federal government mails him a canister filled with 300 joints as part of a program overseen by the FDA. He has been smoking marijuana every day for 35 years, he says, 23 of them legally. (The FDA killed the program in 1991, but patients already enrolled were grandfathered in; many of them were cancer or AIDS patients, and death has cut their numbers to fewer than 10.)

The joint's drawback is the amount of the drug that is lost. Lucas estimates that 50 to 70 percent of marijuana's active ingredients disappear into the air as the joint burns while the patient isn't smoking it. And while it burns, it gives off a strong scent of marijuana that can threaten patients' freedom if they are not one of the few legal users.

On the good side, joints allow patients to regulate their intake and facilitate a rapid onset of effects. "Nothing else works fast enough for me," says Myrden, who smokes 25 to 30 joints a day. Lucas' cannabis club owns a Volcano, but he still considers the joint the gold standard of delivery methods. "Smoking is the one that everyone is trying to catch up to," he says. For patients worried about the consequences of smoking, Lucas has a suggestion: "I guess theoretically they could use cigarette filters, but I haven't seen those save a lot of lives."

Security: 6
Safety: 3
Portability and Ease of Use: 10
Medical Effectiveness: 24
Value: 43
 

LdyLunatic

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Related in Slate

Last month, Sydney Spiesel debunked the FDA's politically motivated announcement that marijuana has no medical benefits. In August 2005, Seth Stevenson considered moving to Amsterdam, home to, among other things, some of the friendliest drug laws on the planet. Also that month, Dana Stevens reviewed Weeds, a Showtime sitcom satirizing suburban life. In 1999, Seth Stevenson tested mood enhancers purchased from his neighborhood purveyor of herbal substances—the GNC.

Complete Title: Hits and Misses: What's The Best Way To Take Medical Marijuana?

Ryan Grim writes for the Washington City Paper.

Source: Slate (US Web)
Author: Ryan Grim
Published: Friday, May 5, 2006
Copyright: 2006 Washingtonpost.Newsweek Interactive Co. LLC
 

rickyjack9

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i agree with the AMA, doctors common sense, and Brooke Shields
that smoking any burning stuff will eventually cause lung problems, period.
Thats our opponents main objections and how can we argue with that logic? we cant. ive smoked pot for over 40 years and now that im approaching 60 find my lungs are finally suffering a bit along with stamina, breathing.

the answer is VAPORIZING. But the volcano or a cheaper apparatus causes vapor to be given off, not smoke, so there goes the main opponents argument against smoking anything. which will harm the lungs in the future.
are you aware that vaporizing gives 2 or 3 times the thc that smoking gives
and without the carcenigens that smoke creates. so says Paul Stanford
(tv host) who used to smoke till his lungs/bronchials started causing him coughing fits, etc. Coughing will always have a negative connotation to non-smokers, doctors, etc. and this makes sense to me a 40 year smoker.
VAPOR methods are our future. some of us older smokers are experiencing lung/bronchial problems. thats a fact. You younger smokers think youre immune from this but someday it will catch up to you. I know from experience.
Im not into selling vaporizers, but if what Paul says is correct, it delivers a clean, almost clear vapor with 2 to 3 times the THC content. it pays for itself rather quickly.
and takes away one MAJOR objection that smoking anything is unhealthy, period. a joint may be more convenient but also contains some bad things things that vaporizing can alleviate. yes joints, bongs whatever is more popular at the moment but if vaporizing gives triple the THC compared to 'smoking/burning' then we need to consider it the healthier, more efficient way of medicine delivery. ask around for vapor opinions. all ive talked to swear by it. it wont happen overnight of course but if smoking is upgraded to vaporizing and gives 2 or 3 times the medicine output, then lets take away
the smoking burnt substances argument. even the vaporized residue is still
valuable in cakes or even smoking as it has some THC left in it. smoking just has that negative connotation. How can one convince a non-smoker or a doctor that its ok, acceptable and healthy? its just easier to smoke mj than vaporize it. but we need to open our eyes, invest in a vapor apparatus, receive 2 or 3 times more THC delivery. it would pay for itself rather quickly.
it reminds me of clean coal technology. change can be difficult, but i for one am a vaporizer believer. stop the coughing, nothing sexy about a coughing lung, but a smooth vapor with 2 to 3 times the potency and better taste makes sense to me. lets evolve. many will scoff at this notion but listen to the vapor people. they swear by it. or you can wait till youre 60 and be forced to quit, cut down, so get a vaporizer asap and rid our opponents of one of their main arguments against use of our sacred medicine, namely inhaling smoke that has some bad things in it. and save our lungs. further our cause. its a pain getting a vaporizer but its the future, i beleive.
and it makes logical sense does it not? be happy and safe and correct.
improve where plausible. Get the AMA off our backs. vaporize asap.
that way no one can complain that we 'smoke' bad stuff and harm our respiritory system. well, time to roll one since i don't have a vaporizer yet.
but its on my priority list. people who vaporize swear by it and more potent too. 2 to 3 times, WOW. sincerely 40 year smoker whose lungs are starting to ache occaisionally. im looking for a cheapo vaporizer. the price jumped once it got popular. capitalistic but its worth it. or find cheaper one.
like i said, talk to any vapor person. they are truly the enlightened ones.
and lung happy too which is way more important. choke on that, AMA.
communication is the key. knowledge is how we turn that key.
 

winstonwolf

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I am a vape user and proponent but I've noticed something about them that I've never seen discussed.

In my experience, there's a great deal of variation from one stash of MJ to another when it comes to vaping... far less so than I experience with smoking. Some weed just doesn't vape well. (That same weed might smoke fine.) Has anyone else noticed this?
 

Smokey Mcpotster

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I have notice that some types take more heat to get going. From what I have read different types of thc release at different temps. Lower temps 360-380 give more "headdy" effect. At higher temps. 390-410 give the "couch lock" effect. The one thing I noticed when I started vaping was how clean and uplifting it was. Very easy to "get busy" with projects I have. It's still in the beginning but there are quite a few sites/articles to read. I have a home made one- lightbulb (google, easy to make)- until the one I ordered comes in a couple of weeks. I bought a portable one that runs off of a AAA battery, pretty slick for on the go. Eventually I wan't to get a home unit with adjustable temp. control.

Also the volcano recieves all the talk. $600:eek:

Happy smokin'
Do some research, some very good quality vapes for 175-250$ Silver surfer,Dabuddah, Extreme come to mind. Worth looking into imo.
 

winstonwolf

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Smokey Mcpotster said:
Do some research, some very good quality vapes for 175-250$ Silver surfer,Dabuddah, Extreme come to mind. Worth looking into imo.
I'm very satisfied with my Extreme (although, in all fairness, I should mention that it's also the only vaporizer I've ever used).
 

Smokey Mcpotster

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I understand Art:D . It's been a long time for me as well. If you ever get a chance to try one, I would. I think you will like the taste. For me it was to conserve smoke. That first sweet taste sold me.

Winston- I looked at the v-tower, I'm not much for bags. That's a sweet vape tho. :D:D. With the fishing opener here, I'll be outside a lot, so I ordered the portable. I'm looking at a Da Buddah or possibly a V tower AFTER I get my grow started. I want something with an adjustable temp, like you noticed some burn better than others.
 

WeedHopper

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Me and the Wife are both in our 50's and we cant wait to get the Volcano. Tired of Smoking and Coughing. We use Pipes and Bongs. Havent smoked a joint in a long time. No doubt that Smoking is hard on your lungs. I am starting to develope a cough and I hate it. I quit smoking ciggs a year ago and my lungs do feel much better but I can tell the Pipes aint helping the cause. BUt,,untill we get the Volcano,,Its the Bong for me.
OH,,and I have tried a few cheap Vaps and they sucked. You cant Vap if ya cant control the temps, and the cheap ones ya cant control the temps. You eather get it to hot and it burns the weed or not hot enough to Vap it.:rolleyes:
But Im with ya,,Vaps the way to go if ya have the Doe.
 

Smokey Mcpotster

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Shock- Flavor is great. You get the real taste of the herb, very sweet. I'm pretty sure most vapes have ceramic heater elements. Most of the parts are glass. The tube that brings the air from the heater and the bowl were glass on the models I looked at. Something to look into and try if you get the chance. I agree with the price issue. It's still rising in popularity, so I would think prices will get more competitive.
 

Shockeclipse

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Smokey Mcpotster said:
Shock- Flavor is great. You get the real taste of the herb, very sweet. I'm pretty sure most vapes have ceramic heater elements. Most of the parts are glass. The tube that brings the air from the heater and the bowl were glass on the models I looked at. Something to look into and try if you get the chance. I agree with the price issue. It's still rising in popularity, so I would think prices will get more competitive.
I am really temped to purchse one but I think ai may wait a while until prices go down. The shop around the corner has a few and they range from 600-1000+. Theres no way I could justify spending that to my fiancè lol.
 

smokster

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we (me and my wife) got our volcano for christmas and love it. we havent smoked a joint since. i use to love a good bong hit first thing in the morning, but this thing is even better. your stash will last longer, your buzz will last longer and the taste is the best part. the high you reach is unreachable with a joint. the first time i smoked the volcano, i hit it five times, walked down to the lake, went to change the radiator on my jeep, popped the hood on it, took out the four bolts that hold it in and got side tracked for a few minutes. next thing i knew, i had lost two of the four bolts and have never found them. then i caught myself hiding behind the hood of my jeep everytime a car went by. im in my late 40's and been smoking forever and this was the first time i felt like this in many moons, i loved it!!!!! never looked back, been smokin the volcano everyday since.
 

ArtVandolay

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Shockeclipse said:
Does vaporizing give you that flavor still? I prefer smokng from a clean glass aparatus but I hav never used a vaporizer, too expensive IMO.
I completely agree. And, there is so much I'd rather do with $600. Beginning with 6" fans and ducting. :)
 
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ArtVandolay said:
I completely agree. And, there is so much I'd rather do with $600. Beginning with 6" fans and ducting. :)
> i can't justify the price at 600+ bones. i'm a gonna get my buzz either way. i dont care if i'm smoking from a pipe , a homemade bong, an apple, a corn cob pipe, or a piece of wood. i'm gonna get mine anyway i know how w/o high cost.

and like my buddy art says:hubba: , 6" fans, and ducting cost around 250.;) .
then i got enough left for those new tires...bb...:p
 

smokster

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i just use oven bags, they are cheap and are the perfect size......it is a lot of money for the volcano, but it cuts back on how much weed you go through, so it pays for itself in a short time. (thats what i keep telling myself)
 

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