Not all medical cannabis is made equal, an obvious statement as nutraceutical and pharmaceutical companies race ahead to innovate products. But how does one product differentiate from another? Delivery is one differentiating component, but not all delivery systems yield the same result. Let’s look at one of the current leader in delivery of CBD and THC – suspension in oil.
Why do people like it? Well, for a start – you don’t smoke it and that sits well with many. Arguably it is easier to deliver the specific quantity of active ingredients which the patient requires as you can dial up or down on a patient led needs basis. It is easy for individuals who are swallowing compromised. Children can drink it over popping a pill. The list goes on.
So what is the problem? The downsides rotate around bioavailability, stability and contamination.
Bioavailability determines the rate of absorption, and how you ingest cannabinoids makes a huge difference. Ingesting orally can be significantly less effective than other methods, such as sublingual which has been shown to be much more effective, so suspension in oil may not be optimal in terms of how much of the active ingredients are made available to the body. One also needs also to factor in the period of time of absorption, and a longer absorption period provides better efficacy for most diseases which are treated with medical cannabis. Long release pills and patches (as examples) may therefore have an edge on oil suspension
Arguably bioavailability is the easy one as it can readily be tested for prior to use. What about stability and contamination due to patient activity? These are lesser well studied given breaching a bottle of medical cannabis suspension in oil which is then treated differently by patients can lead to unexpected results. What are the environmental conditions in which the bottle is stored? How is the patient administering the drug, do they touch the delivery implement with their tongue? Are they sucking the last of any drops out of a dropper and returning the dropper to the bottle, introducing contaminants (e.g. bacterial) which then affect the product? So many patient led variables lead to many unknowns and many potentially unknown unknowns given conditions outside of a lab cannot all be pre-identified and potential outcomes tested accordingly.
What does this mean for medical cannabis? Likely a sector-wide move to more tightly defined delivery mechanisms (such as sprays and capsules) to ensure more exact dosing, bioavailability, stability and product integrity is achieved, with the result that medical cannabis walks and talks more like a pharmaceutical and less like a nutraceutical as the industry progresses.
This is good news to proponents of the industry, driving further movement towards greater mainstream acceptance of medical cannabis.