Maximum Yield Cannabis USA March/April 2019 | Page 48
ask a
NURSE
Q
I’m considering using a cannabis suppository
but have read a lot of contradictory information
online. Is this a safe method? Will I get high?
Thank you for any information you can provide!
Samantha S.
a S
uppositories are a popular method of cannabis
administration and can be effective at treating
some conditions and disease. However, information
available on healthcare forums, blogs, and social
media posts includes prevalent misconceptions
about the efficacy of suppositories and erroneous
interpretations of the existing research. The following
information should enable you and others to make
more informed decisions about which delivery method
is best to treat their condition.
During rectal administration, fluids are absorbed by
the rectum’s blood vessels and are mostly directed into
the body’s circulatory system, which distributes the fluid
to the organs and bodily systems. Typically, a drug that
is administered rectally has a faster onset, a higher
bioavailability, a shorter peak, and a shorter duration
than when the same drug is administered orally.
Multiple factors affect the absorption rate of rectal
medications, including molecular size, water-solubility,
depth of insertion, dehydration, low surface area, and
the base of a suppository preparation. Additionally,
absorption rates of suppositories are slower than
that of other delivery methods and the rate at which
suppositories absorb is largely dependent on chemical
additives in the suppository. Currently, there is some
debate about whether rectally administered cannabis
can effectively treat conditions affecting the entire body.
Commonly-referenced research states that rectal
absorption rates of cannabis are as high as 50-70 per cent.
In these studies, however, delta-9-THC was coupled
with an ester hemisuccinate, which is an additive
designed to increase absorbency by breaking down
fat-soluble compounds into water-soluble compounds.
Other studies designed to test rectal absorption of
cannabis demonstrated that, without hemisuccinate,
rectal absorbency was three per cent or less. In fact,
there exists some general agreement that fats and oils
are poorly absorbed from the rectum. Cannabinoids
are lipids (fats) and cannabis products are nearly
always extracted into an oil or fat base, so it’s
reasonable to assume that whole-plant cannabis oil
products are poorly absorbed rectally. And, because
most preparations of cannabis suppositories do not
contain hemisuccinate, it is safe to assume most of
these preparations are not being adequately absorbed.
Clearly, more research is needed.
While Radicle Health occasionally recommends rectal
administration for conditions that can benefit from
a topical cannabis administration (such as fissures,
hemorrhoids, and rectal cancer), this route can
produce results that are incomplete, unpredictable,
and erratic. Importantly, Radicle Health does not
recommend rectal administration for patients
undergoing chemotherapy because of the increased
risk of infection and rectal bleeding. Patients should
always consult with a healthcare professional before
considering rectal administration.
DO YOU HAVE A QUESTION FOR A NURSE?
Email [email protected] to get an answer.
ET Eloise Theisen, AGPCNP-BC, is a dedicated and patient-focused nurse. For more than 17 years, she has specialized in aging,
cancer, chronic pain, dementia, Alzheimer’s, Parkinson’s, anxiety, depression, fibromyalgia, and various autoimmune and
neurological diseases.
eturning
cannabis health
care to healthcare
professionals.
48
Maximum Yield
We help patients use cannabis to
treat chronic illness, and we teach
healthcare professionals about using
cannabis as a treatment modality.
.com
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