EDIBLES VS. INHALED CANNABIS PRODUCTS

Cannabis products come in all shapes and sizes. These products are often broken down into how they are consumed, or how the active ingredients are entering the body. Generally, the two main categories are cannabis products that are consumed orally, better known as edibles, and cannabis products that are inhaled. Both edible and inhaled products contain the same active ingredients, known as cannabinoids, but the way these cannabinoids enter the body to exert their effects is drastically different.

When cannabis is smoked or vaporized, cannabinoids like delta-9-tetrahydrocannabinol (THC) are released into the smoke or vapor. This allows the smoke to then be inhaled into the lungs where the cannabinoids can be absorbed into the blood (Huestis et al., 1992). This is also a key step in activating cannabinoids like THC. Heating the cannabis flower or bud causes a process called decarboxylation. This process transforms the cannabinoids from their naturally occurring, inactive form to their active form which can interact with various tissues in the body.

Conversely, most edible products are typically made from a process that uses solvents to latch on to and remove the cannabinoids from the plant. These solvents can then be removed from the cannabinoids to create a purified extract or concentrate (Michalizzi et al., 2021). These concentrates can then be dissolved in oils because cannabinoids, like THC, are lipophilic (McClements, 2020), meaning they dissolve in fats. These extracted cannabinoid compounds can then be made into edible products such as candies or baked goods. It is important to note that although concentrate products are described here pertaining to edible consumption specifically,  another common route of administration for concentrates is inhalation.

Fun Fact: Did you know that approximately, 4.81 million edible cannabis products are sold in the state of Colorado each year? This accounts for nearly 45% of all cannabis sales in the state! That’s a lot of candy.  

Which type of product is safer, edible or inhaled?

Instinctively, you may think that edible products are safer. You may associate inhaled cannabis products with tobacco cigarettes, and we all know the negative impact tobacco use can have on our health. This may come as a surprise, but the answer of which is safer isn’t as cut and dry as you might expect.

Inhaled Products

Research has shown that a single use of cannabis can provide short-term bronchodilatory effects, meaning it helps expand the airways allowing air to flow easier into and out of the lungs. It is for this reason that cannabis has been used as a treatment for asthma since the 19th century (Kaplan, 2021). However, these effects subside after only a couple of hours.

Long-term cannabis use via inhalation may be less beneficial. One study, published in 2022, found that cannabis use was associated with reduced lung function. Yet, the authors do note that this was largely due to cannabis users having larger lung volumes than their non-user counterparts. It was also noted that the major impact of inhaled cannabis use on respiratory health may be the result of impaired gas transfer between the lungs and the blood (Hancox, 2022).

The precise mechanism of action of inhaled products has not yet been fully discovered and may indeed vary depending on the method of use. There are a variety of ways to inhale cannabis including joint, bong, pipe, vape, dabs, and blunts, but it is still uncertain if one or more of these methods carries more risk than any of the others.

Edible Products

So far it has been difficult to fully assess whether edible products consumed as intended have side effects similar to or different from inhaled products. This is in part due to most of the research exploring edible products being done with relatively low doses in a controlled, clinical setting. In this controlled environment, it is difficult to evaluate the real-world risks of edibles. For example, the major risk of edible products come with ingesting too much, and that’s something we can’t evaluate in a clinical research study. It’s also challenging to test the effects of higher doses of THC or the presence of contaminants, as it wouldn’t be ethical to give participants higher doses of THC than they were used to or give them contaminated edibles.

Luckily, there is ongoing research at CUChange in Boulder, CO that is exploring and assessing the use of edible products in a more practical, real-life setting outside the walls of a laboratory. In this center, research participants consume self-selected doses of edible products inside their own homes and then complete assessments for a variety of psychological and physiological variables (Bidwell et al., 2022).

Another aspect of edibles to take into consideration is the fact that most of these products are sold as chocolate, gummies, brownies, and cookies. These products may be easily mistaken for non-cannabis products, particularly by children. It is therefore especially important to ensure that these products are kept out of reach of children to avoid inadvertent intoxication. A study conducted analyzing phone calls to the Oregon/Alaska Poison Center over 2 years found that 28% of these calls were for children under the age of 12 years old who had accidentally ingested edible cannabis products (Noble et al., 2019). In addition, research suggests that the rate of these accidental exposures may be increasing (Chao et al., 2016).

How long does it take to feel the effects?

One final aspect to take into consideration when comparing edibles to inhaled products is the time it takes for them to enter your system and start exerting effects.

The route for inhaled products to enter your system is much more direct than it is for edible products.  When the smoke from inhaled products enters your lungs, it can directly diffuse from your lungs into the blood. The cannabinoids in your blood are then circulated throughout your body and can exert their effects. These effects can be felt very quickly and usually peak within approximately 15-minutes (Spindle et al., 2021). While the effects of inhaled products are quick to take effect, their effects also dissipate rather quickly.  

Edibles on the other hand take effect much slower. Peak intoxication with edibles can take anywhere from 1-2 hours with the intoxicating effects lasting much longer than inhaled products (Spindle et al., 2021). Because edibles can take so long to take effect, it’s not uncommon for individuals to get impatient and consume more product before their first edible takes full effect. This can lead to over-intoxication and an overall bad experience.

Although there are no reported deaths caused solely by acute cannabis toxicity, exposure to too much cannabis is associated with negative effects. Symptoms of acute cannabis toxicity may include drowsiness, tachycardia (an unusually fast heart rate), agitation, confusion, nausea, and vomiting (Noble et al., 2019).

Conclusions

In summary, edibles may be more likely to lead to accidental overexposure and thus negative effects. Because of this, even though there may be some negative effects associated with inhaled products, it would be overly simplistic to make a blanket statement that edibles are safer than inhaled forms of cannabis. Context is important when deciding what route of administration to use. If use is for medical purposes, individuals should work with their medical care team and/or someone knowledgeable about cannabis products to decide what product type will minimize the risk of unwanted effects.

Contributing Authors: Madeline Stanger, WenHao Ma, Josh Elmore, & Jonathan Lisano 

Check out the studies below for more information:

Bidwell, L. C., Karoly, H. C., Torres, M. O., Master, A., Bryan, A. D., & Hutchison, K. E. (2022). A naturalistic study of orally administered vs. inhaled legal market cannabis: cannabinoids exposure, intoxication, and impairment. Psychopharmacology, 239(2), 385–397. https://doi.org/10.1007/s00213-021-06007-2

Cao, D., Srisuma, S., Bronstein, A. C., & Hoyte, C. O. (2016). Characterization of edible marijuana product exposures reported to United States poison centers. Clinical toxicology (Philadelphia, Pa.), 54(9), 840–846. https://doi.org/10.1080/15563650.2016.1209761

Huestis, M. A., Henningfield, J. E., & Cone, E. J. (1992). Blood cannabinoids. I. Absorption of THC and formation of 11-OH-THC and THCCOOH during and after smoking marijuana. Journal of analytical toxicology, 16(5), 276–282. https://doi.org/10.1093/jat/16.5.276

Hancox, R. J., Gray, A. R., Zhang, X., Poulton, R., Moffit, T. E., Caspi, A., Sears, M. R. (2022). Differential effects of cannabis and tobacco on lung function in mid-adult life. Amer J Resp and Critical Care Med. 205(10). https://doi.org/10.1164/rccm.202109-2058OC

Kaplan A. G. (2021). Cannabis and Lung Health: Does the Bad Outweigh the Good? Pulmonary therapy, 7(2), 395–408. https://doi.org/10.1007/s41030-021-00171-8

McClements D. J. (2020). Enhancing Efficacy, Performance, and Reliability of Cannabis Edibles: Insights from Lipid Bioavailability Studies. Annual review of food science and technology, 11, 45–70. https://doi.org/10.1146/annurev-food-032519-051834

Micalizzi, G., Vento, F., Alibrando, F., Donnarumma, D., Dugo, P., & Mondello, L. (2021). Cannabis Sativa L.: a comprehensive review on the analytical methodologies for cannabinoids and terpenes characterization. Journal of chromatography. A, 1637, 461864. https://doi.org/10.1016/j.chroma.2020.461864

Noble, M. J., Hedberg, K., Hendrickson, R. G. (2019). Acute cannabis toxicity. Clin Toxicol (Phila), 57(8):735-742. https://doi.org/10.1080/15563650.2018.1548708

Spindle, T. R., Martin, E. L., Grabenauer, M., Woodward, T., Milburn, M. A., & Vandrey, R. (2021). Assessment of cognitive and psychomotor impairment, subjective effects, and blood THC concentrations following acute administration of oral and vaporized cannabis. Journal of psychopharmacology (Oxford, England), 35(7), 786–803. https://doi.org/10.1177/02698811211021583