When it comes to recommending prescription medications, doctors and pharmacists need to consider the principle of bioavailability. It is a principle your average consumer is not aware of for the simple fact that we really don’t need to know a lot about it. But if you are a medical cannabis patient, bioavailability could make a difference to your chosen delivery method.
The Basic Principle of Bioavailability
Bioavailability is a medical term that describes the amount of a substance made available for addressing the issue at hand. Imagine a cannabis tablet that contains THC along with a variety of terpenes and the inactive ingredients that go into making tablets. How much of the THC is available to the body following ingestion? The measurement of that volume would be the product’s bioavailability.
Doctors consider bioavailability when prescribing medications for the sole purpose of ensuring that a patient experiences maximum symptom relief. Unfortunately, medical cannabis is not dispensed by way of a formal prescription. Medical cannabis patients are free to choose their preferred delivery methods. They ultimately end up determining their own dosage as well.
Bioavailability and Common Delivery Methods
Each of the different delivery methods influences a medication’s bioavailability. The only delivery method that offers 100% bioavailability is intravenous (IV) delivery. An IV procedure introduces medicine directly into the bloodstream for immediate and complete absorption.
Medical cannabis patients need not worry about IV delivery. To my knowledge, no states allow such delivery. That leaves patients to choose from among the following:
- Inhalation – high bioavailability
- Sublingual – moderate to high bioavailability
- Oral ingestion – low to moderate bioavailability
- Topical – variable bioavailability (depending on product)
- Suppositories – moderate bioavailability
Medical cannabis pharmacies are known to sell products from all five categories. But according to the operators of Salt Lake City’s Beehive Farmacy, inhalation and sublingual delivery are the most popular. Utah patients choosing inhalation can purchase either vaping products or plant material to be used and a specialized dry heating device.
Sublingual products are sold as tinctures or concentrated oils. You put a drop or two under your tongue and that’s it. THC is absorbed into the bloodstream through the skin of the mouth.
Bioavailability and Symptom Relief
Medical cannabis is similar to other types of drugs in the sense that bioavailability has a direct impact on symptom relief. For purposes of illustration, let us compare vaping with consuming a gummy product.
Vaping offers a much higher bioavailability. And because anything inhaled into the lungs gets into the bloodstream almost instantly, vaping medical cannabis offers very quick symptom relief. The downside is that symptom relief doesn’t last all that long. THC exits the bloodstream fairly quickly.
As for the medical cannabis gummy, it has a lower bioavailability. A gummy must pass through the digestive system in order for THC to be absorbed into the bloodstream. Some of the THC is lost in the process. The result is that symptom relief takes longer to kick in. But there is a positive side: since digestion takes longer, symptom relief also lasts longer.
A Pharmacist Knows the Score
Any medical cannabis patient struggling to figure out delivery method and dosage should not hesitate to speak to the pharmacist at his local dispensary. A pharmacist knows the score.
A pharmacist is a medical doctor with specialized training in pharmacology. Pharmacists study the human endocannabinoid system and how things like medical cannabis affect it. GPs and family doctors do not, so they might not be as helpful as your local pharmacist. If you ever have questions about bioavailability, ask your pharmacist. He will tell you everything you need to know.