Dr. Frankel's Journal

Trains, Planes and Automobiles, OR Tinctures, Concentrates and Edibles

February 7, 2011
Allan Frankel, MD

For patients and law enforcement, let’s all keep these straight:

1. Cannabis Flowers – This is what most people are familiar with. It is the bud of the plant and is most often smoked. The average per cent THC, the most abundant psychoactive component of cannabis, in buds or flowers, ranges from as low as 4% to as high as 25%. The average THC% in most strains of cannabis is in the 10-15% range. This is a critical number to compare with the options below.

2. Cannabis Edibles – This product, such as the famous “brownies” is meant to be a product that is swallowed and absorbed through the stomach. Once it leaves the stomach in passage to the blood stream and to the brain, it must travel through the liver and be metabolized there. It is the metabolism of THC in the liver that differentiates “Edibles” from all other delivery methods; a chemical change takes place that makes the cannabis much more sedating, longer acting and much less predictable. In my experience, as many as 25% of patients have a toxic reaction to edibles at one time or another and I only recommend using edibles in a carefully monitored setting. Trying to estimate a THC% in an edible is very difficult due to baking processes being so poorly regulated. However, most experts agree that a 5 – 10 mg is an average dose.

3. Cannabis Concentrates or “Hash” – Hash is nothing more than the “hairs” or trichromes of the cannabis flower pressed into a concentrated resin material. It is highly concentrated cannabis and THC % often approach 60% or even more. So, this is 5x more concentrated than the flower, and therefore requires a lower dose. There are issues, such as the use of butane in the creation of Hash, but it’s use is entirely safe for patients, although very psychoactive and often very sedating. Again, the THC% can approach 70%!!

4. Cannabis Tinctures – A tincture is a very dilute extract of cannabis. They are often made with alcohol or glycerin. Often the cannabis is extracted into liquid carbon dioxide. Regardless of how the THC and other chemicals in cannabis are extracted into liquid, the resulting product is a liquid that is extremely dilute. The average tincture that I have had tested runs around 1-2% THC. So, this is much, much lower than the flower and just 2-3% of that in concentrates or hash. The only reason tinctures work so well is that they are absorbed directly under the tongue over a two minute period.

Tinctures are NOT concentrates. They have little to no relationship to Hash and they are not used as edibles. As such, they represent the only predictable manner in which patients can use cannabis.