Dr Frankel was recently featured on Paxton Quigley's radio show, "Cannabis Healing", to talk about cannabis and it's use for end of life/palliative care.
During the past year and a half I have written four articles, both in support of and questioning the use of rectally administered cannabis medicines. As a physician and researcher I’m always looking for new medicines and methods of administration to improve the outcome for my patients. To do so effectively, I must always question and review a medicine’s effectiveness.
I have recommended rectal administration for various conditions, sometimes in conjunction with oral or oral buccal administration. Some of my patients respond well and others do not. Furthermore, to truly establish reasons for such will require a much larger pool of patients.
As I have continued my research and evaluated patient response, I have begun to question rectal administration as an effective method of delivery. My change of opinion is backed by several research studies and discussions with cannabis medicine experts.
Dr Mahmoud ElSohly of NIDA in Mississippi, who’s involved daily in the study of cannabis medicines, makes it clear that years of research in their labs shows that cannabis oil isn’t absorbed rectally. There have been several studies showing oils are not absorbed rectally. Yet, some find better outcomes for patients with certain conditions from rectal administration.
There is anecdotal evidence for both sides of the discussion, some people saying there is psychoactive effect and others who say there is no psychoactive effect.
If high THC cannabis oil gets into the bloodstream, you’ll have a psychoactive effect. If it does not get into the bloodstream, there will be no effect. Many claim they use high THC cannabis without psychoactive effect, and therefore, I’d question if it’s being absorbed.
For my patients receiving benefits from rectal administration, I will continue to recommend they use it. So, patients that don’t benefit from rectally administered cannabis medicines, it’s a natural progression to look to other administration methods.
http://www.sciencedirect.com/science/article/pii/0091305791903534
http://onlinelibrary.wiley.com/doi/10.1002/jps.2600740213/abstract
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