Healthier Alternatives to Smoking Medical Marijuana
Angela Morrow, RN, BSN, CHPN, is a certified hospice and palliative care nurse.
Anita Chandrasekaran, MD, MPH, is board-certified in internal medicine and rheumatology and currently works as a rheumatologist at Hartford Healthcare Medical Group in Connecticut.
The medicinal use of marijuana is legal in a growing number of U.S. states, and other states might eventually join this list. Some patients, however, might be unable to smoke medical marijuana because of their illness, disease, symptoms, treatments and/or other factors. This article explores the alternatives to smoking marijuana that might prove healthier or more viable for patients who’ve received a prescription for medical marijuana.
Marijuana Use for Medicinal Purposes
Requiring a doctor’s “recommendation” or referral and secured from legal vendors, medical marijuana can help relieve numerous symptoms, such as pain, glaucoma, migraine headaches, nausea, and weight loss.
While there are various pros and cons of using medical marijuana, it’s important to understand that the use of marijuana is not without potential side effects. For example, conventional or “street” marijuana might contain harmful fungus and/or pesticides, which can prove especially dangerous for patients with a compromised immune system.
Moreover, the fact that marijuana is usually smoked—either in cigarette form or through the use of tobacco or water pipes—introduces additional concerns. Patients who have never smoked before, or those receiving other treatments that can interfere with their ability to smoke, might find smoking marijuana difficult or simply impossible.
I found that to be a case with a patient with lung cancer and COPD. He suffered from chronic bone pain, nausea, and severe weight loss. He asked his doctor about medical marijuana and received the necessary prescription. When I came to see him, he held a joint but didn’t know how to use it. It was immediately clear that because of his inexperience and because he was using oxygen and was already suffering from a forceful cough, smoking a marijuana cigarette would not be the best method for him.
It’s important to again stress that medical marijuana is a physician-referred treatment and should only be used according to a doctor’s instructions. If you or someone you care for receives a prescription for medical marijuana use but cannot smoke marijuana, non-smoking options might include:
Edible Marijuana: Medical cannabis can be heated and made into oils, butters, and tinctures. Many “cannabis clubs” sell pre-made cookies, brownies, lollipops, and teas. Savvy patients—those willing to take the time to empower themselves through research and knowledge—can also find recipes to make their own marijuana tincture, oil, or butter.
Eating or drinking marijuana’s main or active ingredient tetrahydrocannabinol (THC) is certainly preferable for many patients rather than smoking it, but these alternative methods can also create problems. When consumed via food or drink, THC does not absorb into the bloodstream as quickly as when it is smoked. This can make it more difficult to control the effectiveness of the drug or how much is consumed. In addition, patients who suffer from decreased appetite or nausea might not tolerate eating or drinking marijuana.
Vaporizers: Another option is to inhale marijuana using a vaporizer. This method involves heating the marijuana to a high enough temperature to vaporize the THC but not burn the plant. Patients can then breathe in the vapor from a bag without inhaling the harsh and potentially toxic smoke.
Vaping as it is commonly known, can cause serious lung injury. In 2019, a series of outbreaks across the country of what is called product use associated lung injury (EVALI), have resulted in over 2,291 hospitalizations and caused a reported 48 deaths (as of December 3, 2019). The Centers for Disease Control and Prevention are conducting studies to analyze the components of the TCH from the vaping products. They recommend that people do not use THC vaporizers and to watch carefully for any symptoms if they continue to vape.
Finding the Solution That Works for You
Ultimately, it is possible to find healthier or more suitable alternatives to smoking marijuana, as my aforementioned patient did. He experimented with edible marijuana and found that he enjoyed the marijuana brownies he was able to get at a cannabis club, but as his appetite waned, he found it difficult to stomach the rich chocolate taste. He didn’t want to invest in a vaporizer because his life expectancy was short. However, through the people he met at the cannabis club, he was able to strike a deal with another medical marijuana patient and split the cost of a vaporizer—with the agreement that the other patient would inherit the device after his death. It was an unusual arrangement, to be sure, but it allowed him to continue using medical marijuana for several more weeks.
The alternatives to smoking marijuana that might prove healthier or more viable for patients who've received a prescription for medical marijuana.
Is There a Safer Way to Smoke Cannabis? How the Methods Stack Up
If you’re looking for the healthiest way to smoke cannabis, keep in mind that there’s no totally safe way to do so — even with the purest, most pesticide-free bud. Cannabis smoke contains most of the same toxins and carcinogens that make tobacco smoke harmful to your health.
There are, however, methods that may be slightly less harmful than others. Here’s a look at how different methods compare, plus some smoke-free alternatives to consider.
The dangers of smoke inhalation are well known, so it’s not surprising that a lot of folks assume vaping is the healthier alternative to smoking. Unfortunately, it’s not that simple.
There’s mounting evidence that vaping can have serious health effects. Much of the concern comes from inhaling vitamin E acetate, a chemical additive found in many vaping products containing tetrahydrocannabinol, or THC.
However, this risk seems to apply only to vaping concentrates, not flower. A 2006 study suggests that vaping actual cannabis, not concentrate, is less harmful to your respiratory system than smoking. Still, research on vaping cannabis is pretty limited.
Lung health aside, there’s also a matter of potency. People who vape cannabis report experiencing stronger effects — regardless of the amount of THC in the product — than they do when smoking. This means a higher chance of overdoing it, or greening out, when vaping.
Maybe a teeny, tiny bit, but nowhere near enough to make a difference.
Bongs offer a smoother toke because you don’t get the dry heat from smoking cannabis rolled in paper. Though it feels less harsh when you inhale, your lungs don’t know the difference.
Well, both still involve inhaling smoke, so there’s that. But if you had to choose the lesser of two evils, joints are probably the better option. This is because blunts are made with hollowed-out cigars, and cigars and their wrappers are highly toxic.
Even after removing all the tobacco from a cigar, cancer-causing toxins, such as nitrosamines, can remain. Plus, cigar wrappers are more porous than rolling papers, so the burning is less complete. This results in smoke with high concentrations of toxins.
Then there’s the matter of size. Blunts are a lot bigger than joints, and they hold way more pot. Smoking an entire blunt is like smoking roughly six joints.
Dabbing is supposed to give you a “cleaner” high, but what does that actually mean? Not much.
Budder — another name for dabs or marijuana concentrate — delivers a lot more THC than other weed products, often as much as 80 percent more.
Dabbing is still pretty new, so experts still don’t know the full impact.
There’s evidence that exposure to high THC may lead to long-term mental health effects, like psychosis. The risk of misuse and addiction is also higher when using high-THC products, especially for young people.
Plus, unless you have high-tech lab equipment and are trained in extraction, your dabs may be far from pure. Research shows that dabs can contain contaminants and residual solvents that can to neurotoxicity and cardiotoxicity.
Dabbing also has respiratory effects, even though you’re not technically “smoking.” There have been cases of people developing lung damage from dabbing.
The bad news? There’s no safe way to smoke cannabis. The good news? There are plenty of other ways to consume it.
Here are your main options:
- Edibles. Unlike smoking and vaping, ingesting cannabis won’t harm your lung health. The downside for some is that edibles take longer to kick in because they need to clear your digestive system before getting into your bloodstream. The upside is that the effects also hang around longer. You also have an endless variety to choose from, with everything from gummies to baked goods to cannabutter.
- Sublinguals. These are usually lumped together with edibles, but they’re not quite the same. Unlike edibles, you don’t actually swallow sublingual forms of cannabis, which include things like tinctures, films, and dissolvable tablets. Sublingual cannabis is placed under the tongue for absorption, and is absorbed through your mouth’s mucus membranes, so the effects are felt faster.
- Tinctures. Tinctures are made of alcohol-based cannabis extracts that come in bottles with droppers. You can add tinctures to drinks, but you can also get the effects faster by placing a few drops — depending on your desired dose — under your tongue.
- Topicals. Cannabis topicals are for people looking for the therapeutic benefits of cannabis without the cerebral effects. Creams, balms, and patches can be applied to the skin to relieve inflammation and pain. There’s also cannabis lubricant made for, well, sexy time.
- Suppositories. The idea of shoving cannabis up your butt (or vagina, depending on the product) may make you clench, but it’s definitely a thing. Most of the suppositories on the market are CBD-infused and used for therapeutic reasons, like pain or nausea relief, but some brands have upped their THC content for added effects.
If you’d still rather smoke your weed despite the risks, consider these harm-reduction tips to help make it a little safer:
- Don’t hold the inhale. Inhaling deeply and holding it in exposes your lungs to more tar per breath. Don’t be greedy; exhaling faster is better for you.
- Use rolling papers approved by the Food and Drug Administration (FDA). Rolling papers may seem like NBD, but some contain chemicals and flavorings that can be toxic.
- Stick to glass bongs and pipes. Plastic bongs can contain chemicals like BPA and phthalates, which have been linked to serious health effects, including cancer.
- Keep your stuff clean. Keep your bongs and pipes clean, and don’t roll your weed on dirty surfaces.
- Don’t share mouthpieces or pass joints. Sharing your stash is fine, but not your pipes, bongs, or joints. When you share these, you’re basically swapping spit with that person and putting yourself at risk for infections.
No matter how you dice it, there’s really no safe way to smoke cannabis, whether you prefer to roll one up or are partial to bongs. As cannabis becomes more popular, so do products that allow you to indulge without the smoke.
That said, if you’re partial to puffing and passing, a vaporizer that allows you to use flower, not concentrates, may be a less harmful option.
Adrienne Santos-Longhurst is a freelance writer and author who has written extensively on all things health and lifestyle for more than a decade. When she’s not holed-up in her writing shed researching an article or off interviewing health professionals, she can be found frolicking around her beach town with husband and dogs in tow or splashing about the lake trying to master the stand-up paddleboard.
You can smoke cannabis in a variety of ways, but is one safer or healthier than others?