Please be advised this site does not sell CBD or THC and the examples below are for education purposes only.
This article aims to educate about the advantages associated with the rectal application of cannabis and provide a simple set of guidelines for the effective use of suppositories.
There are many advantages to the rectal administration of cannabis not afforded by other methods. Medicine may still be administered even if the oral route is impaired (eg due to vomiting, an injured jaw or throat or gastrointestinal difficulties) or disallowed due to the oral intake restrictions frequently required both before and after surgery. Avoiding the gastrointestinal tract prevents first-pass metabolism by the stomach’s digestive process which breaks down many different molecules into their constituent parts (including 9-tetrahydrocannabinol, otherwise known as THC).
In the case of THC, the liver transforms around half of what is ingested into the significantly more psychotropic metabolite 11-Hydroxy-9-tetrahydrocannabinol. While not harmful in and of itself and potentially of therapeutic benefit, this molecule causes much more intense cognitive effects than THC. Rectal administration not only avoids these effects, but also allows a much greater proportion of THC to eventually reach the blood stream. This increase in overall efficiency is also shown in the different levels of bioavailability that different administration routes afford, as seen in Fig. 1.
Rectal administration allows for medicine to exert more potent effects over localised ailments (eg hemorrhoidal tissue, inflammation of the rectum, or tumors in the rectal cavity). This form of use also has a much faster uptake than oral administration (around 10 minutes on average) and leads to more consistent blood concentrations of the active constituents. The speed and reliability of their uptake, combined with their circumvention of many of the issues surrounding both ingestion and inhalation, make rectal applications an excellent addition to both new and pre-existing therapeutic regimens.
Fig. 1 Comparative Bio-availability of Different Administration Routes
Inhalation: 10 – 25% efficacy, highly variable, depends largely on the individual’s level of experience
Oral: around 20% efficacy, highly variable, even between doses within a single individual
Rectal: around 50% – 70% efficacy, with predictable effects even between different individuals
When designing a personalised medication regimen its good be aware of the general uptake that’s involved with a given administration route. With suppositories, most people will begin to notice initial effects within the first 10 – 15 minutes after insertion. These effects usually last for between 4 – 8 hours, depending on the individual’s physiology and tolerance to cannabis. This swift uptake time and low psycho-activity allows for acute dosing in most cases, although this depends both on the situation and on individual needs.
There are several issues that can slow absorption in the blood stream. Diarrhea or going to the toilet soon after dosing and impacted fecal matter can slow or prevent the active ingredients from reaching the rectal wall and being absorbed. Tumors or cysts on the rectal wall can also slow or prevent absorption. In this case less medicine would reach the blood, but as the tumors are the intended target of the suppository, the direct delivery of the actives would help prevent an overall reduction in efficacy. Finally, dehydration can reduce the effectiveness of suppositories. Staying well hydrated by maintaining a healthy consumption of both water and electrolytes should prevent this in most cases, but specific medical conditions may cause this condition as well. As always, if there are concerns, a medical professional should be consulted.
Anyone who decides to take advantage of the benefits provided by suppositories should do so with a good understanding of the process involved. Although not overly complex, the few simple instructions outlined below will enable their effective use.
Instructions For Insertion
- Lie on your preferred side with your top leg pulled up towards your chest, or on back with pillow under backside.
- Dip the tube 1/3 into olive oil for ease, insert the tube to around halfway then squeeze it empty.
- Throw empty tube in waste basket and then relax: remain in laying position for ten mins to half an hour.
- Note that if tube is placed too far in, the active constituents may enter the superior (upper) hemorrhoidal artery, which leads to the liver. This can present a similar problem as oral application as the liver will metabolise a significant proportion of the active ingredients.
The unique properties provided by the rectal administration of cannabis have the potential to empower many individuals. Suppositories can be used to refine existing therapeutic regimens to greater effect. Individuals who have been prevented from using cannabis due to an inability to administer, via either inhalation or ingestion, can potentially derive benefit from this wonderful plant for the first time. We strongly believe in the philosophy of empowering all people toward education and resources to help themselves and each other.
Watch this video for an inspiring story: Cannabis killed my stage four terminal lung cancer