Our Western minds tend to head to the gutter whenever suppositories are mentioned. All giggling aside, the use of plant-based suppositories is nothing new or all that humorous. In fact, suppository molds have been found dating back to the 12th century.

Cannabis has been recognized and used as a medicinal plant for centuries, so it only makes sense that, like other cannabis-based medicines, cannabis suppositories are not a new development.

The ongoing cannabis legalization movement has many cannabis patients and enthusiasts experimenting with every delivery method imaginable. This includes digging up some of the oldest herbal remedy delivery techniques used by humans. Using herbal suppositories is an ancient practice used to treat a wide variety of ailments.

Today, suppositories are used to administer medications more effectively and efficiently, particularly in situations where other delivery methods have fallen short. Cannabis suppositories are quite promising because they offer a unique delivery method to the body and provide benefits that are not obtainable with other cannabis delivery methods.

Read also: Methods for Ingesting Medical Marijuana: It’s More Than Just Smoking

Cannabis Suppositories

A suppository is medicine in a solid form that is designed to be inserted into the rectum for absorption. As the suppository melts, the blood vessels in and around the rectum absorb the medicine directly into the bloodstream. To some, this may sound unpleasant, but it is arguably the most efficient and effective route of delivery. Most cannabis-based suppositories will begin working in 15-45 minutes; meaning patients will not have to wait very long for relief. Cannabis suppositories offer multiple benefits to medical marijuana patients and are sure to be an influential part of cannabis-based medicines in the future.

Unique Delivery Method

Perhaps the most significant difference between using cannabis in a suppository versus other consumption methods is how the body processes substances through the rectum. When smoking or eating cannabis, a fair portion of the psychoactive components are transformed by the liver into a more psychoactive molecule. In other words, when the liver processes particular cannabinoids, including THC, it alters the molecule so that when these molecules reach the brain, more cognitive effects are experienced. This enhances the “high” feeling experienced by many cannabis users. Cannabinoids absorbed through the rectum are not routed through the liver (they bypass it completely), which means the cannabinoids go directly into the bloodstream. Bypassing the liver brings forth two potential benefits of cannabis-based medications. First, the medical benefits can be achieved without feeling “stoned” or “high.” Second, it allows the body to absorb more of the active ingredients when compared with other delivery methods.

Medicines administered rectally generally have a faster onset and a higher bioavailability compared with oral administration. When using a cannabis suppository, the medication is absorbed by the rectum’s blood vessels, giving the medicine a direct link to the body’s circulatory system. Once absorbed the medicine — in this case cannabinoids — is distributed to the body’s organs. When smoking cannabis, the body receives roughly 20-50 per cent of the available cannabinoids. The body receives roughly 25-60 per cent of the available cannabinoids when ingesting cannabis orally. But when absorbed through the rectum, the body can receive 50-75 per cent of the available cannabinoids. The higher percentage of cannabinoids delivered, coupled with the fact cannabinoids administered through a suppository will not impair cognitive function, means cannabis suppositories could be the most efficient delivery method for cannabis-based medicines for all patients.

Ask a Nurse: Are cannabis suppositories safe, and will they get me high?

Type of Cannabis Extract Used in Suppositories

One of the biggest influences on the effectiveness of a cannabis-based suppository is the cannabis extraction method used. Though many cannabis suppositories use shea butter or coconut oil as an ingredient, they rely on alcohol-based (ethyl alcohol or others) extractions to ensure the body can absorb the THC or other cannabinoids. Alcohol-based extractions must be used because cannabinoids extracted in fats are not ideal for suppositories. The blood vessels in the rectum do not efficiently absorb fat-soluble compounds. Put another way, when the cannabinoids are extracted into fat (coconut oil, shea butter, etc.), the cannabis suppositories are not going to provide the desired results. Suppositories where the cannabinoids are in an alcohol-based extraction, such as RSO (Rick Simpson oil), are more likely to provide the desired results because they will be more readily absorbed by the rectum’s blood vessels. A general consensus among testimonials regarding homemade cannabis suppositories is the cannabis should first be extracted using the Rick Simpson method and then added back into coconut oil or shea butter for ease of molding into a suppository plug. However, much more research is needed to determine how much of the cannabinoids are being absorbed when using this particular method. Currently, there are studies on cannabis suppositories where the active ingredient (delta-9-THC) is coupled with an ester hemisuccinate. This additive is designed to breakdown fat-soluble compounds into water-soluble compounds.

In other words, the addition of an ester hemisuccinate will maximize the rate of absorption through the rectum. Though RSO extractions seem to be the best choice for DYI cannabis suppositories, the pharmaceutical industry will be focusing on testing and perfecting delta-9-THC-hemisuccinate for cannabis suppositories.

Results May Vary

One major disadvantage of cannabis suppositories (and most cannabis-based medicines) is that individuals can experience varied results. What one person experiences with a cannabis product may be very different than what another person experiences. Aside from a person’s individual tolerance to the active cannabis ingredients, there are many other factors that will affect the results of a cannabis-infused suppository. The molecular size, water solubility, depth of insertion, the person’s level of hydration, and any/all ingredients in the suppository product will greatly affect how a suppository works. Depending on all these factors, a suppository may be more slowly or quickly absorbed, and the percentage of available cannabinoids absorbed could fluctuate. All in all, the results of cannabis suppositories can vary greatly from person to person and product to product. More research is needed to determine standards for cannabinoid levels in suppositories, the extraction method for the cannabinoids, and the other ingredients and/or additives used in the suppository.

Read also: Differences Between Smoking and Ingesting Cannabis

Ailments Treated with Cannabis Suppositories

Due to the unique method of delivery, cannabis suppositories could be the most effective way to treat a wide variety of ailments.

Medical marijuana has shown to work effectively against a long list of ailments (too numerous to list here). However, testimonials on the internet showcase the benefits of cannabis suppository use for people suffering from intestinal or prostate issues. Patients suffering from digestive issues or issues with internal organs may benefit greatly from a cannabis-based suppository and a direct route to the areas of concern.

The ability to absorb cannabinoids directly into the bloodstream without psychoactive effects may make rectal suppositories the future of cannabis-based medications. After all, when treating the body with cannabis, the more cannabinoids administered, the better. However, due to the psychoactive effects of some cannabinoids, it makes it difficult for some patients to administer the dose they need to treat their ailments. For serious conditions, the amount of cannabinoids needed would make the patient enter a semi-comatose state. With cannabis suppositories, a cannabis patient can administer dosages that would otherwise be intolerable through other delivery methods. Even though herbal suppositories are an ancient healing technique, we are still far away from understanding the full potential of cannabis-based suppositories. There is still plenty of research needed on cannabis suppositories themselves, what ailments they are best suited for, and what ingredient(s) should be used to maximize absorption rates and potency. However, the fact there are hundreds of testimonials claiming the medical benefits of cannabis-based suppositories shows this ancient method of healing is in the process of being resurrected.

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