There are many different ways to consume medical marijuana, and no “right” way. Each patient has different symptoms, a different preference. The following is a summary of the ingestion options available to medical marijuana patients in Massachusetts. Smoking Marijuana Flowers In many states, this is the most thought-of form of using medical marijuana. The usual ways to smoke marijuana include grinding or separating the flowers or buds into a smaller and more manageable form and then either rolling it in a wrap or placing it into a pipe. Vaporization is another form of using cannabis. It is achieved by heating up the dried cannabis in a “vaporizer” which does not burn the bud with an open flame but heats it up to a point just before it does burn which releases the cannabinoids in gas form. The gas cannot be seen but is inhaled through a plastic tube or a bag in which the vapor is caught and then inhaled. It is not as hazardous as smoking may be and the potential side effects are not as severe. Vaporizers have traditionally come in a “table top” size but some “E-Pens” claim to vaporize flower as well. Concentrates: Wax, Shatter & Oils Additional options for concentrates are Wax, Shatter and Oils. Extracting and concentrating using chemical processes is not a new thing. Food manufacturers have been doing it for a long time when extracting vitamins from broccoli or caffein from coffee. Hash has also been used for centuries but it was always a long and complicated process. Advancements in butane extractions,similar to the process used for foods, has led to a new and more “high tech” way to smoke concentrates or “do dabs” as the kids are calling it. It may sound complicated and we should always be cautious when chemicals are involved but concentrated Wax and Oils do provide incredibly effective relief for many patients. State Licensed Dispensaries have the resources to test for quality and pure extracts to help encourage safe production and use. Oils and Wax’s may be smoked using traditional smoking tools, like a bong, but VapePens (similar to e-cigarettes) have become the most recent “must have” smoking accessory. Edibles Edibles are a great way to stay medicated without smoking. Eating marijuana-infused edibles usually leads to stronger and longer lasting effects, compared to smoking. However, relief may take anywhere from 30 minutes to 3 hours depending on what is in the patients stomach and how potent the edible is. There have been recent concerns related to overly potent edibles and the difficulty in controlling dosing. Patients should be sure to read packages for recommended dosing and always start with smaller amounts until you know how edibles will affect you. “Start low, and go slow.” Tinctures Tinctures are liquid concentrates of marijuana cannabinoids mixed with glycerin or alcohol. Patient can put a few drops underneath their tongue and feel the effects, usually within 30 minutes. Tinctures can come in CBD-only products, for those who want no psychoactive effects or THC. The effect can be rather strong, with a relatively small amount of product consumed. Topical Treatments Cannabinoids combine with a penetrating topical cream can be used on the skin. Salves (usually made with coconut oil and bees wax) and creams (usually made with shea butter) can be rubbed directly on the skin to help with relief of muscle strain, inflammation and allergic skin reactions. Capsules For many the idea of smoking medication, eating medicated food or dropping something mixed with alcohol under your tongue does not seem like a “normal way” to medicate. Marijuana cannabinoids in capsules seems more traditional for many patients accustomed to taking traditional medications in capsule format. The science behind recommending dosing for the amounts of THC, CBD and other cannabinoids has come a long way. Kitchens producing edibles and extracts are creating industry standards while patients and their doctors use trial and error methods for trying new products. For many patients all the options are exciting and provide a lot of hope, but it can also be overwhelming for people who are new to marijuana. Patients should remain active in tracking success and sharing reports with their physicians, caregivers and dispensary agents. We should all remain optimistic for what is to come!