Legalization of medical cannabis continues to spread to additional states in our nation and while that’s something many using cannabis as medicine are excited about, for those who are new to cannabis more often than not, these new patients are looking for options that don’t include smoking or are seeking specific methods of use that target conditions via specialized product types. Cannabis suppositories are one such option that exist in select markets.
Today, consumers and patients alike are considering the use of suppositories to manage localized conditions of the reproductive and gastrointestinal systems. Those who have used infused suppositories and report the effects and their experiences are indicating that they’ve found relief from women’s health issues as well as helping with sexual health.
Women are using them vaginally and rectally and men are using them rectally as well. For women diagnosed with endometriosis it’s important to do their due diligence and ensure they are utilizing the right cannabinoids when using or making suppositories. CBD can prevent the endometriotic cells from migrating outside the reproductive system, but THC can actually cause the migration of endometriotic cells into other systems and could further worsen their symptoms. (McHugh, D., 2012) Also, important to note that most suppositories available on the market are not gender-specific unless other botanicals have been added that a particular gender would want to avoid.
Although suppositories are sometimes the only option for those who cannot take anything by mouth or inhale, for example hospice patients, infants, or those with severe nausea or neurological conditions, were not sure how effective they are and if they provide overall systemic benefits because of the limited absorption and bioavailabilty. (ElSohly, M., 2018)
For those not familiar with bioavailability, it’s a fancy word for how much of the CBD or THC you consume your body will actually be able to access and use. For example, let’s say a person consumed 100mg of CBD via inhalation or a sublingual tincture, it’s possible that as little as 30% of that will be used by the body. Some report that the bioavailability of vaginal and rectal suppositories is as low as 0-10%. One company has a patented cannabis suppository that reports a bioavailability of up to 80%, but this version by ElSohly can only be made by the University of Mississippi, not manufacturers in your home state. There may seem to be a coincidence that the company with the patented version reported the very low bioavailability of other versions mentioned above, but Perlin, E. & et al came to the same conclusion in 1985.
So what does this tell you? That cannabis suppositories are likely a better option for managing local symptoms of the gastrointestinal system and the women’s reproductive tract. We have male patients using them for ulcerative colitis or crohn’s and women using them for painful periods or to promote comfort during sex.
If you’re ready to try cannabis-infused suppositories, do your homework, talk to your medical professional, and be aware that suppositories may not be the best form of treatment for specific medical conditions. Cannabis physician and expert, Dr. Bonni Goldstein states that suppositories should not be used when a patient is undergoing chemotherapy because of the compromised immune system and risk of infection. (Goldstein, B., 2020)
At Cannabis Care Team, when we discuss the use of cannabis suppositories with patients we share a few best practices and how to save money on their treatment is always one of them. The best way to save money on cannabis suppositories is to make them yourself. Check out this recipe using a concentrated version of THC purchased from a medical dispensary, How to Make Marijuana Suppositories at Home | Massachusetts Medical Marijuana Doctors: Inhale MD or simply add a full-extract THC or CBD cannabis oil to cocoa butter or coconut oil (the kind that is solid at room temperature), mix well, add the mixture to suppository molds that can be purchased online, freeze or refrigerate, and keep there until ready to use. Insert above the rectal sphincter (about an inch) so it doesn’t fall out, and lay down for at least 15-30 mins to prevent leakage.
We hope this answered some questions, but for specific education regarding your personal healthcare needs, don’t hesitate to reach out to 888-810-WELL (9355), and always remember information on our site is provided for general informational and educational purposes only. It is not a substitute for professional medical advice. Before taking any actions based upon such information, we encourage you to consult with your personal health care provider.
References:
ElSohly, M., Gul, W., & Walker, L. (2018). Pharmacokinetics and Tolerability of Δ9-THC-Hemisuccinate in a Suppository Formulation as an Alternative to Capsules for the Systemic Delivery of Δ9-THC. Medical Cannabis and Cannabinoids, 1(1), 44–53. https://doi.org/10.1159/000489037
Goldstein, B. (2020). Cannabis Is Medicine: How Medical Cannabis and CBD Are Healing Everything from Anxiety to Chronic Pain (1st ed.). Little, Brown Spark.
McHugh, D., Page, J., Dunn, E., & Bradshaw, H. (2012). Tetrahydrocannabinol and n-arachidonyl glycine are full agonists at GPR18 receptors and induce migration in human endometrial HEC-1B cells. British Journal of Pharmacology, 165, 2414-2424. Doi:10.1111/j.1476-5381.2011.01497.x.
Perlin, E., Smith, C. G., Nichols, A. I., Almirez, R., Flora, K. P., Cradock, J. C., & Peck, C. C. (1985). Disposition and bioavailability of various formulations of tetrahydrocannabinol in the rhesus monkey. Journal of pharmaceutical sciences, 74(2), 171–174. https://doi.org/10.1002/jps.2600740213
