Insert Here: Marijuana Suppositories Give Patients Options, but Need Research

Here’s one way to look at the concept of medicinal cannabis suppositories: They’ve opened back doors for determined patients who require an alternate consumption method.

Some patients swear by suppositories, said Dr. Sue Sisley, an Arizona cannabis researcher with Scottsdale Research Institute. The online literature and various anecdotes suggest suppositories are an effective way to receive the therapeutic benefits of THC or CBD without as much, or any, psychoactive effect.

Some cannabis connoisseurs choose to use rectal suppositories for their potential localized effects in treating conditions like Crohn’s disease, inflammatory bowel disease, or colon cancer, but it still works for chronic pain, nausea, and muscle spasm as well, experts report.

Understandably, the market for suppositories is still pretty small. Most people aren’t comfortable with the idea of sticking medicine in unusual places, said Dr. Keith Power, medical director at Giving Tree Dispensary.

Power is an emergency room doctor, so he has experience with all sorts of suppositories. It’s difficult to get patients to take suppositories, he admitted.

“Some of them are just saying, ‘No I can’t do this, I won’t do it,’” he said. “So it’s very hard to convince patients sometimes to do so.”

Typically, patients who choose suppositories are older, when getting your medicine in the most effective way is paramount. But when it comes to addressing chronic nausea, it may actually work better than other methods, Power said, especially for patients with regional symptoms or those who don’t want to consume edibles for either dietary or nausea-related reasons.

Sisley expressed some skepticism, however.

Due to her own past difficulties in getting approval for cannabis research, Sisley knows better than most how little scientific literature exists about cannabis products, and suppositories remain in a black hole of information.

Though anecdotal evidence suggests suppositories effectively reduce pain or treat cancer, there’s no research to back it up.

“That’s the folklore,” Sisley said. “The problem with that is if they’re not getting the psychoactive effects, then it’s probably not getting absorbed.”

Scientists don’t know yet exactly how THC, CBD, or other cannabinoids get absorbed through the rectal cavity or the large intestine, but pharmaceutical studies show that absorption is unlikely, Sisley said.

If you use them, it seems the best advice is to go deep. The large intestine has a more porous membrane than the rectal cavity, Sisley said, which means it may have an easier time absorbing cannabinoids.

Infused vaginal suppositories are another option. Leafly.com correspondent Lisa Rough and other cannabis writers have documented their experiments with products including Foria Relief, a vaginal suppository that may provide some relief for menstrual cramps.

Sisley warned that consumers should be wary of suppositories because of the dearth of clinical studies on them.

But in June, an article in the peer-reviewed journal Medical Cannabis and Cannabinoids reported that a clinical trial involving 42 men dosing for 14 days with rectal suppositories showed promising results.

“Delivery of [THC] via the suppository route could have several practical advantages,” wrote the authors, who are affiliated with the University of Mississippi’s School of Pharmacy.

The method could be preferable when patients have difficulty swallowing oral medication. It also provided “longer and higher exposure” of THC than oral consumption, while minimizing psychoactive effects, the study reported.

Nobody’s going to ask you to “puff puff pass” with this consumption method. But it can be said safely that no other delivery method for medical marijuana is more discreet. Cannabis suppositories may not be for everyone, but in the end, they seem to work out perfectly for some patients.