For anybody new to CBD, the array of choices in which to consume it can be confusing, simply because there are so many ways to take CBD. This is apparent with even a glance at the product marketplace, which includes tinctures, capsules, candies, vape pens, ointments, and even doggy treats. And then there is the more traditional way, which nowadays is among the least used ways of taking CBD—ingesting CBD in a marijuana cigarette.

More broadly, there are four ways to take CBD: orally, sublingually (under your tongue), topically, or through inhalation.

Which way is best depends on what effects you are seeking. Inhalation and sublingual administration are generally best if you are seeking quick relief from general pain, as both allow CBD to act quickly. For specific joint or muscle pain, topical application is best, since it focuses on localized pain relief. Oral consumption can work for all of the above but is more often used for longer-term calming effects rather than immediate direct pain relief.

Four ways to take CBD

Sublingually 

Taking CBD sublingually, usually in the form of tincture drops, lozenges, or sprays, is technically also an oral-ingestion method, but one that acts much differently.

CBD taken sublingually bypasses the digestive system and liver altogether, meaning it enters the bloodstream immediately. Its effects arrive within minutes. But efficiency isn’t just about speed, but also something called “bioavailability”—that is, how much of that CBD ends up in your bloodstream. Studies have shown that if it is swallowed, and goes through your digestive system, only 5 percent of it makes it to your bloodstream. On the other hand, when CBD is taken sublingually, it is only broken down by the enzymes in your saliva, with about 35 percent of it making it into your bloodstream. 

Orally

CBD is available in capsule form, or even more popularly in treats ranging from gummy bears to cookies and other candies. You can also take orally via an array of beverages, at least in some places. There have been many products, such as CBD-infused water, coffee, tea, kombucha, and juices. CBD-infused foods are also a growing trend in the culinary world.

Taking CBD through your mouth is probably the easiest, most convenient method. But doing so means that CBD will need to first travel through your digestive system, where it is absorbed into your bloodstream and travels throughout your body. This offers advantages and disadvantages. It is the slowest means for CBD to take effect, but also the longest —  through ingestion, peak bloodstream levels are reported anywhere between one to six hours. Therefore ingestion is often recommended when taking CBD as a daily supplement rather than for a specific one-time need.

One important consideration regarding ingestion is also whether or not you’re taking any prescription drugs. When swallowed, CBD is first metabolized by your liver before circulating through the rest of your body. This can lead it to interact with prescription drugs, and potentially interfere with their processing, because they also are metabolized by your liver.

Topically

Taking topically in the form of a salve, ointment, or creme is by far the most effective way to localize its impacts. If you need immediate pain relief for a specific part of your body, this is definitely the best way to go. However, this is also the method which most limits the overall effects of CBD —  when taken topically, the CBD absorbed directly into the cannabinoid receptors in the area of the body where it is applied. This means it never enters the bloodstream.

 So topical application is excellent for targeting inflammation and pain, but not useful for reducing anxiety or helping with sleep. 

It’s also worth noting that topical application requires higher amounts of CBD to be effective. Skin is not very permeable, meaning the CBD absorption rate via topical application is low. So if you are using CBD topically, make sure you choose products with high CBD concentrations in order to gain the pain relief or anti-inflammatory benefits you seek.

Inhalation

Inhaling CBD happens in two ways, smoking or vaping. Both are highly effective means of administration because they take effect almost immediately. Lungs are a large surface area for absorption, meaning CBD enters the bloodstream more quickly through inhalation than any other method. This also means the effects last less long, passing in and out of the bloodstream more quickly than other methods.

Generally, vaping is also the quickest method of achieving impacts because the CBD oils used are more potent than cannabis flowers. It’s subjective, but many people also find vaping easier than smoking, and the flavors offered by the many different available vape products are more appealing to many users than cannabis smoke.

As a pulmonologist (lung doctor), I strongly discourage people from smoking and vaping. Here’s why. Smoking has different risks, depending on what is being smoked. Tobacco is by far the worst, marijuana is a distant second, and last is CBD. The effects of smoking these substances are too big of a topic to fit in this article.

And if you think vaping is the perfect solution, it’s not. It has its own risks, including a small but real risk of “popcorn lung” from the propylene glycol ingredient. Propylene glycol is a petroleum byproduct and serves as the base of e-liquid, which forms vapor when heated.

But if you insist on smoking, it’s best to seek out strains that are cultivated to maximize CBD. According to a survey conducted by Leafly, those strains include Harlequin, Ringo’s Gift, Sweet and Sour Widow, Cannatonic, and Pennywise.

Inhalation is most effective for delivering the most generalized impacts of CDB, such as reducing anxiety. It is the least predictably effective method when seeking specific applications for pain or inflammation, although CDB inhalation seems to be effective for reducing nausea. 

One area of concern specific to vaping is the often poor regulatory structure surrounding the production of vape oils. A 2017 study of 10 vape products found that seven misrepresented the dosage of CBD found within them and two contained THC, the other most prevalent cannabinoid found in cannabis, which can have anxiety-producing effects opposite of what CBD users are looking for. Other studies, particularly a recent one issued by the U.S. Army, have warned of the risks of adulteration with synthetic cannabinoids that happens more often with vape oils than other CBD products. So for those who choose to vape, it’s particularly important to find trustworthy brands.

Again, this article is meant to provide you with information to help you make wise decisions for your health. Overall, smoking or vaping is just not wise.

Dr. Mike Hansen, MD
Internal Medicine | Pulmonary Disease | Critical Care Medicine

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