Does Smoking Medical Marijuana Increase Risk of Oral Cancer?
Cannabis is the most widely used illicit substance in the United States, with almost half of adults reporting lifetime use.  Rates are increasing among every generation and smoking remains the most popular route of marijuana intake.
When Florida finally allowed for their Medical Marijuana Patients to have legal access to smokable cannabis flower there was a huge spike in the number of registered Floridians who qualified for a medical marijuana recommendation. The traditional act of rolling up and smoking cannabis has remained popular despite all of the new products available for users, but how safe is smoking really? Are there alternatives to ensure the same benefits without the risks?
What IS Medical Marijuana?
Many states, and even some countries, have legalized cannabis for medical use. This means they allow an individual to legally purchase marijuana products if they are approved by a health professional. The qualifying medical conditions approved for medical marijuana use vary from state to state and between countries, but many of them share similar requirements.
Medical marijuana is cannabis specifically meant for medicinal purposes. It is no different from adult-use marijuana in chemical composition, but the consumer selects strains and products with the intent to treat their specific symptoms.
Marijuana can help alleviate symptoms of many different health conditions; however, it is important to note that not all cannabis products are created equal. Most varieties of cannabis are high in THC, which is preferred for certain symptoms like pain, insomnia, nausea, and appetite loss. Other products might contain only CBD, a non-intoxicating compound in marijuana preferred for helping anxiety, seizures, and inflammation. Some patients prefer a balanced mix of both CBD, THC, and other beneficial cannabinoids and terpenes to get a more personalized type of relief.
Risks of Smoking Marijuana
While the risks of smoking tobacco are well-known throughout the world, how much do we know about the potential risks that come along with smoking cannabis flower? While not much research has been completed due to federal limitations on cannabis research, the research that has been done not provide ideal outcomes.
Marijuana smoke and tobacco smoke share carcinogens, including toxic gases, reactive oxygen species, and polycyclic aromatic hydrocarbons, which are 20 times higher in unfiltered marijuana than in cigarette smoke. The more concentrated the smoke is, the greater the depth of inhalation, and the longer breath-holding time with marijuana results in higher tar and carbon monoxide exposure. 
In addition, marijuana use is associated with histopathologic bronchial inflammatory changes comparable to changes observed with smoking tobacco.  Given that cancer is the second leading cause of death in the United States and smoking remains the largest preventable cause of cancer death, similar toxic effects of marijuana smoke and tobacco smoke may have the same health implications.
Alternatives to Smoking Marijuana
Luckily, with recent advancements in research and development, there are plenty of other ways marijuana users can consume cannabis without putting themselves at risk from smoking. The following are some examples of products that are available to Florida Medical Marijuana Patients that do not require inhaling combusted cannabis flower.
The closest alternative to smoking whole flower marijuana is vaporizing it. When cannabis is smoked, the temperature required to cause the dried plant material to catch on fire is so high that it burns off a lot of the beneficial ingredients in cannabis. By vaporizing it, you are heating the material to the desired temperature that activates the helpful chemical components in the plant without burning them off or activating any of the carcinogens.
Full Extract Cannabis Oil (FECO), more commonly known as Rick Simpson Oil (RSO) is the next runner-up. This thick and gooey substance is an extracted oil that contains the majority of the plant’s original profile. Unlike distillate, FECO preserves the majority of the cannabinoids, terpenes, flavonoids, and even some of the chlorophyll from the cannabis plant. This results in a full-spectrum product that can be consumed both orally or topically and provide close to the same effects as smoked cannabis would. Please keep in mind that FECO is a concentrated cannabis extract, with the recommended beginner dose being approximately the size of a grain of rice.
Sublingual oils are becoming increasingly more popular over the years as more and more cannabis naive users begin experimenting with marijuana products. These oils, meant to be ingested orally, are a combination of extracted cannabinoids like THC and CBD, a fatty oil like coconut oil or olive oil, and other additives. Most of these products contain a smaller amount of THC so the psychoactive effects are not as strong as a joint or a concentrate would produce. A downfall of sublingual oils is their low absorption rate once ingested, but are great options for those looking for more of a microdose throughout the day.
Capsules, while might not be the most effective route of ingestion, are one of the easiest routes of administration for new users to get into a routine of using cannabis as medicine. Typically pre-dosed in 5-milligrams, 10-milligrams, and 25-milligram units, they are easily integrated into a morning and evening medicine regimen. The downfall of cannabis capsules is their absorption rate because once ingested a lot of the material does not get absorbed and what is absorbed takes longer to get into the bloodstream and take effect. Users who prefer cannabis capsules can expect to feel relief in around two hours and the relief can last up to eight.
Edibles products were just recently allowed to be produced for Florida Medical Marijuana patients. These products are food items, such as chocolates or gummies, that are infused with cannabis oils. Edibles are pre-dosed, typically available in 2.5-milligrams, 5-milligrams, and 10-milligram pieces. The downside of edibles is that they can produce different reactions depending on if they were dosed correctly or not, the individual’s metabolism, what other ingredients were in the products, and many other factors. Another big difference with cannabis edibles is the chemical change THC goes through when digested. Rather than staying in its more common form of delta-9 THC, it gets converted into 11-hydroxy THC which is a lot more potent than delta-9. As a result, users need to always start with a low dose and work their way up to avoid having an adverse reaction.
Suppositories are one of the most underrated products available for cannabis users. These products can be used both anally and vaginally and provide one of the most effective absorption rates in comparison to ingested cannabis. Both the uterus and the gastrointestinal tract contain a large concentration of cannabinoid receptors, plus they are both very porous areas resulting in quick absorption into the bloodstream.
Another option available for marijuana users is transdermal patches. These patches are applied topically and release a consistent microdose of whichever compound it contains. Unlike topical lotions, transdermal patches breach the surface of the skin and are absorbed into the bloodstream. This results in the effects setting in almost immediately, and if the user has an adverse reaction all they have to do is take the patch off and within minutes they should begin to calm down. Please keep in mind that these products are typically meant for micro-dosing and might not produce strong psychoactive effects.
Obtaining a Medical Marijuana Card in Florida
In order to have legal access to any of the above mentioned products in Florida, one must first become a medical marijuana patient. The first step of this process is to be approved by a state-qualified Medical Marijuana Physician. To see if you pre-qualify for a medical cannabis recommendation by a physician, take this survey. Once approved by a physician, you must apply for a medical marijuana card with the Office of Medical Marijuana Use (OMMU).
The following conditions have been approved by the OMMU for a medical marijuana recommendation:
- Post-traumatic stress disorder (PTSD)
- Amyotrophic lateral sclerosis (ALS)
- Crohn’s disease
- Parkinson’s disease
- Multiple sclerosis (MS)
- Medical conditions of the same kind or class as or comparable to the others listed.
- A terminal condition diagnosed by a physician other than the qualified physician issuing the physician certification.
- Chronic nonmalignant pain caused by a qualifying medical condition or that originates from a qualifying medical condition and persists beyond the usual course of that qualifying medical condition.
If you believe you would benefit from a Florida Medical Marijuana Recommendation but do not see your reason mentioned above, please contact DocMJ at (888)-908-0143. Our team of Patient Care Coordinators is here to help answer any questions you might have in regards to the Florida Medical Marijuana process and can guide you through the process from setting up your initial appointment with one of our doctors to walking you through applying for your ID Card.