Marinol and Cannabis

Tod H. Mikuriya, M.D.*

Marinol (dronabinol) delta -9 tetrahydrocannabinol dissolved in sesame oil. Supplied in fixed doses of 2.5, 5, and 10 milligram soft gelatin capsules. Taken orally.

Cannabis extract: 9 known delta -9 Tetrahydrocannabinols

2 known delta -8 Tetrahydrocannabinols

50 other cannabinoids that may interact with or modify reactions with the Tetrahydrocannabinols, the primary active principles. Source: Marijuana and Health Institute of Medicine, National Academy Press, Washington, DC, 1982, P13-15

Cannabis may be ingested orally or inhaled. Inhalation may be smoked or vaporized.

Anecdotal reports of users of both Marinol and cannabis describe enhancement or constructive supplementation. Others who have tried both have described cannabis as superior to Marinol. Users of cannabis usually inhale.

Oral vs Inhalation: Oral ingestion of either cannabis or Marinol is characterized by:

delayed onset of effects, variable level of effects, and prolonged effects. Inhalation provides quick onset of effects, consistent level of effects, and shorter lasting effects.

The inhalation route is significantly more consistently effective.

Inhalation: Vaporization vs Smoke

Significant irritants and toxic products are produced by combustion which can be minimized by vaporizing Tetrahydrocannabinols and other cannabinoids. Tetrahydrocannabinols vaporize at 400 Fahrenheit. Two crude prototypes have been successfully demonstrated: a modified manually operated auto cigarette lighter element, and a heat gun for electronic shrink tubing set at 400 F. Unfortunately, vaporizers are currently defined by law as illegal paraphernalia.

Clinical Research Needed

Only clinical research comparing Marinol to other Tetrahydrocannabinols and cannabinoids for therapeutic efficacy can clarify this controversy.

Tentative and preliminary clinical findings indicate a significant difference between Marinol and natural crude cannabis preparations in favor of the crude product. Route of administration and fixed incremental dosage may be factors in comparative efficacy and unwanted effects.

*Medical Co-ordinator

Americans for Compassionate Use

March 24, 1994