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The Beauty of Back Door Medicine – Cannabis Suppository

What is so beautiful about the butt hole? It’s a portal of relief! Who knew?

The idea of inserting a foreign substance up one’s bum for health benefits is for some individuals unthinkable; for others, like me, we say, “bring it on!” I am a firm believer in maximizing the delivery method to give myself and the patients I serve the greatest effect possible to minimize or eliminate unwanted symptoms or conditions that undermine quality of life. Back-door medicine involves using cannabis in suppository form. It is inserted into the rectum, where it is efficiently absorbed and its effects registered in the body within 10 minutes.  That is my idea of quick relief!

The administration of medical cannabis via the rectum is advantageous if one is nauseated, vomiting, or has upper gastrointestinal (GI) issues (ulceration, infection or absorption issues). The rectal route bypasses the GI tract entirely, delivering cannabis into the systemic vascular system through the inferior and middle veins and eliminating the first-pass effect. The first-pass effect involves the stomach and liver breaking down the individual molecules of Δ 9-tetrahydrocannabinol (THC) into their constituent parts rendering them more psychoactive in the bloodstream. This rendering is the liver converting THC into 11-Hydroxy-Δ 9-tetrahydrocannabinol, which produces more intense cognitive effects.  

In pharmacology the bioavailability of a drug, in this case cannabis, is the amount of drug unchanged that is readily absorbed into the body. The reported differences in bioavailability across oral, inhalation and rectal methods is noteworthy.  If one smokes cannabis 15%-20% of the cannabinoids are absorbed, orally approximately 10%-25% and rectally 50%-70%1.  

Rectal administration of drugs dates back to ancient times. Drug administration via the rectum takes the form of suppositories (solutions and suspensions), gelatin capsules (solutions and suspensions) and enemas. For the purposes of this article only suppositories will be discussed.  

The rectum is approximately 10-15 cm in length and 15-35 cm in circumference, maintaining a pH of 7-8. The lining of the rectum measures 200-400 cm2 and is free of any villi (finger-like projections) with a smaller surface area then the duodenum. The disadvantages of drugs inserted into the rectum is interruption of absorption by defecation, the surface area of the rectum is smaller than the duodenum and patient acceptability which may vary depending on the culture, country or past experiences. Issues that can slow absorption from the rectum to the bloodstream include diarrhea, the presence of fecal matter, hemorrhoids, tumors or cysts on the rectal wall, and fissures.

Cannabis suppositories are commercially available, however, making your own in the comfort of your home using a few affordable and easy-to-find ingredients is economical and emotionally rewarding. Rectal suppositories are effectively used for conditions involving the stomach, intestines, sex organs, rectum or anus. Any condition can be supported using rectal suppositories from inflammatory bowel disease to neuropathy, including pain syndromes like reflex sympathetic dystrophy. Cancer therapy is another condition that is nicely supported using this route of administration. An additional use for suppositories is vaginal application for endometriosis, painful menstrual cramps, fibroid pain, ovarian cyst pain, and polycystic ovarian disease.  

The base of most suppositories is gelatin or cocoa butter. The cocoa butter base is a fat-soluble medium that assists in absorption and is soothing to the lining of the rectum or vagina. Once the medication enters the body, it begins to melt or dissolve to release its medication into the systemic vascular system.  

It is very important to freeze your suppositories until you are ready to use them. Once unwrapped, immediately insert rectally or vaginally, as the suppository will quickly begin to melt in your hand quickly. Insertion is 1” to 1 ½” into the rectum. If inserted too far, it will be absorbed via the superior venous system and circulate through the liver therefore engaging the first-pass effect. A number of recipes abound on the internet, so finding one that works for you is paramount.  

Although discussing suppositories during happy hour may not be the most pleasant topic of conversation, getting the most medication from whatever route of use is imperative. The rectal route is suitable for short and long-term drug delivery. Most importantly, it is possible to bypass the hepatic first-pass elimination.  

Don’t think of rectal suppositories as a torpedo, a missile or a foreign object, but rather a remarkable delivery system that can be made in your kitchen and used to provide a therapeutic effect so your body can reclaim your health. Making one’s own suppositories for health and healing is an adventure worth trying.  

Remember, beauty is in the eye of the beholder; pain or symptom relief is true beauty. Whip it up, insert it up, and then live it up! Let’s start inserting our rights up the back door.

To your health via Up Yours, Dr. Dana

Rules of Engagement:  

~Before Insertion

  1. Properly wash your hands and make sure your fingernails are clean and without sharp edges.

  2. Wear disposable gloves.

  3. If you are dehydrated use a lubricating gel for ease of insertion, have it ready placed on a paper towel.

  4. Before removing the suppository from its protective case, check its consistency; it should be firm, if it is too soft, run cold water over the encasing, then remove it.

~Insertion

  1. Lie on one side with your top leg pulled towards your chest.

  2. Lift your buttock cheek to expose the rectum.

  3. Insert the suppository lengthwise with the tip going in first.

  4. Use your index finger to insert the suppository.

~Placement

  1. With your gloved finger, gently push the suppository past the anal sphincter or 1” to 1 ½” into the rectum and no further.

  2. If the suppository is not inserted past the anal sphincter it will be expelled.

  3. Ideally the suppository will be absorbed into the inferior and middle veins of the rectum.  If deeper then 1 ½”, it will unfortunately be absorbed into the superior vein and initiate the liver’s first-pass effect and you will experience psychoactive interruption.

~After Insertion

  1. After the suppository is in place, hold your buttocks tight for the first few seconds to keep it from sliding out.

  2. Remain on your side for several minutes post-insertion to allow it to fully disperse through the rectum and to prevent unintended expulsion.

  3. Cure Your Own Cancer.  Cannabis suppositories: Is the posterior superior? Published on January 22, 2015. Retrieved June 15, 2018. https://www.cureyourowncancer.org/cannabis-oil-suppositories.html.

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