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TABLE 1. Pharmacokinetic comparison of THC application to humans via intravenous, respiratory and oral routes. (Agurell et al. 1986, Azorlosa et al.
1992, Frytak et al. 1984, Wall et al. 1983, Ohlsson et al. 1980, Perez-Reyes et
al. 1981, Perez-Reyes et al. 1973)
Parameter

Intravenous

Absorption

100%

10-30 (up to 50)%

> 95%

Systemic bioavailability

100%

10-30 (up to 50)%

10-20%

0.02 mg/kg

0.06-0.1 mg/kg

0.2-0.3 mg/kg

1 mg

3-6 mg

ca. 10-20 mg

30-50 ng/ml

30-50 ng/ml

3-5 ng/ml

2-4 mg 10-20 (up to 50) mg

30-40 (up to 90) mg

Psychotropic threshold per kg


body weight
Psychotropic threshold per
individual
Maximum plasma concentration
at the psychotropic threshold
Dose producing marked
intoxication*

Inhaled

Oral
(lipophilic vehicle)

Onset of action

within seconds

within seconds 30-60 (up to 120) min

Duration of action**

2-3 (up to 4) h

2-3 (up to 4) h

5-8 (up to 12) h

* Doses producing a marked intoxication vary according to duration of therapy. Longer use may result in the
development of tolerance, and higher doses are needed to achieve the similar effects.
** Duration of action varies according to examined effect and especially with oral use according to dose.

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FIGURE 1. Assumed risk associated with smoking herbal cannabis vs. THC
content (as % of the dried plant material) corresponding to that caused by tobacco cigarettes. The worst-case scenario is assumed, that smoking a certain
amount of cannabis increases the risk of respiratory cancer and other damage
4 times higher than smoking the same amount of tobacco (see text). The risk of
0.2 grams of cannabis corresponded to 1 tobacco cigarette. Depending on
THC content 0.2 grams of cannabis contain 4 mg (2% THC), 10 mg (5% THC),
20 mg (10% THC) or 40 mg THC (20% THC). About 4 puffs are needed to
smoke 0.2 grams of cannabis (see Table 2).

Assumed damage
(tobacco euqivalent)

Assumed damage from smoking 5, 10, 20 or 40 mg of THC


in cannabis versus THC content
10
9
8
7
6
5
4
3
2
1
0

5 mg THC
10 mg THC
20 mg THC
40 mg THC

10

12

14

THC content (%)

16

18

20



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TABLE 2. Dosing-scheme for cannabis taken orally and smoked

Amount of cannabis taken

THC content in herbal cannabis


2% THC

5% THC

10% THC

0.05 g

1 mg THC

2.5 mg THC

5 mg THC

0.1 g

2 mg THC

5 mg THC

10 mg THC

0.2 g

4 mg THC

10 mg THC

20 mg THC

0.5 g

10 mg THC

25 mg THC

50 mg THC

1 puff (0.05 g)

1 mg THC

2.5 mg THC

5 mg THC

2 puffs (0.10 g)

2 mg THC

5 mg THC

10 mg THC

4 puffs (0.20 g)

4 mg THC

10 mg THC

20 mg THC

oral

smoking*

8 puffs (0.40 g)

8 mg THC

20 mg THC

40 mg THC

16 puffs (0.80 g)

16 mg THC

40 mg THC

80 mg THC

* Ingested THC was calculated according to the formula: x = amount of cannabis/100 by THC content. It
was assumed that an average of 50 mg of cannabis are smoked with one puff, calculated from the following
data. Marijuana cigarettes provided by the U.S. National Institute of Drug Abuse (NIDA) weigh about 800
mg (Azorlosa et al. 1992, Azorlosa et al. 1995). Perez-Reyes et al. (1981) noticed that about 24 puffs were
necessary to smoke a low-dose NIDA marijuana cigarette, corresponding to 33 mg of cannabis per puff.
Liguori et al. (1998) used a smoking regime with 64 mg marijuana per puff. It should be noted that THC becomes concentrated in the uncombusted parts of a cigarette so that the first puffs yield a little less THC than
the later (Tashkin et al. 1991).

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FIGURE 2. Average plasma THC levels (ng/ml) in seven healthy young males
following ten puffs from a cannabis cigarette containing 1.75 or 3.55% THC
with a breathholding duration of 0, 10, and 20 seconds immediately after smoking (drawn according to data from Azorlosa et al. 1995).
160
140
120
100
80
60
40
20
0

1.75% THC
3.55% THC

0 sec

10 sec

20 sec

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