A recent study published in Canadian Journal of Health Technologies examined the effectiveness of using metered-dose inhalers (MDIs) for medical cannabis and the evidence based guidelines for MDI use. The researchers found MDIs offer precise doses of delta-9-tetrahydrocannabinol administration that is well tolerated by patients.
MDIs offer patients a smokeless and discreet way to consume medical cannabis. MDIs are portable devices commonly used to administer consistent doses of bronchodilators (medication to relax muscles in the lungs) in aerosol form. MDIs have traditionally been used to manage asthma or Chronic Obstructive Pulmonary Disorder (COPD), but they are increasingly being used for cannabinoid administration. Customized cannabinoid formulations (ratio of THC to other cannabinoids), effective propellant design, solution and suspension options, and strength and dose are all key factors in promoting bioavailability using an MDI.
The study design included a randomized controlled trial and a non-randomized cohort study. The RCT and non-randomized study assessed the same MDI device known as the Syqe Inhaler. The Syqe contains medical cannabis containing 22% delta-9-THC, 0.1% cannabidiol, and 0.2% cannabinol. The RCT enrolled 27 patients who were mostly male (70.4%) with a mean age of 48.3 years. Pain diagnoses included diabetic neuropathy, pain neuropathies, and phantom pain. Most patients (77.8%) had previously smoked cannabis. The RCT revealed MDIs significantly reduced pain intensity. The researchers found no consistent or prolonged cognitive impairment occurred following inhalation of medical cannabis using a MDI in patients who had previously used medical cannabis.
The non-randomized study indicated a statistically significant reduction in muscle spasticity and nausea intensity. The questionnaire administered in the non-randomized study also revealed that patient and health care professionals were satisfied with using MDIs for medical cannabis.
The study highlighted the need for more detailed and evidence-based guidelines for using metered-dose inhalers for medical cannabis. Future research will address the evidence gap on long-term efficacy and safety data for MDIs.