Rectal Use Of Cannabis — Is the Backdoor a Better Entrance?

Key takeaways.

If you’re turning your nose up at the idea of sticking cannabis up the butt, this article will catch you by surprise.

Rectal use of cannabis might be far from “traditional” or “conventional”, but it’s potentially even more therapeutic than other administration routes — depending on what you’re using it for. Rectal cannabis isn’t about sticking cannabis flowers into your anus — let’s get that really clear from the beginning. Specially formulated suppositories or, if for vaginal use, pessaries, are created for the purpose of putting cannabis in places the sun (almost) never arrives.

Your colon’s epithelium is rich with cannabinoid receptors, which automatically raises a very good argument for rectal cannabis use — especially if your ailment is colon-related. We’re also learning that cannabinoid receptor expression in the colon is a biomarker for certain colon inflammatory diseases.

It might not sound appealing and it’s probably not the way anybody would use cannabis recreationally. But if popping a small object in your anus to deal with otherwise treatment-resistant conditions like hemorrhoids or Crohn’s disease could help, you would probably do it, right?

What’s the case for rectal cannabis?

As we already just mentioned, the primary case for rectal use of cannabis is the fact that your colon contains cannabinoid receptors. They are biologically active to endogenous (and exogenous) cannabinoids, so sticking cannabis up your bum definitely does something.

Rectal cannabis might also be more bioavailable than other forms of cannabis, according to at least two studies. It’s thought that because rectal administration bypasses first-pass metabolism (in the liver), less of it is excreted and more of it arrives in systemic circulation. However, at the same time, most people who report using cannabis rectally say that the psychoactive effects are dramatically reduced, which suggests that the cannabinoids do something else. For some medicinal cannabis users, this is an advantage.

Others theorize that because cannabinoids get quickly delivered to local organs such as the liver and intestines, there is less opportunity for cannabinoids to pass the blood brain barrier.

There isn’t an awful lot of scientific research in the way of different health conditions that benefit more greatly from rectal use of cannabis. In one murine study, 2-AG (an endogenous cannabinoid) was rectally inserted in two doses and improved symptoms of colitis. This means we can at least hypothesize that cannabinoids are biologically active at the cannabinoid receptors in the colon — and rectal use delivers cannabinoids nearly directly to the colon.

What might someone use rectal cannabis for?

In the absence of nearly any scientific research, why would someone want to use rectal cannabis? Rick Simpson uses the theory of bioavailability to support the use of rectal cannabis for almost any therapeutic ailment that would call for cannabis.

But in reality, there’s just no need to stick cannabis up your bum if your problem is anxiety, restlessness or insomnia. But there might be a need if you suffer from diseases such as Crohn’s Disease, IBS, hemorrhoids, anal inflammatory problems or injuries (such as fissure, abscess).

Rectal or vaginal use of cannabis may also deliver cannabinoids to the pelvic area, pelvic veins and lymph vessels, and could therefore help with pelvic problems. But again, there’s a lot of debate as to whether or not cannabis makes it very far into systemic circulation if it's administered rectally, and there’s no scientific evidence to confirm either way.

Knowing what we know about cannabis, it makes a lot of sense to use cannabis for inflammatory conditions that revolve around that area. Locally, it is analgesic, and at the same time, can reduce inflammation at the site.

Bioavailability is always a big topic when it comes to cannabis. Therapeutics should be efficient, and a person shouldn’t have to take a copious amount to induce the necessary effects. Because of metabolic functions in the liver, stomach, and intestines, it’s easy for a lot of cannabinoids to be lost when consumed orally. The administration route is a way to mitigate some of these issues — if the problem is near the rectum or pelvis, put the medicine there or as close as possible.

Is the backdoor a better entrance?

Given the fact that most rectal cannabis users report a diminished psychoactive effect, it’s probably not something you want to do recreationally. Unless of course, you were just in the mood to experiment and add to your diverse range of life experiences. 

At the same time, there’s a lot of anecdotal evidence that rectal cannabis use might be therapeutically more effective than oral cannabis. There’s also some evidence that cannabis is more bioavailable through the backdoor thanks to bypassing liver enzymes.

So is cannabis really better through the back entrance? Well, you probably have to try it to find out! If you’ve got a colon or rectal problem and have considered using cannabis, do you really have anything to lose?

Have you ever used rectal cannabis before? What did you use it for and was it therapeutically effective? We’d love to hear from you in the comments.