The use of marijuana as a medicine remains controversial, yet marijuana's active ingredient is regularly prescribed in both Canada and the U.S.

In fact, pills that contain THC, like Marinol (dronabinol) and Cesamet (nabilone), are often recommended as substitutes for marijuana.

But while it's easy to think of the treatments as equal, research highlights some important differences.

Time of Onset
A study conducted last year at the New York State Psychiatric Institute was the first ever to compare a THC pill, dronabinol, with smoked marijuana for managing pain.

In the study, smoking a joint took full effect within 15 minutes. Dronabinol, on the other hand, took 60-90 minutes to reach its peak.

As Florida physician Dr. Heather Auld points out in a recent article, a shorter time of onset is better for pain patients.

Duration of Effect
While marijuana and dronabinol performed about the same in pain reduction, the study found dronabinol's effect to last longer.

In this case, experts say a longer-acting treatment is preferable.

Dose Flexibility
The biggest advantage of smoking marijuana is the ability for patients to self-adjust dose. Due to the shorter time of onset, patients can easily adjust dosing by taking additional puffs when necessary.

On the other hand, the delay in onset of THC pills, combined with their extended action, makes it difficult and dangerous for patients to self-adjust dose.

Studies show that both smoked marijuana and dronabinol suffer from inconsistent bioavailability, which also makes it difficult for doctors to predict dosing. This makes the flexibility offered by smoking even more beneficial.

Also, while it might be inconvenient to roll a joint every couple hours, vaporizers are widely preferred by doctors, and provide an easier way for patients to take marijuana throughout the day.

Side Effects
A study concluded that patients get just as high from taking dronabinol as they do from smoking a joint.

On the other hand, some believe dronabinol's delay in onset could make it less subject to abuse.

Source: LeafScience