In light of the increasing buzz around medical cannabis, it’s worth slowing down to ask what exactly is cannabis, how does it affect the body, and what are the medical applications?

Cannabis (cannabis sativa) is a multi-use crop which has been cultivated for thousands of years. There are three variants of the plant: C. Sativa, C. Indica, and hybrid strains, with each resulting in different psychological and physiological effects depending on the cannabinoids and other compounds of the plant.

Although the cannabis plant contains nearly five hundred identified compounds, only about 85 are cannabinoids, and the two most relevant to its medical applications thus far are THC (delta 9 tetrahydrocannabinol) and CBD (Cannabidiol) (Hand et al 2016).

As we discussed in our post on the endocannabinoid system, cannabinoids – whether those produced naturally in our bodies or those found in medical cannabis – bind to receptors throughout our body to tell it to take a particular action when it gets ‘out of balance’ (Di Marzo et al 2014). This process results in a range of responses, from managing our immune system to actually forming thoughts (Sadhir 2016).

The physical and psychological benefits of cannabis are becoming more established among medical researchers despite the Schedule I Controlled Substance classification in the United States and Schedule II classification in Canada. Indeed, two 2017 meta-analyses reviewed over 10,000 studies published since 1999 and found clinical evidence for the medical benefits of cannabis outlined below (McCormick et al 2017; Dowsett et al 2017). The rest of this post will go over the two major cannabinoids for medical applications, the strains they are found in, and their effects.

THC is the chemical which causes the psychoactive ‘high’ in the mind and/or body often associated with cannabis consumption and has been found to be effective for patients with nerve related pain, chronic pain, migraines, inflammation, nausea management, and appetite stimulation (Dowsett et al 2017; McCormick et al 2017; Hand et al 2016; Sadhir 2016). THC is typically dominant in the Sativa strain (although Indica can be high in it as well) – a tall and thin variant – with general effects of alertness, increased energy, uplifting or euphoric sensations, and appetite stimulation, and so is typically prescribed for day-time use (Leweke et al 2012; Dowsett et al 2017; Nahtigal et al 2016).

CBD is considered non-psychoactive, and is often prescribed to relieve symptoms treatable through medical cannabis while avoiding or minimizing the consciousness-altering effects (Leweke et al 2012; Joy et al 1999). The mild effects of CBD have even led to successful treatments with children (McCormick et al 2017). Strains high in CBD have been used in anticonvulsant treatment in severe forms of epilepsy and the ‘tremors’ associated with Parkinson’s and certain spinal cord injuries, as well as in treatments for diabetes, sleeping disorders, anxiety, pain management, and inflammation (Dowsett et al 2017; McCormick et al 2017; Greydanus & Merrick 2016; Hand et al 2016). Higher levels of CBD are found in Indica strains (which also have more balanced mixtures of CBD and THC), which are short and wide, and have general effects of relaxation and sleepiness. For this reason, Indica strains are typically prescribed for evening and night-time use.

Licensed and Personal Producers have developed a variety of strains with different concentrations of cannabinoids so as to target particular effects and conditions. As always, you should only pursue medical cannabis through a slow and documented treatment plan and in consultation with your physician and Patient Educator.

 

References:

  • Di Marzo, V. et al. 2004. The endocannabinoid system and its therapeutic exploitation. Nature reviews Drug discovery, 3(9), 771-784.
  • Dowsett, L.E. et al. 2017. Cannabis Evidence Series: An Evidence Synthesis. Calgary: Government of Alberta.
  • Greydanus, D.E., & Merrick, J. 2016. Cannabis or marijuana: A review. Journal of Pain Management, 9(4), 347-373.
  • Hand, A., Blake, A., Kerrigan, P., Samuel, P., Friedberg, J. (2016). History of Medical Cannabis. Journal of Pain Management, 9(4), 387-394.
  • Joy et al eds. (1999). Marijuana and medicine: assessing the scientific base. National Academies Press.
  • Leweke et al (2012). Cannabidiol enhances anandamide signalling and alleviates psychotic symptoms of schizophrenia. Translational Psychiatry, 2(3)
  • McCormick, M. et al. (2017). The Health Effects of Cannabis and Cannabinoids: The Current State of Evidence and Recommendations for Research. Washington: The National Academies Press.
  • Nahtigal et al. 2016. The pharmacological properties of Cannabis. Journal of Pain Management, 9(4), 481-491.
  • Sadhir. 2016. Pharmacology of Cannabis. Journal of Pain Management, 9(4), 375-379.