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Various articles and educational resources relating to medicinal cannabis
Explore various articles and other educational resources on the topic of medicinal cannabis
According to research, a number of medical illnesses can benefit from the use of medical cannabis.
When used responsibly and with the proper knowledge, cannabis is safe to consume.
Cannabis contains cannabinoids, such as THC and CBD. The human body contains a network of receptors known as the Endocannabinoid System (ECS), to which these cannabinoids attach, resulting in effects that depend on the chemical. There are 60 different cannabinoids in the cannabis plant.
A brief history
Utilising cannabis as a medicine is not a new concept, and has been used in Asia before the Christian era. During the 19th century, medicinal cannabis found its way into Western medicine, reaching a peak in the last decade of the century.
The 20th century saw the Western use of medicinal cannabis decrease significantly due to difficulties obtaining consistent results from different batches of plant material with varying potencies.
Professor. Raphael Mechoulam, in the 1960s, began his cannabinoid research which would ultimately discover the chemical structure of cannabinoids. The ability to further isolate the cannabinoid THC (tetrahydrocannabinol) greatly increased scientific interest in the cannabis plant. The pharmacological, metabolical and clinical effects were studied in detail, and the discoveries paved the way for further discoveries, such as the finding of cannabinoid receptors and the endocannabinoid system within the human body.
Cannabis is made up of main active ingredients known as cannabinoids (phytocannabinoids), with the most common being THC (tetrahydrocannabinol) and CBD (cannabidiol). These are the most studied cannabinoids, but we are aware of over 100 different cannabinoids found in the plant.
THC and CBD have both been found to activate certain receptors in the body – the CB1 and CB2 receptors. These interactions mitigate and alter neurotransmitter release action. The key components, THC and CBD, have extensive medical potential and are effective in treating and managing a wide range of symptoms and conditions.
The 3 Species
CBD does not bind to the CB1 receptors, thus is considered non-psychoactive. It functions by slowing the degradation of natural endogenous endocannabinoids, increasing the quantities of endocannabinoids in the body. This is seen as an effective solution for anxiety, seizure, and pain conditions.
THC, on the other hand, does bind to the CB1 receptors in the brain, which causes the downregulation of neuronal signals. Thus it is considered psychoactive and impairing; however it does boost mood, relieve pain, stimulate appetite, and assist with sleep.
More than 100 different cannabinoids (cannabis-specific chemicals) have been identified in cannabis, but two, in particular, are medically important: Delta-9-Tetrahydrocannabinol (THC) and Cannabidiol (CBD).
THC and CBD act via the endocannabinoid system, and have different effects on the body. Medicinal cannabis products have different actions depending on the ratio of THC to CBD that they contain. CBD acts to balance out some of the adverse effects of THC, so combining THC with CBD can allow patients to consume higher doses of THC with a reduced risk of unwanted side-effects.
Medicinal cannabis products have different actions depending on the ratio of THC to CBD that they contain.
Medical Cannabis | Hemp | |
|---|---|---|
Origin | Cannabis sativa: the flowering strain with medical properties | Cannabis hemp: a fibrous ‘hemp’ strain |
Purpose | Strains are bred to produce cannabinoid-rich flowers | Strains are bred to produce fibre and seeds |
Application | Adjusted to medical formulations and used to treat various conditions & symptoms with accurate dosing. | Food, plastics, textiles, various hair and skin products, OTC CBD products |
Part of plant used | Predominantly flowers/buds, and occasionally the leaves and stems | Seeds and occasionally leaves and stems |
Cannabinoid levels | Over 100 cannabinoids, including THC and CBD | Almost no pharmacologically active compounds |
Production Methods | Resin is extracted from flowers and formulated into full-spectrum medical products | Seeds are pressed and the oils from these are collected and formulated into various products |
Hemp derived CBD oil and cannabis derived CBD oil are extremely similar, but have their differences.
The first main differentiator is cannabinoid content. CBD derived from hemp usually contains high concentrations of CBD, and very little THC, if measurable at all. CBD products derived from cannabis may contain significant amounts of THC.
Hemp products are legal in South Africa, as long as they don’t contain more than the extremely low specified amount of THC. These products are often sold as dietary supplements to assist in restoring balance in the body by stimulating the ECS. Cannabis derived CBD products can only be legally obtained by prescription.
Quite simply, cannabis extract utilising the whole plant contains the ‘full-spectrum’ or a ‘broad-spectrum’ range of cannabinoids as well as other plant materials. An isolate in contrast contains a single isolated cannabinoid.
The entire range of cannabinoids and other compounds such as terpenes can be found in ‘full-spectrum’ cannabis extract. In contrast, ‘broad-spectrum’ cannabis extract will not contain the entire range, but will have certain compounds removed to create an ideal balanced mixture, which is done in a strictly regulated environment and manner.
Isolates, meanwhile, will contain only one specific cannabinoid. This can be either naturally extracted from the plant material or manufactured in a laboratory to create a synthetic.
These various forms of cannabis extract provide differing physiological reactions in the body, thus providing certain therapeutic effects. However, these may also differ in their interactions with other medicines.
Terpenes are naturally occurring compounds found within all plants that provide various smells and tastes. These also contribute to the characteristics of certain strains, providing unique medical benefits in addition to the aromas and flavours. Below are six common terpenes found in the cannabis plant.
Pinene is a potent bronchodilator and may assist in the treatment of respiratory conditions like asthma.
Properties
- Anti-inflammatory
- Bronchodilator
- Energizing
Myrcene is able to add to THC effectiveness, as well as being a helpful sleep aid.
Properties
- Sedative
- Muscle Relaxant
- Sleep Aid
Limonene is a powerful antifungal, a strong mood-booster, antibacterial and anticarcinogenic terpene.
Properties
- Anti-anxiety
- Anti-depressant
- Anti-bacterial
Linalool shows great potential as an anti-convulsant and anti-bacterial agent, and includes pain and anxiety reduction qualities.
Properties
- Anaesthetic
- Anti-convulsant
- Anti-anxiety
Caryophyllene boasts medical properties against diabetes, depression, anxiety, osteoarthritis, and colitis.
Properties
- Anti-inflammatory
- Cell protection
- Analgesic
Humulene is considered to be anti-tumor, anti-bacterial, anti-inflammatory, and anorectic (suppresses appetite).
Properties
- Anti-inflammatory
- Appetite Suppressant
- Analgesic
Flavonoids are compounds which occur naturally in numerous plants and not cannabis alone. However, flavonoids that are unique to cannabis are known as ‘cannaflavins’.
These provide pigmintation to plants and their flowers, attracting insects for pollination. These compounds also filter harmful UV rays and fend off unwanted fungi or pests.
These compounds also work closely with terpenes in providing the smells and flavours cannabis is known for. In addition, they also contribute to the 'entourage effect', whereby these compounds work better in unison than they do when isolated and enhance the effects of THC, CBD and other cananbinoids.
Flavonoids are believed to be an anti-oxidative, anti-inflammatory, and anti-mutagenic and have their own anti-carcinogenic properties, as well as the ability to regulate the functions of key cellular enzymes.
The sublingual consumption method requires the drops to be placed under the patient's tongue and absorbed via mucus membranes. This provides a faster onset than ingestion. This method commonly takes 30-45 minutes to take effect, with a longer duration of 4-6 hours.
Inhalation requires the vaporisation of dried cannabis flower. This method removes the harsh and irritating effect on the lungs and throat associated with smoking/combustion of cannabis. This allows for a cleaner and healthier intake. This method has the quickest onset, usually within minutes, but a short duration of only 1-2 hours.
Ingestion includes eating or drinking a product in which medicinal cannabis is infused. This then passes through the stomach before reaching brain receptors. This method generally takes 60-90 minutes to take effect, with the longest lasting action of about 6-8 hours.
The use of topicals requires the application of cannabis cream or oil to the skin, which is then absorbed. This can offer relief to the affected area without the high, making it suitable for rash or skin irritation treatment.
When obtaining cannabis from an illegal market, there are numerous risks. Legal manufacturers adhere to strict regulations and procedures imposed by regulatory authorities; while illegal growers do not comply with any regulations.
Licensed manufacturers are given standards and guidelines to which they must adhere, to ensure the highest quality medical grade product, safe for the patient to consume.
There are a number of factors to take into consideration when choosing between legal or illegal cannabis:
In unregulated or illegal markets, the end product is not held to various standards.
This results in a low-quality product, with little consistency and minimal safety standards - which greatly increases the risk of adverse events.
Cannabis is host to numerous microorganisms, most of which are harmless, but harmful ones can be introduced with poor cultivation practices and human contamination.
Most patients are already immunocompromised, and unwanted pathogens pose a serious health risk.
When cannabis is obtained from an illegal source, it may be contaminated with harmful pesticides. Research has indicated that up to 70% of the pesticide content in cannabis is present in the smoke - all due to unregulated practices.
Illegal market cannabis is often obtained from an unknown source. This allows for inaccurate potency measures, which leaves consumers unsure as to what exactly they are consuming and further increases their risk of adverse events.
Cannabinoid receptors can be found throughout the body, within cell membranes, and are thought to be more numerous than any other bodily receptor system. Research has identified two cannabinoid receptors: CB1 - most commonly present in the nervous system, connective tissues, glands, gonads and organs; CB2, seen predominantly in the immune system and its associated structures. Researchers have even speculated that a third CB receptor awaits discovery.
CB1 receptors are primarily located in several regions of the brain and central nervous system (CNS). These are further found in the cerebellum and within both male and female reproductive systems. CB1 receptors mediate the psychoactive effect of cannabinoids. CB2 receptors are primarily distributed in the immune system, and appear to be responsible for anti-inflammatory and other immune-related activity.
Cannabinoids have garnered much attention and you may have found yourself wondering: what is the Endocannabinoid System, or ECS, and what role does it play? This is a molecular system that regulates many bodily processes, such as immune response, inter-cell communication, pain, sleep, inflammation, metabolism and appetite, memory, and more. It is via this receptor system and metabolic enzymes that cannabinoids interact within the body and trigger beneficial effects. Despite this system's importance, it was discovered relatively recently and is only just being fully understood by the larger medical community.
CB1 Receptors
CB1 receptors located in the brain and central nervous system:
Brain
Lungs
Vascular System
Muscles
Gastrointestinal Tract
Reproductive Organs
Immune System
Bone Marrow
Liver
Pancreas
CB2 Receptors
CB2 receptors found on cells throughout the immune system:
Spleen
Bones
Skin
Immune System
Liver
Bone Marrow
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