The endocannabinoid system (ECS) consists of cannabinoid receptors and endocannabinoids.
Cannabinoid receptors are proteins that can be thought of as a lock that can be activated by specific molecules including cannabinoids. There are two main cannabinoid receptors CB1 and CB2 that are present in various areas throughout the body.
CB1 receptors: These are located primarily in the brain and central nervous system.
CB2 receptors: These are located primarily in the peripheral nervous system, such as immune cells and the gut.
Endocannabinoids are molecules that are produced naturally in the body and can be thought of as the “keys” that activate the cannabinoid receptors. The term endocannabinoid can be broken into two parts, “endo” short for endogenous meaning originating from an organism and “cannabinoid” which are a family of molecules named after the cannabis plant. The two main endocannabinoids are: anandamide and 2-arachadonyl-glycerol (2-AG).
The ECS controls a number of physiological functions that maintain homeostasis (balance) in a wide range of living organisms including humans.
Cannabis, like all plants is complex and contains a large number of compounds (over 400 identified). However, there are three main chemical groups commonly discussed, these are cannabinoids, terpenes and flavonoids.
Cannabinoids are often the most abundant compounds found in cannabis and can account for up to 20-30%+ of the mass of cannabis flowers. The most common cannabinoids found in cannabis are:
THC: This is the cannabinoid that produces the intoxicating effect of cannabis and has many potential therapeutic effects including; pain relief, nausea relief, appetite stimulation, improved sleep and reduced seizure frequency.
CBD: This is a non-psychoactive (non-intoxicating) cannabinoid found in high concentrations in many cannabis varieties. CBD may provide relief for conditions such as anxiety, skin conditions, epilepsy and pain as well as having potential neuro-protective and anti-psychotic properties. It is also thought that CBD may help with bone recovery.
Terpenes are compounds that produce the smell of the cannabis plant (and almost all plants) and have antioxidant, anti-inflammatory, antibacterial, and antifungal properties. Common terpenes found in cannabis include;
Limonene (also found in lemons and citrus fruits)
Linalool (also found in mints and lavender)
Beta-caryophyllene (also found in hops and black pepper)
Beta-myrcene (also found in lemongrass and thyme)
Alpha-pinene (also found in pine trees)
Flavonoids, like terpenes also contribute to the smell of the cannabis flower and contribute the vibrant colours found in many fruits and vegetables. Flavonoids may also be used as an antioxidant, anti-inflammatory, anti-tumour and pain relief.
THC and CBD both come from a family of compounds called phytocannabinoids (cannabinoids produced by plants) and are the major compounds found in cannabis.
THC and CBD have subtle differences and act in different areas of the body.
The primary difference is that THC produces intoxicating effects (high) whilst CBD has no intoxicating effects.
THC primarily acts on the CB1 and CB2 receptors whilst CBD has minimal interaction with these receptors and is thought to act on other biological pathways to provide therapeutic effects.
Hence THC and CBD are often used to treat separate conditions/symptoms.
Cannabis has chemical compounds called phytocannabinoids which interact with the endocannabinoid system (ECS) present in every human.
The interaction between the phytocannabinoids and the ECS can be thought of in terms of a lock and key.
The ECS contains proteins called receptors which act as the locks. Phytocannibinoids then act as the keys that bind to the receptors of the ECS (the lock) and produce a response in the body.
The interaction between these phytocannabinoids with the receptors of the ECS has shown potential to treat a number of conditions.
Medicinal cannabis has been linked to the treatment of many conditions and symptoms for a range of ailments. Some of the most well documented and promising leads for medicinal cannabis use are:
Spasticity in MS patients (THC+CBD)
Chronic/neuropathic pain (THC/CBD)
Chemotherapy-induced nausea (THC)
Wasting syndrome from HIV/AIDS (THC)
It is important to note that many of these conditions are not approved uses for medicinal cannabis, however, both anecdotal evidence and early stage clinical studies have been reported which support the efficacy of medicinal cannabis to treat these conditions.
Cannabis contains a number of active compounds with only one of these (THC) producing a notable “high”.
Many conditions may be treated with medicinal cannabis products that contain no THC and hence these products will not get you high.
However, for certain conditions such as pain and glaucoma, it is likely the necessary medicinal cannabis product will contain THC and hence will produce the intoxicating effect associated with cannabis.
One of the active compounds in cannabis, CBD, may moderate the intoxicating effect of THC and could be used to counteract some of the intoxicating effects associated with cannabis. This has led to the popularity of cannabis strains and formulations which have an even ratio of CBD and THC.
Responsible use is essential - patients should avoid dangerous tasks like driving after consuming THC products.
Medicinal cannabis products are produced to a high standard to ensure the safety of the medicine.
Although adverse effects are possible and there are risks associated with all medicines, medicinal cannabis has an excellent safety profile and adverse effects are often mild.
However this should be discussed with your Health Care Professional.
Common side effects include:
Medicinal cannabis may also cause increased appetite, increased heart rate, liver damage and change blood pressure.
Hence, cannabis is not recommended for patients with heart conditions or who are on blood pressure medication.
Medicinal cannabis is also potentially unsafe while pregnant and breastfeeding, however research on this is limited and hence caution is advised.
There may also be increased risks in certain drug forms such as inhalation since smoking or vaporizing the plant may cause damage to the lungs. However, not all medicinal cannabis products require inhalation and hence these adverse effects can be avoided.
No, you do not have to smoke medicinal cannabis. Many medicinal cannabis products will be in the same form as current medicinal products (pills, sprays, drops etc).
Although some medicinal cannabis products will be in a form that can be smoked or vaporized, smoking medicinal cannabis is not recommended.
Consistent delivery of active cannabinoids is difficult to achieve with smoking. Further, the smoking of any substance is associated with significant health hazards such as lung disease.