Cannabis as Medicine: 101

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The “sacred” plant, as many of our ancestors referred to it, has traditionally been used as a first line of therapy in various parts of the world.

For most cultures, the use of cannabis as a medicine can be traced back to thousands of years ago. For the Chinese, early uses have been reported dating back to 2700 B.C., where the herb was used for its anti-depressant, antiseptic, antibiotic, analgesic, anesthetic and sedative properties.  

As time started to pass by, the healing theories of marijuana plants were quickly replaced by those of big pharmaceutical companies. Without a doubt, pills were immediately introduced to the market. The Canadian government paid less attention to cannabis having medicinal properties, and added it to a list of restricted drugs under the Opium and Narcotic act in 1923.

Legalization of medical use

It wasn’t until the movement by thousands of patients and patient advocates in the 1990’s that propelled the government to allow fair access to medical marijuana. This brought the legislative act known as the Medical Marijuana Access and Resources (MMAR) into legislature on July 30th, 2001 permitted patients access to cannabis for medicinal purposes, from Licensed Producers approved by Health Canada. Patients also had the right to produce their own or designate a grower to produce medical cannabis on their behalf.

oil 205x300 - Cannabis as Medicine: 101  Due to uncertainty and lack of controlling measures, the government further restricted medical cannabis access by preventing patients from having growing privileges. This restriction gave origin to the new legislative, known as the Marijuana for Medical Purposes Regulations (MMPR). Canadian patients were again appalled which forced the government to change their rules and revert back and adopt the original parameters of the MMAR allowing patients access to cannabis from both Licensed Producers as well as the option to grow their own medical cannabis or have a designated grower. This legislative was known as the Access to Cannabis for Medical Purposes Regulations, or simply the ACMPR.

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As of October 17th 2018, the Canadian government has decriminalized recreational use of cannabis under legislative bill C-45, also known as the Cannabis Act. The passing of bill C-45 has created a legal framework for recreational users and has also incorporated the rules and regulations of the ACMPR.

The cannabis movements taking place throughout time had definitively attracted a lot of attention from physicians and scientists around the world. The renewed focus led to questions around the medicinal properties of cannabis, and how they interact with the human body.

The Endocannabinoid System

It was the works of Dr. Raphael Mechoulam and his team of scientists that led to important discoveries of endogenous and exogenous cannabinoids and their interactions with receptors in the human body and brain referred to as the Endocannabinoid system (ECS).

The ECS has been identified in humans as early as during the developmental stages of an embryo. The ECS is the body’s natural system that works to regulate and maintain homeostasis. The brain produces endogenous cannabinoids, referred to as endocannabinoids. The two most well-researched endocannabinoids, called Anandamide (ANA) and 2-Arichidonylglycerol (2-AG), interact with the cannabinoid receptors, CB1 and CB2, located throughout the human body. Once the naturally occurring molecules interact with its receptors, a series of downstream effects occur which protect the mind and body from pathological illnesses. As the body ages, it experiences both internal and external stress; this reduces the natural production of our endocannabinoids, leading to a disruption in the body’s homeostasis, eventually resulting in acute and chronic medical conditions.

THC and CBD

Dr. Mechoulam also led his team to discover the significance of natural plant cannabinoids: tetrahydrocannabinol (THC) and cannabidiol (CBD). THC is known for its psychoactive “high” effects, whereas CBD, is devoid of these properties. These two phytocannabinoids have demonstrated the ability to interact with cannabinoid receptors CB1 and CB2 located within the human body and brain, causing anti-inflammatory, anti-spasmodic and anti-epileptic effects, along with regulating a patient’s mood, appetite and sleep patterns.

The “Entourage Effect”

The plant molecule in is fact composed of thousands of additional phytocannabinoids, along with terpenes and flavonoids, biological compounds that provide added medicinal properties and aromas of the plant. These all interact together and enhance the medical effects of cannabinoids on its receptors, which is known as the “entourage effect”.

Some key terpenes to be noted are:

  • Beta-Myrcene: Analgesic, anti-inflammatory, antibiotic, and anti-mutagenic properties.
  • Limonene: Anti-fungal properties.
  • Pinene: Anti-inflammatory, a bronchodilator, and antiseptic properties.
  • Linalool: Improve cognitive and emotional functions, decrease inflammation, and promotes calming and relaxing effects.
  • Beta-caryophyllene: Anti-inflammatory and antinociceptive properties.

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Medical uses of cannabis:

Many research studies conducted in animals and humans support the claims that cannabis can be used to help a variety of medical conditions, including, but not limited to:

  • alleviating acute and chronic pain due to medical conditions such as fibromyalgia, pain from motor vehicle accidents, and pain due to various types of cancer,
  • controlling muscular spasms related to Multiple Sclerosis,
  • stimulating appetite and relieving nausea for patients undergoing chemotherapy,
  • controlling seizures in epileptic patients for both the pediatric and adult population,
  • controlling behavioural outbursts and reducing anxiety in individuals affected by autism spectrum disorders (ASD),
  • improving mood and regulating sleep for patients suffering from depression, anxiety, and post-traumatic stress disorder (PTSD), and
  • reducing the gastrointestinal inflammation of inflammatory bowel diseases such as Crohn’s disease and Ulcerative Colitis

Consequences of Cannabis Use

Like any medication, there are side effects to the use of the cannabis plant. According to Health Canada, patients should be aware of the following:

  • short and long-term effects in concentration and decision-making,
  • may cause or worsen depression and anxiety,
  • may lead to a psychotic episode,
  • may worsen or lead to cardiovascular or respiratory disease, and
  • may negatively impact the reproductive organs and it functions for both males and females.

Consumption Methods:

Methods of consuming cannabis depend on a lot from one’s environmental influence and cultural upbringings. For free-spirited individuals during the 70s, it is natural to smoke a joint (grinded cannabis rolled into a cigarette paper), whereas for many senior citizens, the concept of smoking herb may have a lot of stigmas associated with it, hence reaching out for cannabis-infused ingestible may seem socially and morally acceptable.

Whatever the consumption method may be, as a cannabis user, there are few important things to keep in minds such as the time for onset of medicine to take effect and the duration of effects.

Inhalation

Whether you decide to smoke or alternatively vaporize cannabis, the onset of action is typically within 15 minutes, and can last up to 4 hours. Most patients tend to share favourable feedback as the quick onset of action allows for relief from break-through pain and anxiety that they may experience at any given point during the day.

For patients interested in smoking, patients can light up a joint. Unfortunately, the burning of paper releases combustive material which may be toxic to the lungs.

An alternative to smoking a joint is to inhale cannabis using a medical device known as a vaporizer. Patients will fill the electronic device with dry flower, heat the instrument, and slowly inhale. This significantly reduces the potential harm to the user’s respiratory organs.

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Ingestion, topical, and rectal

Oils can be consumed in its raw form by placing a few drops under the tongue (sublingually) or may be incorporated into a tea or juice. Oils can also be used in cooking to create baked goods or healthy meals.

Oils can also be packed into gel capsules taken orally or as suppositories for rectal administration.

The onset effects generally take 30-90 minutes and may last up to 6-8 hours, causing long lasting relief. Most patients tend to benefit using cannabis oils later in the day, providing overnight relief from their ailment.

Oils may also be combined with base cream to create a topical ointment. The cream is applied to areas of inflammation and pain and provides faster relief with a shorter duration of effects.

Is Cannabis right for you?

Although there is an immense amount of research that still needs to be conducted by the Canadian government and universities, there is also a considerable amount of anecdotal evidence that supports the use of this natural plant product.

The question, “is cannabis right for you” is a question you should definitely engage your primary care physician or a knowledgeable and experienced health care professional.

Each individual will react and respond differently to the cannabinoid profile of a plant. It thus becomes imperative for medical cannabis seekers to follow the medical framework for appropriate education and receive professional guidance on strain selection, dosing, and consumption of the medicine.

The more the government invests, the more knowledge will be imposed on the medical community, the safer the outcomes for Canadians patients.

Until next time, stay safe and medicate appropriately.

 

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