Treatments-benefits-medical-marijuana

Treatments and Benefits

What are Cannabinoids?
There are three types of cannabinoids known to scientists today: endocannabinoids (found within the human body), phytocannabinoids (found in plants such as cannabis), and ones created in a lab known as synthetic cannabinoids. In addition to cannabinoids, the chemical profile of the cannabis plant contains other compounds like terpenoids, amino acids, proteins, sugars, enzymes, fatty acids, esters, and flavonoids, just to name a few.


Choose a Cannabinoid

  • CBC: Cannabichromene
    (CBC)
     is a cannabinoid found in the cannabis plant that is believed to inhibit inflammation and pain, stimulate new bone growth, and block the growth of cancerous tumors.


  • CBD: Cannabidiol
    (CBD)
     is a cannabinoid that gives cannabis its sedative effect, and has been known to ease a number of symptoms from difficult conditions and disorders related to rheumatoid arthritis, autoimmune diseases, diabetes, epilepsy, nausea, bowel disorders, schizophrenia, and many more.


  • CBN: Cannabinol
    (CBN)
     is a cannabinoid found in cannabis that acts as a natural sleep-aid for those suffering from insomnia, sleep apnea, and other sleep disorders. Cannabinol contains antibacterial properties (when applied as a topical), and stimulates bone growth to help combat osteoporosis in patients.



    • CBG: Cannabigerol
      (CBG)
       is a non-psychoactive cannabinoid found in cannabis. Cannabigerol is typically found in higher concentrations in hemp rather than in varieties of cannabis cultivated for high THC content and their corresponding psychoactive properties.


    • CBG: Cannabigerol
      (CBG)
       is a non-psychoactive cannabinoid found in cannabis. Cannabigerol is typically found in higher concentrations in hemp rather than in varieties of cannabis cultivated for high THC content and their corresponding psychoactive properties.


    • CBN: Cannabinol
      (CBN)
       is a cannabinoid found in cannabis that acts as a natural sleep-aid for those suffering from insomnia, sleep apnea, and other sleep disorders. Cannabinol contains anti-bacterial properties (when applied as a topical), and stimulates bone growth to help combat osteoporosis in patients.




    Medical Marijuana: Much More Than Just THC and CBD

    For years now Δ9-tetrahydrocannabinol (THC) has been the most popular and widely researched cannabinoid in cannabis science. However, nowadays it seems like cannabidiol (CBD) has stolen the spotlight given its ability to provide therapeutic relief to children suffering from various epileptic disorders, while lacking the psychotropic effects (i.e. high) of THC. It’s even gotten to the point that state legislature are passing laws “CBD-only” medical marijuana legislation.

    Given all of this, it is easy to see how CBD and THC can be viewed as being in competition. But the reality is that both compounds, along with as many as 66 other cannabinoids, play important roles in providing the therapeutic benefits associated with cannabis therapy. They work in conjunction with approximately 420 additional compounds (terpenes, flavonoids, etc.) to give cannabis its versatility in treating a multitude of medical ailments.

    You might be familiar with the the Big Six cannabinoids: THC, CBD, CBG, CBN, CBC, and THCV. Each cannabis plant contains these and many other cannabinoids at various percentages as part of the plant’s total chemical profile.

    “The chemical profile of the cannabis plant contains other compounds like terpenoids, amino acids, proteins, sugars, enzymes, fatty acids, esters, and flavonoids…”

    In addition to cannabinoids, the chemical profile of the cannabis plant contains other compounds like terpenoids, amino acids, proteins, sugars, enzymes, fatty acids, esters, and flavonoids, just to name a few.

    Naturally, you consume all of these compounds when medicating with cannabis. The question is how do all of these compounds work together to provide therapeutic relief? The answer can be found in a concept called the “entourage effect.”

    In addition to cannabinoids, the chemical profile of the cannabis plant contains other compounds like terpenoids, amino acids, proteins, sugars, enzymes, fatty acids, esters, and flavonoids, just to name a few.

    Naturally, you consume all of these compounds when medicating with cannabis. The question is how do all of these compounds work together to provide therapeutic relief? The answer can be found in a concept called the “entourage effect.”

    The Entourage Effect: Chemical Teamwork

    First described in 1998 by Israeli scientists Shimon Ben-Shabat and Raphael Mechoulam, the basic idea of the entourage effect is that cannabinoids within the cannabis plant work together, or possess synergy, and affect the body in a mechanism similar to the body’s own endocannabinoid system.

    This theory serves as the foundation for a relatively controversial idea within pharmacology community, that in certain cases whole plant extractions serve as better therapeutic agents than individual cannabinoid extractions. The entourage effect theory has been expanded in recent times by Wagner and Ulrich-Merzenich, who define the four basic mechanisms of whole plant extract synergy as follows:
    1. Ability to affect multiple targets within the body
    2. Ability to improve the absorption of active ingredients
    3. Ability to overcome bacterial defense mechanisms
    4. Ability to minimize adverse side effects.

    Affecting Multiple Targets

    Many studies have demonstrated the effectiveness of cannabis as a therapeutic agent for muscle spasms associated with multiple sclerosis. A study conducted by Wilkinson and colleagues determined that whole-plant extracts were more effective than THC alone.

    Researchers compared 1mg THC vs. 5mg/kg cannabis extract with the equivalent amount of THC, and found the whole plant extract to have significantly more antispastic effect.

    The researchers attributed this result to the presence of cannabidiol (CBD) within the cannabis extract, which helps to facilitate the activity of the body’s endocannbinoid system.

    Improving Absorption Of Active Ingredients

    The entourage effect can also work to improve the absorption of cannabis extracts. Cannabinoids are chemically polar compounds, which makes them at times makes them difficult for the body to absorb in isolation.

    “With the assistance of terpenoids like caryophyllene, absorption of cannabinoids can be increased.”

    Absorption of topicals provides a prototypical example of this problem. The skin is made up of two layers, also known as a bi-layer, which makes it difficult for for very polar molecules like water and cannabioids to pass through.

    With the assistance of terpenoids like caryophyllene, absorption of cannabinoids can be increased and therapeutic benefits achieved.

    Overcoming Bacterial Defense Mechanisms

    The entourage effect also accounts for cannabis extracts to be effective in treating various bacterial infections. There are a number of studies which show the antibacterial properties of cannabinoids.

    “Whole-plant cannabis extracts have non-cannabinoid constituents which also have antibacterial properties.”

    However, bacteria develop defense mechanisms over time to combat the effects of antibiotics ultimately allowing them to become resistant to therapies which were previously effective.

    Thus, it is beneficial that whole-plant cannabis extracts have non-cannabinoid constituents that also have antibacterial properties. These molecules attack bacteria through pathways which differ from cannabinoid pathways. Given the attack on multiple fronts, the development of bacterial resistance is limited.

    Minimizing Adverse Side Effects

    Finally, the entourage effect allows certain cannabinoids to modulate the negative side effects of other cannabinoids. The most fitting example of this is CBD’s ability to modulate the perceived negative effects of THC.

    Many patients have heard about (or experienced) the increased anxiety and paranoia sometimes associated with cannabis consumption. Thanks to the entourage effect, research has shown that CBD can be effective in minimizing the anxiety associated with THC, lowering users’ feelings of paranoia.

    As you can see, THC, CBD, and the remaining cannabinoids don’t have to compete with one another – they can work in tandem alongside the other components of cannabis extracts to provide therapeutic relief for a wide variety of ailments.


    Finding The Optimal Therapeutic Ratio Of THC And CBD

    We have explored the entourage effect and how all the compounds within the cannabis plant work together to give the plant its therapeutic versatility. But one question remains in minds of many medical cannabis patients: “What is the optimal ratio of cannabinoids for my needs?” The answer, like many questions in the world of medicine, is still being researched.

    Given the fact that tetrahydrocannabinol (THC) and cannabidiol (CBD) are the two most prominent chemical compounds in the cannabis plant, the vast majority of research to date has focused on the ratio of these two cannabinoids. While the ability to control cannabinoid ratios within your own medicine remains limited, the information provided here will hopefully give you some insight into the future of cannabis based therapy.

    THC and CBD: The Beginning Of A Beautiful Friendship

    Research on the benefits of tetrahydrocannabinol (THC) and cannabidiol (CBD) in isolation is well established. THC demonstrates analgesic, anti-emetic, and anti-inflammatory properties, whereas CBD possesses anti-psychotic, anti-seizure, and anti-anxiety properties.

    “Subjects reported more pleasurable effects and less anxiety with the combination of CBD and THC than they felt with THC alone.”

    However, research on the simultaneous use of THC:CBD is less robust – its origins can be traced to Brazil in the mid-1970s. In this study, patients were given between 15-60mg of CBD in conjunction with 30mg of THC, and the effects were measured. Subjects reported more pleasurable effects and less anxiety with the combination of CBD and THC than they felt with THC alone. 

    Furthermore, a group of scientists examined the effects of administering CBD at a dose six times that of THC. They found that 73% of study participants reported a decreased feeling of being “high” when compared to THC alone. 

    Follow-up studies have demonstrated that the combination of the two cannabinoids reduced users’ experiences of tachycardia (increased heart rate), gait instability, and difficulty in eye tracking exercises. These results support the theory that CBD works to minimize some of the negative side effects of THC. 

    Modern Therapeutic Applications Of The Cannabinoid Ratio

    The most recent research into THC:CBD ratios comes out of the pharmaceutical industry, specifically around the GW Pharmaceuticals‘ Sativex, which has a 1:1 ratio of THC and CBD. In the clinical trials phase of drug development, researchers examined the effects of THC, CBD, and combination extracts on sleep, pain control, and muscle spasms. They found that 1:1 THC-CBD extracts provided the most therapeutic relief across all categories. 

    THC and CBD combinations also show therapeutic promise across a number of disease states for which there has been limited therapeutic breakthrough to date. 

    In Amyotrophic Lateral Sclerosis (ALS), THC has been shown to delay motor deterioration and increase long term survival. Recent work has built on this study to show that the addition of CBD in conjunction with THC leads to a 14% increase in motor performance and an increase in survival beyond the survival rates with THC alone.

    In cancer, cannabis has long been credited with helping people combat the nausea associated with chemotherapy. Furthermore, THC and CBD each possess cytotoxic (cell destroying) and anti-angiogenic (prevention of development of new blood vessels) properties. These two properties are critical to combating the spread of cancer within the body, making whole-plant cannabis extracts a viable medical option. 

    Practical Implications For Medical Marijuana Patients

    As it stands, there is still an overwhelming trend towards favoring one cannabinoid over another. Due to federal prohibition in the US, the vast majority of cannabis is grown indoors. Additionally, historical patient demand has pushed cultivators to favor strains with higher THC. 

    Thus the typical products in your local dispensary will have THC:CBD ratios as high as 20:1 for flowers and 80:1 for concentrates. However, given the emergence of CBD into the public consciousness, more people are considering cannabinoid ratios.

    “Standardized testing is essential to the advancement of our understanding of this issue.” – Dr. Jeffrey Hergenrather

    Dr. Jeffery Hergenrather, President of the Society of Cannabis Clinicians, addressed the issue of cannabinoid ratios as follows: 

    “While cannabinoid ratios in most cannabis may be about the same, it is the terpene content which typically creates the different qualities that we have parsed as the difference between Indicas and Sativas for some time. It is highly likely that terpenes may very well alter the properties of the cannabinoids. Standardized testing is essential to the advancement of our understanding of this issue.” 

    Overall, we are still very much in the infancy of our understanding of the therapeutic potential of cannabis. But it is important as we move forward to be inclusive of whole-plant cannabis medicine in our policy making and not hold some cannabinoids in higher esteem than others. To do otherwise could leave a lot of sick people without viable medical solutions.

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    FROM THE MJ DIRECTORY: Malik Burnett, MD
    Dr. Malik Burnett is a physician advocate who completed his medical and business training at Duke University. He believes that a public which is better informed about the science behind cannabis will be able to use cannabis safely and experience its many benefits. He is currently a Policy Manager in the Office of National Affairs at the Drug Policy Alliance in Washington DC and a contributor for Medical Jane. 

    Information source: medicaljane.com


    CHOOSE AN AILMENT  :  medicaljane.com



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