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Interesting facts about medical marijuana

Publications 15 November 2022 No Comments

Medical marijuana becomes more and more popular as an alternative way to treat multiple ailments. Simultaneously, CBD oils and cannabis cosmetics are getting as precious as gold. Well, not really. But you probably get the point… What is it about this plant that attracts so many people? What is the difference between medical and recreational marijuana? What does science have to say about the therapeutic potential of 'weed'? Sit tight because we have the answers for you!

What is ‘marijuana’ exactly?

Marijuana is the name of the dried inflorescences from female, non-pollinated Cannabis sativa plants. For millennia, people have used marijuana for its psychoactive, relaxing or analgesic effects. Nowadays, it is considered to be a soft drug, which in many countries is illegal to grow or distribute. However, in recent years several states in the US have legalized the medical use of marijuana, and ever since the industry is booming. Now, let’s take a closer look at these plants, shall we?

There are two main subspecies of cannabis that exhibit psychoactive properties: sativa and indica. Although similar, they slightly differ in respect both to physical structure as well as the influence on the human organism. Sativa plants are taller – they can reach up to 3 meters in height – and induce high mood, energy as well as appetite. Indica plants, on the other hand, grow no taller than 1.5 meters but are bushier and prompt relaxation with drowsiness. Noteworthy, it is unlikely to find a pure sativa or indica plant as hybrids are much more common. 

Every cannabis plant contains numerous active compounds that are responsible for the influence of marijuana on the human organism. These chemical substances, mostly cannabinoids, are almost exclusively present in cannabis. They can also be produced, surprisingly, in the human body! That is perhaps the reason why marijuana is able to exert many different effects – in a way, it fits with our innate structure, the so-called endocannabinoid system. And no, unfortunately our body does not produce CBD oil, but it is able to synthesize other compounds, e.g., anandamide (by the way, “ananda” means “bliss” in Hindi). Naturally, many questions still need to be answered, and the researchers are working towards it. By now, they have isolated multiple cannabinoids that seem to play an important role in the therapeutic potential of marijuana.

The (in)famous THC

Perhaps the most well-known (and the most controversial) cannabinoid is called Δ9-tetrahydrocannabinol, or THC for short. In 1964, it was isolated by Bulgarian-born chemist Raphael Mechoulam in his laboratory in Israel. This ingredient of marijuana is primarily responsible for its psychoactive effects – the influence on mood, senses, and the mild relaxation commonly known as ‘high’. What is more, results of various research studies have established that it has analgesic, anti-inflammatory, neuroprotective and antispastic effects. For these reasons, various clinical tests have assessed its therapeutic potential in the context of multiple diseases.

The ‘sober’ CBD

The next highly important cannabinoid is known as cannabidiol or CBD. Interestingly, it has been discovered earlier than THC – in 1940 by Roger Adams – but only recently has gained a similar recognizability. This is mostly due to the rise of CBD products that basically offer benefits traditionally associated with THC but without the psychoactive part. Additionally, clinical tests have demonstrated that CBD actually has analgesic, anticonvulsant, and anti-inflammatory properties.

The hidden gems

THC and CBD are by no means the only ingredients of cannabis that can potentially influence the human organism. By now, scientists have identified over 500 active compounds contained in these plants. Among them, the most important are terpenes (e.g. β-myrcene, limonene, α-pinene), flavonoids (e.g. apigenin, quercetin, kaempferol), phenolic compounds and phytosterols. Interestingly, some of them can interact with cannabinoids and thereby modify their effects. For instance, terpenes – particularly densely packed in cannabis oils – can either act in synergy with THC or CBD, and thus enhance them, or inhibit them. In the case of CBD, terpenes appear to block the transport of cannabinoids from the blood to the brain. This variety of compounds present in cannabis accounts for the differences between supplementing pure cannabinoids versus administering marijuana as such. This effect has even been researched by scientists and is known as the ‘entourage effect’. It refers to the idea that some compounds found in hemp (other than THC) can possibly act in synergy with each other, strengthening their effects.

Medical versus recreational

Every cannabis plant contains some amount of cannabinoids and thus provides certain effects. Yet, in the case of medical marijuana, scientists select certain breeds and cross them in order to achieve a desired proportion of THC and CBD. The cultivation environment and material harvest are carefully controlled as extracts are standardized. Thus, the percentage of cannabinoid content is clear. This is not possible to achieve in the case of recreational marijuana, as there are no clear guidelines regarding its cultivation. Why is standardization so important for medical cannabis, though? Scientific evidence shows that some disorders and symptoms can be better treated with cannabidiol, while others – with tetrahydrocannabinol. Therefore, for medical professionals it is essential to know the chemical composition of marijuana. Usually, a qualified specialist decides on the strain of hemp and advises the optimal way of administration as well as dosing. 

Another distinctive difference between medical and recreational marijuana is the way it is being administered. Recreationally, people usually smoke hemp using special pipes or joints. However, medical marijuana comes in many other forms, such as oils or pills. If, however, it is prescribed in the form of dried inflorescences, the specialist will usually recommend vaporizing it. This method uses high temperature to release the active compounds of marijuana without burning it. The dried material is thus heated, until it changes into fluid and then gas which can be inhaled as a steam. This way, the adversarial effects of smoking are avoided, which is especially important for patients suffering from a lung disease.

The medical potential of marijuana

Current research studies show that cannabis can be successfully incorporated in the therapy of many ailments and disorders, both of physical and psychological nature. So far, the results prove the potential of this plant in the treatment of chronic pain, cancer, a few neurological diseases, digestive syndromes as well as psychological disorders. Some of these effects have been already demonstrated during clinical trials with human participants, whereas others were observed within case studies or in vitro experiments. All in all, researchers suggest that cannabis has a significant therapeutic potential and thus requires further research.

  1. Chronic pain 

The analgesic effect of marijuana has been known for a long time – it was even mentioned in ancient Chinese pharmacopeia ‘Shennong Bencaojing’ dated roughly at 100 CE. Modern researchers have discovered two distinct mechanisms responsible for this effect. First, THC has the ability to modulate the excitability of the postsynaptic neuronal cell and thus inhibit the pain signal transmission. Second, it can upregulate the secretion of endogenous opioids called dynorphins that diminish the sensation of pain. 

Research results show that medical marijuana is more effective in the treatment of chronic rather than acute pain. Sometimes, it can help patients who don’t respond to classical medications such as morphine. So far, it has been tested as an analgesic in muscle spasticity, cancer, migraine and fibromyalgia, as well as to relieve pain resulting from menstruation or inflammation. Some reports show that the extract of the entire plant is more potent than isolated cannabinoids. Noteworthy, the administration of medical marijuana in combination with traditional analgesics allows to lower their dose and thus reduce their side effects. 

  1. Cancer

In vitro and in vivo studies have shown that cannabinoids are able to inhibit the proliferation of cancer cells in animal models. Most commonly, they induce apoptosis (programmed cell death) in cancerous cells. Importantly, they do not affect the development and proliferation of healthy cells. Thus, the tumor progression can be selectively impaired at various levels. This effect has been confirmed in a variety of cancer types: glioblastoma, breast, pancreatic, prostate, colon and lung cancer, as well as lymphoma. Unfortunately, these results still need to be replicated in clinical trials with human participants. However, it is well established that in terminally ill patients, medical marijuana helps to manage pain, stimulate the appetite, lower anxiety, and improve sleep quality.

  1. Neurological diseases

Cannabinoids have been successfully applied in the therapy of many neurological conditions, most notably in epilepsy. In this disease, the abnormal firing of the brain’s cells causes violent seizures that often impair proper functioning. Approximately 25% of patients diagnosed with epilepsy do not respond to traditional treatment. However, the administration of cannabis, particularly oils rich in CBD, helps to decrease both the frequency and the intensity of seizures. Those observations, first made by parents of young patients, have been subsequently confirmed in the series of randomized controlled clinical trials with human participants. Currently, medical marijuana is regularly prescribed to treat epilepsy. 

In the case of other neurological diseases, there is also substantial research on the potential of therapeutic cannabis, but treatments are yet to be established. For example, cannabinoids have been shown to protect dopaminergic neurons against oxidative stress, which could be relevant in the treatment of Parkinson disease. On the other hand, THC has a proven ability to limit the storing of amyloid plaques in the brain and thus inhibit the development of Alzheimer disease. The same cannabinoid, tested in animal models, helped to slow down the accumulation of prions in brain cells and thus prolong the lifespan of animals infected with prion diseases such as Creutzfeldt-Jakob disease. These encouraging results promote further research on the therapeutic applications of medical marijuana in neurological disorders.

  1. Digestive tract issues

Nausea and vomiting are frequent side effects of chemo- and radiotherapy that additionally decrease the appetite of patients. It has been proven that the administration of CBD, THC or synthetic cannabis provides the stimulation of cannabinoid receptors within the central nervous system and the digestive tract, which inhibits the gag reflex. As a result, patients can go through therapy with more ease and strength, as their appetite is restored. What is more, cannabinoids limit the inflammation within the intestine tissue, as well as promote the process of cellular regeneration. Thus, they might be helpful as an aid to ailments such as Crohn disease. On top of that, active compounds found in cannabis are able to calm down the irritable bowel syndrome by lowering the neurochemical transmission within the guts. In effect, they help to regulate the functioning of the digestive tract. 

  1. Psychological distress

Cannabinoids have been proposed as viable treatments to some psychological disorders, yet evidence from clinical trials with human participants is still scarce. So far, it has been demonstrated that both THC and CBD may modulate the density of serotonin in the brains of mice. This neurohormone is the target of classical depression medications. Thus, it has been suggested that cannabinoids might be helpful to treat this condition. Recently, scientists have also started to investigate their potential in post-traumatic stress disorder (PTSD) therapy. The preliminary results are promising, as they demonstrate the potential of CBD to aid traditional psychotherapy and to help confront troubling memories with more ease. Nevertheless, in all cases of psychological distress, the research is still recent, and more studies are needed to establish safe procedures of medical marijuana treatment.

One to heal them all?

Although science does back up the idea that cannabinoids have clinical potential, most research is still in the early phase and its results, however promising, must be replicated. Thus, it is not realistic to believe that medical marijuana is a magical cure to all our pains. Still, it has many benefits – as a painkiller it is less toxic and addictive than opioid analgesics and it is harder to overdose it. Furthermore, its efficiency in the treatment of epileptic seizures has been proven. Other medical applications are possible, but more research is required to figure out optimal doses and proportion of cannabinoids. All in all, medical marijuana brings hope to a lot of patients who suffer from chronic pain or drug-resistant disorders. Perhaps in the near future, cannabis-assisted therapy will become more and more available.

Categories: Publications

natalia

M.A. in Cognitive Sciences at the Osnabrück University. Worked in laboratories located in Poland, Australia and Germany. Her research subjects include the neurophysiology of the brain, eye tracking tests, EEG and VR. She is passionate about yoga and promotes a healthy lifestyle but also enjoys reading fantasy books. She definitely likes cats, dogs and all other lovely pets.

References

Bitencourt R.M. and Takahashi R.N. "Cannabidiol as a Therapeutic Alternative for Post-traumatic Stress Disorder: From Bench Research to Confirmation in Human Trials". Frontiers in Neuroscience, 2018

Pellati, Federica et al. “Cannabis sativa L. and Nonpsychoactive Cannabinoids: Their Chemistry and Role against Oxidative Stress, Inflammation, and Cancer.” BioMed research international, 2018

Russo, Ethan B. “Taming THC: potential cannabis synergy and phytocannabinoid-terpenoid entourage effects.” British journal of pharmacology, 2011

Velasco, G et al. “Anticancer mechanisms of cannabinoids.” Current oncology, 2016

Vučković, Sonja et al. “Cannabinoids and Pain: New Insights From Old Molecules.” Frontiers in pharmacology, 2018

Zanelati, T V et al. “Antidepressant-like effects of cannabidiol in mice: possible involvement of 5-HT1A receptors.” British journal of pharmacology, 2010

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