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What’s all the hype with medical cannabis?

Medical cannabis
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A once vilified plant seems to be all the rage in the healing world right now, particularly in the area of Mullumbimby (part of the Byron Bay shire) where my naturopathy clinic is located. Many people seem to be turning to CBD for health answers, often not knowing what quality or potency of product they should be taking for the results they’re looking for. Here is a very basic guide to the medicinal properties of cannabis, some of the drug interactions which exist, and some of the potential safety concerns.

What can Cannabis can be used for?

Medicinally cannabis may have potential use in cancer, palliative care, epilepsy, anxiety, depression, PTSD, schizophrenia, pain relief, diabetes, osteoporosis, multiple sclerosis, neurodegenerative diseases

What’s the difference between CBD and THC?

CBD and THC are two of the best researched and known cannabinoids present in the cannabis plant.  They have different effects in the body and the most effective medicines contain varying degrees of both working synergistically.

THC

Delta 9-Tetrahyrocannabinol (THC) confers the psychoactive properties of the plant.

Medicinal properties include:

  • Pain relief
  • Nausea-relief
  • Appetite stimulant
  • Reducing inflammation
  • Anti-cancer properties
  • Anti-convulsant
  • Antioxidant

How does THC work?

THC is a partial agonist to the CB1 and CB2 receptors; CB1 receptors are found predominantly in the central nervous system, whilst CB2 receptors are found mostly in the immune system. 

CBD

Cannabidiol (CBD) confers non-psychotrophic properties of the plant.

Medicinal properties include:

  • Antidepressant
  • Antipsychotic
  • Anti-anxiety
  • Mediates pain perception, inflammation and body temperature.
  • Protective against osteoporosis
  • Protective against cancer cell proliferation
  • Enhances apoptosis (programmed cell death) which confers anti-cancer properties.  
  • Anti-inflammatory
  • Antioxidant

How does CBD work?

CBD binds only weakly to the CB1 and CB2 receptors, instead working through its interaction with many biochemical pathways in the body.  CBD also modulates the psychoactive effects of THC through allosteric binding to the CB1 receptors, and through the inhibition of FAAH (fatty acid amide hydrolase).  FAAH inhibition increases levels of anandamide (a naturally occurring endocannabinoid) which occupies the CB1 receptors and means the THC can’t bind so strongly.

Other components of cannabis with important medicinal properties include:

Cannabinol (CBN), Cannabichromene (CBC), Cannabigerol (CBG), Terpenes and Flavonoids.

What do I need to look out for?

Drug interactions

Since cannabis is metabolised using cytochrome P450 enzymes, there are potential interactions with many drugs which use the same family of enzymes for their metabolism.

Some of the potential interactions include:

THC may decrease serum concentrations of clozapine, duloxetine, naproxen, cyclobenzaprine, olanzapine, haloperidol and chlorpromazine.

CBD may increase serum concentrations of macrolides, calcium channel blockers, benzodiazepines, cyclosporine, sildenafil, antihistamines, haloperidol, antiretroviral, atorvastatin and simvastatin.

CBD may increase serum concentrations of SSRIs, tricyclic antidepressants, antipsychotics, beta blockers and opioids.

THC and CBD increase warfarin levels.

Alcohol may increase THC levels.

Smoking cannabis may decrease theophylline levels.

Cannabis has additive CNS depressant effects with alcohol, barbiturates and benzodiazepines.

This is one of the reasons why proper prescription of cannabis is so important.

Safety


Cannabis has a far more favourable safety profile than most would realise, with no reported deaths due to overdose.  With a therapeutic ration of 1:20,000, a person would need to smoke around 20,000 joints consecutively to receive a lethal dose.

In terms of physical dependence caused by cannabis, it falls well below tobacco, alcohol and cocaine.

There are of course potential adverse effects of cannabis use, many of which can be greatly reduced through proper prescription, and appropriate usage of high quality, full-spectrum products.

Short term side effects can include:

  • Loss of inhibition
  • Spontaneous laughter
  • Affected perception of sound, colour or other sensations
  • Altered mental and cognitive state 
  • Anxiety/paranoia
  • Bloodshot eyes
  • Fatigue
  • Altered balance
  • Increased heart rate
  • Low blood pressure
  • Increased appetite

Long term side effects can include:

  • Impaired concentration, memory and learning ability
  • Sore throat
  • Hormonal imbalances; including reduced sex drive, irregular menses, and decreased sperm count
  • Drug-induced psychosis, particularly in younger or susceptible individuals
  • Detrimental cognitive effects on an adolescent brain
  • Cannabinoid Hyperemesis Syndrome 

I hope this information was informative and helpful for you.  Medical cannabis when used appropriately can play a vital role in a person’s healing journey.

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