In recent years, the Medicinal use of Cannabis has spread as a result of scientific research, and has several beneficial effects.
Cannabis is one of the oldest plants cultivated by mankind. There is evidence of its use for medical purposes dating back more than 2500 years.
Within the plant are numerous substances, of which cannabinoids, CBD, and THC are currently of primary interest. But with more than 130 identified cannabinoids, in addition to other components of the plant, cannabis is a complex substance with a lot of therapeutic potential (1,2).
THC is the main source of the pharmacological effects caused by the use of cannabis. Since THC activates the CB1 and CB2 receptors, it has a psychotropic (mental) effect (1).
CBD has a lower binding affinity for the CB1 and CB2 receptors and no psychotropic effect, but does have other mechanisms of action.
Other notorious cannabidoids are: CBG, CBC, CBV, THCA, CBDA, CBN, THCV, CBDV. Each has a specific therapeutic potential.
The plant produces a diverse group of chemical compounds collectively called phytocannabinoids (2). More than 80 phytocannabinoids have been identified, and offer benefits like antioxidants.
Cannabis is also rich in terpenes, which are responsible for its smell and taste. They are substances that easily pass to the brain, with great pharmacological properties (1).
It also has numerous other metabolites called flavonoids. Cannflavin A and B are flavonoids which have anti-inflammatory activity thirty times greater than aspirin.
To date, five cannabinoids produced by the human body have been identified.
Cannabinoids have different properties, including: analgesic, muscle relaxant, immunosuppressive, anti-inflammatory, anti-allergic, sedative, mood improving, appetite stimulating, anti-hemetic, chemotherapeutic (3,4), bronchodilating, neuroprotective (5, 6.7), and antineoplastic (8).
Evidence from institutes such as the British Medical Journal proposes cannabis as a therapeutic option for (1, 3,4,5,6,7,11):
- Chronic pain
- Multiple sclerosis
- Resistant epilepsy
- Nausea and vomiting from chemotherapy
- Degenerative disease of the nervous system
The adverse effects that can be experienced are variable and will depend on the dose, method of administration, previous experiences, drugs taken, personal expectation, mood, and social environment in which the medication is used, and include: altered state of consciousness, euphoria, happiness, relaxation, sociability, disinhibition, altered perception of time and space, increased heart rate, conjunctival injection, pupil dilation, increased appetite, decreased concentration and coordination, anxiety, and panic (9,10).
In practical terms, THC and CBD are quite safe when used with other drugs. The most important interactions are with warfarin (anticoagulant), alcohol, theophylline, and benzodiazepines (12,13,14).
Patients with acute psychosis or unstable psychiatric conditions should absolutely not use any cannabinoid derivatives (15,16).
The medical literature reports that cannabinoids have great therapeutic potential, and should be prescribed and monitored by a doctor with academic training in their use.
Cannabis is a therapeutic option for different health problems. In order to experience a sustainable benefit with the least risk of adverse effects, I offer you this service. In your first appointment, we will carry out a clinical history, complete a physical examination, and assess the medical condition you seek to improve.
After discussing your expectations, I will prescribe your cannabinoid therapy, and we will carry out subsequent controls. As part of your prescription, I will also include nutritional recommendations, supplementation, an exercise regimen, and lifestyle changes to improve your condition.
* Does not include recommended products.
- Fernandez-Ruiz J, Sagredo O, Pazos MR, Garcia C, Pertwee R, Mechoulam R, et al. Cannabidiol for neurodegenerative disorders: important new clinical applications for this phytocannabinoid? Br J Clin Pharmacol. 2013;75:323–33.
- Chang AE, Shiling DJ, Stillman RC. Delta‐9‐tetrahydrocannabinol as an antiemetic in cancer patients receiving high‐dose methotrexate. A prospective, randomized evaluation. Annals of Internal Medicine 1979;91(6):819‐24
- Frytak S, Moertel CG, O’Fallon JR. Delta‐9‐tetrahydrocannabinol as an antiemetic for patients receiving cancer chemotherapy. A comparison with prochlorperazine and a placebo. Annals of Internal Medicine 1979;91(6):825‐30.
- Sagredo O, Garcia-Arencibia M, de Lago E, Finetti S, Decio A, Fernandez-Ruiz J. Cannabinoids and neuroprotection in basal ganglia disorders. Mol Neurobiol. 2007;36:82–91. [PubMed] [Google Scholar]
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- Center for Behavioral Health Statistics and Quality. National survey on drug use and health. Rockville, MD: Substance Abuse & Mental Health Services Administration; 2013.
- Mechoulam R, Parker LA. The endocannabinoid system and the brain. Annu Rev Psychol. 2013;64:21–47
- Ware MA, Doyle CR, Woods R, Lynch ME, Clark AJ. Cannabis use for chronic non-cancer pain: results of a prospective survey. Pain. 2003;102(1-2):211–216
- Martin JH, Schneider J, Lucas CJ, Galettis P. Exogenous cannabinoid efficacy: merely a pharmacokinetic interaction? Clin Pharmacokinet 2018; 57: 539–545.
- Gaston TE, Friedman D. Pharmacology of cannabinoids in the treatment of epilepsy. Epilepsy Behav2017; 70 (Pt B): 313–318
- Devinsky O, Cilio MR, Cross H, Fernandez‐Ruiz J, French J, Hill C, et al Cannabidiol: pharmacology and potential therapeutic role in epilepsy and other neuropsychiatric disorders. Epilepsia 2014; 55: 791–802.
- Toennes SW, Ramaekers JG, Theunissen EL, Moeller MR, Kauert GF. Comparison of cannabinoid pharmacokinetic properties in occasional and heavy users smoking a marijuana or placebo joint. J Anal Toxicol 2008; 32: 470–477.
- Therapeutic Goods Administration . Australian public assessment report for nabiximols. Available at https://www.tga.gov.au/sites/default/files/auspar-nabiximols-130927.pdf
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