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How Much Do We Really Know About the Two Most Popular Cannabinoids?

Written by Brianna Handal PharmD'24
Published on December 16, 2019

More than half of the states in America have legalized medical marijuana. With this alarming number of states with legalization laws, there is still not much research on the plant. This is because marijuana is classified as aschedule I drug, in the same category as ecstasy and heroin. It is thought to be abused and lack medicinal benefits. With the up and coming research behind this drug, there are actually some potential extraordinary medicinal benefits associated with cannabis. Cannabis is composed of many chemicals, the main ones being THC (Delta-9-Tetrahydrocannabinol) and CBD (Cannabidiol). THC and CBD are also the most known ingredients in the plant, but do we really know what THC and CBD contribute to the effects of cannabis?

THC is the psychoactive part of cannabis that results in most of the effects that cannabis users experience. THC is what causes the “high” and euphoria that users feel. Most of the strains of cannabis contain between 12-21% THC levels. THC is a partial antagonist of CB1 and CB2 receptors. Activation of these receptors play a role in behavior, cognition, emotion, appetite control, and many more factors. While some reports suggest that THC is an antidepressant, THC can be dangerous because, when used in excessive doses, THC can act as a depressant. Cannabis is used for medicinal benefits because THC is an analgesic, a medication used to relieve pain. THC is also an appetite stimulator, which can be useful for patients who have trouble gaining an appetite. Although THC has the ability to relieve pain and cause euphoria, too much of this drug can cause psychotoxic effects such as impaired cognition, difficulty concentrating, memory impairment, and behavioral disobedience. High levels of THC are not recommended for elderly patients due to side effects of dry mucous membranes, dizziness, weakness, and increased fall risk. Excessive THC is also not recommended for patients who are schizophrenic and/or have anxiety disorder.

CBD, a non-psychoactive part of the cannabis plant, is important and has become very popular in OTC drugs within the past year. It has a low affinity for the CB1 and CB2 receptors and also does not produce the “high” feeling that THC does for its users. CBD usually occurs in low levels in many strains of the plant, approximately less than 1%. CBD provides pain relief and can decrease the negative effects of THC, such as memory impairment, anxiety, and psychoactivity. Being neuroprotective, CBD is a useful anti-seizure medication. Some side effects associated with CBD include diarrhea, headache, appetite suppression, and stimulation (causing restlessness). CBD is only used for symptom management and is no way a form of disease modification. Current studies are finding that CBD can act as an inhibitor for tumor growth in breast cancer models, not patients. CBD receptors are present in breast cancer patients, but for now, the current effects seen in real patients are just pain relief rather than cancer remission. Although cell growth is not completely stopped, the rate growth is slowed. CBD is found to induce program cell death in breast cancer cells using a connection between apoptosis and autophagy. There are no current studies that state that CBD has cured any diseases.

THC and CBD are both analgesic molecules that provide many medicinal benefits for users. When taken at appropriate doses, it is unlikely for harm to be caused, but when taken excessively, short term and long term effects are experienced. When using cannabis, users should be aware of how much of each molecule is in the strain to avoid excessive dosages.

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