Medical cannabis is a plant-based medicine derived from the Cannabis sativa or Cannabis indica plant, used under the guidance of a healthcare professional to manage symptoms of various medical conditions. Its therapeutic effects come from active chemical compounds that interact with a regulatory system throughout the human body. This interaction can help modulate processes like pain, mood, and inflammation, offering a potential option for patients when traditional treatments have not been successful.
The Active Ingredients
The therapeutic properties of medical cannabis originate from a class of chemical compounds known as cannabinoids, of which the plant contains over 100 different types. The two most studied and abundant are delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD). THC is the primary psychoactive component, responsible for the “high,” while also contributing to pain relief and appetite stimulation.
CBD is non-psychoactive and is frequently studied for its potential to help with symptoms such as anxiety, inflammation, and certain forms of epilepsy. This makes it appealing for patients seeking therapeutic effects without altered mental states. Other compounds, like terpenes and flavonoids, are also present, which are responsible for the plant’s distinct odor and flavor. The theory of the “entourage effect” suggests that the combined action of all these compounds may produce a greater therapeutic benefit than any single isolated compound.
The Body’s Endocannabinoid System
The mechanism by which cannabis affects the body involves a complex internal regulatory network called the Endocannabinoid System (ECS). The ECS is present in all vertebrates and works to maintain homeostasis, or internal balance, across multiple physiological functions. This system is composed of endocannabinoids, which are compounds naturally produced by the body, enzymes that break them down, and cannabinoid receptors.
The two main types of receptors are Cannabinoid Receptor Type 1 (CB1) and Cannabinoid Receptor Type 2 (CB2). CB1 receptors are predominantly located in the brain and central nervous system, where they influence mood, pain sensation, and memory. CB2 receptors are mainly found in the peripheral nervous system and immune cells, playing a role in regulating inflammation and immune response.
When medical cannabis is consumed, the plant-derived cannabinoids mimic the body’s own endocannabinoids and bind to these receptors. THC primarily acts by binding to and activating CB1 receptors, which mediates its psychoactive and pain-relieving effects. CBD does not bind strongly to either receptor, but instead modulates the ECS indirectly, potentially by affecting the enzymes that degrade endocannabinoids. This interaction across the ECS helps explain the broad range of therapeutic effects that cannabis can have on the body.
Therapeutic Uses and Forms of Consumption
Medical cannabis is commonly used to manage symptoms for a variety of conditions, not necessarily to cure the underlying disease. Conditions for which it is frequently considered include chronic and severe pain, muscle spasticity associated with multiple sclerosis, and severe nausea and vomiting from chemotherapy. It is also authorized for use in specific, rare forms of epilepsy, such as Dravet syndrome and Lennox-Gastaut syndrome. The conditions that qualify for medical cannabis use vary significantly depending on specific regulations.
Forms of Consumption
Patients have several different forms of medical cannabis available, each offering a unique onset time and duration of effect. The choice of consumption method is generally tailored to the patient’s condition and their need for either fast-acting or sustained symptom management.
- Inhalation methods, such as vaporization, allow cannabinoids to enter the bloodstream quickly through the lungs, providing rapid relief for acute symptoms like nausea or breakthrough pain.
- Oral consumption, which includes capsules, edibles, and tinctures, results in a slower onset because the compounds must pass through the digestive system, but the effects typically last much longer.
- Topical creams and balms are applied directly to the skin to target localized pain and inflammation in muscles and joints, without causing systemic psychoactive effects.
- Suppositories and oral sprays, placed under the tongue, offer administration methods that bypass some of the digestive process or allow for more precise dosing.