Medical Cannabis

 

I recently read a very well-written online article in a popular science journal about the medicinal uses for cannabis, the research behind it, and the rationale for its legalization. I finished the article, read through the comments left under the post, and noticed that many health professionals had left negative comments about the use of “marijuana” and said they would not “advocate for smoking weed”. I realized then that perhaps the evidence available wasn’t being absorbed because many people weren’t reading past the initial impression of what they thought of as a drug of abuse.

So, I would like to provide a very brief rundown of what this so called “weed” might be used for medically. First, we need to clarify between two uses: recreational, and medical.

  • Recreational drug or alcohol use is just that: recreational, or for fun. For this use, we may not be as concerned with its medicinal properties, but instead may be more intrigued with the psychoactive properties from the THC component of the plant, AKA the part that gets you high.
  • Medicinal use involves prescribing of cannabinoid therapy for a specific medical condition(s).

Marijuana is actually slang terminology and is more properly termed cannabis. There are a few species of the cannabis plant, and each varies with respect to its pharmacological effects. Pharmacological is a fancy word meaning how a drug acts within the body. Each plant (specifically, the female) species or hybrid of species possesses both THC and CBD components in differing ratios. Its more the ratio of these components that is important than the actual strain of the plant.

Common strains of cannabis: Sativa and Indica

 

Before we go further, let’s review the acronyms, THC and CBD. THC stands for tetrahydrocannabinol, and it is an active component of the cannabis plant. It is the psychoactive cannabinoid of the plant that is known for most of the hallucinatory and mind-altering effects. CBD, also an active component but without psychoactive properties, stands for cannabidiol. CBD acts on the body’s endocannabinoid system to provide relief of pain, nausea, anxiety and inflammation. Therefore, we can see that CBD is the compound most often used medically to provide symptomatic relief to patients for many common medical issues, however, there are synergistic benefits when CBD and THC are used in combination.

Some other important facts:

  • The two most common preparations of cannabis are dried plant buds and extracted oils. Dried cannabis is generally consumed by smoking or vaporizing, and the THC and CBD active components are absorbed into the body through the lungs. Oils are extractions of the most medically beneficial compounds, such as CBD. Oils are usually consumed as edibles, but not without risk of overconsumption due to the delayed onset of effects.
  • There is a growing body of evidence for medical cannabinoid therapy. Most of the evidence we currently have is for pain conditions, such as chronic neuropathic and cancer pain. We also have seen benefit in multiple sclerosis related pain and spasticity. Other conditions that may benefit from cannabinoid therapy include chemotherapy-induced nausea and vomiting, and epilepsy. The research is still ongoing as we become more familiarized with its usage in the medical community.
  • Although cannabis use has zero-associated mortalities to date, there may be patients with certain medical conditions that could experience harm with cannabis use, such as persons with heart disease, mood disorders, substance abuse disorders, and patients who are pregnant or breastfeeding (among others). Cannabis may also interact with some prescription and non-prescription medications, making it important to check with your pharmacist to ensure its safe use.

At this time, herbal medical cannabis has not gone through Health Canada’s drug approval process, and therefore does not have any Health Canada approved indications, yet. There are some Health Canada approved synthetic cannabinoid treatments available on the market which are approved for select medical conditions. We will likely have more information about herbal cannabis therapies when recreational cannabis becomes legalized later this year.

For now, persons that are interested in receiving more information about whether medical cannabis is an option for them should first speak to their physician or nurse practitioner, as only they can provide the correct medical documentation required to receive medical cannabis here in Canada at this time. If you have any questions, feel free to contact our pharmacists for more information!

 

Author: Chelsea Argent, RPh.