The media is continually reporting various aspects of the medicinal efficacy of cannabis. It helps cancer patients endure the wrenching nausea of chemotherapy. It allows multiple sclerosis sufferers to enjoy an afternoon in the park without their wheelchair. It delivers significant seizure reductions to children with epilepsy so they can attend school and have a semblance of a life.
But what exact part of cannabis actually provides these benefits to patients? What separates “medical” quality cannabis from what should be avoided by any consumer, medical or lifestyle? If the chemicals in cannabis that provide value to humans in the form of physical and mental therapy are identified, can’t breeders, cultivators, processors, and medical specialists then strive to produce only those strains of the plant that offer the most or certain types of these chemical compounds?
Cannabinoids: Primary Chemical Components
The primary chemical components of cannabis, which translate into the effects felt and deliver value to patients, are the beloved cannabinoids. Cannabinoids are simply chemical compounds that cause reactions when they enter the body via the lungs as smoke and vapor or through the stomach as edibles. They can even permeate the skin, as is the case with cannabis topicals. The path via smoking and vaporizing is slightly different than that of cannabis when eaten. The effects of ingested, or eaten, cannabis are typically stronger and last longer because it is processed by the stomach and liver before it enters the blood stream. This process actually produces slightly different molecules. When metabolized by the liver, THC changes from delta-9 THC into 11-hydroxy-THC.
Cannabinoids were first discovered in 1940 by Roger Adams in the United States and again in 1964 by Dr. Raphael Mechoulam at Hebrew University in Jerusalem. These special chemicals work synergistically with the human body and, more specifically, the endocannabinoid system. There are more than 111 cannabinoids found within the cannabis plant. This includes the most famous examples, like THC and CBD, as well as more minor players that are found in significantly smaller quantities, like CBN and CBG. There are also variants of major cannabinoids, like THCV and CBDV.
When smoked or vaped, cannabinoids enter one’s lungs and are immediately transferred to the heart, where they’re pumped directly to the brain. Once in the brain, cannabinoids seek out specialized receptors into which they fit almost perfectly. Technically, this “lock and key” mechanism is labeled a “binding affinity” between the cannabinoid molecule and the receptor site.
This entire process requires about 2.5 minutes. Thus, from the time a patient takes a toke of smoke or vapor, roughly two to three minutes will pass, depending on one’s metabolism and body chemistry, before they begin to feel the psychoactive effects or medical benefits of the cannabinoids — such as reduced pain, inflammation, or nausea (the three greatest medical benefits of cannabis).
The Path of THC
Consider THC, or tetrahydrocannabinol (also known as delta-9 THC), the most common cannabinoid and the primary psychoactive constituent of the herb. THC is what delivers euphoria, relaxation, and cerebral alterations of the senses — commonly referred to as being “high.” However, THC also provides significant medical therapy to patients in the form of anti-inflammatory effects, among others. For example, THC and cannabis have been shown to put Crohn’s disease, which results in inflammation of the gastrointestinal system, into full remission.
THC has also been shown to have great efficacy for psychological conditions like depression and PTSD. Some strains of cannabis, such as Trainwreck or Girl Scout Cookies, may contain as much as 25 or even 30 percent THC. The intensity of such strains can cause confusion, disorientation, and paranoia in some patients (click here to learn how to combat these side effects). Open competition in states that have abolished prohibition is beginning to result in products that cater to consumers who want low-THC cannabis flowers and edibles. Those with high tolerances for cannabis or intense chronic pain can seek out concentrates, which are high-potency extracts from the cannabis plant that typically contain 40-90 percent THC.
THC molecules begin in the dried and cured raw flowers of the plant as a slightly different molecule called THC-A. The “A” stands for “acidic,” because THC-A is the acidic precursor to THC. While this might sound complicated, it means simply that the THC-A molecule loses a carbon dioxide molecule that splits off after the application of heat during smoking or vaporizing. This CO2 molecule is simply lost, while the new THC molecule suddenly possesses a very high binding affinity with the special receptors mentioned above. Other cannabinoids, such as CBD, also feature acidic precursors (in this case, CBD-A).
There are primarily two types of cannabinoid receptors in the body’s endocannabinoid system: CB1 and CB2. CB1 receptors, found throughout the brain and central nervous system, accommodate the THC molecule. Because they are found in their largest concentrations in the brain, it makes sense that this popular cannabinoid is responsible for euphoria and psychoactive effects. CB2 receptors, found throughout the immune system and its associated organs, bind with CBD, or cannabidiol, a cannabinoid that delivers no euphoria or cerebral activity. CBD has, however, been shown to deliver great medical efficacy, including reducing seizures and shrinking tumors for both children and adults with severe conditions like epilepsy and cancer.
There may be additional receptor types that have yet to be discovered. The Schedule I status of cannabis, which has resulted in a gross lack of cannabis research in the United States, has stifled the scientific progress necessary to learn more about cannabinoids, the endocannabinoid system, and the delicate interaction of the two (something called the entourage effect). The stagnation of Congress on the topic of cannabis research has resulted in patient suffering, an opiate addiction and heroin epidemic, and rampant alcoholism because those who self-medicate in prohibitionist states are not given safe, legal access to cannabis medicine.
Back to Basics
Each disease or ailment is different — not to mention the subjective reactions of patients to various therapies, including the cannabinoids within the kind herb. Human trials are necessary to best help patients gain safe access to targeted medicine and to avoid the negative side effects of a wide range of pharmaceutical drugs. However, there is a vast body of foundational knowledge that has been accumulated since 1940 when the THC molecule was first discovered.
The cannabis and medical communities know enough about the effect of cannabinoids to administer CBD oil to epileptic children and THC to Crohn’s patients. Unfortunately, the most important thing known to the cannabis community is that more research is necessary into the sometimes subtle manner in which cannabinoids interact with the human body, including how they buffer and temper each other and how they interact with other special molecules found in cannabis, including terpenes.
This post was originally published on November 13, 2015, it was updated on October 3, 2017.