The cannabis plant contains active compounds known as cannabinoids that have a variety of benefits on the human body, including anti-inflammatory, pain-relieving, anti-anxiety and calming effects. The plant is covered in specialised hairs called trichomes which coat the entire flower structure and secrete these active compounds to give the plant its therapeutic effects. Medicinal cannabis treatment often refers to the ‘entourage effect’ of the plant. This refers to the synergistic effect of the cannabinoids and terpenes in the cannabis plant which work together in full spectrum products to produce the most effective treatment outcomes.
Medicinal cannabis refers to products created using these therapeutic compounds to treat common medical conditions and symptoms. These products may have one or more active ingredients and be available in a range of different dosage forms depending on what you and your prescriber deem most appropriate. The selection and strength of active ingredients will also depend on the type of medical conditions or symptoms being treated.
There are two main species or strains of the cannabis plant that both have their own unique properties. Cannabis sativa produces an uplifting and energising effect while cannabis indica produces a relaxing and calming effect. Sativa strains are generally used during the day to increase energy and relieve fatigue, depression and other mood disorders. Indica strains are generally used at night to help with insomnia and relieve pain. Generations of crossbreeding have left us with a few, if any, pure sativa or indica strains. Most medicinal products available are a hybrid of the two which may produce a mixture of effects.
In Australia, the Therapeutic Goods Administration (TGA) is responsible for the regulation of medicinal cannabis and the approval of all applications for patient use of medicinal cannabis.
The human body naturally produces endocannabinoids which act similarly to the active ingredients found in the cannabis plant. The body also has cannabinoid receptors which can be bound to by both endocannabinoids and phytocannabinoids to help alleviate or manage symptoms of pain, insomnia, anxiety and muscle spasms. This is referred to as the human endocannabinoid system (ECS) which is unique to every person and plays a role in the regulation of appetite, pain, mood and memory.
There are over 500 compounds and 104 active cannabinoids in the herbal plant known as ‘phytocannabinoids’. The human body also naturally produces cannabinoids known as ‘endocannabinoids’ which assist in maintaining regular bodily functions. The most clinically effective and well-studied cannabinoids used in medicinal treatment are cannabidiol (CBD) and delta-9-tetrahydrocannabinol (THC).
THC binds to receptors in the central nervous system to produce euphoric (psychoactive) effects and relieve insomnia, spasms, nausea and appetite loss. CBD binds to receptors in the peripheral nervous system so it does not produce euphoric (psychoactive) effects but has anti-inflammatory, anti-anxiety and anti-epileptic effects.
Terpenes are plant chemicals found in oils, spices, fruits and vegetables. In the cannabis plant, terpenes are pharmacologically active and impact the effect of cannabinoids. Terpenes are also responsible for the smell or aroma of the cannabis plant and have their own unique characteristics.
- Pinene: found in pine; helps with inflammation, alertness and memory
- Limonene: found in lemons; increases the effects of THC and CBD and has anti-depressant and anti-inflammatory activity
- Myrcene: found in hops; helps with insomnia and muscle tension
- Linalool: found in lavender; helps with relieving pain, inflammation, insomnia and anxiety
- Beta-caryophyllene: found in black pepper; helps with pain, inflammation, anxiety and depression
Medicinal cannabis is available in a variety of dosage forms.
- Soft gel capsules, liquids and gummies are ingested by mouth. This form takes 1-1.5 hours to take effect but has a longer duration of action so it is ideal for the management of chronic symptoms.
- The whole flower can be inhaled using a dried herb vaporiser. This form works within 5-15 minutes but has a shorter duration of action so it is used for the fast relief of acute symptoms.
- Creams or lotions can be applied to the skin for local action. These compounds are not absorbed into the bloodstream.
Both methods of inhaling cannabis involve the heating of the flower to create a vapour which is then inhaled. Smoking is not recommended as the process may release harmful byproducts and the high temperature of burning the flower results in the loss of a significant proportion of the cannabinoids in the flower. Alternatively, vaporising (or ‘vaping’) allows the flower to be heated at lower temperatures to facilitate the activation and release of the cannabinoids and terpenes of the whole plant. This method ensures the most efficient extraction of active cannabinoids from the plant to create a better dosing experience.