Medicinal Cannabis : Few facts

Dr Sona A Pungavkar
Medicinal Cannabis refers to any part of a marijuana (Cannabis sativa or indica) plant used to treat a health condition. It is not used to create a euphoric state but to ease symptoms and / or prevent them.
Endocannabinoids
The human body can make it’s own cannabinoids, called as endocannabinoids. These are responsible for activities, which maintain homeostasis (consistency within various bodily systems) and from generation of new cells to healing in response to injury.
Cannabinoids
Nearly 100 different components are known to be present in the cannabis plant, called as cannabinoids. These are responsible for effects brought about in human body. Two commonly referred compounds are THC (tetrahydrocannabinol) and CBD (cannabidiol). The psychoactive effect is considered to be causedby THC, while CBD is known for it’s potential to treat illnesses like seizures. However, most Cannabis researchers, including the team at Cannabis Health and Sciences (CHS) believe that all cannabinoids act in a synergistic manner, referred to as the entourage effect. Hence, full extract of the plant works the best.
Cannabinoid Receptors
The cannabinoids attach themselves to specific sites in brain tissue, are called as cannabinoid receptors. These are of two types, CB1 and CB2.CB1 receptors seem to influence cognition, memory, motor movements, and pain perception. Most CB1 receptors exist in brain, but some can be found in nerves of liver, thyroid, uterus, bones, and testicular tissue.CB2 receptors are mainly found in immune cells, spleen and gastrointestinal systemand to a lesser extent in brain.
Uses of medicinal Cannabis
Although, research into cannabis has been limited by the legal status, currently a lot of research is happening into it’s health related benefits.
One of the most well-established medical uses for cannabis is in increasing appetite for AIDS and cancer patients. Italso helps in reducing pain and inflammation and improving muscle control in conditions like cancer, multiple sclerosis and rheumatoid arthritis. It has a neuroprotective effect and can help in conditions like Alzheimer’s disease, stroke and Parkinson’s disease,
Another important use of medicinal Cannabis,is control of seizures and allowing reduction of number and dosage of anti-epileptic drugs, especially in young children, thus helping to prevent side effects.
The extract is also known to have an anti-tumor effect and help in post-traumatic stress disorder and anti-anxiety effects.Ironically, although Cannabis has been considered as a harmful drug for a long time, it is actually used in the treatment for drug addiction, particularly morphine and heroin.
Ways of administering medicinal Cannabis
Medicinal Cannabis can be used by ingestion, by inhalation, as a suppository in rectum or vagina and by application on skin.Inhalation of medicinal Cannabis can be done via smoking using a rolled paper cigarette (“joint”), in a pipe, through a water-filtering bong or through a vaporizer. Oral intake of Cannabis can be in form of a food item, such as chocolates or cookies, infusion in a drink like soda, or filled into a capsule as an oil.Topical application of medicinal Cannabis can be in form of a patch or ointment.
Onset of action of cannabis depends on the mode of administration. When smoked, the effects are immediate because the cannabinoids go quickly into the bloodstream via lungs. Oral intake is associated with slow onset of effects, approximately about 30 to 60 minutes from ingestion, with the peak occurring after two to three hours.
Topical cannabis has certain advantages including elimination of harmful effects of smoke and release directly into the bloodstream via skin.
Side-effects of medicinal Cannabis
Use of Cannabis can cause short and long term effects. Unwanted short term effects include disruptionof short-term memory and ability to make decisions, and alteration of mood, making a patient feel happy, elated, sleep or anxious. When consumed in large doses, some people could experience hallucinations, paranoia and delusions.
The ill effects over long term are usually related to the smoke and  include lung infections and cough for those who inhale the medication,in addition to depression, anxiety, lethargy and suicidal tendencies. Consuming Cannabis is not advisable during pregnancy.
Potential of medicinal Cannabis for addiction.
There is no agreement on addiction, but criteria for cannabis dependence has been established by World Health Organization. Cannabis has a very low risk compared to other commonly abused drugs, estimated at about 9%, as compared to 32% for nicotine, 23% for heroin, and 15% for alcohol. Dosage in medicinal Cannabis is significantly low, further reducing the risk.
Thus, the benefits of medicinal Cannabis far outweigh the unwanted effects. We, at CHS, are looking forward to legalization of medicinal Cannabis in India soon, which can bring about several welcome changes such as helping the Indian patient population, creating jobs, improving economy and aiding the opioid addiction crisis.
The author is a Cannabis researcher, a senior radiologist and Vice President, Cannabis Health and Sciences.