CBDs, THC & other initials: A physician’s approach to medicinal cannabis – thecoastnews.com

This is part 2 in a series of three.

Cannabis contains well over 400 different chemicals, of which at least 60 are cannabinoid compounds. That means that they effect changes in our bodies through, conveniently named, cannabinoid receptors. Think of this as a lock and key theory: a cannabinoid chemical (such as delta-9-tetrahydrocannabinol, most commonly referred to as plain old THC) will attach itself to a receptor that is shaped specifically for it to fit in the brain (or elsewhere in the body) where it elicits a particular effect, such as euphoria. If the chemical doesn’t fit the receptor, it will not produce an effect.

Let’s address THC for a moment; if one were to consume a salad made up of potent cannabis plants, he or she would not get high. The reason for this is that THC does not exist in a usable form in the plant. This is because it is bound to an acid group and is called THC- A. Exposure to heat, however, induces the acid group to fall off (called decarboxyl ation) rendering the THC psychoactive. So, the THC compound in cannabis must be heated at some point in order to exert certain effects in the body. [Note that smoking a “joint” or using a “bong”/waterpipe is not the most efficient process; it is estimated that lighting a joint (marijuana cigarette) only converts about 30 percent of the THC-A to THC. Hence, what some producers do in order to boost the percentage of THC concentration in cannabis is to “decarboxylate” (i.e. subject to low heat for a period of time) their products after it is harvested. This is often done for “edible” products.]

Cannabinoid receptors are located throughout the body and are part of the endocannabinoid system. The effects for which they are most widely known involve pain control, appetite, mood and memory. There are subtypes: CB1 (found mainly in the brain) and CB2 (found in the immune system, in nerve endings, and elsewhere). Other receptors are suspected, but as of yet have not been identified. With the current surge in popularity of cannabis products and the demand for information, research has stepped up so we will hopefully know more in the near future.

Contrary to common belief, the benefits of cannabis are not all attributable to either the THC or the CBD content of a particular product. There is another large group of chemicals referred to as terpenes which are volatile hydrocarbons that contribute to the odor and taste of the plants, for example. While not inherently psychoactive themselves, they can mediate the effects of the chemicals that affect how a user perceives its highs.

It should be noted that cannabis is most effective when the combination of all of these are ingested together. This is referred to as an entourage effect. Marinol (dronabinol) is a synthetic-derived THC pill that was developed for cancer and AIDS-related nausea and vomiting. However, it does not work nearly as well as a product that also contains CBD and terpenes.

The two species of cannabis, sativa and indica, have different effect profiles.  Per Weedmaps.com: sativas have been considered “cerebral,” “heady,”, “uplifting”, “energizing,” whereas indicas have been described as “relaxing,” “sedating,” “full-bodied,” “couchlock,” or “stony”. So, if one needs to remain fairly alert and energetic, a sativa strain would seem to be appropriate. Can’t sleep? An indica might be helpful (slang for indica is “in da couch!”).

As   caution, however, be aware that there are some hybrids that contain elements of both, but have different terpene profiles. These are generally advertised as having “sativa-like” or “indica-like” effects.

Dr. Pearson is a board-certified Family and Sports Medicine physician who has been practicing in North County since 1988. His office is located in Carlsbad Village. Feel free to contact him with any questions at www.medicine-in-motion.com.

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