The world is currently enjoying a resurgence of marijuana as a medical drug rather than a prohibited recreational substance. Since medical marijuana was legalized in California in 1996, different parts of the world have slowly changed their own laws to incorporate cannabis back into the world of medicine and recreation.
While many parts of the world have legalized the use of marijuana for recreational purposes, there are still countries who restrict its use to medical purposes. The body of evidence for the medicinal use of cannabis continues to grow larger, and more and more people around the world are seeking out its medical properties. From pain relief to seizure management to treating nausea, there are many uses for medical cannabis.
With all of that in tow, there is still ongoing research and investigation into how cannabis should be used medicinally and how it can be targeted for the most effective results. Media attention has created the illusion that medicinal marijuana is a “cure all”, but the truth of the matter is that medicinal cannabis, like any other medical drug, is more effective when used in the right circumstances and in the right way.
In this article, we explore the evolving landscape of medical marijuana and how it can be best used by patients for the best results.
From stigma to solution – the rising role of cannabis in medicine
The world is coming out of a 100-year cannabis prohibition, and we are only just beginning to understand (again) how cannabis can be used for medicine. Whereas once, hemp oils and cannabis tinctures used to line the shelves of pharmacies, cannabis use was pushed into the proverbial closet for over a century while people self-medicated in private. Now, the field of medical cannabis research is exploding, bringing forth new ideas about how to use cannabis as a therapy for various diseases.
The first person to reveal the structure of CBD and THC was Raphael Mechoulam in the 1960s, and it was through his studies that human beings discovered the existence of the endocannabinoid system at all. This was arguably the turning point at which we realized on a scientific level that cannabinoids affect the human body in profound ways, and may have a place in the world of medicine.
Since the discovery of the endocannabinoid system, many health conditions are thought to be affected by changes in it or dysfunctions of it, including:
- Inflammatory Bowel Disease
- Depression & Anxiety
If you’ve ever delved into the world of medical marijuana, that list of conditions will look strikingly similar to the list of diseases that cannabis is purported to treat. This is because the many compounds of cannabis target the endocannabinoid system directly, thereby having a profound effect on disease progression and severity in conditions caused by dysfunction of the endocannabinoid system.
Cannabis, its effects on the endocannabinoid system, and its role in medicine
The reason cannabis has such a profound effect on humans is because cannabis’ active and psychoactive constituent, THC, is structurally very similar to the brain’s own anandamide. Anandamide is the human brain’s very own endogenous cannabinoid, and because THC is chemically very similar, it has effects at the CB1 and CB2 receptors that are very similar to anandamide.
The endocannabinoid system plays a role in many aspects of the human nervous system, such as brain centers that control pain, mood, thinking and concentration, and appetite. With this simple understanding in mind, it becomes quite obvious why cannabis is being used to treat a variety of conditions that cause pain, nausea, depression, or anxiety.
Cannabis and its compounds, primarily THC and CBD, interact with the human body’s cannabinoid receptors to produce a cascade of chemical reactions that produce medicinal effects. This includes a reduction in inflammation, an interruption to the brain’s pain circuitry, and in certain circumstances, an activation of the body’s anti-tumor capabilities.
Scientists are still very much in the early stages of understanding how cannabis can be used effectively to treat various conditions, and how to produce a pharmaceutical grade product that has those effects. Let’s have a closer look at some of the medical conditions that cannabis is currently being used to treat.
How is cannabis being used in medicine?
Cannabis is currently under investigation for its application in a broad range of diseases. The body of evidence and research continues to grow as we develop an understanding of who benefits most from medicinal marijuana.
Epilepsy is among one of the most highly researched fields in medical marijuana application. It all started with a strain of cannabis called Charlotte’s Web, which was bred specifically for use in treating epilepsy. Suffering from frequent seizures, CHarlotte’s parents approached a group in COlorado who created a cannabis product that reduced her seizures by more than 90%.
Since then, cannabis has been researched extensively for its use in treating epilepsy. Epidiolex was the first pharmaceutical grade product released for the treatment of epilepsy, and has been available via prescription since 2018. It is used specifically for the treatment of Dravet Syndrome and Lennox-Gastaut Syndrome.
While cannabis is touted as a powerful anti-cancer drug, there is no consensus in the scientific community as to whether CBD or THC can slow the progression of cancer. However, it is very effectively being used to treat many of the side effects of chemotherapy such as nausea, vomiting, and wasting. It is considered a companion to traditional therapies in that it helps to maintain higher quality of life by reducing pain and nausea and improving sleep.
Depression & Anxiety
Cannabinoids such as CBD have effects on important mood centers of the brain, such as the 5-H1TA serotonin receptor. Activation of this receptor increases the release of dopamine, and many pharmaceutical drugs use this mechanism of action to relieve conditions such as anxiety and depression. However, there is limited evidence about cannabis’ ability to relieve depressive symptoms. In a 2021 observational trial, researchers found that there was an overall reduction of self-reported depression in cannabis users, but not in anxiety at baseline.
While many users report a reduction in their anxiety and depressive symptoms, this isn’t entirely backed up by science and research.
IBS and IBD
Ethan Russo, cannabis scientist, suggests that a Clinical Endocannabinoid Deficiency (CECD) is behind conditions such as irritable bowel syndrome and inflammatory bowel disease. His research is on the cutting edge, suggesting that dysfunctional endocannabinoid systems are what lead to IBS and IBD, and therefore, cannabis is an effective treatment for them.
There is a large body of research supporting the symptomatic relief of IBS and IBD. However, there’s no evidence that cannabis actually reduces disease severity or prognosis. In this way, cannabis helps to improve quality of life, but not necessarily disease outcomes.
Another common use for cannabis in medicine is in pain management. It is generally thought that cannabis is highly effective in treating neuropathic pain, but isn’t necessarily a good tool for acute pain such as injuries. It is overall the most common reason for people to use medicinal cannabis, and is considered an effective alternative treatment to opioids.
A prescription for hope
There are many benefits to the use of cannabis and other natural medicines. Aside from the fact that these medicines help people to move away from prescription drugs, they are also easier to access and can be grown at home by most people. Modern scientific evidence supports many of the historical uses of cannabis as a medicine, and we are just beginning to understand why cannabis is so effective at treating certain diseases.
It’s important that the media, and people in general do not hype up marijuana to be a cure-all for everything, as this diminishes the integrity of cannabis as an effective medicine for specific conditions. It also takes away from the importance of scientific research to understand how cannabis as medicine can be well targeted towards individuals who need it.