This report is a collection of news items and research reports related to the effects of medical cannabis.
Some of this information is anecdotal and has to be validated by formal clinical trials.
But if only a fraction of the results claimed by personal users is correct, then we indeed have a very useful substance within our armoury that can be used to treat pain, promote weight loss and reduce insulin resistance – areas of health that have become almost epidemic in proportion and seemingly not being able to be efficiently treated with any mainstream drug.
As cannabis becomes more integrated within mainstream culture, potential consumers are becoming more educated on the many benefits of THC and cannabinoids.
Not only does cannabis consumption lower insulin resistance, but it also improves fasting insulin and facilitates metabolic function.
Even athletes (rightly or wrongly), and those engaged in moderate recreational fitness, have claimed benefits from daily consumption.
It would seem that recent research has discovered cannabinoids are produced naturally in the body and are stimulated by exercise.
The pain-relieving effects of both plant and human-derived cannabinoids may provide solutions when prescribed for physical health improvement.
It is only the THC component in cannabis that is psychoactive and has a range of potentially adverse side effects.
The CBD components are not addictive and appear to not have any serious side-effects.
In Australia, all cannabis products or plants have been controlled under Schedule 9 of the Poison’s Act.
Recent changes have transferred these substances to Schedule 8, which means that they can be prescribed by a GP, and Victoria the first state to legalise the medical use of cannabis.
Other states will harmonise with Victoria when they have had their own clinical trials reach a conclusion.
It is not known as yet if any additional restrictions will have to be observed or whether any product will appear on the PBS as yet.
A PBS listing has the potential of significantly reducing its budget requirements.
Because of its safety profile (toxicity, low adverse event and nil addiction) the CBD component should be advocated by pharmacy bodies to become schedule 3 as soon as practicable because of its potential to treat a wide range of chronic conditions, particularly neurological pain, dementia and diabetes.
Insulin is a hormone made by the pancreas that converts sugar to energy, or stores it in the liver as glycogen.
An oversupply of sugar creates an elevated insulin response that converts it to central fat (and creates weight gain).
A study published in the American Journal of Medicine has found that regular cannabis consumers have fasting insulin levels 16% lower than non-consumers.
The study also found that cannabis consumers had 17% lower insulin resistance levels and lower average waist circumferences.
The researchers concluded that there were significant associations between marijuana use and smaller waist circumferences.
Some athletes have made claims that marijuana or its isolated active ingredients, such as delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) act as performance-enhancing drugs, by easing anxiety and increasing pain threshold which enables a better result for them.
Marijuana also has an anti-inflammatory effect and that the cannabinoids may mimic the body’s natural endorphins, which may explain the increase in pain threshold.
This may also hold the possibility of quicker recovery times from strenuous exercise and sporting events.
Contrary to popular thought, it’s not just the endorphins (the compounds which make you feel excited after activities such as exercise and sex) that make physical activity a pleasant experience.
A 2003 study found that exercise actually activates the endocannabinoid system in the same way that the cannabis plant does.
The endocannabinoid system is a group of lipids and cell receptors that cannabinoids (THC and CBD) bind to.
The endocannabinoid system is responsible for easing pain, controlling appetite, and influences mood and memory.
Studies have found that human-produced cannabinoids increase as you exercise, causing you to feel a little “high.”
It’s not news to the medical community that the human body stores tetrahydrocannabidiol (THC), the main psychoactive in cannabis, in fat.
However, a study published in August 2015 in Drug and Alcohol Dependence has shown that this storage process can give exercisers an extra boost, even up to 28 days after consumption.
As the body begins to burn off fat, small amounts of THC are released back into the bloodstream, producing an effect similar to consuming a small amount of cannabis. THC blood levels were shown to increase by approximately 15% immediately after moderate exercise, yet this increase was no longer present two hours after the workout.
Peak blood concentrations of cannabinoids occur in 3-8 minutes after you inhale, as opposed to 60-90 minutes after you eat a cannabis food product- or an oil-containing cannabinoids, with neural effects beginning after 20 minutes and reaching a peak within a range of 2-4 hours.
THC binds cannabinoid receptor 1 (CB1), mainly localized in the brain, while cannabinol (CBN) binds CB2, which exists mainly on immune cells.
CBD binds neither receptor, but still affects numerous metabolic processes including appetite, pain sensation, immune function, stress reactivity, hormonal secretions, and muscle and fat tissue signalling.
A 2013 adjusted epidemiological study showed that obesity rates are significantly lower for all groups of cannabis users (inclusive of gender and age) compared to those who had not used cannabis in the last 12 months.
The lower Body Mass Index (BMI) of pot-smokers may be explained by an adaptive down-regulation of brain endocannabinoid signalling.
While acute THC stimulates appetite, the repeated stimulation of CB1 receptors by THC decreases receptor expression and sensitivity, and long-term stimulation may result in antagonistic rather than agonistic triggering of CB1 receptors, which would dampen down hunger signals.
Furthermore, CBD and another component of marijuana, tetrahydrocannabivarin (THCV), may reduce body weight, as animal models of obesity have shown THCV to increase metabolism of fat cells.
However, only a few species of marijuana grown commercially have this substance, but that may change as crops are grown with a specific medical outcome in mind.
Drug manufacturers have recognised the opportunities to synthesise molecules that can act like cannabinoids or that can stimulate natural cannabinoid production.
Tragically, one of the first trials of this type of drug resulted in serious injury or death for some of the participants.
The clinical trial occurred in France in December 2015 and was sponsored by Bial, a Portuguese drug company.
In particular, neither the French authorities nor Biotrial (A French contract-research organisation) has disclosed the identity of the molecule administered in the trials.
Bial did say that the drug was an FAAH (fatty acid amide hydrolase) inhibitor; FAAH is an enzyme produced in the brain and elsewhere in the body that breaks down neurotransmitters known as endocannabinoids.
By blocking these enzymes, FAAH inhibitors cause endocannabinoids — which activate the same neural receptors as the active chemical in cannabis, and might have painkilling properties — to accumulate in the body.
So there will be some cautions needed for these types of synthetic products as they appear on the market, and more reason to use Australian grown cannabis oil with its low adverse events profile.
Opportunities for compounding pharmacists will occur in being able to produce cannabis oil with standardised combination levels of THC and CBD.
Already, some cannabis oil products are appearing on the Internet from farms licenced by the Australian government.
Quoted price from a Western Australian producer was $349 for 3 x 10ml syringes.
i2P has previously encouraged Australian pharmacists to apply for licences to grow marijuana as a means of guaranteeing supply and preventing the market cost price from getting too high, as has happened in Europe and in the US in states that have legalised its use.
But there is no doubting that this will be a product for Australian pharmacists and down-regulation of the CBD component to schedule 3 is required as soon as practicable, because it will form a major component of primary health care.
Other i2P articles about Medical Marijuana: