Understanding Medical Cannabis – What are the basic Components?

This article is one of a series planned for the provision of basic information relating to medical cannabis – a catch-all generic term for a range of cannabinoids that individually or collectively qualify for the terminology of medical cannabis.
It can be confusing because that term is often used interchangeably with other names such as medical marijuana, hemp, weed, grass, CBD, THC and many other colloquial terms.
There is no difference between the medical version of marijuana compared to the illegal product, and it is for that reason that, although CBD from Oregon is beneficial, the word “cannabis” is preferred when describing the medical version.
However, if you used that terminology in another country e.g. the US, they would likely scratch their heads because they would not be familiar with the term “cannabis”.

Our politicians need to do more work on the terminology for this substance, because existing legislation captures every single form of cannabis under one label, which has the effect (deliberately intended or unintended through ignorance) of catching all forms and components of cannabis under Schedule 8 of the Poison’s Act, when it should only apply to less than an estimated 10 percent of components relative to toxicity and addictiveness.

Extra resources tells us that the restrictions originally placed on marijuana related to a UN resolution banning the substance through a resolution that 150 countries globally signed up to not long after World War 2 had finished.
If you navigate here, you will know that addiction is a real problem. The resolution was promoted by the US government which described marijuana as a “gateway drug” opening up a pathway to heroin addiction.
For over 70 years research was not permitted for marijuana and it has been relentlessly pursued through various law enforcement agencies and aggressively prosecuted.
Many US prisons still contain inmates who received long prison terms for using or distributing marijuana and there are now new attempts being made to have these people freed.
One has to ask why marijuana was singled out in this fashion, and the only response that makes any sense is that Big Pharma actively lobbied the US government to achieve such a ban, because their own research indicated that if marijuana was adopted for medical use, it had the potential to blunt a lot of opportunities to bring synthetic drugs to the marketplace.
Seventy years ago Big Pharma corrupt marketing activities were not fully understood or recognised.

Big Pharma is currently exploiting terminology confusion and confining all  marijuana components restricted to schedule 8 and further, creating an extra overlay of red tape by regulating that prescribers need to be registered at both state and federal levels before they can legally prescribe.
That seems to have the effect of buying time for drug manufacturers to synthesise a range of cannabinoid molecules or grow genetically modified crops while preventing the natural plant oil (on which its reputation has been won) from being readily accessed through pharmacies at a Schedule 3 level – a more appropriate regulation for over 90 percent of cannabis components.

Thus an opportunity for Australian farmers, manufacturers and compounding pharmacies is rapidly being lost and the Australian public will have to pay a higher price, as usual, to accept what appears to be an inferior product in terms of safety and spectrum of activity.

At this point we would like to introduce readers to a 2015 study of medical cannabis published in the JAMA and titled and titled “Cannabinoids for Medical Use – A Systematic Review and Meta-analysis” which provides some evidence for your own knowledge base, and is accessed at this link Cannabinoids for medical use
So far, up to 80 individual cannabinoids and up to 400 other non-cannabis phytochemicals have been isolated from various strains of marijuana plants.

Cannabinoids are compounds that are produced naturally by various strains of the marijuana plant that can have potent antioxidant and neuroprotective functions. These compounds can assist the body’s healthy regulation of the central nervous, immune and internal endocannabinoid systems.

Cannabinoids resemble the body’s endocannabinoids, which are compounds our bodies produce naturally to control cell communication.
Research has shown that when the endocannabinoid system is deficient, unpleasant symptoms and diseases may occur.
When cannabis is administered, cannabinoids bind to receptor sites in the brain and body.
This can have different effects depending on which receptors the cannabinoids bind to.
As research on these compounds grows, so does our understanding of the effects of these cannabinoids and in the type s of relief they can provide.

Because of the way in which legislation has evolved in Australia, it has hampered any research initiatives into the natural plant forms found in Australia.
Unlocking a cash flow from Australian grown crops is essential before researchers can access grants for investigation – another opportunity loss for Australia.

Neuroprotectant effects by cannabinoids help to maintain healthy blood flow by counteracting factors that can decrease blood flow in the brain.
Cognitive function may be impaired if blood flow to the brain is restricted.
Medical cannabis is one of the few substances which has shown a regenerative effect after a stroke.
Given that one American dies every four minutes from the after effects of stroke, this must create a major reason for fast-tracking medical cannabis and making it accessible for the average Australian in its least toxic (natural) form which would arrive at a lower cost, simply because no patent is involved.

Cold process whole plant extractions have been shown to provide most benefit.
Extractions involving heat can alter the product profile dramatically.
It is heat (through hot solvents or smoking) that causes some cannabinoids to become more potent and psychoactive.
Cold extracts show no psychoactivity at all.

Studies suggest many of these compounds (cannabinoids and phytochemicalsa) work together to produce a synergy of benefits & effects.
This is known as the Entourage Effect

The Entourage Effect magnifies the therapeutic benefits of the plant’s individual components, so that the medicinal impact of the whole plant is greater than the sum of its parts. 

A whole of plant extract suitable for pharmacy and S3 classification could be derived from the full spectrum of certain parts of the plant, excluding the buds (which are high in a cannabinoid known as THCA, which converts to THC and becomes psychoactive if heated).
If an extract is made using cold extraction processes and includes THCA there is no dependence or addictiveness induced in a patient by this substance.
THCA seems to have a beneficial effect on blood sugar levels for Type 2 diabetics.
But it could open a door to be very easily reprocessed and abused where the THCA can be converted by heating to become THC which may induce unwanted side-effects.
THC products above 3 percent w/v would need to be restricted by prescription.
Again, a Schedule 4 classification is the only real regulatory component required here.
CBD oil is currently available in the US and is sold in a range of formats that include CBD oil diluted with olive oil or coconut oil, as a CBD oil paste, CBD oil in capsules, sublingual tinctures and sprays, as a topical ointment, as an edible in chewing gum or for use in a vaporiser similar to an e-cigarette vaporiser.

Perhaps this latter form is the reason tobacco companies are showing an interest in e-cigarette technology.
If THCA (non psychoactive) becomes an ingredient of a vaporiser, it would convert to a THC addictive product- less addictive than nicotine but nonetheless a very profitable opportunity for predatory tobacco companies.

To establish a dose for a patient, one size does not fit all and it is best to start small and gradually increase the dose until the desired result is achieved.
Branded forms of CBD have added to the overall confusion as to the correct dose.
A recommended dose is 25mg of CBD taken twice a day.
This dose should be increased by 25mg every three to four weeks until symptom relief is achieved, with the proviso that the CBD dose be decreased in the event of worsening symptoms.

Some dosage recommendations for some conditions are as follows:

To increase appetite in cancer patients: 2.5 milligrams of THC by mouth with or without 1 mg of CBD for six weeks

To treat chronic pain: 2.5-20 mg CBD by mouth for an average of 25 days
To treat epilepsy: 200-300 mg of CBD by mouth daily for up to 4.5 months
To treat movement problems associated with Huntington’s disease: 10 mg per kilogram of CBD by mouth daily for six weeks
To treat sleep disorders: 40-160 mg CBD by mouth.
To treat multiple sclerosis symptoms: Cannabis plant extracts containing 2.5-120 milligrams of a THC-CBD combination by mouth daily for 2-15 weeks. A mouth spray might contain 2.7 milligrams of THC and 2.5 milligrams of CBD at doses of 2.5-120 milligram for up to eight weeks. Patients typically use eight sprays within any three hours, with a maximum of 48 sprays in any 24-hour period.
To treat schizophrenia: 40-1,280 mg CBD by mouth daily for up to four weeks
To treat glaucoma: a single CBD dose of 20-40 mg under the tongue. Doses greater than 40 mg may actually increase eye pressure.
According to CannLabs, America’s top full-service testing lab for cannabis products, there is no established lethal CBD dose.
Consumers should read product inserts carefully to ensure they are taking the right amount of CBD, and talk to the prescriber (or pharmacist) about any questions or concerns.

How to Use CBD Oil

CBD is most commonly taken orally in an olive oil/coconut oil base, or as a  concentrated paste or drops/ tincture format.
To take CBD oil first hold it under the tongue to be absorbed in the mouth prior to swallowing.
This step is important because some of the CBD taken will be broken down by the digestive system.
Other oral methods include capsules, mouth strips, and edibles such as chocolate bars and delta 9 gummies.
Many people also use CBD oil via vaporisers or inhalers as this is a near instant delivery method that can be quite effective.
Others use CBD oil by taking it through the skin via lotions, balms, creams or patches.
There are many ways to take CBD oil, what matters most is trying a few different approaches and seeing what works.
Again, everyone is different
One caution: THC is detectable by a roadside test for up to 30 days past the last dose.

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