Friday, September 20, 2019

Herbs and Nutritionals Series: Medical Cannabis

"What do you think about CBD?" 
Photo by Sharon McCutcheon on Unsplash

This question comes up for me pretty much every week for me now. CBD--cannabidiol (CAN-uh-bi-DI-all)--is a chemical found in varieties of hemp or cannabis, the two plant names are essentially interchangable. Cannabis comes in three major species: sativa, indica, and ruderalis. The first two are the varieties that are most famously associated with their use for their mind-altering properties; the ruderalis--and not all botanists agree that it's a separate species--has not been subject to cultivation and selective breeding. It's considered "wild" cannabis, although even these are beginning to be bred by some cannabis horticulturists.

"Hemp"--a casual term for the plant--has come to specifically refer to industrial hemp grown for fiber that can be used in fabric, paper-making, and other consumer products. The species isn't as important as the strain of species when considering what a cannabis plant is to be used for. It's selective breeding that drives the end product in cannabis farming. This means that the Cannabis sativa grown in Iowa for fiber might be tall, with light foliage, few flowers, strong fibers, and almost none of the chemicals that make people "high." On the other hand, the C. sativa grown at a recreational marijuana farm in Washington State could be shorter, leafy, with plentiful, resinous flowers saturated with those chemicals. C. indica and C. ruderalis are shorter and less desirable as a source of industrial fiber, and so these are not bred for any purpose other than the psychoactive chemicals that people find desirable for medical or recreational use.
Industrial Hemp. Note the long, thin stems and lack of
significant flowers. Photo: "Valyxyz" on Pixabay
Psychoactive marijuana. Shorter, bushier, with many
resinous flowers. Photo: "futurefilmworks" on Pixabay

So it's breeding and strain that determines what's in a batch of marijuana. This has become a big business! Hundreds of nurseries, farms, growers, labs, and marketers form a new industry catering to both medical and recreational marijuana. So today I'll share a few points that my readers might find useful.

The chemicals that cause users to feel high are tetrahydrocannabinols (tet-ra-HYDRO-can-NA-bin-alls) or "THCs", mainly THC-9, and a lesser amount of THC-8. THCs resemble a naturally occurring brain chemical, or "neurotransmitter", called anandamide (ah-NAN-dah-mide), which comes from the Sanskrit word for "pleasure"--so it should come as no surprise that marijuana is something many people find pleasurable!

But activating anandamide circuits in the brain also comes with some sensations that some people find uncomfortable: It can raise emotional arousal, so it can feel like anxiety to some. It alters processing of sound and vision to a small extent, and while some find these experiences fun (or at least not bothersome), others can find the experience weird and unpleasant. So as I tell my pharmacology students: any drug that affects the mind can have unintended effects on susceptible brains. The THC in cannabis is no different. In some ways, psychiatric drugs and homeopathy are the same--one size never fits all!

There are several other psychoactive chemicals in marijuana. I won't go into all of them here, but the talk of the town these days is CBD.

CBD is a sedative, for the most part. It quiets the nervous system, which is why it was originally legalized in Pennsylvania, after parents of children with intractable seizures testified to the legislature. Since legalization in 2016, regulations have been developed and medical dispensaries have sprung up. To get it, a person has to be diagnosed with one of 21 medical conditions and see a PA-licensed physician who is authorized to write a recommendation letter for marijuana--so not all providers are in that program. The dispensaries distribute products in various forms (edibles, oils, resins, flowers, etc.) that contain various ratios of THC and CBD.

The other chemicals are usually not listed but are also less directly related to the therapeutic effects most people are aware of. More on this later.

Industrial hemp also contains varying amounts of CBD, and because it doesn't contain any significant THC, CBD is being sold--legally as far as everyone's concerned--in hemp oil-based products. So basically we have two industries: a highly regulated medical marijuana supply system that starts with a visit to a PA-licensed physician who is on the state's provider registry, and allows access to quality-validated, marijuana-derived products that contain various amounts of THC and CBD. And we have an unregulated, hemp oil supply system that starts with a visit to an online or local retailer--or even just a 7-Eleven! In this system let the buyer beware.

In my next installment, I'll talk about what CBD does, and a bit about some of the other features of medical marijuana that have effects on health and well-being.

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