As medical cannabis has evolved, so too has its vernacular expanded. Tinctures, topicals, concentrates and edibles are just some of the terms that patients may encounter in the early days of a cannabis-based treatment. But for all intents and purposes, understanding the herb itself is quite simple. Particularly, cannabis sativa is made up of two primary components: terpenoids, which are naturally occurring hydrocarbons that produce the plant’s aromatic characteristics, and cannabinoids, the plant’s main therapeutic component.
To date, more than 100 cannabinoids have been identified, with two particularly abundant cannabinoids demonstrating the most significant clinical impact. The first and most common, tetrahydrocannabinol (THC), was discovered by famed cannabis researcher Dr. Raphael Mechoulam in 1964. The other, cannabidiol (CBD), is recognized as the main non-psychoactive ingredient in the cannabis plant. We will discuss both in further detail, and look also at the starter molecule which is transformed into both cannabinoids by enzymes, cannabigerol (CBG).
THC is nearly identical to a compound the body produces called anandamide. The reason why anandamide doesn’t naturally create the effects many experience with THC on the same scale is the result of a feedback loop. To put it simply, when a receptor is activated, part of this complex process involves telling the source of the anandamide that it doesn’t need to make more. As the plant’s primary psychoactive component, THC is said to produce a range of therapeutic benefits, as both an antiemetic, which reduces nausea and vomiting, and an analgesic, helping patients manage pain. When patients are selecting a medical cannabis strain, a simple rule to remember is that the higher the THC content of the variety, the more powerful the impact from consumption will be. Most of the evidence supporting THC focuses on the use of cannabis for pain management. Overall, research has pointed to a role for THC in the management of neuropathic (nerve) pain, multiple sclerosis (MS), and neuropathic pain associated with AIDS/HIV, as well as showing effects on nausea, mood and sleep.
Cannabidiol is arguably the most significant cannabinoid uncovered in recent years. In the context of the medical community, CBD has gone from a relatively unknown cannabinoid to one of the most coveted for therapeutic use. Although our understanding of the impact of CBD on patients is limited clinically to anecdotal reports, it continues to be the focus of attention for many researchers due to its lack of reported psychoactive effects. Evidence suggests CBD is effective at regulating pain and inflammation, and it is reported to help treat a range of symptoms and ailments, including seizures, anxiety, and movement disorders.
In any discussion about cannabinoids, it is important to note the cannabinoid that is transformed into both THC and CBD, cannabigerol. The best way to picture this is as an enzymatic fork in the road. While commonly only present in small amounts in the cannabis sativa plant, CBG has been bred over the years to increase the proportion of the molecule present in certain strains. Another non-psychoactive cannabinoid that has shown promise in early clinical trials, CBG has demonstrated unique anti-microbial qualities that researchers believe may prove valuable from a medical perspective in future.
Other molecules that have been identified as having therapeutic benefits include cannabielson (CBE), cannabitriol (CBT), cannabichromene and cannabinol (CBN). Because cannabinoid science is still in its infancy, the three discussed in detail above are the best understood at this point, though researchers and labs around the planet are investigating new means of isolating compounds and using combinations of cannabinoids to create new drugs and products. As more research is done, and the function of new cannabinoids discovered, the true potential of cannabis – which was largely unrealized in the last 75 years – will become clear.