After decades of prohibition and suppression, cannabis products are finally getting some proper scientific attention. It was not that the scientists did not want to study cannabis, it is because the punishments for possession or distribution of the drugs was so severe that it made studying cannabis for any reason other than to understand the negative effects of the drug impossible.
This situation is changing and looks to change as more countries legalize cannabis. Recreational users in Canada recently celebrated a victory as their country legalized and regulated recreational cannabis use. What was not talked about in the press was the opening up of cannabis to the scientific community that this brings. The ease with which researchers can obtain, modify, and study cannabis is much greater now. With this easing of policy will come lots of science. This is a relief because the current science of cannabis is overwhelmingly inadequate.
So far, the two best-understood cannabinoids (chemicals found in cannabis and in the brain) are cannabidiol or CBD; and delta-9 tetrahydrocannabinol, or THC. To say they are well understood is a slight overstatement, the data that have been published generally come from small-scale studies with a sometimes worrying attitude towards scientific rigour; many studies lack controls or are too small to be represented.
Despite this, there is enough data to talk about the difference between THC and CBD with some degree of certainty. Both were isolated in the last century when scientists were discovering the chemicals in cannabis that gave it the effects it has. THC was of special interest to governments and researchers because it is the chemical that delivers the “high” of cannabis. CBD took a little while longer to get any real attention because it has no psychoactive effects.
THC and CBD are both cannabinoids. A cannabinoid is a member of a diverse family of chemical compounds that alter the way that neurotransmitters (the signal packets of the nervous system) are released in the brain.
The endocannabinoid system is an evolutionarily ancient system of receptors in the nervous systems of many complex organisms, humans included. It is involved in many biological processes, from digestion to skin regulation, homeostasis, and mood. It has only recently been discovered and it is not well understood, but it is known to be involved in the development or progression of diseases as diverse as Alzheimer’s, Parkinson’s, irritable bowel syndrome, and arthritis.
It is because of the extremely wide range of applications that are possible with CBD and THC that they are causing so much excitement. The potential for positive interactions with the ECS is enormous, as initial studies have been showing.
Many commonly used drugs for fighting infections, inflammation, or mental illness have very direct effects. It is hoped that the more general and mediatory effects of cannabinoids are more useful and tolerable than some of these conventional treatments.
Cannabinoids are largely tolerable drugs, even at high doses. Cannabis itself is basically impossible to overdose on and the numbers of people reporting negative side effects are surprisingly low. Most people have no adverse effects. Cannabis is believed by some to be addictive, but it is not nearly as addictive as opiates or opioids, both of which are killing tens of thousands of people a year. The same dopamine producing pathway is activated with cannabinoids as with other directly addictive drugs but for as yet unexplained reasons most people suffer few if any severe withdrawal symptoms when ending their cannabis use.
There is some initial evidence to show that when given the choice, most people choose to use marijuana based products for pain relief rather than opioids.
There are hundreds of thousands, possibly millions, of people in jail or with criminal records because of this drug. The psychoactive effects terrified legislators in from the 1920’s onwards, and by 1970, it was completely prohibited. The American government led the criminalization of the drug and spent hundreds of billions of dollars trying to wipe out its production. Needless to say, even after so much money was spent and millions of people died, the trade is still going strong.
The United States’ Federal Government still considers THC to have “no medical value”, irrespective of the scientific literature. The fear of people changing their perspectives with cannabis and cannabinoids and the massively disproportionate view of the negative effects of THC are still enough to keep it illegal. Despite this, dozens of states have legalized medical marijuana and/or recreational use of marijuana so America remains in a confusing legal status.
Tetrahydrocannabinol interacts mainly with the CB1 and CB2 receptors of the endocannabinoid system. It activates them and changes the way the neuron they are attached to communicates. This results in the noticeable changes that consumption of THC produces. Unlike a drug like an SSRI (Prozac is a common example), it does not bind directly to a receptor, it behaves more as an agonist, altering the receptor’s behaviour.
In rats and mice, studies have shown that locomotor (movement) activity in the brain is suppressed, potentially explaining the lack of coordination that strong cannabis can induce. Body temperature is reduced and a strong analgesic (pain relief) effect has been observed. Rats and mice are similar enough in biology for the reader to assume that there will be similar effects in humans, but many animal studies never translate to humans, so at this point, nobody knows if this is exactly how THC works in the body.
One recent area of interest has been “entourage” effects, or the combinations of different cannabinoids and how they affect each other. These are very early days for such studies but preliminary results show that when CBD and THC are used together, they mediate the action of the other, producing a range of results.
Of particular interest to medical science is the strong immunomodulating (making changes to the immune system’s functioning) and anti-inflammatory properties THC possesses. Studies have found that THC suppresses local immune responses so powerfully that viral infections can be made worse. If the right dose is found, this powerful antimicrobial effect could be harnessed.
THC is prescribed to some cancer chemotherapy patients to ease nausea that the drugs often cause. Weight loss through loss of appetite and vomiting due to chemotherapy is a significant risk factor for survival and recovery, so the use of a powerful anti-nausea drug is very helpful. The relative lack of side effects is especially welcome to people undergoing treatment.
Another recent use of THC is for neuropathic pain. When nerves become inflamed due to infection or damage, the pain can be intolerable and debilitating. Many drugs for neuropathic pain have some severe side effects, increasingly over a long time frame. THC’s long-term safety record has yet to be fully evaluated, but it is certainly mostly tolerable and non-addictive in the short term, making it a viable alternative to some drugs.
Cannabidiol, or CBD, is very closely related to THC and often works in tandem in the body with THC. It does not, however, produce psychoactive effects. For the treatment of paediatric conditions and for people who want to manage their conditions while maintaining their jobs and lifestyles, CBD presents an almost unique hope for some treatments.
CBD has an affinity for the CB1 and CB2 receptors that is 100 times less than THC. It seems to modulate the effects of other cannabinoids instead of having a direct interaction. More research is needed to explain how this works.
It should be reinforced at this point that the scientific record is far from complete and the conclusions this article draws are based upon some relatively dubious scientific papers. The picture looks hopeful but other drugs have presented wonderous potential only to fail at the large-scale test stage. There is probably enough evidence to conclude that cannabinoids are generally safe, but this author always advises caution with poorly studied drugs.
The effects of CBD are myriad and fascinating. They are still being discovered, for example, the neuroprotective effects that are being trialled with people who suffer chronic head injuries, like American football players and soldiers. A condition called chronic traumatic encephalopathy (CTE) is drawing a lot of attention because it is so common amongst professional-level football players (up to 99% in one sample of players’ brains). The condition leads to a much higher suicide, domestic abuse, and violence risk. People who tested positive for THC in their blood were found to have less damage to their brains than people who had not consumed cannabis. CBD has been shown to have similar effects but as the trials have yet to be finished, the conclusions will have to wait.
It is not just footballers and soldiers who are potentially beneficiaries of the effects of CBD and THC, some initial studies have shown that any kind of traumatic brain injury can be protected against to a degree by cannabinoids interacting with the CB1 pathway. How this works is not yet understood, but it definitely looks promising.
CBD’s role as an anti-epilepsy drug is the area that is drawing most attention in the press. Cases of previously untreatable infants who were having dozens of potentially brain-damaging seizures a day being treated with CBD and having far fewer seizures, or eliminating seizures entirely, have made headlines. Recent clinical trials have found CBD to be safe for treating epilepsy.
Other applications of CBD include the treatment of anxiety disorders and depression. One study on animals found that the effect of CBD was demonstrably anxiolytic and antidepressant effects. Again, the difficulty extrapolating from animals to humans prevents drawing solid conclusions, but it certainly fits with the anecdotal evidence. There is a generalized mood stabilizing effect that CBD has that is possibly mediated by THC, so the two could potentially be used together. The 5HT1A receptor is known to be related to many different depressive disorders and one recently discovered pathway for CBD’s interaction with the brain is through this receptor. It could be that by modulating the interactions of this receptor, CBD is able to regulate depressive symptoms.
The endocannabinoid system is thought to be a contributor to depressive conditions. One clinical study has found that endocannabinoids are “differently regulated in major depression” and after stressful incidents. One possible use of CBD is to ameliorate these effects. This has yet to be properly proven.
There is some hope for cannabidiol being used as a tolerable schizophrenia drug. There are noted antipsychotic effects for CBD which could prove useful as many treatments for schizophrenia are intolerable or ineffective. Excessive use of cannabis, especially during adolescence, raises the chances of developing schizophrenia, so it is clear that the endocannabinoid system is involved with the condition, as well as with other causes of psychosis. While it may be a cause of schizophrenia, it CBD might also be able to help treat the condition.
The effectiveness of cannabidiol for reducing spasticity due to multiple sclerosis has been studied, albeit fairly briefly. While one study showed that cannabis use helped ease people’s symptoms, another showed that it was no better than a placebo. It is, however, one of the most commonly used drugs for the relief of MS symptoms, irrespective of legality. A recent study showed that CBD helped people control their bladders much better than a placebo. The loss of bladder control is one of the most debilitating and embarrassing symptoms of MS and the use of CBD to both ease their spasticity and bladder problems are becoming increasingly popular.
Some people are using CBD for the treatment of irritable bowel syndrome. There are no conclusive data to show that it works, but there is mounting anecdotal evidence to that effect. The endocannabinoid system is extensive in the gut and the regulatory and anti-inflammatory effects of CBD are promising but far from proven for the gut.
Cannabidiol and Tetrahydrocannabinol
The above list of uses and effects of cannabidiol and tetrahydrocannabinol are only some of the effects on medical conditions of these remarkable compounds. More areas are being investigated, including ADHD, ADD, acne, Alzheimer’s, eating disorders, migraine, obesity, OCD, heart disease, chronic inflammatory conditions like rheumatoid arthritis, fibromyalgia, and more. The more that is discovered about cannabinoids, the wider the range of potential uses gets.
THC and CBD are only the two best-understood cannabinoids, there are over 100 in the cannabis plant, many of which have barely been investigated. The combination and proportion of cannabinoids seem to play a big role in their effect and efficacy, so there is a lot of work to do.
Other chemicals, like terpenes, are found in the cannabis plant and seem to contribute to the action of cannabinoids. This is where the science seems to have reached its limit, but as the scientific community gets greater access to cannabinoids, these effects are going to be explored further.
Does CBD Contain THC?
Only if you buy “full spectrum” CBD oil, which is all the cannabinoids and terpenes found in the cannabis sativa plant in an oil. Because the “entourage” effects of cannabidiols seem to be so important, many people are deciding to use a full spectrum CBD oil that contains a high concentration of cannabidiol but enough cannabinoids and terpenes to enable the entourage effects.
Cannabidiol can be obtained in its pure form. It is prescribed regularly where it is legal for many different conditions and is highly tolerable in its pure form. For people who want the benefits of cannabinoids but without the psychoactive effects of THC, pure CBD products are a leading choice.
If you choose to use CBD, THC, or any combination of cannabinoids, make sure it is legal where you are residing. If it is not, please do not buy, possess, or sell it. Cannabis and cannabinoids might seem like medicines because of their medicinal effects but the legal penalties for possessing the drug can be severe.