Is my medical cannabis Indica or Sativa?

Today, we're tackling one of the most common patient questions: "Does my medical cannabis flower offer Sativa or Indica effects?".

You'll see these labels thrown around (especially in the recreational cannabis industry), but:

• Are these terms relevant for UK medical cannabis prescribers or patients?
• If not, what should we really be focusing on when discussing UK medical cannabis flower cultivars?

But first…

What do the terms "Indica and Sativa" traditionally mean?

The Indica vs. Sativa debate has raged on for more than a few decades.

In the legacy cannabis market, these terms have been used to group together the two main types of cannabis plants: taller "Sativa" cultivars native to subtropical regions like Thailand, Colombia, and Mexico and the shorter, bushier "Indica" cannabis plants native to the cooler, mountainous areas around India, Afghanistan, Pakistan, and Morocco.

Sativa-dominant cultivars have been long associated with more uplifting effects, while Indica-heavy options are associated with sedation and relaxation, but, are these terms still useful today?

Why Indica and Sativa classifications are outdated in medical cannabis

So, is there an actual genetic difference between "Cannabis Sativa" and "Cannabis Indica"?

The answer is, no. In fact, they aren’t even scientific terms. 

All cannabis plants come from the same genus, Cannabis sativa L., and researchers believe that only external/environmental factors (like light exposure and temperature) and selective breeding affect the evolution of a cannabis cultivar's characteristics.

You can think of it like this - all humans are part of the same species: Homo Sapiens. But, depending on our cultural heritage, our skin colour, eye colour, hair colour, and average height differs.

A man from the UK can meet a woman from Kenya, and they have the genetic ability to have children together. And those children will be Homo Sapiens, even though they may look a little different to either of their parents. Similarly, a "Sativa" cannabis plant from Thailand can be cross-bred with an "Indica" cannabis plant from Afghanistan to create a new cultivar that can express a mix of characteristics from its parents.

So, are the terms "Indica" and "Sativa" (and the differences in the effects they're believed to provide) completely meaningless?

Not necessarily.

While having a full understanding of what Indica and Sativa mean historically is a good thing, in the UK medical cannabis industry, we focus more on the cannabinoid profile of a cultivar and the dominant terpenes present rather than its traditional classification.

What are cannabinoids and terpenes?

Cannabinoids and terpenes are the key compounds in cannabis that influence a plant's potential therapeutic effects.

Cannabinoids explained

Cannabinoids can be split into two groups:

• Endocannabinoids - Naturally produced by humans, these are the chemical signalling compounds that interact with our endocannabinoid system receptors to help maintain balance and homeostasis.
• Phytocannabinoids - these are plant-derived compounds that have such a remarkably similar structure to our endocannabinoids that they can interact with the same receptors.

Cannabis-produced cannabinoids are phytocannabinoids, but for the sake of simplicity, they are almost always referred to as just cannabinoids. 

The two major cannabinoids that Cannabis sativa L. plants produce are Tetrahydrocannabinol (THC) and Cannabidiol (CBD). While over 110 cannabis-produced cannabinoids have so far been isolated, it is really only these two that we currently focus on in medical cannabis treatment, especially when discussing different prescribable cultivars. The rest are produced in such small amounts that they don't have a significant impact on the therapeutic effects of a particular cultivar.

That said, research into the range of minor cannabinoids, such as Cannabinol (CBN), Cannabigerol (CBG), and Tetrahydrocannabivarin (THCV), is ongoing. As we learn more, these compounds may become more relevant in our discussions about medical cannabis treatment - especially when extracts and concentrates are involved.

Learn more: What is a cannabinoid?

Terpenes explained

Terpenes are aromatic compounds that give different cannabis cultivars their range of distinct smells and flavours. But they do more than just alter the sensory experience.

Like cannabinoids, research shows that terpenes also have therapeutic potential.

Some interact with the endocannabinoid receptors, but most interact with other receptor systems in the body. They have been shown to offer a range of health benefits, for example:

• Myrcene is linked to anti-inflammatory properties, pain relief, and sedation.
• Limonene to mood elevation, reduction in anxiety, and better gastrointestinal health.
• Beta-caryophyllene to pain management, anxiety and depression relief, and an antioxidant effect.

They also work together with cannabinoids to create what is referred to as the entourage effect - where the therapeutic compounds produced by the plant work together synergistically, enhancing each other's benefits.

Learn more: Exploring the role of terpenes in medical cannabis

Where does that leave the Indica vs. Sativa debate?

We now understand that the traditional classifications of Indica and Sativa are not as reliable predictors of a cultivar's effects as once thought. Instead, these terms have become marketing buzzwords used to attract consumers looking for specific experiences.

As Dr. Ethan Russo, one of the world's leading cannabis researchers, explains:

“There are biochemically distinct strains of Cannabis, but the sativa/indica distinction as commonly applied in the lay literature is total nonsense and an exercise in futility. One cannot in any way currently guess the biochemical content of a given Cannabis plant based on its height, branching, or leaf morphology"

In simple terms, the effects of a particular cannabis cultivar are far more closely related to its unique cannabinoid and terpene profile than whether it is classified as an Indica or Sativa.

How do I find the best medical cannabis cultivar for my health needs?

One of the prescribing specialists from our world-class clinical team will work with you to find the most appropriate cultivar for your treatment needs. They will consider your medical history, current symptoms, and any potential interactions with other medications you may be taking.

So instead of focusing on Indica vs. Sativa or searching for specific strain names, trust that our team will work with you every step of the way to find the best medical cannabis treatment plan for you. They will discuss both the cannabinoid and terpene profiles of any recommended cultivars and help you understand how these compounds may benefit your health.

This personalised approach is the cornerstone of our medical cannabis treatment philosophy, and we are committed to ensuring that all our patients receive the highest quality care and support throughout their journey.

Learn more: Why Releaf patients aren't given a 'medical cannabis menu'

Moving beyond Indica and Sativa

They say that “The only constant in life is change”, and the cannabis industry is no exception.

Medical cannabis legality has brought with it so much more access for researchers and scientists to explore the potential of this incredibly fascinating plant. As we continue to learn more, it is clear that our understanding of cannabis will continue to evolve.

So let's say goodbye to the outdated ideas of Indica vs. Sativa and embrace the new frontier of personalised medical cannabis treatments based on the best science available - not old classifications or marketing gimmicks.

Want to find out more about how we can help you access personalised medical cannabis treatment? Head to our fast and free medical cannabis eligibility checker. It takes under 30 seconds to complete and will give you a much fuller understanding of whether a UK medical cannabis prescription may be right for you.