A complete guide to the medical administration of cannabinoids

For close to a century, cannabis use has been somewhat demonised, and definitely misunderstood. Fortunately, the stigma surrounding medicinal cannabis is slowly dropping away as the wider public begins to recognise the potential medicinal therapeutic benefits of this incredible plant.

The cannabis plant contains over 110 cannabinoids (phytocannabinoids), all of which may have the potential to provide distinct benefits, both psychologically and physically, via the body's endocannabinoid system (ECS). These cannabinoids are responsible for many reactions in the body and work to regulate mood, appetite, and energy levels amongst many other things.

In this guide, we will delve into the medical applications of cannabinoids, or more specifically phytocannabinoids, and look to see if we can shed some light on these naturally occurring compounds found in the cannabis plant.

What are cannabinoids?

Cannabinoids come in two distinct groups.

Endocannabinoids are the cannabinoids that are naturally produced within the body. These cannabinoids interact with receptors in the endocannabinoid system to regulate a vast range of bodily functions, such as sleep, appetite, and immune system response. The most up-to-date research suggests that the ECS is responsible for regulating homeostasis, or balance, in the body. There have been two endocannabinoids discovered thus far, anandamide (arachidonoyl ethanolamide) and 2-arachidonoyl glycerol (2-AG).

Phytocannabinoids, on the other hand, are the cannabinoids produced by cannabis and hemp plants. The two major phytocannabinoids are delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD).

Along with THC and CBD, there are minor cannabinoids produced by cannabis and hemp plants. These include cannabinol (CBN), cannabigerol (CBG), and cannabichromene (CBC). Each of these cannabinoids may offer its own unique health benefits. Thanks to the recent explosion in cannabis legality, researchers are finally being permitted to delve into the vast potential of these compounds for medical applications. 

When ingested, cannabinoids work by interacting with the CB1 and CB2 receptors in the ECS (along with a range of other mechanisms), potentially helping the body in regulating various systems. These interactions can result in symptomatic relief when consumed by patients.

While there has been a decent amount of peer-reviewed research into both THC and CBD, our understanding of both the major and minor cannabinoids is still in its infancy. Thanks to the shift in both policy and cultural attitudes regarding cannabis, this research is beginning to catch up and the full potential of cannabinoids is slowly coming to light.

What are the historical apllications of cannabinoids?

Cannabinoid ingestion by humans began as early as 12,000 years ago near the Altai Mountains in Central Asia, although we have to look a little closer to find actual hard evidence of cannabis usage.

The first recorded administration of cannabis comes from China, where Emperor Shen Nung (commonly referred to as “the father of Chinese medicine") wrote about the plant’s therapeutic properties in 2800 BC. From here, cannabis travelled both east and west in the centuries following and is mentioned in texts stretching from the Indian Hindus and Assyrians to the ancient Greeks and Romans. These pieces of historical writing told of cannabis being taken to treat a huge range of health issues, including depression, amenorrhoea, inflammation, arthritis, asthma, and appetite loss.

In more recent times, up until about twenty years ago, cannabis consumption has been less socially accepted and more restricted. This was firstly due to political and industrial pressures, but later spilled over to the public consciousness as a result of misinformation campaigns and propaganda. However, the tide is finally beginning to turn, with cannabis and its possible therapeutic potential now being re-examined.

What is the endocannabinoid system (ECS)?

The endocannabinoid system (ECS) is a vast internal network located throughout the entire human body and is composed of cell receptors (CB1 and CB2), signalling molecules, and enzymes.

These receptors are have the potential to be activated by both our own endocannabinoids and the phytocannabinoids produced by cannabis. When cannabinoids interact with the receptors, they can help to regulate a number of bodily functions, including appetite, sleep cycle, immune system response and more.

The most recent science is pointing to the ECS being a major player in maintaining homeostasis, or balance, in the body. As such, it is believed that supporting and maintaining a healthy endocannabinoid system could be of great benefit to an individual's overall health and well-being.

The endocannabinoid system exists not only in humans, but also in all animals, including birds, mammals, fish, and reptiles, and even invertebrates such as sea urchins, leeches, mussels, and even nematodes.  

What is the importance of the medical application of cannabinoids?

The importance of the medical administration of cannabinoids lies in their ability to interact with the endocannabinoid system. By doing so, they may be able to help in promoting homeostasis, and potentially provide relief from a range of illnesses.

Research into the medical applications of cannabis is still in its preliminary stages, but there are more than a few papers that are showing that cannabinoids may have a positive effect on the symptoms of certain medical conditions, and also the symptoms that these illnesses bring. The most notable of these include chronic pain relief, reducing inflammation, seizure control, and improving patient sleep and appetite.

Types of cannabinoids

We have reviewed the difference between our own endocannabinoids and phytocannabinoids further up in this article, but let's have a quick look at the phytocannabinoids that come in the highest concentrations.

1. Tetrahydrocannabinol (THC) is the main psychoactive cannabinoid produced by cannabis, which can induce euphoric and uplifting sensations. THC also shows promise in being beneficial for the symptomatic relief of a range of health issues, but more research is needed before any concrete claims can be made about the efficacy of THC in medical settings.  
2. Cannabidiol (CBD) is the other major cannabinoid produced by both cannabis and hemp. Unlike THC, CBD does not produce a psychoactive effect. CBD has fast become a well known cannabinoid due to its possible potential for therapeutic relief of a range of health issues, such as chronic pain and inflammation, epilepsy, anxiety, depression, and insomnia.
3. Cannabinol (CBN) is a cannabinoid that is formed as THC degrades and ages over time. It may induce a sleepy, sedative effect.  

Other phytocannabinoids include CBG (Cannabigerol), CBC (cannabichromene), THCV (tetrahydrocannabivarin), CBDV (cannabidivarin), THCA (tetrahydrocannabinolic acid), CBDA (cannabidiolic acid), CBCA (cannabichromenic acid), CBGVA (cannabigerolic acid), and THCV-A (tetrahydrocannabivarinic acid).

Medical applications of cannabinoids

While the need for further research into the medicinal applications of cannabis is ever present, there are some promising studies that point to the possibility of therapeutic potential of cannabinoids, especially when it comes to -

1. Pain management
2. Nausea and vomiting cessation
3. Appetite Stimulation
4. Skin redness and irritation reduction
5. Anxiety reduction

These applications are just a few examples of the diverse applications that cannabinoids may possess. 

As the research continues, we may see more potential for cannabinoids to help improve the quality of life for those suffering from chronic and acute illnesses.

Methods of administration

One important factor that is often overlooked by medicinal cannabis patients is the method of administration. There are a few different ways that cannabinoids can be integrated into your health and wellness routine, each offering its own advantages and disadvantages.

1. Inhalation: One method of consuming cannabinoids is inhaling them through a vaporiser cartridge. By taking a few puffs, the cannabinoids can enter the bloodstream relatively quickly.
2. Oral ingestion: You can consume cannabinoids in gummies, edibles, drinks, and tinctures. This is a popular form of consumption, especially for patients who have no desire to inhale. It is good to keep in mind that the cannabinoids will take more time to reach the bloodstream when using this consumption method.
3. Topical application: This method involves applying a small amount of cream to the skin. The cannabinoids are then absorbed through the pores and interact with receptors in the skin. This can be beneficial for treating localized pain or inflammation. 
4. Sublingual: This method is used for tinctures by placing a few drops underneath the tongue and waiting up to one minute before swallowing. When consumed this way, the cannabinoids are absorbed faster into the bloodstream than they would be when eaten, while still cutting out inhalation. 

While all methods effectively deliver cannabinoids to the body, personal preferences and specific consumer requirements may favour certain consumption methods over others. It's important to consider factors such as onset time, duration of effects, dosage control, and overall convenience when selecting a preferred method of consumption.

Risks and side effects

The potential risks and side effects of cannabinoids should be considered before you consider adding medical cannabis to your health routine. It is essential that you consult with a healthcare professional before making any changes to your current treatment plan, or before considering the administration of medical cannabis generally. In the UK, only registered and qualified doctors are allowed to prescribe medicinal cannabis. 

Short-term and long-term effects

These risks and side effects for the short term may include:

• Mood changes
• Change in sensory perceptions
• Weakening of body movements
• Red eyes
• Dry mouth
• Low blood pressure

Risks and side effects for long-term usage may include:

• Change in learning functions
• Change in brain development in people under the age of 25
• Interrupted thought processes
• Short term memory vagueness

While most patients who consume medical cannabis do not experience any issues, these are potential side effects you should be aware of. 

Interaction with other medications

In rare cases, cannabinoids may interact with other medications, which could lead to unwanted side effects. However, for the most part, cannabis has limited interaction with other medicines. This only highlights the need for consultation with a qualified medicinal cannabis physician before you consider taking it. 

What medications do cannabinoids interact with?

Medications including antidepressants, antipsychotics, sedatives, and blood thinners may interact negatively with cannabinoids. 

Risk of addiction and abuse

While there are risks of addiction and abuse, similar to any substance you ingest daily, the risk is generally considered lower than for other substances. This may be due to our body's own endocannabinoid system producing endocannabinoids. THC and CBD mimic these cannabinoids (anandamide and 2-AG respectively).

THC is seen as a higher-risk compound for those with dependency issues, as it offers a psychotropic effect. CBD poses no risk of addiction, as it is totally non-intoxicating. 

Though the compounds are low risk, it’s important to take caution when taking cannabinoids regularly. 

Are cannabinoids legal?

In the UK, CBD products are legally sold online and over the counter. They must not contain more than 0.2% THC. THC products are legally obtainable via private prescription, which may be issued by a specialist doctor. Patients must have already tried other forms of treatment before medicinal cannabis can be prescribed.

The current state of research

Recent research has shed light on the possible positive effects of cannabinoids and their compatibility with the human endocannabinoid system. These studies have revealed the potential therapeutic benefits of cannabinoids in various aspects of human health and well-being.

We are seeing a stark political and cultural shift regarding the views on cannabis (and specifically medical cannabis) taking place globally, and with it comes the opportunity for researchers to finally gain the type of access they nedd to the plant to continue this vital area of inquiry. As this body of research grows, so does our understanding of not only the therpauetic limitations, but also the huge potential of cannabinoids. And while there is an obvious need for further research, current studies are providing us with valuable insights into the possible therapeutic power of this plant.

We can only hope that as more research is conducted, we will be able to expand our knowledge around the administration of cannabinoids for medicinal purposes. This way, more people can benefit from its potential therapeutic effects and have a better understanding of this oten misunderstood plant. 

Clinical trials and studies

Hundreds of clinical trials and studies have already been conducted on cannabinoids that give insight into their efficacy and safety.

Let’s quickly look at a few of the more interesting ones 

• A study published in The Journal of Pediatric Pharmacology and Therapeutics was conducted to further advance the knowledge and awareness of how CBD reacts with epilepsy patients, including those with Dravet syndrome and Lennox Gastaut syndrome.
• This study looked into the effect that CBD may have on weight loss
• Another study, from 2019, investigated the potential effects of CBD on depression.
• This review looked at a huge range of peer-reviewed papers and discusses the pharmacology, safety, and efficacy of cannabinoids in the possible treatment of various diseases.

Future prospects

In future months and years, there is likely to be a growth of cannabinoids becoming available to those who need them most, as even more countries begin lifting prohibitive regulations on cannabis for medical purposes. 

For those looking for treatment with cannabinoids, it's important to be aware of your country's laws surrounding them. In the UK, at the time of writing, cannabis is legal for medical administration when prescribed by a specialist doctor. 

At Releaf, we believe that access to medical cannabis is important. That's why we offer tailored monthly packages based on your cannabis prescription, specialist consultations for medical cannabis, and a unique medical cannabis card for protection.