After decades of lobbying by patient advocates and healthcare professionals, on the 1st of November 2018 here in the UK, medical cannabis became legally available to patients suffering from a huge range of conditions including (but nowhere near limited to) chronic pain, multiple sclerosis, fibromyalgia, epilepsy, mental health concerns, and cancer treatment-related nausea.
But with this new availability comes many questions, and these are necessary for the safe application of medical cannabis. In this article, we'll have a closer look at the pros and cons of taking medical cannabis as a complementary treatment option.
Understanding medical cannabis
Medical cannabis refers to the application of the cannabis plant or its extracts for the treatment of various medical conditions, or the reduction of symptoms relating to those conditions. Cannabis contains over 110 different compounds known as cannabinoids, which interact with the body's endocannabinoid system to produce a vast range of effects.
The two cannabinoids produced in the highest quantities, and the most well-known, are tetrahydrocannabinol (THC) and cannabidiol (CBD). While both cannabinoids are remarkably similar in chemical structure and both offer certain therapeutic benefits, THC produces intoxicating effects, whereas CBD does not.
But before we go any further, it is essential to break down the endocannabinoid system further, and understand how medical cannabis affects it.
The endocannabinoid system (ECS)
The endocannabinoid system (ECS) was only detected in the late 1980s, but is the largest receptor system and the master regulator of homeostasis in the human body. Homeostasis is the maintenance of a stable internal environment despite external changes. Think of it as your body's way of keeping everything in balance – from temperature and pH levels to appetite, mood, sleep patterns, immune response, sexual function, and so much more.
The ECS consists of three main components:
- Endocannabinoids: These are naturally occurring cannabinoids produced by the body that bind to cannabinoid receptors and act as chemical messengers, prompting the body to take specific actions.
- Cannabinoid receptors: There are two types of cannabinoid receptors – CB1 and CB2. CB1 is found primarily in the central nervous system (brain and spinal cord). CB2 is primarily found in the peripheral nervous system (immune cells, digestive system, and reproductive organs).
- Enzymes: These are responsible for breaking down the endocannabinoids after they have completed their function.
The endocannabinoid system works similarly to other neurotransmitter systems in the body, such as the dopamine or serotonin systems, by using chemical messengers to communicate with different parts of the body. However, what makes the ECS unique is that it is a retrograde system, meaning it allows communication in both directions – from the postsynaptic neuron (receiving end) to the presynaptic neuron (sending end). In simpler terms, this means that the ECS can regulate and fine-tune its own activity, making it a powerful modulator of many bodily functions.
So, how does medical cannabis fit into all of this?
By now, you have most likely noticed the similarity in the words – endocannabinoids and cannabinoids. All of the members of the cannabis sativa L. genus (along with some other plants) produce compounds that are almost identical to the endocannabinoids produced by our bodies. These plant-based cannabinoids are known as phytocannabinoids.
Phytocannabinoids like THC and CBD can interact with the endocannabinoid system, just like endocannabinoids do. As a result, they can elicit various effects on the body depending on their concentration, method of administration, and individual factors. THC binds strongly to the CB1 receptors, which are mostly located in the brain, leading to the well-known psychoactive effects of cannabis, along with a variety of curative effects. On the other hand, CBD has a more indirect effect on the ECS by influencing enzymes and receptor activity (along with weakly binding to the CB2 receptors), resulting in a range of therapeutic benefits without producing any intoxicating effects.
To break this all down, the phytocannabinoids produced by cannabis (and hemp) plants have a similar chemical structure to our own endocannabinoids. This allows them to interact with our endocannabinoid system receptors, modulating the body's functions and promoting internal balance.
In other words, medical cannabis helps our bodies to rebalance and heal themselves.
The pros of medical cannabis
As the prohibition of medical cannabis has slowly, but surely, started to fade with each passing year, and more countries start to legalise it for medical use, the access that medical researchers are being legally afforded to the plant only increases. This is leading to not only a more solid understanding of how the cannabinoids we already know work, but also the discovery and isolation of new cannabinoids and their effects.
There is an ever-increasing body of research that is heavily pointing to the potential that medical cannabis holds in treating various medical conditions, or at least reducing the severity of symptoms connected to those conditions.
Relief from chronic pain and inflammation
One of the most widely studied and documented benefits of medical cannabis is its ability to alleviate pain. The endocannabinoid system plays a crucial role in regulating pain perception, with several studies showing that cannabinoids can reduce both nociceptive and neuropathic pain by activating the CB1 and CB2 receptors. This makes medical cannabis particularly effective in treating chronic pain conditions such as arthritis, fibromyalgia, and multiple sclerosis.
Anxiety disorders are the most common mental health condition globally,
In addition to pain relief, medical cannabis has also been shown to have anti-inflammatory properties. Inflammation is the body's natural response to injury or illness, and a vital component of the immune system, but when inflammation becomes persistent, lasting for weeks or months, it can lead to a range of health issues.
CBD, in particular, has been shown to have potent anti-inflammatory effects, without producing any psychoactive effects. This is due to the role that the CB2 receptors play in regulating the immune response, the fact that CBD interacts with this specific receptor, and that the CB2 receptors are mainly found on immune cells. This makes CBD a promising treatment for chronic inflammatory conditions such as Crohn's disease and rheumatoid arthritis.
Management of symptoms associated with neurological disorders
Neurological disorders are among the most challenging to treat, as they involve complex and delicate systems in the body. However, medical cannabis has shown promising results in managing symptoms associated with neurological conditions, such as epilepsy, Parkinson's disease, and Alzheimer's disease.
The endocannabinoid system plays a significant role in regulating brain function and maintaining healthy communication between neurons. As such, medical cannabis can help to reduce seizures in epilepsy patients by activating the CB1 receptors. It has also been shown to improve motor symptoms and quality of life in Parkinson's disease patients, with CBD having a neuroprotective effect on brain cells.
Reduction of cancer treatment side effects
Cancer treatments such as chemotherapy and radiation therapy can come with some pretty unpleasant and often severe side effects. The nausea and vomiting, the cessation of hunger, and the pain that accompany these treatments can be debilitating, making it challenging for patients to continue their treatment.
Medical cannabis has been shown to alleviate chemotherapy-induced nausea and vomiting, allowing patients to continue their treatment without experiencing as much discomfort. It has also been shown to increase appetite in cancer patients, helping them to maintain a healthy weight during treatment. Cannabinoid therapy has also been shown to help increase hunger, acting as a two-fold attack on the side effects of cancer treatment. And when it comes to pain related to cancer and its treatment, medical cannabis, has shown promise in reducing pain levels and improving quality of life for cancer patients.
Alleviation of anxiety and depression symptoms
There is a substantial amount of anecdotal evidence and clinical studies that suggest medical cannabis can have a positive impact on mental health. CBD has been shown to have calming and mood-regulating effects, making it effective in reducing the symptoms of anxiety and depression. It stimulates the release of serotonin, and in doing so, helps to regulate mood. THC has also been shown to offer an antianxiety effect, but the dose must be carefully controlled to avoid adverse effects.
In terms of the control of depression symptoms, the CB1 receptors play an essential role in regulating emotional behaviour. THC has a much stronger binding affinity to CB1 receptors than other cannabinoids, which can help to improve mood and reduce anxiety in patients with depression. With that said, the need for further research and clinical trials to determine the most effective dosages and combinations of cannabinoids for mental health treatment is crucial.
It is important to note that while medical cannabis may offer relief from these symptoms, it should not be used as a sole treatment for mental health conditions, and patients should seek professional help for a comprehensive treatment plan.
Seizure reduction in epilepsy patients
Epilepsy is a complex neurological disorder that affects millions of people worldwide, and more than a third of those with epilepsy have treatment-resistant seizures. For many, traditional treatments are simply not effective in managing seizures, leaving them with limited options and often debilitating side effects.
Thankfully, medical cannabis has shown significant promise in reducing seizure frequency and severity in some patients. Studies have shown that CBD can reduce the number of seizures by up to 90% in patients with Dravet syndrome and Lennox-Gastaut syndrome, two rare and severe forms of epilepsy.
These are just a few of the potential benefits of medical cannabis. Research and clinical trials continue to uncover more potential applications for this powerful plant, providing hope for those suffering from various medical conditions. However, it is essential to consult with a healthcare professional before starting any treatment involving medical cannabis.
Are there drawbacks to taking medical cannabis?
As with any medication or treatment, there are potential drawbacks and side effects that must be considered. Most of these are considered to be less severe than those associated with many traditional pharmaceuticals, but it is essential to understand and be aware of them before beginning medical cannabis treatment.
Short-term side effects
- Dizziness
- Drowsiness
- Dry mouth
- Increased heart rate
- Red, itchy eyes
- Raised blood pressure
- A reduction in mental clarity
While these may be unpleasant, they are generally mild and temporary. Adjusting dosage or strain type can often reduce or eliminate these side effects.
Long-term risks
One of the main concerns surrounding medical cannabis is the potential for long-term negative effects on brain development, particularly in adolescents. Research is ongoing, but studies have shown that regular and heavy cannabis use during adolescence can lead to changes in the brain's structure and function. This may affect cognitive abilities, memory, and emotional regulation later on in life. Again, this only points to the critical need to always consult with a healthcare professional before starting any medical cannabis treatment, especially for adolescents.
Risk of dependence
It is important to note that as THC is intoxicating, i.e., it has psychoactive effects, it can lead to dependence and addiction in some individuals. While this is less common with medical cannabis compared to recreational use, patients should always adhere to the dosage guidelines set out by their healthcare professional and monitor any changes in their behaviour or feelings of dependence.
Interactions with other medications
When ingested in edible form, medical cannabis can potentially interact with other medications in the body, as it is metabolized by the liver. This may cause an increase or decrease in the potency of certain medications, leading to adverse effects. It is crucial to discuss any current medications with your prescribing doctor before starting medical cannabis treatment.
Roadblocks to access for patients here in the UK
While medical cannabis is legal here in the UK, it is exceedingly difficult to obtain a prescription through the NHS. As of writing, NHS doctors are only allowed to prescribe medical cannabis for three specific medical issues:
- For the reduction and control of severe epileptic seizures
- For the control and management of spasticity in multiple sclerosis patients
- For nausea and vomiting associated with chemotherapy
This limited list of conditions leaves many patients without access to medical cannabis treatment, even if it may be beneficial for their condition. Thankfully, private clinics like Releaf offer a viable option for those seeking treatment.
Doctors who are listed on the General Medical Council's specialist register and working with a private clinic can prescribe cannabis-based medicinal products for any condition they deem appropriate. This allows for a more personalized approach to treatment and expands access to medical cannabis for those who may benefit from it.
The stigma surrounding medical cannabis
Despite being legal, there is still a significant amount of stigma attached to cannabis as a whole, and medical cannabis is no exception. Many patients may be hesitant to try medical cannabis due to fear of judgment or societal disapproval. With continued education and awareness, this stigma is slowly dropping away, and patients can feel more comfortable seeking treatment through medical cannabis.
The wrap-up
In this brave new world of medical cannabis, the potential benefits for patients are ever-growing and definitely worth exploring. While there are still barriers to access and concerns surrounding long-term effects, the evidence for medical cannabis as a viable treatment option continues to grow. By working closely with your prescribing doctor and staying informed on current research, patients can make an informed decision about whether medical cannabis is right for them.
Releaf understands that embarking on your medical cannabis journey can be overwhelming, and even slightly intimidating – that’s why we offer tailored monthly packages, specialist consultations for medical cannabis, and our unique medical cannabis card to give you the peace of mind that your treatment is protected, all based on your medical cannabis prescription.
