A recent article in American Nurse Today (Nov. 2019 Vol.14 #11 p.6-11) written by Eloise Theisen MSN, AGPCNP-BC, and Eileen Konieczny, RN, BCPA outlines the long history that cannabis has taken for medicine and spiritual use. Currently, 33 states, the District of Columbia, Guam and Puerto allow medical cannabis use under specific qualifying conditions, and 11 states (and the District of Columbia) allow adult recreational use.
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The endocannabinoid system maintains homeostasis which makes it a unique target for medical applications. This molecular signaling system consists of cannabinoid receptors (CB1 and CB2 are the most common and well studied), ligands, and enzymes that regulate sleep, pain perception, memory, mood, and appetite.
The receptors can be stimulated by our own endogenous cannabinoids, by plant-derived cannabinoids (phytocannabinoids), and by synthetic cannabinoids.
Ligands act as chemical messengers to get cannabinoids to interact at the receptor site while enzymes break down cannabinoids after they’re completed their function.
CB1 and CB2 receptors are found throughout our bodies.
When activated CB1 receptors mitigate anxiety, stress, pain, inflammation, depression, post-traumatic stress symptoms, and neurogenerative disorders.
CB2 activation mitigates inflammation, mental health disorders, neurologic disorders, and multiple sclerosis.
Cannabinoids are chemical compounds that can influence the cannabinoid receptors and promote the release of neurotransmitters. They include phytocannabinoids, endocannabinoids, and synthetic cannabinoids.
Phytocannabinoids are produced by the cannabis plant.
Endocannabinoids are molecules produced naturally and on-demand by our bodies.
Synthetic cannabinoids are created in the laboratory and are single, isolated molecules.
The two most studied phytocannabinoids are delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD).
In 2018 the FDA (Food and Drug Administration) approved a medication called Epidiolex, an oral solution of plant-derived CBD for treatment of seizures in Lennox-Gastaut and Dravet syndromes in patients 2 years and older.
Dronabinol derived from THC is approved by the FDA to treat AIDS patients and patients undergoing chemotherapy experiencing nausea and vomiting.
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In December 2018, The Agricultural Improvement Act (“Farm Bill”) legalized hemp and defined it as any part of the Cannabis Sativa L. plant, including cannabinoids. These changes removed hemp from restriction under the Controlled Substance Act.
THC produces euphoria, psychoactive effects that influence mood, conscious and behavior. Side effects are dose-dependent. THC can lead to a substance use disorder.
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CBD improves mood by decreasing anxiety and depression and is effective for treating nausea and vomiting: seizures, inflammation, and neurogenerative disorders; and pain.
Cannabis products can be administered by many routes; topical, transdermal, inhalation, sublingual, ingestion however buyer beware. Cannabis plants are bio-accumulators that absorb contaminants and pollutants from the soil and environment. Heavy metals, pesticides, and other toxins may be present in the plant and when extracted or concentrated can be detected in the final product. Cannabis product testing requirements vary from state to state, so check with your state’s cannabis regulatory agency to understand specific testing requirements.
As cannabis legalization continues to bring more products into the public and medical field finding credible information about cannabis products may rest solely on the consumer. Just as in any other medical situation when a person has questions – ask.
