Intro to Cannabinoids: THC & CBD

INTRO TO CANNABI-WHAT? 

The primary active ingredients in cannabis are called cannabinoids. THC, the most famous cannabinoid, tends to get all the recognition, but there are over 80 known cannabinoids found in the cannabis plant. When consumed, these cannabinoids, coupled with terpenes and other phytochemicals, provide therapeutic benefits and alleviate symptoms of chronic illness. Today's post will focus on the two most prevalent cannabinoids, THC and CBD.  We’ll dive into some of the other cannabinoids and terpenes in upcoming blog posts -  so stay tuned! 

HOW DO CANNABINOIDS WORK? 

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In order to provide symptom relief, these cannabinoids need somewhere to interact in our body.  Fortunately for us, we all have this really intriguing set of receptors that make up the endocannabinoid system, or ECS. The ECS is responsible for regulating homeostasis - or equilibrium in the body. It keeps us feeling “normal” and influences things like memory, mood, appetite, energy, metabolism, immune function, pain, sleep, and the stress response. If you have a chronic illness you probably did a little checklist in your head as you read that list - they are all common problem areas for those of us with chronic illness. When consuming medical cannabis, these therapeutic cannabinoids are delivered to the blood stream and travel to receptors in the endocannbinoid system. These cannabinoids interact with the receptors of the ECS, telling the body to turn up or down various processes so it can recalibrate and you can feel better. 

THC

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When most people think of cannabis, they are thinking of delta-9-tetrahydrocannabinolic acid or THCA, the most common phytocannabinoid in the cannabis plant. Through heating, such as smoking, vaporizing, or cooking, THCA is converted to the psychoactive form THC, which is responsible for the "high" associated with cannabis. In addition to the pleasant uplift in mood, THC is a medicinal powerhouse, helping to alleviate a wide array of symptoms. 

THC is widely considered non-toxic, but it needs to be used with caution. In high doses, and in the absence of other cannabinoids like CBD, THC can cause an increase in anxiety, sedation, paranoia, heart beat, and short term memory loss. High doses of THC over time can also lead to an increased tolerance requiring patients to use more and more medication to reach the same effects. Abstaining for a few days to a week will reduce the tolerance and allow you to use lower amounts of medication. 

USES & BENEFITS OF THC:

  • anti-inflammatory

  • analgesic (pain relief) 

  • neuroprotective 

  • reduces intraocular pressure 

  • reduces spasticity and muscle tension

  • euphoria, uplift in mood, anti-depressant 

  • anti-microbial, antitumor, and & antioxidant

  • anticonvulsant (seizures)

  • appetite stimulant, reduces nausea and vomiting, useful for multiple GI conditions

  • sleep aid/sedation

CBD

CBD, or cannabidiol, has largely been in the shadows of THC. It rose to fame with the story of Charlotte Fiji and her struggle with a severe and mostly untreatable form of epilepsy called Dravet syndrome. This once trash crop (cannabis farmers would ditch crops that tested to be high in CBD) is now revered in the medical cannabis community. Parents of children with severe epilepsy often pick up and move their families to legal states, just for the option to treat their children with CBD. CBD has shown great promise in reducing or eliminating seizures without the life altering side effects of traditional pharmaceuticals. Children like Charlotte are not only able to better control their seizures, they are able to function, learn, interact, and thrive on a level that would not be possible otherwise. 

There’s a misconception that medical cannabis patients are just looking to get high. While many do enjoy this positive side effect (lets face it - chronic illness sucks), many of our patients would prefer to avoid being high all together. Others enjoy the relaxation and mood benefits of euphoria, but would prefer to keep it reserved for evenings or times they aren't working. Fortunately, high-CBD medicines are non-intoxicating, making them a great choice for patients wanting to stay clear headed. CBD also counteracts the euphoria associated with THC, allowing patients benefits from both THC and CBD medicines without being stoned. Due to CBD’s modulating influence on THC, it can also be used to reduce unwanted side effects of high doses of THC like paranoia, sedation, anxiety, and increased heart rate. 

While THC tends to work rather quickly and the effects are quite apparent, many patients report that CBD is more subtle and has a cumulative effect - meaning it may take a few weeks of consistent dosing to notice any benefits.  In both my personal experience as a patient, and my professional experience working with other patients, I've found this to be true - especially for chronic pain and conditions that involve underlying inflammation like autoimmune diseases. Anxiety, on the other hand, tends to respond very quickly to CBD, especially when inhaled. 

Unlike THC, CBD does not increase tolerance with repeated use. Some new users may report initial sedation, but this typically resolves within the first week or two. Most patients find CBD to be mildly alerting, while helping them to feel better overall, which in turn improves sleep quality. 

USES & BENEFITS OF CBD:

  • anti-inflammatory

  • analgesic (pain relief) 

  • anticonvulsant 

  • reduces spasticity and muscle tension

  • antidepressant, mood stabilizer, antipsychotic  

  • antitumor

  • neuroprotective

  • reduces nausea

  • muscle relaxant 

HOW DO I KNOW WHICH CANNABINOIDS ARE RIGHT FOR ME? 

There is no easy answer. When it comes to cannabis medicine, research is still in it’s infancy. There is one thing we know for sure - everyone’s endocannbinoid system is different. While learning as much as you can about cannabis and cannabinoids will be helpful, listening to your body and experimenting with different medicines until you find what works best for you is always the best approach. 

We also know about something called the entourage effect. The entourage effect is the understanding that cannabinoids, terpenes, and other phytochemicals in cannabis work best together, in a synergistic concert. When interacting with the endocannabinoid system, these chemicals enhance and play off of each other - working like a team to provide maximum benefit. Strains and products with an equal ratio of CBD to THC are usually a good starting place for most patients, especially those with with chronic pain. 

Authored by: Kristina Risola, MA, CRC, CHWC
Director of Operations

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