Cannabis is one of the most widely used substances for recreational purposes, and also the most controversial substance. The more you keep something restricted, the more curiosity is generated. The stories and myths surrounding cannabis are many so much so that one can get confused with what is real and what is a lie. Some are too good to be true, for example, that cannabis can cure hundred’s of conditions including neurodegenerative disorders and some are really mystical.
There are drugs and synthetics which can make you literally mad right after consuming it for example the drug Flakka , at least that’s the street name, which can make you believe that you have a strength of Hercules or give you a false sense of thinking that a group of people are after you and it can kill you. Or a drug like Heroine, which was first used as a tool for morphine addicts to treat the addiction and later the patients become addicted to Heroine itself. Whereas cannabis doesn’t really have a bad history behind it, there is a link to it, but a lot of co factors are involved like behavioral traits, family issues, or money related problems.
According to the Narcotic Drug and Psychotropic Substances Act, the following definitions are given:-
Cannabis (hemp)” means:
(a) Charas, that is, the separated resin, in whatever form, whether crude or purified, obtained from the cannabis plant and also includes concentrated preparation and resin known as hashish oil or liquid hashish;
(b) ganja, that is, the flowering or fruiting tops of the cannabis plant (excluding the seeds and leaves when not accompanied by the tops), by whatever name they may be known or designated; and
(c) any mixture, with or without any neutral material, of any of the above forms of cannabis or any drink, prepared therefrom;
-NDPS Act 1985
Cannabis has been in the human civilization since time immemorial, we have even had government authorized shops in India, which legally sells Bhang, which has been used since 1000 BC. It is illegal in India now, but it is not enforced unlike other African and middle eastern countries.
It should be noted that medicinal cannabis and recreational cannabis are different.
Cannabis has a psychoactive substituent which is Tetrahydrocannabinol (THC) and the non-psychoactive substance called Cannabidiol, it is the second component which is of more interest to researchers. Cannabidiol acts as an antagonist on CB1 and CB2 receptors whereas THC acts as an agonist on CB1 and CB2 receptors.
Animal Model Studies
Animal studies have shown good results when the receptors CB1 and CB2 were stimulated and conditions like multiple sclerosis, neuropathic pain, reduction in tumour growth and angiogenesis in some form of cancers. Some of the studies done to reduce nausea vomiting and increased feeding, reduced seizures and nociception in visceral pain.
Cannabidiol reduces the psychoactive effects of THC, improves its tolerability and perhaps its safety too in regards to psychiatric effects.
Below mentioned products are a few of the important ones to be given considerations
- Dronabinol- synthetic THC
- Oral cannabis extract
- herbal medicinal cannabis with defined amounts of cannabidiol and THC
- unregulated cannabis
In Netherlands, the Office for Medical Cannabis overseas production keeps it regulated. Different strains are produced under stringent conditions following good lab practices and herbal cannabis is produced with high quality, the amount of THC is variable but defined. This is distributed to pharmacies and is supported by patient information.
Nabiximol is the only medical cannabis which is registered in the ARTG ( Australian Register of Therapeutic Goods ).
In Canada, now its legal to consume up to 30 grams of weed, the law allows one to grow the plants in their houses, which is four plants per residence, and it is up to the provinces to legalise or regulate the rules for the retailers and also the producers must be registered by the federal government.
Selling to minor age groups is still a crime in Canada, driving under its influence is also a crime which can cost up to 1000 dollars fine.
Pharmacokinetics and Analytical Aspects
The effects of THC when taken by smoking, develops in 1 hr fully, and lasts to about 2-3 hours. A small fraction is converted to 11-hydroxy-THC, which is a more active form then THC itself, and probably contributes to effects. It is highly lipophilic, that means it can get deposited in body fat, and this is why the amounts of THC is detectable even after weeks of a single dose.
I have put some really relevant and important aspects although the research is still going on and a lot of effects are still being explored, these are some which are the most important from my perspective.
- The sensation of relaxation and well being, similar to the effects of alcohol, but without the recklessness and aggression. Cannabis users are less prone to road accidents, but accidents do happen.
- Feeling of sharpened senses with sounds and lights seeming intense
- People report time passing really slow.
- The delusions and alarming sensations are rarely seen with cannabis users.
- Reduction in intraocular pressure,
- bloodshot eyes, due to vasodilation
- increased appetite
In overdose cannabis is still safer than other abused substances, drowsiness and confusion might be there but not life-threatening respiratory or cardiovascular depression. Some patients have reported a feeling of euphoria and drowsiness when they have taken Nabilone in low doses to treat nausea and vomiting by cytotoxic therapy.
Cannabis overdose is rare, patients may experience paranoia, however, no treatment may be required other than simply calming the patient. If necessary only symptomatic treatment.
Potential and actual clinical uses of cannabinoids
- glaucoma (to reduce eye pressure in the eye)
- nausea/vomiting associated with cancer chemotherapy
- cancer and aids to reduce weight loss
- neuropathic pain
- head injury
- tobacco dependence
- drug addiction
A lot of public pressure has been going up on the legalization of cannabis for multiple uses for medical science, but if it always kept illegal then scientific facts will be blurry and patients won’t get the benefits out of it.
There are numerous studies conducted which show that smoking pot doesn’t really cause aggression, but being high on alcohol definitely possesses a lot of risks. A study conducted in the Netherlands and published in the Journal of Psychopharmacology, also concluded on the hypothesis that smoking cannabis made the subjects more relaxed, while the group which was given alcohol did have cases of subjective violence.
Research is still going on on other multiple uses, such as for treating multiple sclerosis, appetite suppression, epilepsy, chronic non-cancer pain, however in each of the mentioned cases, further research is needed.
It should be noted that the long terms effects of cannabis are still under study. Numerous studies have shown in preliminary results and scientific groups have warned that long-term use of cannabis is associated with schizophrenia.
It should also be noted that the long-term impact on the lungs of cannabis or its derivatives which are smoked is unknown. Meaning we do not know if it can cause cancer or not. Do not assume that just because a few papers claim that cannabis derivatives MAY treat cancer it will not cause cancer. Many anticancer drugs are confirmed carcinogens, point to be noted!
Cannabis may not cause addiction but has some evidence to suggest dependence in some cases. People with subclinical psychological disorders often find their conditions worsen after and with the use of cannabis. Such cases strengthen the case of the use of cannabis against psychiatric disorders. Marijuana is known to trigger psychosis in many. This has been proven with 10 year long studies. This is not surprising since historically often compounds that interfere with the brain function can have a lasting impact on the brain, abuse it and this impact is likely permanent.