MEDICAL CANNABIS

The Cannabis plant has a long history as a medicinal plant and was fundamental in the discovery of the Endocannabinoid system within the human body. Cannabinoid receptors and cannabinoids together constitute the Endocannabinoid system.

The Endocannabinoid system (ECS) is a group of endogenous cannabinoid receptors located in the mammalian brain and throughout the central and peripheral nervous systems, consisting of neuromodulatory lipids and their receptors. It is an important physiologic system involved in establishing and maintaining human health.

Our own Endocannabinoid system covers all cells and nerves; it is the messenger of information flowing between our immune system and the central nervous system (CNS). It is responsible for neuroprotection, helps control brain and nerve activity (including memory and pain), energy metabolism, and heart function, and micro-manages the immune system. This is the primary control system that maintains homeostasis; the stable internal environment despite fluctuations in the external environment. Cannabinoids promote homeostasis at every level of biological life, from the sub-cellular, to the organism.

Overview

Cannabis is a flowering plant with evidence suggesting it has been used for medicinal purposes for millennia in cultures throughout the world as a curative for both mind and body.

Cannabinoids are a class of diverse chemical compounds secreted by Cannabis flowers, with at least 118 having been isolated, including the widely publicised Tetrahydrocannabinol (THC) and Cannabidiol (CBD).

When Cannabis is consumed, Phytocannabinoids bind to receptor sites in the brain and body (interacting with the Endocannabinoid System) mimicking the naturally occurring Endocannabinoids produced in the bodies of humans and animals.

Secreted in the same glands that produce Cannabinoids are around 200 Terpenes which give Cannabis its distinct and varying aromas. With the same Terpenes found in other plants occurring in Cannabis such as Linalool (Lavender), Caryophyllene (pepper & cloves), Limonene (citrus, rosemary, juniper, peppermint) and Myrcene (mango, lemongrass, thyme, hops).

Medical cannabis can be delivered orally as a tincture or via oil-filled capsules, topically via skin creams and transdermal patches or oils, and infused into food products such as olive oil or vaporised for respiratory delivery.

Different Cannabinoids have different physiological effects depending on which receptors they bind to. For example, THC binds to receptors in the brain whereas CBD has a strong affinity for receptors located throughout the body. Different types of medical effects can be achieved through targeting different receptors using differing quantities of Cannabinoids (e.g. THC vs CBD).

CBD and other Cannabinoids

Medical Cannabis refers to the use of cannabis and its constituent cannabinoids, such as tetrahydrocannabinol (THC) and cannabidiol (CBD), as medical therapy to treat disease or alleviate symptoms.

Cannabis has been used in a multitude of medical conditions. The plant contains more than 460 compounds. At least 118 of these are cannabinoids: active chemical compounds that interact with cannabinoid receptors in the brain that communicate with the immune and nervous systems.

The most psychoactive cannabinoid found in the cannabis plant is tetrahydrocannabinol (commonly known as THC). Other cannabinoids include cannabidiol (CBD), cannabinol (CBN), cannabicyclol (CBL), cannabichromene (CBC) and cannabigerol (CBG); they have less psychoactive effects than THC, but play a significant role in the overall therapeutic effect of cannabis. The most studied are THC, CBD and CBN.

One of the most important discoveries about the chemical makeup of cannabis is CBD which is non psychoactive but clearly a therapeutic active phytocannabinoid, accounting for more than 50% of known therapeutic applications. Unlike THC, CBD does not only activate CB1 and CB2 receptors but also interacts with many other non-endocannabinoid signalling systems such as ion channels and enzymes.

CBD will “talk” to just about every major organ system in the body via the endocannabinoid system, affecting various processes to help restore normal balance and physiological homeostasis.

This explains its therapeutic potential and wide scope of medical applications with appealing treatment options for patients seeking anti-inflammatory, anxiolytic, analgesic, anti-epileptic, anti-nausea, neuroprotective, and anti-oxidant effects without psychoactive interference.

CBD has shown anti-inflammatory, anti-convulsant, anti-emetic, anxiolytic and anti-psychotic effects, and therefore may be used in the potential treatment of anxiety, metabolic disorders including diabetes, neuro inflammation, epilepsy, nausea and schizophrenia.

These are the various medical applications of CBD:

The entourage effect

The entourage effect is a term to describe the phenomenon that different cannabinoids interact and open up medicinal possibilities for other cannabinoids. Terpenoids and other part of the plant are also playing a role in the entourage effect. Since there are at least 118 different cannabinoids to find in cannabis plants the complexities- and possibilities to combine them are almost endless.

Cannabis Seeds

Different strains of cannabis perform in a variety of ways. Although it is possible to use all kinds of cannabis for medicinal purposes, some are more appropriate for specific conditions than others.

Medicinal Cannabis Indica strains have high proportions of both cannabidiol (CBD) and THC. This creates a more sedative feeling centred in the body, which helps patients relax as muscle tension is reduced. Indicas are most effective in treating muscle spasms and tremors (including those caused by multiple sclerosis and Parkinson’s disease), chronic pain, arthritic and rheumatic stiffness and inflammation, insomnia, anxiety and related conditions.

Medicinal Cannabis Sativa varieties tend to be high in THC, with a lower proportion of CBD, giving them a more energetic effect which is experienced in the mind and body. These medicinal strains are most effective for the treatment of nausea (resulting from chemotherapy or HIV/AIDS medications, for example), appetite stimulation, migraine headaches, depression, chronic pain and similar symptoms.

Hybrids of Indica and Sativa medicinal cannabis strains offer an advantage to many patients. Combining Sativa genes with a mostly-Indica strain can aid mental clarity and decrease sedative effects, while adding some Indica genes to a Sativa-dominant strain can lower the tendency of pure Sativas to occasionally stimulate anxiety. Some hybrids which mix Indica with wild Ruderalis strains have high proportions of CBD with relatively low proportions of THC. These strains are useful for patients who prefer the medicinal benefits offered by CBD with less of the psychoactive properties of THC.

Medical Research & Related Articles

The links below provide access to a miniscule proportion of the medical research that has been and is being conducted on cannabis. There is also overwhelming anecdotal evidence of the successful use of cannabis in dealing with cancer, the effects of chemotherapy, epilepsy, Alzheimer’s, Crohn’s disease, multiple sclerosis, chronic pain and a host of other ailments.

1. Medical Marijuana: What the Research Shows

By Bara Vaida
Reviewed by Michael W. Smith, MD

Dustin Sulak, DO, is a doctor on the front lines of medical marijuana.

Sulak has recommended various forms of marijuana to his patients and has seen striking results. Patients with chronic pain needed fewer prescription pain meds. Patients with multiple sclerosis had less painful muscle spasms. Patients with severe inflammatory bowel disease began to eat again.

“These responses are the most impressive to me,” says Sulak, who practices at Maine Integrative Healthcare in Manchester. Maine is one of 20 states, along with the District of Columbia, where medical marijuana is legal. “With inflammatory bowel disease, we’ll see patients who were at death’s door turn around dramatically.”
Sulak’s experience is powerful and adds to the large body of personal stories — dating from 5,000 years ago — about the therapeutic value of marijuana.

But the scientific evidence behind the drug’s benefits remains elusive, even as 10 more states consider legalizing medical uses in 2014. The problem: In 1970, the federal government classified marijuana as an illegal, highly addictive drug with no medical value, making research harder to do.

A Marijuana Discovery

Here’s what is known: About 20 years ago, scientists discovered a system in the brain that responds to 60 chemicals in marijuana, also known as cannabis. It’s called the endocannabinoid system. This system plays a role in many of the body’s functions, such as in the heart, along with the digestive, endocrine, immune, nervous, and reproductive systems. The discovery sparked interest in finding specific chemicals made from marijuana that could be targeted for specific conditions.

Since that time, scientific projects around medical marijuana worldwide have sped up dramatically. Many of the studies that have been done show that chemicals in marijuana can help treat some conditions. They have helped manage pain and reduced muscle spasms in MS patients. They’ve worked as an appetite stimulant, and as an alternative drug for brain disorders such as schizophrenia and Tourette’s syndrome.

Few of these studies, though, followed a controlled clinical trial. This is considered the best type of trial because it compares a drug to another drug, or to a placebo (a “fake” treatment).

Based on medical science, it seems possible that marijuana-based treatments could be developed for some conditions; but federal restrictions make it hard for the research to advance, Bostwick says.

That’s because scientists in the U.S. have to get approval from the Drug Enforcement Agency (DEA) and the FDA to do research on medical marijuana.

A series of studies allowed by the DEA came to a conclusion similar to Bostwick’s. The 13 studies were done by The Center for Medicinal Cannabis Research at the University of California in San Diego between 2000 and 2010.

The conclusion: “Cannabinoids may be useful medicine for certain indications” and deserve further research, wrote Igor Grant, professor and executive vice chairman of the Department of Psychiatry at the university. The studies also showed that inhaling marijuana through a vaporizer or a spray was a better way to deliver it than by smoking.

Among the unanswered questions about medical marijuana is the risk to users. About 10% of people who smoke marijuana become addicted. It’s not known what that means if it is being used for medical reasons, Bostwick says. He adds that some patients find the effects of marijuana “intolerable.”

Marijuana-Based Drugs

Despite the obstacles, three FDA-approved drugs are made from marijuana. They include:

Marinol and Cesamet: Both drugs are used to treat nausea and lack of appetite related to chemotherapy and in AIDS patients. They are man-made versions of THC, the primary chemical in marijuana that gives users a “high.” Both were approved in the 1980s.
Epidiolex: This drug to treat children’s epilepsy received FDA approval in 2013. Its use is highly restricted.

Another drug, Sativex , is in clinical trials in the U.S. for pain with breast cancer. It is a combination of chemicals from the marijuana herb and is sprayed into the mouth. Sativex is approved in more than 20 countries to treat muscle spasms from MS and cancer pain.

Research on Marijuana

No single organization tracks all research studies of medical marijuana and marijuana-based drugs and herbs. The following review is a summary of controlled studies since 1990. It is based on reporting; research provided by NORML, the marijuana legalization advocacy group; and data found in PubMed, the National Institutes of Health’s RePORTER, and a database maintained by the International Association for Cannabinoid Medicines, a medical marijuana research organization based in Cologne, Germany.

Alzheimer’s Disease: One 1997 trial found that synthetic THC could ease symptoms of Alzheimer’s. Patients were less agitated and ate better after treatment.

Autism: Two animal studies show that chemicals in marijuana may help symptoms of some forms of autism. A study of children with autism is underway at the University of California Irvine Medical Center.

Cancer: Several studies on animal and human cells and a small study on 9 people suggested THC and other cannabinoids (chemicals derived from cannabis) might slow the growth of brain cancer. Multiple lab studies in human cells have also shown the potential for them to slow other kinds of cancers, such as breast cancer and leukemia; no studies in people have taken place.

Chronic Pain: More than 45 studies have looked at marijuana and pain related to chronic diseases such as cancer, diabetes, fibromyalgia, multiple sclerosis, HIV, rheumatoid arthritis, and spinal injuries. The studies have included smoked marijuana, along with herbal and man-made forms. The majority of the studies showed an improvement in pain relief in comparison to a placebo or to other traditional pain medications. About a quarter of the studies showed no improvement.

Epilepsy : Personal stories and animal studies have shown that cannabidiol, one of the chemicals in cannabis, may help seizures in children with epilepsy. New York University just announced it will do a study of children with epilepsy and marijuana.

Digestive Disorders: Personal stories and several early studies have shown that smoking marijuana can help people with digestive diseases such as colitis, irritable bowel syndrome , and Crohn’s disease. Some of the results included a reduction in bowel inflammation and reduced acid reflux. Further, some patients were able to retain more nutrients in their bodies, and the disease went into remission.

Multiple Sclerosis: More than 24 studies have looked at smoked marijuana, cannabinoids, and MS. Most reported that it helped relax patients’ rigid muscles and helped with pain. Sativex is approved to treat MS in 24 countries, but not in the U.S.

Schizophrenia: Two clinical trials showed that THC and cannabidiol could help with psychotic and other symptoms. The National Institutes of Health is funding a small clinical trial that also aims to show whether THC and cannabidiol can ease symptoms.

To access the original article please go to: WebMD Feature Archive (www.webmd.com)

2. Marijuana as Medicine: Can we see past the smoke?

Centre for Medicinal Cannabis Research – University of California, San Diego:

Click here to view presentation:http://cmcr.ucsd.edu/images/PDFs/Med_cannabis_APA_Denver_08-06-16.pdf

3. Marijuana and Cannabinoids: A Neuroscience Research Summit:

Presentation by Barth Wilsey, MD

The Marijuana and Cannabinoids: A Neuroscience Research Summit was convened by the National Institutes of Health (NIH). The Summit focused on the neurological and psychiatric effects of marijuana, other cannabinoids, and the endocannabinoid system. Both the adverse and the potential therapeutic effects of the cannabinoid system were discussed. The goal of the summit was to ensure evidence-based information is available to inform practice and policy, particularly important at this time given the rapidly shifting landscape regarding the recreational and medicinal use of marijuana.

The meeting was sponsored by several NIH Institutes and Centers: the National Institute on Drug Abuse (NIDA); the National Institute on Alcohol Abuse and Alcoholism (NIAAA); the National Center for Complementary and Integrative Health (NCCIH); the National Institute of Mental Health (NIMH); and the National Institute of Neurological Disorders and Stroke (NINDS).

The event was held on March 22-23, 2016 at the Natcher Conference Center on the NIH campus in Bethesda, Maryland.

Click to view the presentation:
http://www.cmcr.ucsd.edu/index.php?option=com_content&view=article&id=%2055

4. National Centre for Complimentary and Integrative Health

Please click https://nccih.nih.gov/health/marijuana to access comprehensive advice and research studies for consumers and health professionals.

5. Clinical Studies and Case Reports

Please click here http://www.cannabis-med.org/studies/study.php for a comprehensive list of both controlled and open studies on the effects of medical cannabis use in a number of diseases and medical conditions.

Testing/R&D

Medigrow sets up its facilities ad protocols in line with the highest international GMP standards.

All our products are rigorously tested to ensure they are of international grade and suitable for use as medicinal products. We use a gas chromatography testing system which is the preferred method of testing in the USA and is rapidly gaining traction in the Netherlands and other growing regions.

The cannabis cannabinoid gas chromatography system is designed for measuring THC, CBD, CBG, CBN, and other cannabinoid constituents in cannabis. It may also be used to measure synthetic cannabinoids, most edibles, butane residue, terpene, and aroma measurement, using optional analytical columns.

Use of gas chromatography allows our testing to remain accurate (within 1% accuracy) at an affordable price with minimal waste production, ultimately preserving our environment.

We have also committed to supply products to the South African Medical Research Centre for advanced research and innovation. We are committed to a continued quest for improvement and innovation in the field of medical cannabis. This field is evolving at a rapid rate and we will ensure that African products earn their place in the international market.

The relatively new entrance of cannabinoids as an accepted medicine will hopefully usher in decades of future research by doctors and medicinal scientists.