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CBD: The “Medical” in “Medical Cannabis”?
written especially to this blog
Traditionally, cannabis has been associated with intoxication. In fact, it was this connection to intoxication, particularly among Mexican immigrants that persuaded the citizens of the U.S. that cannabis should be outlawed in the first place. However, cannabis, which has been used as a medicine across cultures for thousands of years, is a complex plant, and intoxication is only part of the story. THC, or Tetrahydrocannabinol, does have a psychoactive effect due to the receptors in the brain that it binds to. THC also has medicinal qualities and has been used to treat pain, nausea and PTSD. But, THC is one of an estimated 80-90 active cannabinoids in the cannabis plant. Another cannabinoid that has emerged in the spotlight is CBD. CBD stands for cannabidiol, and it is a compound which has shown remarkable benefits in children with severe epilepsy and other seizure disorders. CBD, unlike THC, does not bind to the receptors in the brain responsible for psychoactivity. Therefore, CBD is a highly valuable tool due to its high level of effectiveness, and lack of side effects.
It should be noted, that stripping the plant of THC completely is not advantageous. In addition to cannabinoids, the chemical profile of the cannabis plant contains other compounds including terpenoids, amino acids, proteins, sugars, enzymes, fatty acids, esters, and flavinoids, just to name a few. All of these compounds work together through a process called “entourage effect,” which is responsible for the therapeutic benefits of the cannabis plant. When singular components are synthesized from the plant, they are not shown to be as effective as utilizing the entire thing.
In addition to helping maximize the benefits of the plant, the entourage effect plays a role in helping to minimize the side effects of various cannabinoids. The most fitting example of this is CBD’s ability to modulate the potentially negative side effects of THC. THC and CBD work in tandem to create medicinal effects while balancing each other out in the context of the patient’s own endocannabinoid system. Many cannabis users are familiar with the side effect of increased anxiety and paranoia sometimes associated with cannabis consumption. Thanks to the entourage effect, research has shown that CBD can be effective in minimizing the anxiety associated with THC, lowering users’ feelings of paranoia.
CBD rich cannabis has an important place in the medical landscape. The U.S. government has had a patent on CBD as a neuroprotectant since the 1990’s. In additional to children, CBD medications are appealing to older patients and those who are actively trying to avoid psychoactivity associated with THC. In the United States, there are 23 states that have comprehensive medical cannabis laws, and an additional 16 states that allow the use of cannabis that have high levels of CBD and low levels of THC. Interestingly, many of these laws were passed at the urging of parents, desperate for access to CBD rich cannabis to treat their children with life threatening illnesses, such as the case of Grace in Mexico. While CBD is a great tool for starting the medical cannabis conversation, it should not be the end. Comprehensive laws that allow access to CBD and THC products are most useful in helping the greatest number of people.
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Amanda Reiman is Manager of Marijuana Law and Policy at the Drug Policy Alliance, where she works to develop DPA’s marijuana reform work as it relates to litigation, legislative and initiative drafting, campaign strategy, policy advocacy, media relations, fundraising, and public education in the local, state, federal, and international jurisdictions in which DPA is active. Reiman joined DPA in 2012 after working with Berkeley Patients Group, a renowned medical marijuana dispensary, as director of research and patient services. Reiman is currently a lecturer in the School of Social Welfare at the University of California, Berkeley, where she teaches Drug and Alcohol Policy, Substance Abuse Treatment, and Sexuality and Social Work.