What is Cannabis and how does it work?

Cannabis medicine is derived from the flowers or buds of the cannabis plant. Cannabis refers to a group of three plants with known psychoactive and therapeutic benefits; Cannabis sativa, Cannabis indica and Cannabis ruderalis. The cannabis plant is rich in chemical compounds that are believed to offer many different positive effects on the body. The various compounds found in cannabis can be broken down into different categories including, cannabinoids, terpenes and flavonoids. Our focus will be on cannabinoids and terpenes as these compounds are believed to be responsible for the various psychoactive effects and health benefits felt while using cannabis. 

Cannabinoids 

Research has found that the cannabis plant produces between 80-100 cannabinoids (chemical compounds that are unique to the cannabis plant). The two most commonly studied and researched cannabinoids are Delta-9-tetrahydrocannabinol (THC) and Cannabidiol (CBD). These two compounds serve different medical functions, but also complement each other when used in combination. 

THC

THC is the main psychoactive compound in cannabis and is responsible for the “high” or intoxicating effect, most commonly associated with this type of medicine. THC can affect perception, mood, emotion, cognition and motor function and has therapeutic potential to relieve pain, inflammation, nausea and vomiting. 

CBD

CBD is the second most commonly discussed cannabinoid, popular for its strong medicinal effect, and that it is non-intoxicating in most cases. Research on CBD shows that it may help with anxiety, inflammation, pain and has strong anti-epileptic effects in some patients. 

How does it work?

Cannabinoids exert their effects by interacting with cannabinoid receptors found within the human endocannabinoid system.  The body’s endocannabinoid system is a molecular system which uses neurotransmission to send and receive messages between the brain and the rest of the body. It is through this system that our bodies work to maintain “homeostasis” or balance by regulating many processes in the body, including; immune response, communication between cells, appetite, metabolism and memory.  Since cannabinoids look and act like endocannabinoids, due to their similar molecular structure, the brain recognizes them as such, and allows them to alter communication between the brain and body. 

Terpenes

Similar to cannabinoids, terpenes are naturally produced chemical compounds secreted from the flowers of the cannabis plant and are responsible for giving the various cannabis strains their distinct taste and aroma. Research has identified over 100 different terpenes in the cannabis plant. As investigation of terpenes continues, researchers are beginning to believe that these compounds play a much larger role than originally thought in the therapeutic benefit of individual cannabis varieties. This points to the importance of the Entourage Effect in cannabis therapy. 

The Entourage Effect

The Entourage Effect is the widely accepted idea that the therapeutic benefit of cannabis is largely due to all of the cannabinoids and terpenes working in conjunction with one another. Research has found that terpenes may add significant therapeutic value when combined with different compounds and may play a role in enhancing the positive effects of THC and CBD. Although more research is needed to better understand this phenomenon, pre-clinical studies examining the anti-pain and anti-inflammatory effects of CBD have found that whole-plant extracts of CBD are more effective at reducing pain and inflammation than isolated CBD.

Baron, E. P. (2018). Medicinal Properties of Cannabinoids, Terpenes, and Flavonoids in Cannabis and Benefits in Migraine, Headache, and Pain: An Update on Current Evidence and Cannabis Science. Headache: The Journal of Head and Face Pain, 58, 1139-1186. https://doi.org/10.1111/head.13345 

Russo, E. B. (2011). Taming THC: Potential cannabis synergy and phytocannabinoid-terpenoid entourage effects. British Journal of Pharmacology, 163, 1344-1364. https://doi.org/10.1111/j.1476-5381.2011.01238.x