CANNABIS MEDICINE
Cannabis 101
Research has shown medicinal cannabis to have a positive effect on a range of medical conditions.
Medicinal cannabis is derived from the cannabis plant, with its various components and cannabinoids being used in medical therapy to alleviate numerous symptoms. Medicinal cannabis consists of strains specifically chosen and developed to create certain desirable medical properties.
Medicinal cannabis is legal in South Africa.
However, you can only obtain medicinal cannabis via a Section 21 application to the South African Health Products Regulatory Authority (SAHPRA).
Cannabis is safe to consume with the right guidance and understanding.
Cannabis contains cannabinoids, such as THC and CBD. The human body contains a network of receptors known as the Endocannabinoid System (ECS), to which these cannabinoids attach, resulting in effects that depend on the chemical. There are 60 different cannabinoids in the cannabis plant.
Researchers have identified hundreds of active ingredients in cannabis, but the two main ones are the phytocannabinoids Delta-9-Tetrahydrocannabinol (THC) and Cannabidiol (CBD).
THC is psychoactive, meaning it is responsible for the “high” feeling, whereas CBD is non-psychoactive and therefore does not provide a “high” feeling. Both have their unique characteristics and applications, and can be beneficial when used in combination.
The entourage effect refers to the enhanced effectiveness of CBD and THC when taken with these other naturally occurring active ingredients.
More than 100 different cannabinoids (cannabis-specific chemicals) have been identified in cannabis, but two, in particular, are medically important: Delta-9-Tetrahydrocannabinol (THC) and Cannabidiol (CBD).
THC and CBD act via the endocannabinoid system, and have different effects on the body:
Medicinal cannabis products have different actions depending on the ratio of THC to CBD that they contain. CBD acts to balance out some of the adverse effects of THC, so combining THC with CBD can allow patients to consume higher doses of THC with a reduced risk of unwanted side-effects.
The cannabis plant and its products have many different terms to describe many different functions, which can cause plenty of confusion for consumers and patients.
Hemp derived CBD oil and cannabis derived CBD oil are extremely similar, but have their differences.
The first main differentiator is cannabinoid content. CBD derived from hemp usually contains high concentrations of CBD, and very little THC, if measurable at all. CBD products derived from cannabis may contain significant amounts of THC.
Hemp products are legal in South Africa, as long as they don’t contain more than the extremely low specified amount of THC. These products are often sold as dietary supplements to assist in restoring balance in the body by stimulating the ECS. Cannabis derived CBD products can only be legally obtained by prescription.
Whole plant cannabis extracts contain the ‘full-spectrum’ or a ‘broad-spectrum’ range of cannabinoids and other plant materials. On the other hand, an isolate contains a single isolated cannabinoid.
‘Full-spectrum’ cannabis extract will contain all the cannabinoids from that plant, as well as other compounds such as terpenes.
‘Broad-spectrum’ cannabis extract will not contain the full range of compounds. Instead, certain compounds are removed from the extract to create the ideal balance or mixture – this is done in a strictly regulated manner and environment.
Isolates will only contain one specific cannabinoid, which can be either naturally extracted from the plant or synthetically manufactured in a laboratory.
These various forms of cannabis product will allow for differing physiological actions in the body and provide numerous therapeutic applications. However, they may also differ in the way they interact with other medications.
These are the naturally occurring chemicals responsible for the smell and taste of all plants. Terpenes lend certain traits and characteristics to different strains of cannabis, creating unique and specific medical benefits, as well as flavours and smells. Below we’ve listed six common terpenes that are found in cannabis.
Pinene is a potent bronchodilator and could be helpful in the treatment of respiratory conditions such as asthma.
Myrcene is able to augment THC effectiveness, and is also a helpful sleep aid.
Limonene is a potent mood-boosting, antifungal, antibacterial and anticarcinogenic terpene.
Linalool has clinical potential as an anti-convulsant and anti-bacterial agent with pain and anxiety reduction qualities.
Caryophyllene has beneficial properties against diabetes, depression, anxiety, osteoarthritis, and colitis.
Humulene is considered to be anti-tumor, anti-bacterial, anti-inflammatory, and anorectic (suppresses appetite).
Flavonoids are naturally occurring compounds found in numerous plants, not just cannabis. However, that are exclusively found in cannabis – these are known as ‘cannaflavins’.
These compounds provide pigmentation for the plant and its flowers, helping attract pollinating insects. These compounds also filter harmful UV rays and ward off pests and fungi, making them quite vital to the cannabis plant.
Flavonoids further work hand-in-hand with terpenes to provide cannabis’ unique scents and flavours. They also work with terpenes and cannabinoids to assist in the entourage effect, whereby the efficacy of both CBD and THC are enhanced.
It is believed that these compounds act as an anti-oxidative, and anti-inflammatory, anti-mutagenic and have their own anti-carcinogenic properties, along with their ability to regulate key cellular enzyme functions.
Ingestion
Ingestion refers to eating or drinking a product infused with medicinal cannabis. Ingested cannabis passes through the stomach before reaching receptors in the brain, which means a slower onset but generally produces the longest lasting effects. With this method, it often takes 60-90 minutes for effects to be felt, and these reach their peak within 2 hours. Effects can often last between 6-8 hours after consumption.
Inhalation
Inhalation requires vaporisation of cannabis plant material or the combustion of plant material as in smoking. Vaporising lacks the harsh, irritating effect that smoking can have on the lungs and throat, allowing for a cleaner and healthier intake when compared to smoking. Inhalation via vaporising or smoking cannabis has the quickest onset of action, usually within minutes, but effects will only last for 1-2 hours
Topicals
Topical delivery refers to application of cannabis oil or cream onto the skin. This offers relief without the high, making it ideal for treating rashes and other skin conditions.
Sublingual
Sublingual consumption is when products are placed under the tongue and absorbed through the mucus membranes. This delivers a faster onset of the effects than ingestion, making it ideal for many patients. Sublingual oils commonly take action within 30-45 minutes, and have a longer duration of about 4-6 hours.
Intake Methods
The various methods of consuming medical cannabis can produce different responses, the same way that different strains of cannabis produce different effects in the body.
Ingestion
Ingestion consists of eating or drinking a product infused with medical cannabis. Ingested cannabis passes through the stomach before reaching receptors in the brain, which means a slower onset but generally produces the longest lasting effects. With this method, it often takes 60-90 minutes for effects to be felt, and reach their peak within 2 hours. Effects can often last between 6-8 hours after consumption.
Inhalation
Inhalation requires vaporisation of cannabis plant material or the combustion of plant material as in smoking. Vaporising lacks the harsh, irritating effect that smoking can have on the lungs and throat, allowing for a cleaner and healthier intake when compared to smoking. Inhalation via vaporising or smoking cannabis has the quickest onset of action, but effects will only last for 1-2 hours
Topicals
Topical delivery requires the application of cannabis oil or cream onto the skin. This offers relief without the high, making it ideal for treating rashes and other skin level conditions.
Sublingual
Sublingual consumption is when products are placed under the tongue and absorbed through the mucus membranes. This delivers a faster onset of the effects than ingestion, making it ideal for many patients. Sublingual oils commonly take action within 30-45 minutes, and have a longer duration of about 4-6 hours.
Intake Methods
The various methods of consuming medical cannabis can produce different responses, the same way that different strains of cannabis produce different effects in the body.
When purchasing or consuming cannabis from the black market, you are taking numerous risks. Legal producers of cannabis products follow stringent procedures imposed by the regulatory authorities in their respective countries, while illegal growers do not necessarily comply with any specified regulations or standards.
Licensed producers are given standards and guidelines which they can be held to, to ensure they are delivering the highest quality medical grade product. This is to ensure that their product meets health and safety standards.
Various factors to take into consideration when choosing between a legal and black market cannabis producer:
Pharmaceutical Standards
Microbial Contamination
Cannabis hosts numerous microorganisms. Most of these are harmless, but harmful ones can be introduced to the plant via poor cultivation practices and human contamination.
If a patient is immunocompromised, unwanted pathogens can pose a health risk.
Pesticides
Cannabis obtained via the black market may potentially contain harmful pesticides which have not effectively been cleared from the plant. Research has shown that up to 70 percent of the pesticide content in cannabis is present in the smoke.
Unknown Potency
Black market cannabis is grown from unknown sources. With this comes inaccurate measures of potency, leaving consumers unsure of what they are consuming, and increasing the risk of adverse effects.
In an unregulated market, such as the black market, products aren’t held to certain standards.
This provides low-quality products, with little consistency and no safety standards – increasing the risk of adverse effects.
Cannabis hosts numerous microorganisms. Most of these are harmless, but harmful ones can be introduced to the plant via poor cultivation practices and human contamination.
If a patient is immunocompromised, unwanted pathogens can pose a health risk.
Cannabis obtained via the black market may potentially contain harmful pesticides which have not effectively been cleared from the plant. Research has shown that up to 70 percent of the pesticide content in cannabis is present in the smoke.
Black market cannabis is grown from unknown sources. With this comes inaccurate measures of potency, leaving consumers unsure of what they are consuming, and increasing the risk of adverse effects.
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