wild rose college of natural healing by terry …...wild rose college of natural healing cannabis:...

Wild Rose College of Natural Healing CANNABIS: An Introduction for Healthcare Providers By Terry Willard ClH, PhD & Jeananne Laing ClH

Wild Rose College of Natural Healing Terry Willard Cl.H PhD. ©2019 1

Cannabis: An Introduction for Healthcare Providers

Nine of the Phytocannabinoids Even though there was a comprehensive review in 2016, showing over 200 phytocannabinoids produced by cannabis, we are going to focus on 9 (nine) coming from 4 (four) cannabinoid families. • CBC (cannabichromene) • CBD (cannabidiol) • CBDV (cannabidivarin) • CBG (cannabigerol) • CBN (cannabinol) • THC (tetrahydrocannabinol) • THCV (tetrahydrocannabivarin) • CBDA (cannabidiolic acid) • THCA (tetrahydrocannabinolic acid) Delta 9 -Tetrahydrocannabinol (THC): is the most popular psychoactive phytocannabinoid. THC is not found in the plant itself, as stated earlier, it has to go through decarboxylation to turn into THC from THCA. Through the decades of selective breeding by recreational cannabis growers a few plants have moved from 2 – 9% THCA (potential THC) in the 1960’s up to as high as 25+% at current level. So, some of the cannabis today is very different from what was available in the past. (This isn’t your father or grandfather’s cannabis). This shows us that previously the cannabis industry was really only interested in this secondary metabolite. It is pretty impressive, that the breeders found the right pressures to change the metabolic functions of the plant. However, breeders where not focusing on the whole plant’s activities, just the THC potential. Besides being psychoactive, THC exhibits potent anti-inflammatory and analgesic activity, neuroprotective, reduce intraocular pressure, spasticity, and muscle tension. THC interacts with both CB1 and CB2 G-protein endocannabinoid receptors. Even though THC is nontoxic some consumers (especially novices) experience a “psycho-toxic” effect of panic, anxiety, sedation and rapid heartbeat. Cannabidiol CBD: is a derivative of CBDA, most common in the fiber cannabis or hemp varieties. A common misconception is that plants high in CBD are quite sedative. Most likely the reason people notice this reaction is because they often have high myrcene (a terpene we will discuss



later) especially if cultivated under sunlight. Two of the most commonly found high CBD cultivars are Charlotte’s web and ACDC. Some feel they might be the same plant with almost identical genetic fingerprints. CBD is not psychoactive, but some people feel they get a little bit of a feeling of mild intoxication, though subjectively very different than THC. This effect is almost due to a terpene/CBD interaction. CBD interferes with THC’s ability to stimulate CB1 receptors (a negative allosteric modulator of THC). CBD has analgesic and autoinflammatory effect in a large range of symptoms and conditions. It is also a very potent antioxidant. CBD has evidence to work against brain and breast tumors, while simultaneously protecting normal tissue. CBD and its cousin CBDV are effective anticonvulsants. One of the reasons that CBD has such a wider range of uses than THC is that it interacts with a much larger range of receptor sites than THC, both inside the endocannabinoid system and outside of it. This gives it an ability to work on conditions ranging from acne to strokes. It also has a strong anti-bacterial effect on several bacteria like Staphylococcus aureus. Cannabigerol (CBG): comes from the mother constituent of Cannabigerolic acid (CBGA) through decarboxylation. Research on this constituent is fairly recent with most likely more results coming in the future. It has a potent appetite stimulant effect that has been employed when patients are on chemotherapy (cachexia). CBG can be used to treat IBS. Beside interacting with the endocannabinoid system, it interacts with several receptors outside it. It is an extremely potent antibacterial. It has been employed as an antitumor agent, especial prostate and oral cancer. Cannabigerolic acid (CBGA): is the third most prevalent cannabinoid produced in cannabis. It is a non-psychoactive ingredient that has an analgesic action. Little is found in the mature flower but can be still found in the leaves and fiber of the plant. Cannabichromene (CBC): is usually obtained by collecting immature flowers about 6 weeks before maturity as CBCA and then decarboxylated. CBC does not interact with the endocannabinoid system and has its major target transient receptor potential channels (TRP channels) found in plasma membranes. This is similar to the interaction of several plant constituents like garlic (allicin), chili pepper (capsaicin), wasabi (allyl isothiocyanate); others are activated by menthol, camphor, peppermint, and cooling agents. CBC exhibits a large range of effects including antifungal, antibiotic, anti-inflammatory and analgesic. It has also found promise as an antidepressant.



Cannabinol (CBN): is the oxidation by-product of THC. It was commonly detected among poorly stored, old cannabis. Most considered it the sign of bad product, but it does give some patients a nice sedative effect. If taken orally and passed through the liver, it converts to a form (11-hydroxy-CBN) which binds better to the CB1 receptors. This produces a better action taken orally than inhaled. It has a significant antibiotic effect and has been used in treating burns because it reduces perceived thermal sensitivity. This shows that even poorly handled and storage, cannabis still retains some medicinal value. Cannabidivarin (CBDV): This propyl form of CBD has shown promise as an anticonvulsant, with and without CBD. Tetrahydrocannabivarin (THCV): is a derived from THCVA which has been shown to reduce appetite and thus is a potential diet supplement. It has been used to reduce delayed memory recall. It does increase connectivity in brain networks and therefore is being researched for tremors, dementia and Alzheimer’s. Even though some reports indicate that it has a strong psychoactive effect that is more intense than THC, but of shorter duration. Studies in the UK have shown that 10 mg of THCV is not psychoactive. THCV can inhibit THC action, making it less intense. CBDA (cannabidiolic acid): is the most common phytocannabinoid produced by fiber (hemp) plants. It has shown promise as an anti-nausea treatment, especially anticipatory nausea. THCA (tetrahydrocannabinolic acid): is the most common cannabinoid found in recreationally grown plants. Even though it is the precursor of THC, it is non-psychoactive until it is converted into THC. It was once thought to not have medicinal activity due to it being non-psychoactive, however we now know it is actually quite effective. It is anti-inflammatory, immune-modulating, neuroprotective and anti-tumor.



Phytocannabinoid Abbreviation Action Notes

delta 9 -Tetrahydrocannabinol

THC Psycho-activity at just below therapeutic doses THC increases production of endocannabinoids in the brain (The Endocannabinoid System 2014 Medical Cannabis Institute. Dustin Sulak, DO)

Analgesic (reduces pain)

Micro-dosing THC enhances pain relief from endocannabinoids (in mice)

Antiemetic (manage nausea/vomiting)

Δ9 THC is the form of THC in heated cannabis (see boiling chart)

Sleep aid some Δ8 THC is created in

the plant …however

Appetite stimulant when we ingest Δ9 THC the body changes it into Δ8 THC which has much more potent potential for impairment (psychoactive properties)

Antispasmodic

Anticonvulsant

Antioxidant

Anti-cancer

Cannabidiol CBD Non-Psychoactivity ”CBD … does not appear to bind to either CB1 or CB2 receptors at physiologically meaningful concentrations, but there is some emerging evidence suggesting it may act as a non-competitive, negative, allosteric modulator of CB1 receptor”



Analgesic (reduces pain)

works with a wide range of receptors (not just CB1 and CB2)

Anti-inflammatory very few side effects Anxiolytic (anti-anxiety)

counteracts some of the impairing/psycho-activity of THC, as well as THC induced anxiety (keep some handy as a first aid to THC overwhelm)

Neuroprotective studies into CBD’s

effectiveness as an antibiotic

Anti-epileptic

Antispasmodic

Anticonvulsant

Antioxidant

Anti-tumour

Anti-proliferant

Bone Stimulant

Immune modulating

Vasorelaxant

Antipsychotic

Anti-biotic

Cannabigerol & Cannabigerolic acid

CBG & CBGA Non-Psycho-activity the precursor to CBG, is CBGA

CBGA is also the precursor

to all the other acid cannabinoids (THCA, THCVA, CBDA, CBDVA, CBCA, CBCVA) CBGA is present in the developing plant … however not much remains in the fully mature plant



Early studies show it may prove to stimulate brain cell and bone growth and shows promise as an anti-bacterial and anti-insomnia medicine

Early studies found to stimulate brain cell and bone growth

Demonstrates promise as an anti-bacterial and anti-insomnia medicine

strong appetite stimulant

in mice models, shown to be an effective treatment for IBS

antibacterial

shows promise as an anti-tumour agent, especially in cases of prostate and oral cancers

Cannabichromene CBC Non-Psycho-activity the acidic (unheated) form of CBC, called CBCA (Cannabichromenic acid) forms in the immature flowers, about six weeks before maturity

Anti-biotic



Anti-fungal The effect of

cannabichromene on adult neural stem/progenitor cells. Noriko Shinjyo, VincenzoDi Marzo. 2013

Antiviral

Anti-inflammatory

Analgesic

Stimulates bone growth

Increases neurogenesis (development of new brain cells)

Study shows that CBC increases neurogenesis (development of new brain cells):

10 times more effective than CBD in treating anxiety and stress

Cannabinol CBN Mildly to Non-Psycho-activity

This cannabinoid is not produced by the cannabis plant, but occurs as a result of THC degradation, i.e. it is found in abundance in older samples of cannabis flowers and resin

Most sedating of all the cannabinoids

Demonstrates promise in treating glaucoma, and pain and may prove effective against MRSA infections



Cannabidivarin CBDV Non-Psycho-activity Slightly degraded form of CBD

Anti-epileptic

Anti-nausea

shows promise on its own as an anticonvulsant, and seems to work synergistically with CBD

Tetrahydrocannabivarin THCV Great interest as an appetite suppressant

Pronounced energetic effects

May effectively counter anxiety, stress, & panic disorders without suppressing emotion

Reduces tremors associated with Alzheimer’s, Parkinson’s, and other neurological disorders

Diminishes appetite

CBDA (cannabidiolic acid)

Non-impairing for most people

THCA (tetrahydrocannabinolic acid)

the ‘raw’ cannabinoids

Anti-inflammatory

Antioxidant

Anticancer

Strong immune booster



Improved intestinal function

Improved neural function

Neuroprotective

Rebuilds bone

The body does not convert THCA to THC (that happens through a heating process outside the body). However, the body can convert CBDA into CBD, especially when taking juice from the fresh leaves

Fresh Juice Drinking juiced fresh

cannabis leaves creates up to 4x more serum CBD than other methods of consumption. Juice has a short shelf life 4-12 hours. Best consumed with other fresh juices. Can be frozen.

CBD-A

CBDA shows promise as an anticonvulsant, anti-nausea and anti-emetic agent, analgesic and anti-inflammatory.

CBDA may also have antibacterial, antioxidant and cancer preventing properties



Synthetic Cannabinoids

CAUTION! many who take these potent drugs recreationally end up with psychiatric conditions.

HU-210 - created in 1988 by Dr Mechoulam’s team

100s x more potent and longer acting than plant THC

used as an antidepressant, anti-anxiety & analgesic

shown to prevent the inflammation of Alzheimer’s disease

WIN 55,212 - in rat studies

shown to be a potent analgesic for neuropathic pain

Sativex (THC & CBD from cannabis plant extract)

analgesic for cancer pain

spasticity from MS

Dronabinol / Marinol (Synthetic Delta-9 THC.)

nausea/vomiting associated with cancer treatments

appetite stimulant for AIDS patients

analgesic for neuropathic pain in MS patients

Nabilone / Cesamet (similar to THC but much stronger)

nausea/vomiting associated with cancer treatments



Dexanabinol (synthetic non-psychoactive cannabinoid)

neuroprotective after cardiac surgery

regain high level functioning (such as regaining memory) after brain injury

possible anti-cancer use (solid tumour) in future

wild rose college of natural healing by terry …...wild rose college of natural healing cannabis:...

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