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Cannabis has been used medicinally and recreationally for over 5000 years. It is a complex plant, which contains over 500 chemical components. Of these, at least 100 are unique to the cannabis plant – the cannabinoids. The plant-derived cannabinoids are termed phytocannabinoids. The major phytocannabinoids, and those we know most about, are delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD). THC possesses psychoactive effects, while CBD is non-psychoactive (i.e. it does not alter perception or consciousness).


The biological activity is mainly linked to the major cannabinoids THC and CBD. However, it is becoming clear that a wider range of cannabinoids and other constituents of the cannabis plant may be involved in its various therapeutic effects. These include the cannabinoids tetrahydrocannabivarin (THCV), cannabichromene (CBC), and cannabigerol (CBG). These minor cannabinoids are thought to subtly modulate or enhance biological effects when taken therapeutically.


The other main compounds in cannabis are the terpenes. These are aromatic compounds which give cannabis varieties distinctive smells and tastes. Terpenes may have additive therapeutic action, meaning they may work together with cannabinoids to modify or enhance medicinal effects. To date, more than 120 different terpenes have been identified in cannabis. Unlike cannabinoids, all major terpenes present in cannabis (e.g. myrcene, alpha-pinene, and beta-caryophyllene) can be found abundantly in nature. It is thought that the terpenes work together with cannabinoids to modify or enhance their effects. This is known as the “entourage effect”.

The human brain and other organs contain naturally-occurring cannabinoid (CB) receptors and the chemicals that bind to them. This is called the human endocannabinoid system (ECS). The role of the ECS is to maintain our body’s ability to function normally by influencing the functioning of other systems. It plays a critical role in our nervous system and regulates multiple physiological processes. This includes the adjustment of our response to pain, appetite, digestion, sleep, mood, inflammation, and memory. The ECS also influences seizure thresholds (i.e. in epilepsy), coordination, and other processes such as the immune system, heart function, sensory integration (touch, balance, sense of space), fertility, bone physiology, the central stress response system (the HPAA), neural development, and eye pressure.

There is ongoing clinical research supporting the use of medicinal cannabis in many conditions including:

- Chronic pain, particularly pain associated with the nervous system;

- Nausea, loss of appetite, weight loss, and vomiting associated with chemotherapy or radiotherapy used in the treatment of cancer, and anorexia and cachexia in HIV/AIDS;

- Pain and muscle spasms or cramps associated with multiple sclerosis or spinal cord damage;


There is also ongoing research on its use in epilepsy (particularly the drug-resistant childhood epilepsies), Gilles de la Tourette syndrome, therapy-resistant glaucoma, fibromyalgia, post-traumatic stress disorder, sleep disorders, bladder dysfunction, symptoms of Parkinson’s disease, and depression. 

Abrams, Donald I., and Manuel Guzman. Cannabis in cancer care. Clinical Pharmacology & Therapeutics 97, no. 6 (2015): 575-586.


Abrams, Donald I., Hector P. Vizoso, Starley B. Shade, Cheryl Jay, Mary Ellen Kelly, and Neal L. Benowitz. Vaporization as a smokeless cannabis delivery system: a pilot study. Clinical Pharmacology & Therapeutics 82, no. 5 (2007): 572-578.

Ashton, C. Heather. Pharmacology and effects of cannabis: a brief review. The British Journal of Psychiatry 178, no. 2 (2001): 101-106.

Bar-Sela, Gil, Marina Vorobeichik, Saher Drawsheh, Anat Omer, Victoria Goldberg, and Ella Muller. The medical necessity for medicinal cannabis: prospective, observational study evaluating the treatment in cancer patients on supportive or palliative care. Evidence-Based Complementary and Alternative Medicine 2013 (2013).


Berman, Jonathan S., Catherine Symonds, and Rolfe Birch. Efficacy of two cannabis based medicinal extracts for relief of central neuropathic pain from brachial plexus avulsion: results of a randomised controlled trial. Pain 112, no. 3 (2004): 299-306. 

Bowles, Daniel W., Cindy L. O’Bryant, D. Ross Camidge, and Antonio Jimeno. The intersection between cannabis and cancer in the United States. Critical Reviews in Oncology/Hematology 83, no. 1 (2012): 1-10.

Darkovska-Serafimovska, Marija, Tijana Serafimovska, Zorica Arsova-Sarafinovska, Sasho Stefanoski, Zlatko Keskovski, and Trajan Balkanov. Pharmacotherapeutic considerations for use of cannabinoids to relieve pain in patients with malignant diseases. Journal of pain research 11 (2018): 837.

Davies, Dame Sally. Cannabis Scheduling Review Part 1 The therapeutic and medicinal benefits of Cannabis based products – a review of recent evidence. (2018).

Davis, BrentUnderstanding the Power and Complexity of Healing Hemp (Summary) (2018). 

Davis, BrentUnderstanding the Complexity of Healing Hemp (2018). 


Devinsky, Orrin, J. Helen Cross, Linda Laux, Eric Marsh, Ian Miller, Rima Nabbout, Ingrid E. Scheffer, Elizabeth A. Thiele, and Stephen Wright. Trial of cannabidiol for drug-resistant seizures in the Dravet syndrome. New England Journal of Medicine 376, no. 21 (2017): 2011-2020.

Ellis, Ronald J., Will Toperoff, Florin Vaida, Geoffrey Van Den Brande, James Gonzales, Ben Gouaux, Heather Bentley, and J. Hampton Atkinson. Smoked medicinal cannabis for neuropathic pain in HIV: a randomized, crossover clinical trial. Neuropsychopharmacology 34, no. 3 (2009): 672. 

Grotenhermen, Franjo, and Kirsten Müller-Vahl. The therapeutic potential of cannabis and cannabinoids. 
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Hazekamp, Arno, and Franjo Grotenhermen. Review on clinical studies with cannabis and cannabinoids 2005-2009. Cannabinoids 5, no. special issue (2010): 1-21.

Hill, Kevin P. Medical marijuana for treatment of chronic pain and other medical and psychiatric problems: a clinical review. Jama 313, no. 24 (2015): 2474-2483. 

Hosking, R. D., and J. P. Zajicek. Therapeutic potential of cannabis in pain medicine. British journal of anaesthesia 101, no. 1 (2008): 59-68.

Kalant, Harold. Medicinal use of cannabis: history and current status. Pain Research and Management 6, no. 2 (2001): 80-91.


Mannucci, Carmen, Michele Navarra, Fabrizio Calapai, Elvira V. Spagnolo, Francesco P. Busardò, Roberto D. Cas, Francesca M. Ippolito, and Gioacchino Calapai. Neurological aspects of medical use of cannabidiol. CNS & Neurological Disorders-Drug Targets (Formerly Current Drug Targets-CNS & Neurological Disorders) 16, no. 5 (2017): 541-553.

Notcutt, William, Mario Price, Roy Miller, Samantha Newport, Cheryl Phillips, Susan Simmons, and Cathy Sansom. Initial experiences with medicinal extracts of cannabis for chronic pain: results from 34 ‘N of 1’ studies. Anaesthesia 59, no. 5 (2004): 440-452. 

Nutt, David. Medicinal cannabis: time for a comeback? Lung cancer 15 (2018): 05.

Porcari, Giulia S., Cary Fu, Emily D. Doll, Emma G. Carter, and Robert P. Carson. Efficacy of artisanal preparations of cannabidiol for the treatment of epilepsy: Practical experiences in a tertiary medical center. Epilepsy & Behavior 80 (2018): 240-246.

Robson, Philip. Therapeutic aspects of cannabis and cannabinoids. The British Journal of Psychiatry 178, no. 2 (2001): 107-115.

Russo, Ethan B., Geoffrey W. Guy, and Philip J. Robson. Cannabis, pain, and sleep: lessons from therapeutic clinical trials of Sativex®, a cannabis‐based medicine. Chemistry & biodiversity 4, no. 8 (2007): 1729-1743.

Sallan, Stephen E., Norman E. Zinberg, and Emil Frei III. Antiemetic effect of delta-9-tetrahydrocannabinol in patients receiving cancer chemotherapy. New England Journal of Medicine 293, no. 16 (1975): 795-797.

Touw, Mia. The religious and medicinal uses of Cannabis in China, India and Tibet. Journal of psychoactive drugs 13, no. 1 (1981): 23-34.

Wade, Derick T., Philip Robson, Heather House, Petra Makela, and Julia Aram. A preliminary controlled study to determine whether whole-plant cannabis extracts can improve intractable neurogenic symptoms. Clinical rehabilitation 17, no. 1 (2003): 21-29. 


Wade, Derick T., Petra Makela, Philip Robson, Heather House, and Cynthia Bateman. Do cannabis-based medicinal extracts have general or specific effects on symptoms in multiple sclerosis? A double-blind, randomized, placebo-controlled study on 160 patients. Multiple Sclerosis Journal10, no. 4 (2004): 434-441. 

Walsh, Zach, Raul Gonzalez, Kim Crosby, Michelle S. Thiessen, Chris Carroll, and Marcel O. Bonn-Miller. Medical cannabis and mental health: A guided systematic review. Clinical psychology review 51 (2017): 15-29. 

Webb, Charles W., and Sandra M. Webb. Therapeutic benefits of cannabis: a patient survey. Hawai'i Journal of Medicine & Public Health 73, no. 4 (2014): 109. 

Zuardi, Antonio Waldo. History of cannabis as a medicine: a review. Revista Brasileira de Psiquiatría 28, no. 2 (2006): 153-157.

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© 2017-2020 Dr. James Odell, ND, OMD, L.Ac. 

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