Marijuana 101

As recreational and medical marijuana are becoming legal in various states across the U.S and media sources are covering the topic, you’re probably wondering more about this ancient plant.

Some ‘Marihuana’ history:

Marijuana (previously written as marihuana) refers to the “dried leaves, flowers, stems, and seeds from the Cannabis sativa or Cannabis indica plant.” 1 The Cannabis family of plants is one of the world’s oldest cultivated plants2 with a long history of medicinal use. In fact, in 1851, cannabis was included in the 3rd edition of Pharmacopoeia of the United States (USP), an annual compendium of national drug information. However, as the medicinal use of marijuana increased, there were growing concerns about safety and potential addiction to marijuana. This concern prompted a federal prohibition of marijuana in 1937,3 which is today being successfully re-challenged in the form of recreational and medical marijuana in a variety of states in the U.S.

What’s in the Pot: THC or CBD?

Believe it or not, there are more than a 104 different cannabinoids (the main chemicals that have medicinal use) that have been extracted from the cannabis plant,4 with more likely to be discovered. The most common cannabinoids are delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD).

THC is more commonly known to be the psychoactive chemical found in cannabis, which can induce feelings of euphoria (described below). These feelings are commonly known as being “high.” There are a number of studies medicinal uses of marijuana with the more common being: anti-nausea, chronic pain relief, and appetite stimulation.5

CBD, on the other hand, is recognized as the non-psychoactive chemical found in cannabis and has gained more popularity in recent years. CBD relaxes the mind and the body and is often used to reduce inflammation, assist with sleep insomnia and apnea, reduce seizures, relieve pain, act as an antipsychotic and has anti-anxiety effects.5 Some data even suggests that THC and CBD can have some anticancer benefits and may reduce the size of cancer cells.1 Depending on the type or strain of cannabis plant and the species of the plant used to become “high,” there may be different amounts of THC and CBD. For example, the plant itself can be smoked, oils can be produced and even resins can be created.3 The next section discusses the other routes of administration of cannabis.

Is smoking the only way to use cannabis?

The routes of administration of marijuana can determine how quickly, how intensely, and for how long an individual can feel “high.” The various options for utilizing marijuana include: “smoking or inhaling from cigarettes (joints), pipes (bowls), water pipes (bongs, hookahs), and blunts (cigars filled with cannabis); eating or drinking food products and beverages; or vaporizing the product.”1 Furthermore, cannabinoids can also be absorbed through the skin; therefore, topical patches, creams, and sprays may also be utilized. Smoking cannabis, which is often the most common method of use, results in THC reaching the brain in seconds to minutes. Maximum levels in the blood are reached about 30 minutes after smoking and can last for several hours. Ingesting marijuana takes longer for the drug to get into your blood stream (30 min to 2 hours) and the “high” can last as long as 5-8 hours3.

Can you use marijuana and drive a vehicle?

No, marijuana is considered an illicit drug according to federal law. According to the NIH, marijuana is the second most common drug found in blood tests of drivers involved in car crashes.6 The role cannabis plays in these car crashes is unclear since marijuana can be detected in the body for several days to weeks, and the risk of combining marijuana with alcohol and other drugs demonstrates a greater risk than marijuana by itself.6

What about synthetic cannabinoids?

Stay away from synthetic cannabinoids, as these products mimic THC and are not marijuana. Synthetic cannabinoids can be significantly more powerful and potent than natural THC and the side effects are often unpredictable. There have been life-threatening effects including “nausea, anxiety, paranoia, brain swelling, seizures, hallucinations, aggression, heart palpitations, and chest pains.”7

So is cannabis legal or illegal? I’m confused…

Federally, marijuana is considered an illicit drug and the DEA (drug enforcement agency) classifies the medication as schedule 1 (the most stringent drug classification). However, each state has its own regulations around recreational and medicinal marijuana use. Check this link to learn about your state as of March 2018.

Can I become addicted to marijuana?

It is possible. About 1 in 10 marijuana users will become addicted. For people who begin using younger than 18, that number rises to 1 in 6.”7

What are the side effects of marijuana?

Besides the ample evidence of medicinal use of THC and CBD, there are some possible side effects, especially if overused.

THC and CBD have slightly different affects on the body. This variation has to do with where the receptors for these compounds are located, some more localized in the brain and others spread around the body.

THC over activates certain brain cell receptors, which may result in effects such as1:

  • Altered senses
  • Changes in mood
  • Impaired body movement
  • Difficulty with thinking and problem-solving
  • Impaired memory and learning

CBD only interacts with cannabinoid receptors weakly, even at high doses, and the changes in perception and thinking that are seen with THC are not seen with CBD.8

Are there any FDA approved medications derived from cannabis?

There are 2 synthetic forms of marijuana that are FDA approved for various uses (dronabinol and nabilone), including appetite stimulation and nausea and vomiting. However, on June 25th, 2018, the FDA approved Epidiolex (cannabidiol), the first FDA-approval that contains a purified substance from marijuana . This medication is approved for the treatment of seizures associated with two rare and severe forms of epilepsy, Lennox-Gastaut syndrome and Dravet syndrome, in patients two years of age and older.

Take a look at some of the trends of marijuana use9:

Trends of Marijuana Use

Fun Facts about marijuana

  • UC San Diego recently received the largest private donation for marijuana related research ($4.7 million) to study effect of CBD in relieving autism symptoms.
  • Hemp and marijuana are sometimes interchanged, but there is a difference. Hemp refers to parts of the cannabis plant that contain less that 0.3% of THC.9
  • On June 25th, 2018 the FDA approved Epidiolex (cannabidiol), the first FDA-approval that contains a purified substance from marijuana, for the use of seizures.
  • It is unlikely an individual will fail a drug test from second hand marijuana inhalation.1
  • According to a recent study: “Medical cannabis laws are associated with significant reductions in opioid prescribing in the Medicare Part D population.”9
  • The body naturally produces its own cannabinoids.7

References:

  1. NIH. DrugFacts - Marijuana. 2018. drugabuse.gov. Accessed June 26, 2018.
  2. Russo EB. History of Cannabis and Its Preparations in Saga, Science, and Sobriquet. Chem Biodivers. 2007;4(8):1614-1648. doi:10.1002/cbdv.200790144.
  3. The Health Effects of Cannabis and Cannabinoids: THE CURRENT STATE OF EVIDENCE AND RECOMMENDATIONS FOR RESEARCH. Washington, D.C.: National Academies Press; 2017. doi:10.17226/24625.
  4. Elsohly Ma G. Handbook of Cannabis. Oxford: Oxford University Press; 2014.
  5. Wells J. Dazed and Confused: Marijuana Legalization Raises the Need for More Research | UC San Francisco. UCSF.edu. https://www.ucsf.edu/news/2017/06/407351/dazed-and-confused-marijuana-legalization-raises-need-more-research. Published 2017. Accessed June 26, 2018.
  6. NIH. How many people take drugs and drive? drugabuse.gov. Accessed June 26, 2018.
  7. CDC. Marijuana and Public Health. https://www.cdc.gov/marijuana/faqs/marijuana-addiction.html. Accessed June 26, 2018.
  8. The Biology and Potential Therapeutic Effects of Cannabidiol. National Institute of Health.
  9. Bradford AC, Bradford WD, Abraham A, Adams GB. Association between US state medical cannabis laws and opioid prescribing in the medicare part D population. JAMA Intern Med. 2018;178(5):667-673. doi:10.1001/jamainternmed.2018.0266.