EDITORIAL BY DR. DAVE HEPBURN
The Medical Cannabis Industry has evolved at a significant rate over the past few years. Regular new medical discoveries by scientists and doctors create stronger evidence on the benefits, and risks, of cannabis. The global explosion of interest in medical cannabis, coupled with a rapidly increasing cannabis evidence base, brings with it a host of inaccuracies and legitimate questions.
To enable clarity, we’ve answered some of the most commonly asked cannabis questions below.
Question: “Is medical cannabis the same as adult use/recreational cannabis?”
Answer: Yes… and no. The difference is in the intent and content. Cannabis for adult use primary includes THC content and is consumed for the purpose of experiencing the psychoactive effects of THC. Cannabis for adult use may have CBD, but typically at low levels. Medical cannabis might contain the very same THC content; however, it is used in doses or combinations with CBD, to align with the desired therapeutic effect. The manufacturing of medical cannabis must also adhere to specific quality control standards to ensure consistency and safety for the patient.
Question: “Is CBD the best medical cannabinoid?”
MYTH: CBD is non-psychoactive, medical, is an oil, therefore good.
MYTH: THC is psychoactive, adult use/recreational, smoked, therefore bad.
Answer: These common myths form a perception that CBD is the best option for treating common conditions. It is not. THC is not only an excellent medication; it is also the only component of cannabis that is effective for several conditions.
Question: “What is the Endocannabinoid System (ECS)?”
Answer: The endocannabinoid system, discovered in the 1990s by a team of medical scientists from Israel, is a system of checks and balances that our brain and body is constantly performing to maintain homeostasis (or balance). The ECS is composed of several ligands (of which anandamide and 2AG are the best studied), which are our naturally produced endocannabinoids, the cannabinoid receptors (CB1R and CB2R) that exist through many systems organs and tissues in our body, and finally the degradative enzymes (FAAH and MAGL) that help synthesize and destroy endocannabinoids. In a nutshell, we can say that the ECS balances us and helps us to eat, sleep, relax, forget and be protected.
Question: “Is cannabis safe for youth?”
Answer: The adolescent brain is not the same as a normal adult human brain. Prior to neuromaturation (age 25-ish), the adolescent brain is actively being ‘pruned’, with various receptors being added and deleted. During these years there are dramatic changes in all aspects of the endocannabinoid system (ECS). Adding plant (exogenous) cannabinoids to a brain that is trying to establish its own system, may not only have a deleterious effect in the production of a normally developing system, but may also influence some types of memory, learning and emotions. In fact, the prefrontal cortex, replete with ECS components, is the last part of the brain to mature. This area of the brain is responsible for executive control, and if it doesn’t function properly, issues ranging from decision making to impulse control can be thrown through a loop. Cannabis is, first and foremost, a plant with compounds that have medicinal value, and needs to be respected as such. Too many youths currently think that cannabis is harmless. They are mistaken. It can be abused and it can cause damage.
Question: “Do I have to get high to experience the therapeutic effects of medical Cannabis?”
Answer: No. Of the many cannabinoids available, only a few cause psycho-impairments, THC being the most widely known. However, many more, including the medically beneficial CBD, CBG and CBC do not cause that same psycho-impairment. Furthermore, many of the beneficial effects of THC exist in doses (micro dosing) that cause no psycho-active effects at all. In higher doses, psychoactive effects can be significantly mitigated by adding CBD.
Question: “Can medical cannabis make me psychotic?”
Answer: This sentiment was a staple of the ‘reefer madness’ campaign, and it still rattles around the stigma section of some frontal lobes. Cannabis has not been shown to cause schizophrenia. In fact, countries where cannabis is prevalent have the same incidence of schizophrenia as countries who have no cannabis use. While it can possibly exacerbate and initiate first break psychosis in those who are genetically predisposed (i.e. have the AKT1 gene), using cannabis is akin to pouring gasoline on a pile of sticks. If there are no underlying embers, it will cause no reaction at all.
Question: “In how many countries is Cannabis now legal?”
Answer: Medical cannabis is legal in 34 countries, but only two countries have legalized cannabis for adult use. While most think the Netherlands is one of those, in fact, it is not. Only Canada and Uruguay have allowed both medical and adult use of cannabis. However, the global tipping point continues.
About the Author:
Dr. David Hepburn is a co-founder of Plena Global, currently serving as the Medical Advisor.
Dr. Hepburn is an award-winning syndicated columnist featured in several major newspapers across the United States and Canada and is a recipient of the prestigious Canadian Community Newspaper Association’s Columnist of the Year Award. As a doctor in the military, he served onboard a ship as a surgeon in the Persian Gulf War. In 1995, he lived in the jungles of Vanuatu where, for eight months, he was the sole doctor and bush surgeon to 30,000 people. His book, “The Doctor is In(sane)” was released in the spring of 2009. He was the co-host of the TV show, “Buyologic” on the Oprah Winfrey Network, and his interest in sports and sports medicine resulted in him being called to be a medical director of the 1994 Commonwealth Games, and a team physician for Canada in the 1996 Olympic Games in Atlanta. Dave has also been, or currently is, the team doctor to national rugby teams as well as junior and professional hockey teams. Amongst the growing number of medical physicians educated about cannabinoid medicine, he is an active member of: Society of Cannabis Clinicians, International Association for Cannabinoid Medicines (IACM), the Canadian Consortium for the Investigation of Cannabinoids (CCIC) and Physicians for Medical Cannabis (PMC).