Cannabis has a range of medical uses and different strains are better for certain conditions than others. Below you will find some general information that will help you choose the most appropriate cannabis product for you.
THC
The medical use of cannabis has been around for thousands of years. There are certain chemicals in cannabis, primarily Delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD), that help treat certain diseases or conditions. Below are just a few health benefits of cannabis. Talk with your doctor or our staff to find the most appropriate strain and type of cannabis for your condition.
- THC (delta-nine tetrahydrocannabinol): primarily responsible for psychoactive effects, may be effective in treating pain disorders, tumors, and nausea
- CBD (cannabidiol): no psychoactive effects, calming. May be used for treating epilepsy/seizure disorders, nerve pain, chronic pain, anxiety, inflammatory diseases, dystonia
- CBN (cannabinol): mild psychoactive effects. May be used to treat nausea or seizure disorders
- CBG (cannabigerol): More common in hemp. Has antibacterial and anti-tumor properties. Reduces intra-ocular pressure in patient with glaucoma.
- Cannabichromene (CBC): Second most common cannabinoid after THC, no psychoactive effects. May be used to treat pain, cancer, depression/anxiety. Also has antibacterial and antifungal properties.
Vaporized/Smoked
- Onset: Rapid onset (seconds-30 minutes)
- Duration: 2-3 hours
- Bioavailability: up to 56%
Oral Administration
- Ingestion:
- Onset: 30 minutes – 2 hours
- Duration: 5-8 hours
- Bioavailability: 4-20%
- Mucosa
- Onset: 15-40 minutes
- Duration: 45 minutes – 2 hours
- Bioavailability: similar and/or higher to oral ingestion
- Oral administration has higher inter- or intra-patient variability in onset and effect
Topical
- Onset: variable
- Duration: variable
- Bioavailability: variable; less systemic absorption and primarily localized effects
General side effects of cannabis: Somnolence, headaches, dry mouth, hypotension, tachycardia/bradycardia, palpitations, sedation, difficulty concentrating, dizziness, changes in mood, altered senses
- Smoking/Vaporizing cannabis: coughing, increased risk of lung/respiratory infections or diseases, increased sputum production or purulence, conjunctival irritation. Topical or oral administration may be preferred to reduce of these side effects.
- Oral administration: Cannabis users may be unaware of the amount of cannabis they may have ingested using edible formulations. The most common adverse effect/downside to oral administration is the higher risk for overdose due to delayed onset, ease of use/administration, and variability in potency between products. This can be avoided with careful selection of products and proper patient counseling.
- Short-term use: Impaired short-term memory, impaired motor coordination, altered judgement, paranoia, changing is mood
- Long-term use: Addiction (9%), cognitive impairment, brain development (mostly observed in adolescents)
- Adverse effects at high doses: agitation, confusion, sedation, psychosis, hallucinations
Drug-interactions (not all-inclusive):
- May decrease the the pharmacological effect of: theophylline, clozapine, chlorpromazine
- May increase the pharmacological effect of: macolides, calcium channel blockers, antihistamines, haloperidol, sildenafil, SSRIs, TCAs, tacrolimus
- May have an additive effect when administered with cannabis: opioids, anxiolytics
Missouri Poison Control: (800) 222-1222
Resources:
- Barrus DG, Capogrossi KL, Cates SC, et al. Tasty THC: Promises and Challenges of Cannabis Edibles. Methods Rep RTI Press. 2016;2016:10.3768/rtipress.2016.op.0035.1611. doi:10.3768/rtipress.2016.op.0035.161
- Borgelt LM, Franson KL, Nussbaum AM, Wang GS. The Pharmacological and Clinical Effects of Medical Cannabis. Pharmacotherapy 2013;33(2):195-209.
- Bridgeman MB, Abazia DT. Medicinal Cannabis: History, Pharmacology, And Implications for the Acute Care Setting. P T. 2017;42(3):180–188.
- Franson KL. Medical Cannabis. Skaggs School of Pharmacy and Pharmaceutical Sciences.
- Pertwee RG. The diverse CB1 and CB2 receptor pharmacology of three plant cannabinoids: delta9-tetrahydrocannabinol, cannabidiol and delta9-tetrahydrocannabivarin. Br J Pharmacol. 2008;153(2):199–215. doi:10.1038/sj.bjp.0707442