Basic facts about medicinal cannabis
What is the endocannabinoid system?
The endocannabinoid system is a signalling system in the body. Activation or inhibition of the system is of particular importance to our cognitive functions, inflammation, blood pressure and digestion. The endocannabinoid system is not unique to humans - all animals have a similar system.
The endocannabinoid system consists of the receptor types CB1 and CB2 and their ligands, referred to as 2-AG and Anandamide. The ligands are formed and degraded again by a number of enzymes, which are also considered to be part of the endocannabinoid system.
What is the difference between THC and CBD?
Cannabinoids are the active compounds found within cannabis. The two most commonly discussed cannabinoids are THC and CBD.
THC (Δ-9-tetrahydrocannabinol) is the main active ingredient within cannabis. THC is responsible for many of the pharmacological effects of cannabis, including the psychoactive effect. CBD (cannabidiol) is the second most prominent compound within cannabis. CBD is not known to cause the noticeable intoxicating, euphoric effects that THC does.
Production and Quality Assurance
How is medicinal cannabis produced?
All Spectrum Therapeutics products are manufactured according to Health Canada standards. The content of the active substances is measured and guaranteed, and the end product undergoes a number of quality checks.
Random monthly pesticide tests occur at all our sites as well as systematic pesticide testing on every product produced at newly acquired facilities and all third-party partners. The pesticide testing regime includes testing for over 96 pesticides, including myclobutanil (USP 2014).
What is decarboxylation?
To be effective, cannabinoids need to be heat-activated in a process called decarboxylation. Decarboxylation means that THCA and CBDA (inactive precursors) are converted to THC and CBD.
Medicinal Cannabis Considerations
Is it dangerous to smoke cannabis?
The burning of the cannabis plant releases toxic and carcinogenic substances, including carbon monoxide, tar and polycyclic aromatic hydrocarbons. These substances can have negative health effects. It is therefore not recommended to smoke cannabis.
Is it safe to drive after taking medicinal cannabis?
Patients prescribed any medicinal cannabis products should seek their doctor’s advice before driving or operating machinery due to the risk of experiencing drowsiness. While drowsiness is not a known side effect of CBD alone , it may occur if the CBD interacts other medications. Some medicinal cannabis products may also include tetrahydrocannabinol (THC), that might have the potential to impair driving. It is an offence to drive while impaired and with evidence in the bloodstream of a qualifying drug(eg medicinal cannabis).
The presence of a qualifying drug alone is not sufficient for an offence; there must first be impairment as demonstrated by unsatisfactory performance of the compulsory impairment test. It is important to note that the law provides a defence for a person who can prove that they were taking medicinal cannabis in accordance with a current prescription and instructions from the manufacturer, the doctor who prescribed it or the pharmacist who dispensed it.
Reference: Ministry of Transport 2019
How can you access medicinal cannabis in New Zealand?
Spectrum Therapeutics medicinal cannabis products are not currently registered in New Zealand. For more information about how to access medicinal cannabis, please visit https://www.health.govt.nz/.
What are the side effects of medicinal cannabis?
Like all prescription medicines, medicinal cannabis products can have side effects.
These may include:
• Fatigue and sedation
• Feelings of euphoria (intense happiness)
• Vertigo
• Nausea and vomiting or depression
• Fever
• Confusion
• Appetite increase
• Hallucinations or decreased paranoid delusions
• Dry mouth
• Psychosis or cognitive distortion (having untrue thoughts)
• Diarrhoea
The extent of side effects can vary with the type of medicinal cannabis product and between individuals.
Terms and definitions
Here is a list of definitions of terms related to medicinal cannabis.
CBD (cannabidiol) is a psychoactive cannabinoid. There is very little difference in the molecular structure of CBD and THC, but it is enough for CBD to have effects that are significantly different from THC. For example, CBD does not have an intoxicating effect like THC - even in large amounts( see below the definition of THC).
CB1 and CB2 receptors are in the endocannabinoid system and are the primary targets in the body for medicinal cannabis.
CBD (cannabidiol) is a psychoactive cannabinoid. There is very little difference in the molecular structure of CBD and THC, but it is enough for CBD to have effects that are significantly different from THC. For example, CBD does not have an intoxicating effect like TCH - even in large amounts.
In order to activate the THC and CBD in the cannabis flowers, the cannabinoids must undergo a process called decarboxylation. THC and CBD have a different molecular structure when they are in the plant. Decarboxylation means that THCA and CBDA (inactive precursors) are converted to THC and CBD, and carbon dioxide (CO2) is given off as a by-product. By heating the cannabis flower to over 105°C, the substances are decarboxylated and the cannabinoids are activated.Heating by smoking is a combustion at 600–900 °C producing toxic byproducts; 30–50% of active ingredients is lost to ‘side-stream’ smoke. Smoking medicinal cannabis is not recommended.
Flowers from the cannabis plant are cut, trimmed clean of leaves and dried at a low temperature and low humidity. These flowers are used to produce medicinal cannabis.
The original name for synthetic THC.
The endocannabinoid system is a signalling system in the body. Activation or inhibition of the system is of particular of importance to our cognitive functions, inflammation, blood pressure and digestion. The endocannabinoid system is not unique to humans - all animals have a similar system.
Molecules formed in the body which affect the endocannabinoid receptors. Two endocannabinoids are formed in the human body: Anandamide and 2-AG (2-Arachidonoylglycerol).
Possible synergy effect arising from several active compounds affecting the endocannabinoid system at the same time. The entourage effect may explain why studies show fewer side effects from the use of plant-based medicines compared with synthetic, pure preparations. This effect may also explain why varieties of cannabis work differently, even though the THC and CBD contents are the same.
A extemporaneous preparation of cannabis is made by a pharmacy. It is made specifically for each patient based on a prescription from a doctor.
Molecules capable of binding to a receptor.
Another word for dried cannabis flowers.
Medicines derived from the cannabis plant.
Naturally occurring cannabinoids in cannabis plants (‘phyto’) which affect the endocannabinoid system.
Substances which affect the brain.
Receptors are found in cells throughout the body. They react to signals in the form of active substances and transmit a response. We have many different receptors in the body which are responsive to specific signals, e.g. the cannabinoid receptors CB1 and CB2, which respond to cannabinoids.
Variants of the cannabis plant.
THC (delta-9-tetrahydrocannabinol)is a psychoactive cannabinoid, which is known for having euphoric effects if cannabis is consumed in large doses. THC acts on both the CB1 and CB2 receptors in the endocannabinoid system.
Aromatic compounds which are formed in many plants, including cannabis. Terpenes contribute to the scent and taste of the plant. It is hypothesised that some terpenes can affect the body, either on their own or through an entourage effect. Examples of frequently occurring terpenes are myrcene, limonene and pinene.
Approved medicinal device for inhalation of medicinal cannabis (dried flowers).