Cannabis, medical marijuana, CBD, THC – words that arouse as much interest as controversy. Knowledge on this subject often comes down to stereotypical thinking about marijuana as an addictive, hallucinogenic, drug. Meanwhile, hemp is a plant that has long been used by humans. It is estimated that people cultivated hemp about 10,000 years ago. For centuries, it was one of the most important crops in the world, used to make materials, ropes, or as food for humans and animals. Hemp was also used as a medicine, and in many cultures it was associated with religious and spiritual practices. Its importance began to decline only in the 20th century, mainly due to the introduction of prohibitions related to the psychoactive effects of THC. In recent years, this approach has begun to change. More and more research indicates the significant benefits that can be brought by the use of hemp in many diseases, and the use itself can be safe and does not cause side effects.
Understanding which varieties of cannabis have medical applications, how cannabinoids work, what their content, what proportions are recommended and for which ailments is crucial for the proper, conscious use of the potential of this plant. Also in the context of cancer. I invited Anita and Piotr Kuźniewicz, popularizers of knowledge about cannabis, authors of the educational portal Stonerchef, which is a library of reliable knowledge based on the latest research, to share their knowledge on cannabis.
Let's start with the basics. Konopi vs. medical marijuana. What exactly is medical marijuana and what active substances does it contain?
Medical marijuana is really nothing more than cannabis grown in a pharmaceutical standard, i.e. with all procedures in place to ensure the purity of the raw material. On a biological level, medical marijuana is the same dried cannabis flowers as so-called recreational marijuana. So we can say that the term “medical marijuana” covers both the intention of use and the quality of the product that the patient consumes. The raw material from the pharmacy should be free of pesticides, heavy metals, molds, and contamination with other psychoactive substances — that is, ticking off all the criteria that plants sold on the black market do not meet.
When it comes to the composition of medical marijuana, the most important compounds are cannabinoids and terpenes. Cannabinoids are the external equivalent of endocannabinoids produced by our body and their presence is responsible for a whole range of medical benefits. Terpenes – or odorous compounds – in turn give direction to the action of individual varieties, and their concentration determines the strength of psychoactive and therapeutic effects. This means that one strain of medical marijuana may work better in the treatment of ADHD, another in the treatment of Alzheimer's, and yet another in depression or anxiety disorders. The same is true for oncology patients, where, in addition to anti-cancer properties resulting from the biology of cannabinoids, varieties are selected to alleviate symptoms such as pain, loss of appetite, nausea, vomiting, depression, insomnia, lack of motivation, or chronic fatigue.
Endocannabinoids produced by the human body are part of the endocannabinoid system. What do we know about it and what are its main functions?
A separate book could be written on this topic, but in short - the endocannabinoid system is the so-called superior system, whose role is to maintain other systems and organs in a state of homeostasis. It practically regulates all important biological functions of a person, from mood, motivation and memory, through pain sensitivity, the body's stress response, the processing of fear and pleasure, to immune reactions, circadian rhythm, hormonal balance, and even skin condition. The fact that our immune cells correctly identify pathogens is due to an efficient endocannabinoid system. Its optimal functioning helps maintain metabolic and mental health, and endocannabinoid dysfunctions have been linked to the development of many serious health problems, including autoimmune diseases, acute depression, migraines, epilepsy, dementia, and severe PTSD. Clinical endocannabinoid deficiencies have also been linked to autism, ADHD, fibromyalgia, and type 1 diabetes. Medical marijuana helps to balance these deficiencies and puts the body in a state that favors dietary and lifestyle changes that are intended to improve the patient's long-term health and quality of life.
By reaching for hemp, we provide external cannabinoids. The two main cannabinoids found in hemp are THC and CBD. What are the differences between them??
THC is a mild psychedelic, meaning it can change our perception of reality and our way of thinking by directly interacting with cannabinoid receptors in the brain and nervous system. This means that it can have an intoxicating effect depending on the dose, and it is also bipolar in nature, meaning that low and high doses have completely opposite effects. For example: low doses support cognitive functions, while high doses can temporarily impair them; low doses reduce stress, while high doses can accentuate anxiety in people sensitive to THC; low doses support the regulation of circadian rhythms, while high doses – especially taken just before bed – can negatively affect sleep architecture. CBD, on the other hand, does not provide psychoactive stimulation. It works by signaling the endocannabinoid system to produce more of its own cannabinoids – and by slowing down the enzymes that break them down. When used concurrently with THC in whole flower or extract form, it tones down its psychoactive effects and enhances its therapeutic potential in the health domains in which it is used. Despite their many differences, THC and CBD share many common features, including anti-inflammatory, analgesic, antidepressant, neuroprotective, antioxidant, anticancer, antiemetic, and metabolism-supporting effects. When THC and CBD occur in hemp alongside terpenes and flavonoids, a special synergy occurs between them known as the “entourage effect.” This biological phenomenon makes hemp flowers and extracts over 300% more biologically active than their isolated counterparts or blends of such.
The broad spectrum of hemp's effects opens up new possibilitiesyou their use in the treatment of many diseasesaboutb. What diseases can be helped by medical marijuana??
Many skeptics claim that marijuana is presented as a “cure-all,” but looking at how many processes the endocannabinoid system is involved in, it is hard to deny the medical versatility of cannabis. However, if we were to point out the conditions for which there is particularly convincing scientific evidence of the effectiveness of medical marijuana, it would be pain of all kinds, autoimmune diseases, depression, anxiety disorders, insomnia, ADHD, autism, immune dysfunction, eating disorders, neurodegenerative diseases, diabetes and obesity, as well as cancer.
What do we know about the effects of medical marijuana on cancer? Does medical marijuana have anti-cancer potential??
Yes, this effect occurs on many levels. THC and CBD are involved in apoptosis, or the programmed death of cancer cells. They also support autophagy, reduce the invasiveness of cancers, may reduce the size of tumors, and inhibit metastasis, or the formation of metastases. As reviews of preclinical studies indicate, cannabinoids can enhance the effectiveness of conventional cancer therapies while protecting healthy cells from injury. For many, this information is completely new and, given the current rhetoric about cannabis, may seem too good to be true — but these properties are well documented in the scientific literature.
In what wayaboutb medical marijuana can support the patientaboutin oncology?
Despite the mounting preclinical evidence, both in vitro and in vivo, clinical trials of cannabis for cancer treatment are still in their infancy. Due to the legal status of cannabis in most countries around the world, studying the medical properties of the whole plant and its extracts has been extremely difficult and has required large private investments, as countries have refused to grant such work. Currently, the most evidence from human studies is in the context of the use of cannabis for the treatment of breast cancer and glioma. In the latter case, the second phase of the clinical trial has been completed, which showed that in addition to an overall improvement in the quality of life, some patients experienced a halt in the disease, and some experienced a reduction in the tumor. The greatest challenge for clinical trials on cancer treatment with medical marijuana is developing specific formulations and proportions between individual cannabinoids and terpenes, because it is their interactions that are crucial for the effectiveness of cannabis preparations. Medical marijuana is worth including in anti-cancer therapy, if only because of its effectiveness in combating the side effects of chemotherapy and radiotherapy, such as pain, nausea, vomiting, loss of appetite, depression, insomnia, and chronic fatigue syndrome. Cannabinoids and terpenes have strong antioxidant effects; this potential is compared to vitamins C and E, which is why marijuana is able to protect healthy cells from damage inflicted by conventional forms of treatment. There is currently some confusion about the interaction between marijuana and immunotherapy, although we do not have enough qualitative evidence to determine whether the immunosuppressive properties of cannabinoids reduce the effectiveness of immunotherapy.
What are the rules for safe use of medical marijuana?
First of all, it is worth listening to the advice of a doctor who determines the dosage, helps choose the right strain for individual health goals and provides information on hygiene of use. Contrary to popular opinion about the addictive potential of marijuana, it is exceptionally mild and it is estimated that clinical symptoms of behavioral addiction concern approx. 5% regular users, and only 1.1% in the age group of 12+ apply for behavioral-cognitive therapy for this reason. It is also worth remembering that 91.1% people who have tried marijuana never even become regular users. This does not change the fact that people with a history of cannabis addiction - or those with a predisposition to developing behavioral addictions - should approach medical marijuana therapy with particular caution. In their case, the role of a doctor and teaching hygiene of use is particularly important for the success of the therapy. The same applies to people with mental disorders of a psychotic nature. Despite its therapeutic potential, a poorly chosen strain or consuming too much in stressful conditions can result in an unpleasant paranoid-anxiety episode and periodic deterioration of your mental state.
When it comes to the most common mistakes made when using medical marijuana, we would point to poorly selected strains and dosing too high at the beginning of therapy. If an ADHD patient gets the wrong strain for their subtype and type of symptoms, it will make life harder for them instead of improving their quality of life; the same is true for a patient with anxiety disorder who instead of a calming strain gets a strain that stimulates the nervous system. When it comes to dosing, it is best to approach the subject in small steps, because even if the initial dose does not bring the intended therapeutic benefits, over time you can develop a tolerance to the psychoactive effects of THC and increase the dose to one that will produce a therapeutic effect — and then stick with it until your resistance to psychoactive stimulation increases again. As a polypharmaceutical plant, cannabis does not lose its medicinal properties when you build a tolerance to THC, as shown in studies on patients with chronic pain.
What is the legal situation regarding medical marijuana in Poland?
It would not be an exaggeration to say that Poland has one of the most liberal legal climates for medical marijuana in the world. Some states in the US might even envy us for it. In fact, there is no list of conditions that qualify for medical marijuana therapy. If a doctor believes that, according to current scientific knowledge, the dysfunctional endocannabinoid system is involved in the condition, they can freely start such treatment. To better illustrate this, a prescription for medical marijuana can be obtained even for persistent stress at work, or for better sleep or acute pain after training in the case of athletes. All the more reason for a doctor to have no objections to starting such therapy on an oncology patient. The fairly wide selection of varieties also deserves praise, of which there are currently over 20 - and this number is gradually growing year by year. Although there has been a lot of talk recently about medical marijuana being provisionally included on the list of substances that can only be prescribed during an actual doctor's visit (not a teleconsultation), the law remains dead for now, and if it does come into full force, it will most likely hit prescription machines and new users looking for an easy prescription in such facilities. In our opinion, clinics operating in accordance with medical art should not be afraid of anything; although we do not say this with 100% certainty.
Thank you very much for sharing your knowledge about hemp and medical marijuana. For more information, please visit https://www.stonerchef.pl, and when considering the possibility of including cannabis therapy in your treatment protocol, you should always consult a specialist
in medical marijuana treatment.
Sources:
- Schloss, J., Lacey, J., Sinclair, J., Steel, A., Sughrue, M., Sibbritt, D., & Teo, C. (2021). A Phase 2 Randomized Clinical Trial Assessing the Tolerability of Two Different Ratios of Medicinal Cannabis in Patients With High Grade Gliomas. Frontiers in oncology, 11, 649555. https://doi.org/10.3389/fonc.2021.649555
- Almeida, C. F., Teixeira, N., Correia-da-Silva, G., & Amaral, C. (2021). Cannabinoids in Breast Cancer: Differential Susceptibility According to Subtype. Molecules (Basel, Switzerland), 27(1), 156. https://doi.org/10.3390/molecules27010156
- Worster, B., Hajjar, E. R., & Handley, N. (2022). Cannabis Use in Patients With Cancer: A Clinical Review. JCO oncology practice, 18(11), 743–749. https://doi.org/10.1200/OP.22.00080
- Kopustinskiene, D. M., Masteikova, R., Lazauskas, R., & Bernatoniene, J. (2022). Cannabis sativa L. Bioactive Compounds and Their Protective Role in Oxidative Stress and Inflammation. Antioxidants (Basel, Switzerland), 11(4), 660. https://doi.org/10.3390/antiox11040660
- Hinz, B., Ramer, R. Cannabinoids as anticancer drugs: current status of preclinical research. Br J Cancer 127, 1–13 (2022). https://doi.org/10.1038/s41416-022-01727-4
- Nagarkatti, P., Pandey, R., Rieder, S. A., Hegde, V. L., & Nagarkatti, M. (2009). Cannabinoids as novel anti-inflammatory drugs. Future medicinal chemistry, 1(7), 1333–1349. https://doi.org/10.4155/fmc.09.93
- Drug Policy Alliance. (2017). Debunking the Gateway Drug Myth: The Vast Majority of People Who Use Marijuana Do Not Go on to Use Other Illicit Drugs. Downloaded from: https://1cf110.a2cdn1.secureserver.net/wp-content/uploads/2017/11/DPA_Fact-Sheet_Debunking_Gateway_Myth_9.14.2017.pdf
Additional materials:
Cannabis and its constituents for cancer: History, biogenesis, chemistry and pharmacological activities
https://www.sciencedirect.com/science/article/abs/pii/S1043661820316108?via=ihub
Cannabis, Cannabinoids and Cannabis-Based Medicines in Cancer Care
https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/35225051
Cannabis Use in Patients With Cancer: A Clinical Review
https://ascopubs.org/doi/10.1200/OP.22.00080?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub 0pubmed
Cannabis sativa L. and Nonpsychoactive Cannabinoids: Their Chemistry and Role against Oxidative Stress, Inflammation, and Cancer
https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/30627539
Cannabis for cancer – illusion or the tip of an iceberg: a review of the evidence for the use of Cannabis and synthetic cannabinoids in oncology
https://www.tandfonline.com/doi/full/10.1080/13543784.2019.1561859
The Health Effects of Cannabis and Cannabinoids
https://nap.nationalacademies.org/read/24625/chapter/1
Cannabis use among recently treated cancer patients: perceptions and experiences
https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/37650961
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Anita Kilian-Kuźniewicz and Piotr Kuźniewicz – internet creators, graduates of SWPS University and pioneers of modern education about hemp, focusing in their work on presenting a full picture of this plant based on qualitative scientific research and extensive empirical knowledge. For 9 years they have been involved in the science of cannabinoids, constantly expanding their competences in the field of psychology, neurobiology and natural medicine. They gained their experience as copywriters on the markets in the United States and Canada, and for 5 years they have been transferring this knowledge to their native soil as Stonerchef. https://www.stonerchef.pl
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Author: Joanna Niewolik
