Medical Cannabis: What Patients Need To Know
It is important to consider what is meant by “Sativa” and “Indica” cannabis. Sativa can be defined by the plant structure ( a tall, narrow leaf plant originating in warm, humid regions or the psychoactive effect which is uplifting and stimulating. Indica can be defined by its structure a shorter, bushy wide leaf plant originating in cooler drier regions or with psychoactive effect which is more sedative, sometimes referred to as couch lock.
There are no pure Sativa (usplifting or Indica (sedative) strains also called cultivars. Most of what is cultivated and consumed is a hybrid of Narrow Leaf Drug ( containing THC and commonly called Sativa) and Wide Leaf Drug (containing THC and commonly called Indica). The effects of cannabis consumption whether psyco-active or medicinal are the result of not only the many cannabinoids (two of which are THC and CBD) and terpenes and other plant chemicals, but also the environmental, emotional, mental, physical and spiritual state of each person.
There are more than 400 phyto-chemicals (plant chemicals) in the cannabis plant. The cannaboids THC and CBD are only 2 of the more than 100 that have isolated. The ratio of those and the other cannabinoids is not what differentiates the many cannabis strains. It is the terpenes (responsible for the smell) as well as the other phyto-chemicals such flavenoids (responsible for the taste) that creates differences in the various strains. These other phyto- chemicals will also influence your desired effect.
The entourage effect ( described Ethan Russo M.D.) is the effect achieved by using the whole plant (mainly the female flower). This offers largest range of phyto-chemicals. It is believed the entourage effect for medicinal purpose is more beneficial than isolated effects of THC and CBD. The documented effects of whole plant consumption include: analgesic ( decreasing pain), anti-inflammatory, anti-nausea, anti-seizure, anti- cancer, sedative, neuroprotective, bone repair, anti-oxidant and anti-bacterial. Research on these effects is available on Pub Med. Go to the Pub Med website and do a cannabis search.
Access to fresh female flowers which contain the highest concentration of chemicals may be the ideal way to use cannabis as medicine. This would not be practical for most patients. As with any herb, it necessary do dry, cure and store the harvested plant material for future use. The techniques used for those processes will determine the quality of the product used for consumption. Many other medicinal products can be made from the female flowers by extracting and concentrating the phyto-chemicals to create: oils, tinctures, infusions and other concentrated products.
Most states are requiring laboratory testing to determine product safety and content. It is important for cannabis products to be free from contamination with mold, pesticides, bacteria, heavy metals, and other toxic chemicals. It also possible to determine the approximate percentage content of the main phyto-chemicals THC, CBD, and terpenes which are responsible for the desired effects. The tests are based on a small sample of the product. The actual content of what is purchsed can vary greatly. Some experimentation by patients under a physician’s guidance will be necessary before the ideal form and dosage of cannabis product is determined.
Hopefully additional studies and clinical trials as well as product standardization will make the patient experience less complicated.
James Brent DDS
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