The Medical Cannabis Guidebook. Mel Thomas
or alcohol-based drinks and hot beverages, or eaten. If cannabis is smoked, the effects are normally felt within minutes; if eaten, the full effects can take up to an hour and are cumulative, often longer lasting and the uptake can be more variable.
When inhaled, cannabis compounds (cannabinoids) rapidly enter the bloodstream via the lungs, to be transported directly to the brain and other parts of the body. The feeling of being stoned or high is caused by the delta-9-THC binding to cannabinoid receptors in the brain.1 There are also cannabinoid-like substances produced naturally by the brain itself, called endocannabinoids. Researchers at Hebrew University in Jerusalem identified the body’s own form of THC, and christened the internally manufactured substance “anandamide” after the Sanskrit ananda, or bliss.2 Most of these receptors are found in parts of the brain that influence pleasure, memory, thought, concentration and time perception. They are also involved in cognition, pain perception and motor coordination.
A pure cannabis joint containing no tobacco.
Around one in 10 people have reported unpleasant experiences at some point in their cannabis use, including confusion and anxiety. Interestingly, the same person may have either pleasant or unpleasant effects depending on their mood and circumstances. Side effects of cannabis use can include increased pulse rate, visual and sleep disturbance, decreased blood pressure, bloodshot eyes, dry mouth, increased appetite and mild lethargy. Heavy usage may possibly result in feelings of paranoia whilst under the influence. However, these side effects are temporary and pass quickly, mainly affecting people who have not used cannabis regularly. Cannabis consumers are therefore advised to accustom themselves to its use with smaller doses initially.
The most common effects of cannabis use are a sense of relaxation, happiness, sleepiness and an enhanced appreciation of external stimuli, with some consumers reporting that colors appear more intense. Many report becoming more animated, with a corresponding release of inhibitions, making them more talkative and humorous. Cannabis can also heighten sexual thoughts, desires and experiences. In India, cannabis has been used for thousands of years as an integral part of Tantric sex, which is not about sexual gratification, but rather devotion and worship; at the point of orgasm the devotee is said to be at one with the universe. Thought processes become enhanced and many philosophers, musicians, writers, poets and artists report using cannabis to increase their creativity. Many consumers report that listening to music and viewing artistic works become much more profound experiences whilst under the influence of cannabis.
The amount of time cannabis takes to be felt is dependent on the route of administration. Inhaling cannabis is the quickest way to administer a dose; vaporized or smoked cannabinoid material arrives in the lungs very quickly, entering the bloodstream and rapidly passing into the brain, and becomes active within minutes, with its effects lasting for several hours. If eaten, the cannabinoid compounds have to be absorbed from the stomach and then pass through the liver, where a percentage is metabolized into 11-Hydroxy-THC, which is four to five times more psychoactive than Delta9-THC.3 It can take from 30 minutes to an hour to reach the brain, with the full effects taking up to three hours.
Pharmaceutical cannabis sprays are designed for “mucosal or sublingual administration,” meaning that the patient sprays it under their tongue, and the cannabinoids are then absorbed into the bloodstream via the mucus membrane. This is quite an effective and convenient method of administration, which allows the cannabinoids to reach the brain within 10 to 20 minutes. However, a significant amount actually ends up being swallowed and absorbed through the gut, resulting in a sizable portion of the medication having a delayed onset. This is far from ideal for medical users who wish to accurately regulate their dosage. Many patients report that the pharmaceutical industry’s expensive cannabis-based medications are vastly inferior to the natural product. Vaporizing organically grown cannabis buds is one of the most effective ways of self-medicating, particularly for pain relief.
The very popular Volcano vaporizer.
For some patients the high associated with herbal cannabis use is undesirable. This is particularly true for those who need to medicate regularly throughout the day. One of the most useful cannabinoids is cannabidiol, or CBD, which unlike THC, binds poorly to the brain’s receptors and can therefore work without getting patients stoned. A company in Safed, Israel called Tikun Olam began its research on CBD-enhanced cannabis strains in 2009. Recreational cannabis is illegal in Israel, but medicinal use has been permitted since 1993. It is used to treat over 9,000 people suffering from illnesses such as cancer, Parkinson’s, multiple sclerosis, Crohn’s disease and post-traumatic stress disorder. Tikun Olam has now developed a strain called Avidekel, which contains 15.8% CBD but less than 1% THC.4 It remains to be seen how medical cannabis users will benefit from this strain, as the pharmaceutical companies making vast sums of money from their monopoly of cannabis-based medications will try to ensure that the general prohibition of cannabis continues so that patients can’t legally grow their own Avidekel-type strains for vaporizing.
Commercially available strains that are high in CBD are now becoming more readily available specifically bred for medical use. One recommended seed company is the CBD Crew. The breeder behind this project is the renowned Shantibaba, who cofounded Mr. Nice seeds with Howard Marks. The authors produce their 1:1 (THC:CBD) 80% cannabinoid content oil using the CBD Crew’s Skunk Haze strain. The highest CBD strain the authors have verified is known as Juanita La Lagrimosa and is produced by Reggae Seeds in Spain. This strain has been laboratory tested and gives consistent results; it comes in at a massive 8.81% CBD content with 6.77% THC. More information on these strains is available on the authors’ website, cannabiscure.info.
A close up view of female plant pistils.
A great deal of misinformation, unsupported by any reputable medical evidence, is quoted with regard to cannabis use and mental health issues. Starting in the 1920s, the prohibition conspiracy began with newspaper headlines and fabricated stories detailing what they termed “Reefer Madness.” Today, the Partnership for a Drug Free America has a budget of around one million dollars a day, with the majority of their funding being provided by pharmaceutical companies who pay substantial sums of money to lobbyists and special interest groups to aggressively campaign against any possibility of cannabis legalization.5 Cannabis does not cause mental health problems; there is no evidence to support this claim. If cannabis use caused mental illness, why would major pharmaceutical companies be marketing cannabinoid-based medications? Furthermore, if cannabis use caused schizophrenia there would be over 150,000,000 recreational users exhibiting an extraordinary range of symptoms worldwide. This is not the case. Professor David Nutt from the U.K. gave a lecture regarding cannabis and schizophrenia in 2009, referring to the idea that stronger cannabis (known as “Skunk”, but not in reference to the strain of the same name) has made smoking cannabis more dangerous, and stated:
“Schizophrenia seems to be disappearing from the general population even though cannabis use has increased markedly in the last 30 years. When we were reviewing the general practice research database in the U.K. from the University of Keele, research consistently and clearly showed that psychosis and schizophrenia are still on the decline. So, even though Skunk