What Are Cannabinoids?
Cannabinoids are chemical compounds that work in conjunction with your body’s endocannabinoid system. The endocannabinoid system regulates and balances many functions in the body, including immunity, communication between cells, appetite, metabolism, and memory.
Cannabinoids can be classified into three groups:
1. Endocannabinoids (produced within the body)
2. Phytocannabinoids (naturally occurring in the cannabis plant)
3. Synthetic cannabinoids (built in the laboratory)
Over 100 phytocannabinoids have been identified in the cannabis plant1. These phytocannabinoids are found in concentrated amounts in the flowers of the cannabis plant.
Each compound is thought to have unique properties, meaning that each of them has different medical benefits.
What Are the Different Classes of Cannabinoids?
Phytocannabinoids belong to two classes: major and minor phytocannabinoids.
Major phytocannabinoids include ∆9-tetrahydrocannabinol (THC) and cannabidiol (CBD). THC and CBD are thought to be responsible for the majority of the physiological effects induced by cannabis2.
Minor cannabinoids appear in smaller quantities in the plant. Common minor cannabinoids include:
• Tetrahydrocannabivarin (THCV)
• Cannabinol (CBN)
• Cannabigerol (CBG)
• Cannabichromene (CBC)
• Cannabidiolic acid (CBDA)
• Cannabidivarin (CBDV)3
The effect of phytocannabinoids depends on their interactions with receptors in our body.
What Is the Cannabinoid Receptor System?
Endocannabinoids are part of the physiological system called the endocannabinoid system (ECS). They interact with many different protein targets throughout the body to induce their effects5,6.
The endocannabinoid system consists of endogenous cannabinoids (naturally occurring cannabinoid molecules made in the body) and their receptors.
There are two main cannabinoid receptors:
• Cannabinoid receptor 1 (CB1R), which is found on neurons in the central nervous system (i.e., brain) and in low concentrations in peripheral organs (i.e., heart, liver, fat tissue, stomach)7
• Cannabinoid receptor 2 (CB2R), which is mostly found in the immune system, microglia, and gastrointestinal system7
There are two major endocannabinoids that bind to the cannabinoid receptors. Some examples of functions the endocannabinoid system regulates include:
• Learning and memory processes
• Immune responses6
Phytocannabinoids (THC and CBD) and synthetic cannabinoids (Dronabinol and Nabilone) interact with many of the same protein targets that endocannabinoids do, resulting in an overlap of activities.
What Are Cannabinoid Acids?
In the cannabis plant, phytocannabinoids like THC and CBD are not produced in large amounts directly by the plant.
Instead, they exist mostly in their acidic forms. They are called tetrahydrocannabinolic acid (THCA) and cannabidiolic acid (CBDA) and exist in smaller amounts in their decarboxylated forms (i.e., THC, CBD)4.
These cannabinoid acids (i.e., THCA, CBDA) turn into their decarboxylated forms (i.e., THC, CBD) through the process called decarboxylation.
Decarboxylation is the process that activates compounds in cannabis such as THC1,4. This happens when certain cannabinoid acids are exposed to heat such as sunlight or in an oven.
Main Differences Between Major Cannabinoids
Besides being the most popular among users, THC and CBD are the two most abundant phytocannabinoids.
They have a couple of key differences between them, including their molecular structure and how they affect the body.
What is THC?
THC is the primary intoxicating molecule in cannabis and allows the user feel the euphoria associated with being “high.” In addition, THC has the potential to relieve pain, inflammation and nausea/vomiting2.
What is CBD?
CBD’s popularity has rapidly grown in medical cannabis applications due to its unique therapeutic profile and effects.
CBD is non-intoxicating at therapeutically relevant doses and may reduce pain, anxiety and inflammation2. It has also been shown to be an effective anti-epileptic8.
What is CBG?
CBG is the third most prevalent cannabinoid after THC and CBD. This cannabinoid is produced early in the cannabis plant’s growth cycle. It is a predecessor from which other cannabinoids are then synthesized.
Emerging evidence from pre-clinical studies shows that CBG has many potential medical benefits, such as:
• Anti-inflammatory and analgesic properties23–27
• Anti-bacterial properties28,29
• Antiproliferative effects30–32
• Inflammatory bowel disease regulation30,33
• Appetite regulation34
What is CBN?
Cannabinol (CBN) is a product of THC.
CBN concentrations and extracts are low in plant material but increase overtime as THC is exposed to light, oxygen, and heat. It is also less potent than THC.
Clinical studies have shown that the chemistry, pharmacology, therapeutic effects, and adverse effects of CBN are well-suited for medical cannabis patients10–14.
A few clinical studies have shown that the combination of THC and CBN improved various aspects of sleep quality12,15,16.
What is THCV?
THCV is structurally similar to THC17.
Clinical studies have shown that the chemistry, pharmacology, therapeutic effects, and adverse effects of CBN are well-suited for medical cannabis patients18–22.
Studies shown that THCV has the potential to treat obesity18,19 and diabetes/metabolic syndrome21.
What is Cannabichromene (CBC)?
CBC is rare and produced early in the plant’s flowering cycle. It is both antibiotic and antifungal, as these two properties may protect the plant in its early life35. Emerging evidence from pre-clinical studies has shown that CBC may have potential medical benefits such as:
• Anti-inflammatory and analgesic effects36–39
• Anti-acne properties40
• Antidepressant effects41
• Anti-inflammatory activity
• Strong anti-bacterial activity
• Mild to moderate anti-fungal activity42
• Low toxicity42
There are hundreds of other minor cannabinoids that are present in the cannabis plant. Some of the other more popular minor cannabinoids include:
• Δ8-THC (Delta-8-THC)
• Δ9-THC (Delta-9-THC)
How Do I Know Which Cannabinoid Works Best?
When choosing a product, you want to think about what symptom or condition you are looking to treat and what dosage your healthcare practitioner has suggested.
Once you have the recommended dose you can find the products that are best suited for you.
For instance, if your healthcare practitioner recommended you a higher THC dose then you would likely want to find a product with higher THC potency. That way, you don’t have to consume significantly large amounts to get the desired dose. However, if you were recommended a lower dose of THC, a low to medium THC product may be best.
It is also good to consider if any compounds other than THC and CBD may be helpful for your treatment. The compounds in cannabis are thought to work together to influence the overall effect you feel when you consume cannabis.
This is called the Entourage Effect and is a hypothesis that cannabinoids are more effective when combined than on their own. For example, some studies suggest that CBD extracts may be more effective than CBD alone at reducing pain and inflammation43,44.
How Do I Consume Medical Cannabis?
Patients have several options when it comes to the consumption of their medical cannabis. Common formats include inhalation, ingestion, and sublingual/oromucosal. Let us break them down for you:
Inhalation (i.e., smoking, vaporizing):
• When smoking or vaping medical cannabis, the absorption of cannabis occurs through the lungs.
• This allows for quicker onset, with effects felt within seconds to minutes of dosing and peak within 30 minutes46,47. However, it also results in a shorter duration of effect, lasting up to 6 hours47. Because the effects are felt almost instantaneously, this route of administration may help those experiencing acute symptoms like breakthrough pain.
• What’s the advantage? Inhalation is the more efficient delivery of cannabinoids46.
Ingestion (i.e., oils, capsules, edibles):
• When you ingest medical cannabis, the absorption of cannabis occurs through the gastrointestinal tract.
• There is a slower onset of action (effects felt within 0.5-4 hours) and lower peak blood levels of cannabinoids47,48. However, the duration of the effects is much longer (may last up to 12 hours or longer47,48) compared to inhalation.
• What’s the advantage? Ingestion is useful for chronic conditions that require higher dosage and longer half-life.
Oromucosal/sublingual (i.e., sprays, oils):
• When sprays or oils are held inside the mouth, absorption occurs through the cheek or under the tongue.
• This allows for the onset and duration of the effects to be quicker and shorter than oral ingestion but slower and longer than inhalation49.
• What’s the advantage? Oromucosal/sublingual methods have faster onset and shorter duration than oral ingestion.
Final Notes on the Cannabinoids Differences and Effects
Each of the cannabinoids mentioned offers its own unique set of medical benefits. Finding a cannabis product that is right for you is a highly individualized process that requires medical oversight.
This is especially important if you take multiple pharmaceuticals due to drug-drug interactions or have multiple medical conditions. You should always consult a healthcare practitioner as effects may vary on an individual basis.
If you’re new to medical cannabis, Aurora’s clinic partner, Canadian Cannabis Clinics, offers free virtual appointments and will assist you in getting started on your medical cannabis journey. You can book an appointment here.
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