The World Health Organisation claims that around 2.5% of the world population or 147 million people consume cannabis. In recent years the therapeutic properties of cannabis have proved its medical importance in the scientific community. Despite that, the recreational use of it is still a debated topic, and only a limited number of research is done to document its medical applications. A sense of social awareness surrounding the wide variety of applications of this plant is emerging and trending all around in real life and throughout the web.
This paper is commissioned to bridge the gap of information between scientific research, healthcare clinics and the public. It will do so through presenting the fundamentals clinical applications of cannabis medicine based on scientific research and the role of the endocannabinoid system, phytocannabinoids and the applications of CBD. This paper can aid healthcare providers as a guide to answer medical questions regarding cannabis use and applications.
Cannabis sativa (C, sativa) is a dioecious plant; it has separate male and female plants that need to pollinate each other. The female plants carry the seeds, and the male plants serve only the purpose of pollinating them before dying off. The pollinated female plants are the ones of interest since they carry all the medicinal and recreational properties. The process of cloning has hence become a practical tool in cultivation to ensure a breed of feminized plants and eliminating the need for pollination by a male plant or seeds for planting. This step ensures that all the plants are females and have the desired properties.
The entire cannabis plant from root to flower is useful, all parts of it contain chemically active compounds. The concentration of the compounds are highest in the flowers, yet the leaves, stem, roots, and seeds all contain much lower levels. These active components are cannabinoids, and in this case, when derived from plants are phytocannabinoids, this is a distinction from the endocannabinoids that the human body produces. There are more than a hundred known cannabinoids, two of the most known are THC (delta-9 tetrahydrocannabinol) and CBD. The first is known for its euphoric and intoxicating properties while the latter has no inebriating effects. The range of cannabis plants is vast, there hundreds of various terpenes and flavonoids that distinguish each strain regarding active components, therapeutic effect and even smell and flavor.
Cannabis sativa is also known as agricultural hemp, its distinguished by its deficient levels of THC content usually between 0.3 to 0.2 %. This low content if THC makes this plant legal to cultivate in most countries around the world, unlike other subspecies that have high THC content, and are commonly referred to as “marijuana.” The low THC concentration means that the plant can produce more concentrations of other cannabinoids such as CBD and CBDA (cannabidiolic acid). These plant-based cannabinoids bind to the same human receptors similar to the endocannabinoids that occur naturally in the human body.
The history of cannabis use predates the science of it by far. Research has shown that humans utilized various parts of the cannabis plant more than 10 thousand years ago. This usage was not restricted to a particular location, but evidence shows that cannabis pollen, seeds, leaves, and flowers were used from the east of Europe throughout Asia until Japan.
Historical accounts and ancient medical texts have plentiful references to cannabis plant usage in medicine in various cultures. A clear example of this is the well renowned medical handbook up to the 19th century, The Canon of Medicine, included several chapters that mentioned the medicinal applications of cannabis. A current list of historical accounts of medicinal cannabis by scientists and physicians can be found in The Handbook of Cannabis Therapeutics. Even during the 20th-century cannabis was an integral part of many remedies worldwide, and also part of the ingredients of drugs found across pharmacies. Cannabis popularity began to change when doses standardization and patenting became difficult, and the pharmaceutical industry opted out for a single molecule medicine instead.
Agricultural hemp was one of the most popular crops not only for its medicinal applications but rather for its industrial capabilities in textiles production. Hemp was the go-to material for making clothing, ropes, and sails for ships. The early 1900’s brought advances in technology and a boom in an industry that allowed hemp to be processed more efficiently and economically. The real potential that hemp had for being competitive set in motion a series of events leading to cannabis prohibition. The prohibition had the full force of international laws and the industry behind it and led a series of campaigns criminalizing and marginalizing nature and anyone who used it, doctors, patients and people alike.
The history of the prohibition and the fight to legalization is denser and more complicated than the few lines mentioned here and are beyond the scope of this work. What is essential is that hemp cultivation was finally legalized in 1998 in Europe, under the condition that it contained a menial amount of THC less than 0.3%. The legalization initially made available products that contained hemp produced phytocannabinoids in forms of foods and supplements. In the United States, the federal law continues its ban on cannabis, while individual states have already legalized it. Currently, there are 29 states where cannabis is legal, and many countries are legalizing even the entire cannabis plant including THC for medical applications.