Cannabis has been widely known across different and many parts of the world. Its popularity owes to the psychoactive properties of cannabis ruderalis, indica, and sativa. Due to these properties, it is widely cultivated, trafficked, and abused as an illicit drug, with half of all drug seizures globally being cannabis. However, cannabis has its medicinal value, especially when the right chemical component, that is, Cannabidiol (CBD), is used as it is non-psychoactive. Thus, this paper explores cannabis, its use, how it works in the human body and from a medical perspective.
Section 1: How cannabis works in the body and information regarding the endocannabinoid system (ECS) and endocannabinoid deficiency syndrome.
According to Chayasirisobhon, S. (2020), THC and CBD are the primary naturally occurring chemicals and “bind with cannabinoid receptors, CB1 and CB2 that are present in the human brain and other body organs”. Their metabolism is dependent on the consumption route. When inhaled, THC and its metabolites enter the bloodstream via the lungs in a rapid manner, and in about ten minutes, they reach the brain and other body organs. This implies that cannabis enters the body through oral digestion or inhalation and through a metabolic process. Thus, the cannabis chemicals infiltrate into different body parts, such as the brain, where it can produce psychoactive effects on the user.
The endocannabinoid system (ESC) plays a significant role in the body when it interacts with cannabis. Endocannabinoid implies that cannabis-like substances are produced in the body and naturally activate the same receptors as the delta-9-tetrahydrocannabinol (THC), an active component of cannabis sativa. Cannabis would be smoked as cigarettes and has formal names such as hemp, cannabis, and hashish and also has informal names including locoweed, ganja, and others. The CBD type would work in our bodies to produce certain medicinal effects. Thus, patients with different pathologies make use of cannabis compounds.
Cannabis has its effects on the body regarding the endocannabinoid system because when an individual smokes marijuana, the cannabinoid compound attaches to the receptor CB1 in the brain and creates a “high” feeling. THC has this behavior, and anandamide is an endocannabinoid that binds to the same receptor. As such, cannabinoids and endocannabinoids in the brain work as neurotransmitters, that is, chemical messengers that transmit information from one cell to the other (Kaczocha & Haj‐Dahmane, 2022). Hence, the neurotransmitters do interact with varied receptors and produce many different effects.
Endocannabinoids are available throughout our bodies, and endocannabinoids bind to them, signaling that the endocannabinoid system (ECS) has to take action. In the central nervous system, there are CB1 receptors, while CB2 receptors are found in the peripheral nervous system and basically the immune cells (Kendall & Yudowski, 2017). Notably, endocannabinoids would bind to any receptor. However, the resultant effects depend on the location of the receptor and the endocannabinoid to which it binds. For instance, endocannabinoids may attach to receptor CB1 in the spinal nerve, and the effect is to relieve pain. Therefore, cannabis works by interacting with a body’s endocannabinoid system (ECS) by binding to receptors to produce certain effects such as pain reliever, signal inflammation, and others.
The ECS is important in the human body as it helps maintain internal homeostasis and controls many body functions. As such, the system controls body activities such as mood, sleep, pain, hunger, and the immune response. The endocannabinoid deficiency syndrome concept occurs at a point when some people have a deficiency endocannabinoid tone that results in less activation of the endocannabinoid system (Silver, 2019). This syndrome may be due to genetic differences or acquired due to certain diseases or injuries. Thus, the endocannabinoid deficiency syndrome may disrupt sleep, mood, digestion, and many other body functions.
Section 2: Different delivery routes patients may use cannabis, onset action for each, and pros and cons for each route.
Cannabis has been established to be used for various purposes and needs. The following are the four different delivery routes that patients may use cannabis.
Inhalation is the first route, and the consumption of cannabis may be in the form of cigarettes. This is the most commonly used method by many people, such as recreational users and also therapeutic users. Notably, vaporizing would be the most efficient way that herbal cannabis would be used compared to smoking. For the onset of action, the absorption of cannabis takes two minutes on the first inhalation, with peak drug effects occurring thirty minutes after use. As such, users remain intoxicated for two to four hours, but minor effects such as memory impairment can persist for up to a day. One pro of this delivery route is that cannabinoids reach maximum concentration a few minutes after consumption, and this brings almost immediate therapeutic benefits to the user. Lastly, its con is that the route may cause adverse effects such as chronic cough and bronchitis.
The second delivery route is the oral administration. Some cannabis products consumed orally by patients include extracts and oils. Its onset of action takes longer than inhalation as it is effective from half an hour to six hours. One advantage of this is that it has a convenient way of administration and thus provides a more targeted therapeutic benefit. Finally, its con is that, the liver degrades the cannabinoids before absorption into the systemic circulation.
Thirdly, topical administration, such as the use of topical ointments and creams, can help in the consumption of cannabis. On its onset of action, it is considered a slow delivery route of one to one-half hours, though, at its peak, it has long-lasting effects of up to 48 hours. Its pro is that it can be applied to specific body regions for localized effect. Finally, its con is that it is challenging to apply on hairy body parts and could result in allergic reactions.
The fourth delivery route for cannabis is the rectal administration, where suppositories are inserted through the vagina or rectum. The effects of cannabis suppositories are evident between ten to fifteen minutes, and they last up to eight hours. One pro to rectal administration is that it has efficient absorption rates of up to 70% with quick absorption and long-lasting effects. Lastly, its con is that it is not portable, and suppositories need to be refrigerated.
In conclusion, cannabis use should be limited to medical purposes only. Healthcare administrators and the government should promote CBD rather than THC and carry out research that would promote certainty of its curative effects. Further, appropriate delivery routes by patients should be promoted to avoid any adverse effects. Thus, cannabis can be approved and restricted for medication purposes to avoid its abuse.
References
Chayasirisobhon, S. (2020). Mechanisms of Action and Pharmacokinetics of Cannabis. The Permanente Journal, 25, 1-3.
Kaczocha, M., & Haj‐Dahmane, S. (2022). Mechanisms of endocannabinoid transport in the brain. British Journal of Pharmacology, 179(17), 4300-4310.
Kendall, D. A., & Yudowski, G. A. (2017). Cannabinoid receptors in the central nervous system: their signaling and roles in disease. Frontiers in cellular neuroscience, 10, 294.
Silver, R. J. (2019). The endocannabinoid system of animals. Animals, 9(9), 686.
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