Medicinal+Properties+of+THC+and+CBD

=**Intro**=

toc Marijuana, also referred to as cannabis, comes from the cannabis plant. Of the 113 [|cannabinoids] found in marijuana, the two main compounds found to have medical effects are THC (tetrahydrocannabinol) and CBD (cannabidiol) [12]. The highest concentration of these cannabinoids is found in the female flowers of the plant [11]. THC is psychoactive while CBD is non-psychoactive. In the U.S., marijuana is medically legal in 29 states and Washington DC [14]. On a federal level, cannabis is illegal and considered a schedule I drug. According to the [|DEA] (U.S Drug Enforcement Agency), schedule I drugs are substances or chemicals defined as drugs with no currently accepted medical use and a high potential for abuse [8]. Other drugs in this grouping with marijuana are heroin, lysergic acid diethylamide (LSD), 3,4-methylenedioxymethamphetamine (ecstasy), methaqualone, and peyote [8]. Also, [|FDA] (Food and Drug Administration) has not approved marijuana as treatment for any medical condition [11]. An implication of marijuana being a schedule I drug isit has greatly hindered research into the effects of marijuana on people. In order to conduct clinical drug research on marijuana or any derivative of it, researchers must file and IND (Investigational New Drug) with the FDA, obtain a schedule one license from the DEA, and get approval from the National Institute on Drug Abuse [11]. Despite this, it has been shown through numerous studies that marijuana has many medical uses and is better and safer than its pharmaceutical counterparts. =** History **=

Marijuana goes a long way back in history. The earliest known reference to medical marijuana was by Emperor Shen-Nung [5]. The Emperor wrote a book on treatment methods in 2737 BCE that included the medical benefits of cannabis [5]. The medical benefits he recognized it to help with were: constipation, gout, rheumatism, and absent-mindedness [5]. Medical marijuana was also used in Ancient India, Ancient Greece, and the Medieval Islamic world [5]. In Ancient India, it was used to treat insomnia, headaches, gastrointestinal disorders, and pain [5]. Medieval Arabic physicians used medical cannabis to reduce a fever, reduce inflammation, help treat seizures, and treat pain [5]. It wasn’t until 1841 that medical marijuana was introduced to the western world. The man responsible for this is William Brooke O'Shaughnessy, an Irish Physician [5]. Up until 1906 marijuana had gone unregulated in the U.S. until the Pure Food and Drug Act required labeling of any cannabis in over the counter remedies. The U.S. public view on Marijuana did not begin to drastically change until after the [|Mexican Revolution in 1910] [7]. Mexican immigrants poured into the U.S. with their recreational use of marijuana. Due of this, the drug became associated with the immigrants [7]. Anti-marijuana campaigners began to attribute terrible crimes to marijuana and the Mexicans that used it [7]. This was only amplified by the great depression, and in 1931 29 states had made marijuana illegal [7]. Then in 1937, after a campaign against marijuana, congress passed the Marijuana Tax Act. This act, in essence, is what made marijuana illegal on a federal level.

=** Medicinal Properties **=

Today, marijuana has been proven to have numerous medicinal properties and aid with the treatment of diseases and their sypmtoms. There are currently many ways for a patient to consumemedical marijuana including: smoking/vaporizing dried buds, eating cannabis edibles, taking THC/CBD capsules, using lozenges, dermal patches, or dermal/oral sprays [5]. Medical marijuana has been shown to help treat people suffering from Multiple Sclerosis (MS), Parkinson’s, cancer, and many other diseases/ailments.

MS
MS is a disease in which the [|myelin sheaths] of neurons on the brain and spinal cord are damaged. The myelin sheaths are on the axons of the neurons and help increase the speed of electrical impulse across the neuron. This damage greatly hinders the nervous systems ability to communicate, resulting in vision loss, pain, fatigue, and impaired coordination. The destruction of the myelin sheaths is caused by the immune system attacking it. To this day, it is unknown as to what causes the immune system to do this. MS is a very terrible disease, and being that there is no cure, medicine for it is all about slowing down the onset of symptoms and improving quality of life for as long as possible. Medical Marijuana has been shown to greatly help treat the symptoms of MS. To begin, marijuana helps the patients manage the pain brought about by the disease [2],[4],[9],[12]. Marijuana has also been show to help with neuroprotection and inflammation. THC was found to reduce the inflammation of the brain and spinal cord in rats with MS [12]. Cannabinoids have also been shown to help reduce axonal damage [12]. Along with these affects, cannabis has been show to reduce the spasticity [2],[9] and muscle stiffness [4] in patients with MS. It is believed these symptoms are caused by the lack of CB1 receptors in the caudate-putamen, globus pallidus, and cerebellum of patients with MS [12]. The cannabinoids in marijuana are agonists to the CB1 receptors which is believed to be the reason they help with muscle stiffness and spasticity [12].

Parkinson’s Disease
Parkinson’s Disease is a chronic, progressive [|neurodegenerative disorder] [12]. In a patient with Parkinson’s there is a degeneration in dopamine containing neurons. This causes motor skill issues such as bradykinesia, tremor, and rigidity [12]. Being that there is no cure for Parkinson’s, treatment is focused on improving quality of life and pushing back the onset of symptoms. In study’s done on the motor skills of subjects with Parkinson’s Disease a great increase was seen when the subjects used marijuana. On the Unified Parkinson Disease Rating Scale their scores went from a baseline of 33.1 to 23.2 after cannabis consumption [10]. The subjects also saw significant improvement in bradykinesia, tremor, and rigidity after consuming marijuana [10]. Cannabis is effective here because of its properties as a CB1 agonist [1].

Cancer
Cancer is caused by abnormal cell growth, which can occur in any cell in the body. The mutated cells grow out of control and spread though out the body killing healthy cells. Cancer currently has no perfect treatment and is the second leading cause of death in the U.S. One of the main treatments for cancer is chemo-therapy. Chemo is a very destructive process to the body as it is meant to kill cancer cells, but also kills healthy cells. A patient undergoing chemo tends to have terrible nausea and vomiting as well as a loss in appetite. Marijuana has been shown to greatly reduce the nausea and vomiting in patient [11]. The effect marijuana has in reducing nausea and vomiting is caused by THC acting as an agonist to the CB1 receptor in the brain [11]. Cannabis helps patients regain their appetite by stimulating the cannabinoid system inside the patient, which regulates feeding behavior [11]. Cannabinoids also help mitigate the physical pain of cancer and chemo.

On top of treating the side effects of chemo and the symptoms of cancer, marijuana has been shown to directly reduce tumor size. CBD in marijuana was found to inhibit the proliferation of the 4T1, a breast cancer cell [3]. The 4T1 cell is an aggressive cancer cell responsible for the over expression of the [|Id-1] gene which intern produces the Id-1 protein which promotes tumor proliferation [3]. THC was also found to reduce tumor cell proliferation in vitro, reduce tumor cell Ki67 immunostaining, and prolong survival time [12].

=** Draw Backs **=

Just like any drug, marijuana has negative side effects. Cannabis has been show to impair basic motor coordination and executive functions like planning, organizing, and problem solving [13]. The effects of cannabis on executive functions is interesting in that some functions can recover after a period of abstinence from the drug while with others it was unclear if the function was recoverable [13]. For instance, it was found that attentional and information processing abilities would come back after a period of abstinence. On the other hand, it was found that with heavy marijuana use the decrease in decision-making and risk-taking executive functions might be permanent impairments. Another study pointed out that marijuana use could elicit acute schizophrenic psychosis [12].

=** Conclusion **=

Marijuana has a very promising future as a medicine to cure or treat the symptoms of many disease. Due to its schedule I classification, there is much unknown about the effects of marijuana because there has been a lack of clinical drug research. There are still many questions to be answered about how cannabinoids interact with tumors and their effectiveness with diseases like Parkinson’s and MS. There is also the question of how marijuana effects humans, especially on a cognitive level.

= References =

[1] Katerina Venderová, “Survey on Cannabis Use in Parkinson’s Disease: Subjective Improvement of Motor Symptoms,” //Movement Disorders//, 2004.

[2] “Smoked cannabis for spasticity in multiple sclerosis: a randomized, placebo-controlled trial,” //CMAJ//, vol. 184, no. 10, 2012.

[3] McAllister SD, “Pathways mediating the effects of cannabidiol on the reduction of breast cancer cell proliferation, invasion, and metastasis.,” //NCBI//, vol. 129, no. 1, Sep. 2010.

[4] Zajicek JP, “Multiple sclerosis and extract of cannabis: results of the MUSEC trial.,” //NCBI//, Jul. 2012.

[5] “Medical cannabis,” //Wikipedia//. .

[6] Alan J. Budney, Roger Roffman, Robert S. Stephens, and Denise Walker, “Marijuana Dependence and Its Treatment,” vol. 4, no. 1, 2007.

[7] “History of Marijuana in the U.S.,” PBS.

[8] “Drug Schedules.”

[9] Celia Oreja-Guevara, “Clinical efficacy and effectiveness of Sativex®, a combined cannabinoid medicine, in multiple sclerosis-related spasticity,” pp. 3–8, Jan. 2014.

[10] Lotan I, “Cannabis (medical marijuana) treatment for motor and non-motor symptoms of Parkinson disease: an open-label observational study.,” //PubMed//, vol. 37, no. 2, 2014.

[11] PDQ Integrative, Alternative, and Complementary Therapies Editorial Board, “Cannabis and Cannabinoids (PDQ®),” //PubMed Health//, 2011.

[12] Natalya M. Kogan and Raphael Mechoulam, “Cannabinoids in health and disease,” //NCBI//, vol. 9, no. 4, pp. 413–430, Dec. 2007.

[13] Rebecca D. Crean, Natania A. Crane, and Barbara J. Mason, “An Evidence Based Review of Acute and Long-Term Effects of Cannabis Use on Executive Cognitive Functions,” //NCBI//, 2012.

[14] “29 Legal Medical Marijuana States and DC,” //ProCon//. 26-Jun-2017.