Medical cannabis is available in a wide variety of strains, from both Cannabis sativa and Cannabis indica plants and in combinations of those two. Tetrahydrocannabinol (THC) and cannabidiol (CBD) are associated with the treatment and management of different conditions and illnesses. An incredibly complex interaction occurs between the two active components and the 700 other metabolites in the whole bud cannabis. One conclusion that has been drawn from research is that CBD, as a non-psychoactive component of cannabis, tempers and reduces the psychoactive effect of THC [1].
The strain best suited to treat a specific medical condition depends on the symptoms being treated. According to The Dutch Office of Medicinal Cannabis, inhaling medical cannabis with high CBD content provides effective relief for pain and muscle spasms. Therefore, the anti-inflammatory properties of CBD may be more effective for patients suffering from inflammatory conditions. On the other hand, cannabis with high levels of THC is preferred for chemotherapy symptoms such as weight loss, nausea and vomiting [2].
In the case of chronic neural pain, the Dutch Office of Medicinal Cannabis recommends a close ratio of THC to CBD.
Medications containing medical cannabis available in Canada:
There are a number of prescription medications containing medical cannabis that have been authorized for sale under the Food and Drug Regulations (FDR) in Canada. These include [3]:
- Marinol ®: A capsule containing synthetic THC. Originally, authorized for the treatment of AIDS-related anorexia and CINV. While still approved for use in Canada it was discontinued by the manufacturer.
- Cesamet®: A capsule containing nabilone, a synthetic cannabinoid, it is authorized for the management of CINV. More recent clinical trials report starting doses of nabilone of 0.5 mg at night to help treat pain or insomnia induced by fibromyalgia and insomnia in PTSD.
- Sativex®, or nabiximols, is a buccal spray containing extracts of cannabis and a standardized concentration of THC and CBD. Nabiximols are authorized to treat some symptoms of multiple sclerosis. In is conditionally authorized for pain relief in adults with advanced cancer. Current dosing recommendations for nabiximols suggest a maximum daily dose of 12 sprays (32.4 mg THC and 30 mg CBD) over a 24 h period.
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[1] ‘The Cannabinoid Spectrum.’ Tweed – American Herbal Pharmacopoeia’, n.d. Web. 21 Oct. 2014
[2] “Medicinal Cannabis Information for Patients.” Institute for Responsible Medicine Use and the Office of Medicinal Cannabis of the CIBG, Ministry of Health, Welfare and Sport, Feb. 2011. Web. 10 Nov. 2014.
[3] “Marihuana for Medical Purposes Regulations.” Canada Gazette. Government of Canada, 15 Dec. 2012. Web. 12 Nov. 2014.