The Ultimate Guide to Medical Cannabis
Just a few short years ago, when I heard the word cannabis, it brought up visions of hippies playing bongos and wearing tie-dye. Either that, or few young guys getting high on their couch with the munchies. Not anymore.
Cannabis, marijuana, hemp, CBD, THC – all of these have become buzzwords in the medical community. But the use of this plant for medicine didn’t just begin a few years back, it has a long history.
Cannabis in Chinese Medicine
The first documented use of cannabis for medical purposes is in the Divine Farmer’s Medical Classic. This is one of the first books written about Chinese herbs, listing many medicinal substances and what they are used for.
According to the Divine Farmer, cannabis “governs the five taxations and seven damages, benefits the five viscera, and descends blood and cold. Excessive consumption causes one to see ghosts and run about frenetically. Prolonged consumption frees the spirit and lightens the body. It’s used to break accumulations and relieve impediment”.
From these quotes it’s easy to see that they considered the plant an analgesic – helping to relieve pain. And by taking small amounts over a long period of time, it can treat mental health issues like anxiety and depression. They must have used only small amounts, because large quantities caused hallucinations. This tells us that they were using at least part of the plant that has some psychoactive qualities.
A few centuries later, a Chinese physician names Hua To used cannabis in a formula with other herbs as an anesthetic for surgery. And again in the 7th century, a Chinese medical text cited “wind withdrawal” as a use for cannabis, which is a term used to describe mental health issues such as anxiety and depression.
The Current Landscape
In the past 20 years, there’s been a lot of new research coming out that shows the benefits of this plant. In the late 80’s – early 90’s, Israeli scientists found the endocannibanoid system: a system in mammalian bodies (including humans) with receptor cites for CBD, one of the chemical constituents of the cannabis plant. Since then, Israel has led the world in cannabis research, and as the plant becomes legalized around the world, other countries have followed suite.
As the newest darling of the natural medical world, researchers, as well as patients, have been experimenting extensively. It’s currently touted as a panacea, but it’s better for some things than others. In fact, research has found some of the best uses for cannabis are for pain and mental health – the same uses the Chinese wrote about centuries ago. A few of the other benefits that have been found are for epilepsy, and as a support for cancer treatment.
Herbalists believe that cannabis is an adaptogen, which means that it has a regulatory function in the body. Many adaptogens have functions that seem to be contradictory by modern Western medicine definitions, such as being able to strengthen immune function in someone who needs it, but also subdue autoimmune reactions if needed. These actions make it seem like it’s good for everything, but that unfortunately isn’t so.
Thankfully, if you’re working with a hemp strain that’s high in CBD, there is no way to overdose. Even in high doses, very few side effects have ever been reported. Occasionally, patients have reported digestive distress, with discomfort and even diarrhea with extremely high dosage, but this is usually in a product containing higher amounts of THC.
We can’t have a discussion about this plant without going over what all the terms mean. So far I have been using the word cannabis, which is an overarching botanical term for the genus of the plant. There are a few different species of cannabis, indica and sativa being the main two. Either of these species can exist as both a hemp plant and marijuana.
Hemp is the name of the plant produced mostly for production of fiber. It can also be used for its seeds, which have both culinary and medicinal uses. The seeds are completely free of any psychoactive substances, and in Chinese medicine are used to moisten the bowels. They don’t include CBD either, which is where many of the benefits we’ve talked about so far come from. The leaves and stems of hemp are usually used in fiber production, but they do contain a small amount of CBD and even a trace of THC. The flowers contain very large amounts of CBD, but still only trace amounts of THC. Unfortunately, it’s still illegal in the states to use the flower, unless you’re in a state where marijuana is legal.
Marijuana, on the other hand, is a cannabis plant that has ben bred to contain larger amounts of THC. THC is the psychoactive component of the cannabis plant – the chemical compound that “gets you high”. The marijuana flowers, the buds, are usually smoked, though the chemical constituents of the bud can also be extracted and used in tinctures and edibles. All of these products contain varying amounts and ratios of CBD and THC, and can be used both recreationally and medicinally.
Cannabidiol, or CBD, is one of the major chemical constituents from the cannabis plant. Our own endocannibinoid system, in the human body, has CB1 and CB2 receptors. Surprisingly, the CBD from cannabis doesn’t fit these receptor cites perfectly, but they do stimulate activity in the receptors.
Tetrahydrocannabidol, or THC, is another of the major chemical constituents. As I mentioned earlier, it is the compound that’s responsible for the psychoactive effects of the plant. Those CB1 and CB2 receptors that are stimulated by CBD actually do fit with THC. This is the reason that whole hemp extract, with its trace amounts of THC, has greater effects. These two compounds work synergistically, so that when both are present, it works better than either one alone.
Getting the Benefits
Now that medical cannabis is legal in the US - and is becoming more accepted, there are so many options to choose from. However, this makes it a bit like the Wild West – how do you know what product to choose? Cannabis is still quite expensive, you don’t want to waste money on a product that doesn’t have a high enough dose to be effective, yet you don’t need to spend extra on more CBD than you need.
As you begin researching, you’ll find that some products contain an isolated extract of the CBD molecule, and others are using the whole plant extract. While I’ve heard of people getting results with just the isolate, your chances are higher when you go with the whole hemp extract. When you use an entire part of the plant (or multiple parts) you’re getting the benefits of synergy. It still contains the CBD, which is supported .3% of THC for better absorption, as we talked about above. On top of that, you’re getting all the other chemical constituents of the plant, like terpenes, which are another type of molecule in plants, that are just now starting to be understood medicinally. These products are totally safe to take in large doses and won’t show up on a drug test.
In certain states and countries where it is legal, you may also find products made with the marijuana plant, boasting higher levels of THC. You’ll probably find those products labeled with ratios CBD:THC. Different ratios work better for different people and different symptoms. The higher THC can cause altered consciousness, and will show up in a drug test. You also have to be more careful in dosing, as large amounts can cause side effects. These products aren’t currently available in South Carolina.
One more thing to consider from an herbalists point of view is using cannabis with other herbs. Traditionally in Chinese herbal medicine, plants are rarely used alone, but are combined into formulas. These combinations help to make some herbs more powerful in lower doses, mitigate side effects, or treat a different aspect of a disease. Herbalists have been working this way for centuries and find it safe and effective. While we’re still learning how cannabis works together with other herbs, finding a product that combines hemp or marijuana with other herbs (or combining them yourself or with the help of an herbalist) is the best way to go.
There are 3 main ways to use cannabis; topically, internally or inhaled. Though smoking marijuana is one way to get its medicine, it’s still not legal here, and also comes with more side effects than topical or internal use.
For pain relief, look for topical CBD oil products that can be applied right to the area of pain. The best products will have a decently high amount of CBD, in the form of whole hemp extract, combined with other herbs. Your best bet is to get a good quality product from a health professional, as they have access to stronger and better formulated products.
Topical oils can also be applied to the inside of the wrist and bottoms of the feet for anxiety, depression and insomnia.
There is also the option to take cannabis internally. One common way is a tincture, where the chemical constituents have been extracted in alcohol and water. Taking drops or sprays of a tincture gets the medicine into the bloodstream quickly. You can also find gummies and other edible products. Just keep in mind that when cannabis is processed through your digestive tract it takes longer to feel the effects, and the effects can be much greater. As with the topical, using cannabis in a formula with other herbs heightens its effect.
Where We Go From Here
Humans have had an interesting and complex relationship with this plant for thousands of years. I think the best way to continue and make the most of what cannabis has to offer us is twofold. One, tap into the wisdom of those who have been medicating with it long term to see how it has been historically used. And two, continue new research and experimentation to open up new horizons. I look forward to what the future holds, and how we can use a very old plant medicine to relieve modern suffering.
Elizabeth Williams is an acupuncturist in Greenville, South Carolina, specializing in pain management, women’s health, and psycho-emotional issues. She’s passionate about helping people feel their best and sharing her wealth of knowledge with the community. Elizabeth is the owner of Dragonfly Acupuncture & Massage, on Wade Hampton Boulevard. Appointments can be made by calling 864-451-4313, or scheduled online here.