Mythbusters: Common Misconceptions about Cannabinoids

THIS ARTICLE IS INTENDED FOR PATIENTS

Medicinal cannabis has become a topic of considerable discussion in recent years. The volume of information available can often be overwhelming and leave us feeling somewhat confused. Below are explanations to some common misconceptions that surrounds medical cannabis.

Smoking or vaping is the only way to obtain medical benefits from cannabis

False. Medicinal cannabis can be administered either through inhalation (vaporiser) or through oral administration (oil, liquid capsules or oro-mucosal sprays). Other routes of administration have been investigated in some studies. The route of administration may impact both the onset of action as well as how the drug moves through the body, with oral administration having a slower onset of action and a longer duration of effect compared with inhalation.

The principal role of our endocannabinoid system is to process cannabis

False. The endocannabinoid system (ECS) is a signaling system that is present throughout our bodies and plays a role in brain development, learning and memory, and maintenance of homeostasis (i.e. maintenance of a stable internal environment within our bodies despite changes in our external environment). Our bodies produce endocannabinoids that interact with the cannabinoid receptors in our ECS, causing them to signal downstream and stimulate these biological processes to occur. All of this occurs within our bodies without any input from cannabis. However, cannabis is capable of interacting with our ECS through its production of phytocannabinoids, such as THC and CBD, and as a result, it is being studied and prescribed for various therapeutic uses.

Medical cannabis is the same as the cannabis being sold on the street

False. Medicinal cannabis is GMP certified to ensure high quality with a known composition and potency of THC:CBD. Furthermore, regulation and licensing of unlicensed cannabis-based medicinal products in the UK is undertaken by the Home Office, Department of Health and Social Care and the Medicines & Healthcare Products Regulatory Agency. Cannabis bought on the street, or from an unlicensed producer, may differ in strength and contain harmful contaminants such as heavy metals, pesticides and mould.

Cannabis is a highly addictive drug

Somewhat false. Cannabis is considered to have a low-to-moderate dependence potential, much lower than other psychoactive substances such as heroine and nicotine, but higher than caffeine.

Medicinal cannabis is only prescribed by doctors as a last resort

True. Medical cannabis is often used as an adjunctive treatment and are typically reserved for use after the patient has failed to respond to other licensed recommended treatment (or off-label use of medicine that is licensed for another purpose). Numerous studies have shown that medicinal cannabis may be useful for various medical conditions. These include chemotherapy-induced nausea and vomiting, chronic pain, neuropathic pain, muscle spasms, certain types of epilepsy and as an appetite stimulant. Investigations into medical cannabis continue and may likely reveal additional therapeutic uses in the future.

If I use medicinal cannabis I will feel ‘high’

This depends on the cannabis composition. THC is the major psychoactive component of cannabis which can cause us to feel ‘high’, while CBD is a non-psychoactive component and is thought to reduce the ‘high’ caused by THC. Psychoactive effects experienced may include euphoria, increased sensory perception, hallucinations, disturbed memory, unsteady gait, slurred speech, anxiety or vomiting. These effects may be reduced by using the lowest dose of THC and optimizing CBD.