I live in Washington state where state law provides for both medicinal and recreational use of marijuana. Federal law does not allow for medical marijuana, but it allows for the unrestricted sale of products derived from hemp. Hemp and marijuana are forms of cannabis. I recommend medical cannabis from marijuana or hemp for some of my Lyme disease patients based on the limited science available and based on the positive responses I witness. In this article I review
- how medical cannabis and medical marijuana works,
- CBD and THC,
- conditions cannabis and marijuana helps,
- how to take medical cannabis and medical marijuana,
- starting doses, and
- possible safety concerns.
Note: This is a long article with a lot of background. Skip to the bottom to see the conditions medical marijuana helps and my recommendations on how to take it.
The Politics of Medical Marijuana
As I write this article twenty five states in the USA allow medical marijuana use and eight all marijuana recreational use. USA federal law currently allows for the use of CBD derived from hemp in all 50 states. Unfortunately the federal government, under the Trump administration, has put out some worrisome writings that it thinks hemp should be regulated the same as marijuana. In addition, US Attorney General Sessions calls for the federal government through US Attorneys at their discretion to enforce federal marijuana laws putting an end to state recreation and medical marijuana usage.
Cannabis, Marijuana, Hemp, CBD, THC
There are two varieties of cannabis plants. They differ in their appearance and chemical make up. The two plants are Cannabis Indica and Cannabis Sativa. Both of these plants are called marijuana. Hemp is a variety of Cannabis Sativa that has less than .3% delta-9-tetrahydrocannabinol (THC). THC is the psychoactive component of cannabis that gets people high. Both Indica and Sativa that have more than .3% THC are regulated as illegal drugs by the US government. Federal courts have ruled that industrial hemp, cannabis sativa with less than .3% THC, cannot be regulated as a drug. Thus cannabidiol (CBD) derived from hemp can be sold as a supplement across state lines and through the internet.
Cannabinoids & The Endocannabinoid System
There are over 400 chemicals called cannabinoids in cannabis that interact with the body’s natural cannabis system. Our natural marijuana/cannabis system is called the endocannabinoid system. The two main cannabis chemicals are delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD). These chemicals interact with our endocannabinoid system in a variety of ways. In addition to cannabinoids, cannabis has terpenes. Terpenes give the flavor and aroma to cannabis. They also change the absorption and effects of CBD and THC.
The endocannabinoid system is distributed throughout the entire body with receptors found in the brain and many major organ systems. There are two major chemical receptors called cannabinoid receptor 1 (CB1) and cannabinoid receptor 2 (CB2). in addition to CB1 and CB2 there are some other minor receptors.
CB1 receptors are found on many organs including the brain and nervous system. They regulate the release of neurotransmitters in the brain and are psychoactive. CB1 regulates the heart and blood vessels, energy, thinking, memory, emotions, pain, muscle control, sensory regulation, the intestinal system, and much more.
CB2 is primarily anti-inflammatory and regulates the immune system. These receptors are found on a variety of white blood cells including B cells that make antibodies, T cells that fight Lyme, bacteria, and viruses, and macrophages that fight viruses. In addition to fighting infections, T cells release inflammatory cytokines that cause most Lyme symptoms. So regulating CB2 can lead to improvements in most of these symptoms.
The endocannabinoid system produces a number of chemicals that bind to the CB1, CB2 and minor receptors. The two major known ones are anandamide and 2-arachidonoylglycerol (2-AG). These two chemicals are broken down by a number of enzymes.