The medicinal use of cannabis preparations (Cannabis sativa L.) has increased dramatically in recent years. There is significant evidence in the scientific and clinical literature to support the therapeutic potential of such preparations in the treatment of the symptoms of various diseases. It is nevertheless necessary to take some important factors into account in order to optimize the possible therapeutic benefits and reduce possible side effects.
The following recommendations are those provided by the Spanish Observatory of Medicinal Cannabis (OEDCM)
Cannabis is a plant with a great diversity of chemotypes, each of which contains different proportions of active ingredients (cannabinoids). So when a medicinal cannabis preparation is consumed, it is absolutely essential to know its composition in cannabinoids, especially the two most relevant: ∆9-tetrahydrocannabinol (THC) and cannabidiol (CBD).
THC acts through specific receptors located on the surface of our cells, specifically the CB1 cannabinoid receptors (most abundant in the central nervous system and responsible for the neurological effects of THC) and the CB2 cannabinoid receptors (most abundant in the immune system and responsible for the anti-inflammatory effects of THC). CBD binds with very low affinity to these CB1 and CB2 receptors, but exerts, through alternative mechanisms, anti-inflammatory and anticonvulsant effects, in addition to preventing some undesired psychoactive effects of THC such as psychosis, anxiety and lack of coordination. Therefore, it is usually advisable that medicinal cannabis preparations have a balanced composition of THC and CBD, although with differing ratios depending on the disease to be treated.
The cannabinoid content of a cannabis preparation depends on factors such as the strain of the plant, its form of cultivation and the extraction technique. It is of course very important that the preparation to be used, in addition to having a known composition of THC and CBD, does not contain heavy metals, pathogenic microorganisms (bacteria and fungi), pesticides or other components that may be harmful to health.
Clearly, cannabis is not a panacea, but it does have therapeutic properties for the symptomatic treatment of some diseases. These include several conditions such as chronic pain, motor disorders associated with multiple sclerosis, cachexia in cancer or AIDS, vomiting and nausea associated with chemotherapy for cancer, seizures in childhood epilepsies and gastrointestinal inflammatory disorders.
As in the case of any other medication, a person wishing to use medicinal cannabis preparations may range from someone who knows nothing about cannabinoids to an accomplished expert in the field. In this sense, the knowledge of medicinal cannabis is evolving very quickly and the fact that the patient has at least some notion about it is important to consuming it correctly and responsibly. There are numerous publications to help acquire such knowledge, as well as, logically, the advice that can be provided by specialized healthcare professionals (doctors, psychologists, nurses...) who are trained in this.
The safest and most effective way to use medicinal cannabis (vaporized, in oil, tincture or cream) will depend on numerous factors such as the symptoms to treat, medical history, age and body weight, other ongoing medication, etc. In principle, it is not advisable to smoke cannabis due to the risk that this implies of developing cardiopulmonary diseases.
It is highly recommended that the patient request the assistance of a doctor or other healthcare professional. It should be noted, however, that many health professionals are unaware of the existence of the endocannabinoid system in our bodies and the possible therapeutic applications of cannabinoids. This is due, in part, to the fact that this knowledge is relatively recent and also, perhaps, to the prejudices or stigmas that have accompanied the use of the plant for recreational purposes. In any case, this situation is progressively changing, as there are numerous specialized publications on this subject. Some associations, such as the OECM (Spanish Observatory of Medicinal Cannabis) or the SEIC (Spanish Society of Cannabinoid Research), can provide medical cannabis advice in our country to any professional who so wishes. In addition, the IACM (International Association for Cannabinoid Medicines) has a very detailed and updated electronic portal about the possible therapeutic uses of cannabis and cannabinoids.
It is highly advisable that the regular specialist doctor be informed of the intention to use cannabis for medicinal purposes so that the patient's clinical evolution drug interactions, etc. can be correctly evaluated. This is recommended even if the specialist is unaware of the possibility of using cannabis medicinally.
Many patients’ medical cannabis associations have a medical service that can issue a certificate to justify to the authorities in question the consumption of preparations of the plant for medical reasons. This service can in turn act as an interlocutor with the regular doctor who is treating the patient.
01 Before self-medicating with cannabis, consult a trusted doctor and inform your regular doctor. If they lack knowledge about the medicinal use of cannabinoids, download this document and give it to them.
02 Consulting with your doctor before using medicinal cannabis is especially important in the event that you are pregnant or intend to be pregnant and / or in the case that you suffer from a psychiatric disorder, as well as if you are using cannabis and experience some type of concerning secondary effect. Adolescence is also a period of high vulnerability to undesired neurological effects of cannabis.
03 Remember that there are therapeutic advisory boards in various associations specializing in medicinal cannabis. They are there to advise you on your correct treatment with cannabinoids, such as routes of administration, dosages, composition, etc.
04 The medicinal cannabis preparation that you are going to use must have reliable analyses and / or certifications for its quality and composition, as well as for the absence of toxic products.
05 Cannabis is a very safe medicine (it is not cytotoxic, or mutagenic, nor can it be lethal through overdose...), but obviously it is not harmless and it has side effects (especially psychoactive ones) that should be minimized. Be well informed about them before use, and also ask if there may be contraindications or interactions with your usual medication.
06 Bear in mind that whether you use marijuana or CBD oil, it is very possible that you will show positive in drug tests on drivers. Request a certificate for your use of cannabis as a medicinal substance.
07 Be very careful with the cannabis you are using. Store it in a safe place away from the sight and reach of children and / or third parties.