Medical Cannabis 101


A basic understanding of medical cannabis is valuable when starting your therapeutic journey. Indica, sativa and ruderalis strains have been strategically bred over many years, leading to modern-day hybrids. Cannabinoids, terpenes and flavonoids are all important medicinal compounds that interact with the body's endocannabinoid system.

Starting your medical marijuana journey can be quite daunting. At Medical Cannabis Dispensary South Africa, we believe that our clients should be armed with the correct knowledge, before making important health decisions. Whilst we make every effort to arm you, our valued client, with as much information as possible, we also encourage you to do your own research. 

To properly understanding how cannabis can be beneficial to your health, it remains vital to ensure that you have all the facts. This rings true whether you are plagued by a debilitating illness or simply wanting to improve general wellbeing. After all, finding the right medical product for your needs could mean the difference between continued illness and a better quality of life.

In this Article

Strain Types

Marijuana has been divided into three sub-species. While most modern strains are hybrids, the three accepted modern classifications are Cannabis Sativa, Cannabis Indica and Cannabis Ruderalis.  Hybrids, which are popular among medical and recreational users alike, result from careful cross-breeding between the sub-species. Ruderalis plants are auto-flowering, which means that they will produce flowers after a set time period, regardless of light exposure. This usually makes “autos” the preferred strain of beginner growers.

Modern strain marketing will lead one to believe that an indica is more physically relaxing and a sativa more cerebrally stimulating. Their alleged effects are as follows:

Sativa

  • Uplifting, energizing and stimulating.
  • Cerebral, spacey or hallucinogenic.
  • Best-suited for daytime use.

Indica

  • Relaxing, calming and sedating.
  • Body buzz or “couch-lock”.
  • Best-suited for night-time use.

However, we now know that the effect is not based simply on indica- versus sativa-dominant genetics. The resulting experience is more accurately based on a complex interaction between: (1) a person’s unique biochemisty and tolerance level, (2) the consumption method being used and (3) the unique chemical make-up of the strain, including cannabinoids, terpenes and flavonoids.

Historically, telling the varieties apart could easily be done by looking at their appearance. Indica plants have wider leaves and are shorter, which makes them well-suited to indoor growing. Sativa plants are tall with long, narrow leaves and are usually grown outdoors. Although modern-day hybrids contain mixed genetics, which can sometimes be visually misleading.

Indica, sativa, ruderalis and hybrid strains

Specific marijuana strain genetics with particular chemical compositions are chosen to manage various symptoms and conditions. While some people choose to make their own cannabis oils, expert formulators have the knowledge and experience to identify which combinations work best for each ailment. It is always best to ensure that you get the right advice when considering a product for therapeutic use. Please visit out Treatment Guidelines for more information about specific conditions.

This healing plant has many proven benefits. Used with expert guidance, it is a completely natural and safe remedy for a wide variety of health challenges. To properly appreciate the significance of medical cannabis, it is important to understand the following phenomenon.

The Endocannabinoid System

Each human and animal body has a built-in endocannabinoid system (ECS). It consists of endocannabinoids that are naturally produced by the body and cannabinoid receptor sites. CB1 receptors are most profound in the brain, while CB2 receptors are found on all kinds of cells, including gastrointestinal, cardiovascular, liver, kidney, bone, skin, lung and immune. When activated, this system plays a vital role in maintaining internal stability and health.

In other words, the ECS is integral to the communication between cells in our bodies and it helps to maintain homeostasis or biological balance. When our ECS encounters a problem, we experience unpleasant symptoms, such as nausea, anxiety, pain and depression. Marijuana plant compounds are able to interact with this system and influence how cells function. Cannabinoids mimic the actions of our bodies’ innate endocannabinoids, which is key to their medicinal value. Get a far deeper scope of the ECS in Cannabis Science.

Cannabinoids

Over 500 natural components have been found within the marijuana plant.  It is difficult to tell exactly how many exist, though over 120 cannabinoids have been identified and they are scarcely found in any other plant. Since many are present at very low levels, especially in commercial products, it makes them difficult for scientists to accurately detect. 

The important point is that there are many and all play a vital role in cannabis products used for medicinal and therapeutic applications.

The marijuana plant does not directly make the most famous cannabinoids, THC and CBD. Instead, it starts by synthesizing several cannabinoid acids. These must be “activated”, usually by heat, to yield the compounds that most consumers are after. This activation process is called decarboxylation. The most abundant cannabinoid acids found in the cannabis plant are THCA and CBDA – precursors to THC and CBD – though there are several, including:

  • CBGA (Cannabigerolic acid)
  • THCA (Δ9-Tetrahydrocannabinolic acid)
  • CBDA (Cannabidiolic acid)
  • CBCA (Cannabichromenenic acid)
  • CBGVA (Cannabigerovarinic acid)
  • THCVA (Tetrahydrocanabivarinic acid)
  • CBDVA (Cannabidivarinic acid)
  • CBCVA (Cannabichromevarinic acid)

Cannabinoid acids are not known to produce intoxicating effects, like THC does, although they do have a variety of interesting properties. For example, many have antibiotic and insecticidal properties. This is likely related to the reason that a cannabis plant produces these compounds in the first place: to defend itself.  As scientific research advances and more testing is done, many more medicinal qualities are being discovered for these acidic compounds.

Each cannabinoid acid that is exposed to heat energy, through decarboxylation, loses the “A” part and turns into a neutral, rather than acidic, plant cannabinoid. The most significant of these are:

  • CBG (Cannabigerol)
  • THC (Δ9-Tetrahydrocannabinol)
  • CBD (Cannabidiol)
  • CBC (cannabichromene)
  • CBGV (Cannabigerivarin)
  • THCV (Tetrahydrocannabivarin)
  • CBDV (Cannabidivarin)
  • CBCV (Cannabichromevarin)

All cannabinoids perform a vital therapeutic function. However, some cannabinoids are found in extremely small quantities in both the raw and processed plant. So we will focus on the most significant ones for medicinal use, which are as follows:

Cannabidiol (CBD)

CBD is a cannabis compound with significant medical benefits. It does not make people feel “stoned” and can even counteract the psychoactivity of THC. This makes it a very appealing option for people seeking relief from inflammation, mild pain, anxiety, psychosis and seizures, to name a few. Due to its non-psychoactive nature, medicating with CBD can be done throughout the day without unwanted feelings of lethargy or dysphoria.

Both scientific and clinical research underscores CBD’s potential as a treatment for a wide variety of conditions. Examples include arthritis, diabetes, alcoholism, MS, chronic pain, PTSD, depression, epilepsy and other neurological disorders. It has demonstrable neuroprotective and neurogenic effects, and its anti-cancer properties are currently being investigated at several academic research centres the world over.

Further evidence suggests that CBD is safe even at high doses, making it an effective therapeutic measure to treat people from all walks of life, including children, the elderly and pets. Learn more about this healing compound in CBD Oil.

Delta-9-Tetrahydrocannabinol (Δ9-THC)

THC is the psychoactive compound found in the marijuana plant. Through decarboxylation, THCA is converted to THC, which is responsible for what is commonly known as the “high”. When ingested, it attaches to cells and temporarily changes how they function, which accounts for its diverse effects on the mind and body. It binds strongly to CB1 receptor sites, found mostly in the brain and central nervous system, to produce a psychoactive effect. However, it has some significant health benefits too.

Δ9-THC and Δ8-THC mimic the action of anandamide – the neurotransmitter produced naturally by the body that is responsible for creating the feeling of wellbeing. Therapeutically, THC has been proven to assist people with a vast number of conditions and symptoms. The list includes pain, inflammation, Alzheimer’s, brain injury, fibromyalgia, glaucoma, cancer, epilepsy, asthma, nausea, vomiting, spasticity, arthritis, migraines, multiple sclerosis (MS), autoimmune diseases and sleep apnea.

Cannabigerol (CBG)

CBG is known as the “mother of all cannabinoids” because its acidic precursor, CBGA, also creates THC, CBD, CBC, CBN and THCV. Like CBD, it is non-psychoactive and is able to alter the overall effects of cannabis. While found in very low overall concentrations, it is slightly more abundant in CBD-rich strains.

CBG acts as a low-affinity antagonist at the CB1 receptor, thereby blocking THC’s psychoactive effects, although its pharmacological activity at the CB2 receptor is currently unknown. Its ability to raise the body’s natural anandamide levels is significant to its medicinal value.

It also has the potential to treat a long list of ailments, including antibiotic-resistant infections, cancer, chronic pain, glaucoma, inflammatory bowel disease, neurological disease, skin conditions, anxiety, depression and weak appetite.

Cannabinol (CBN)

CBN is an example of a plant cannabinoid that is not directly synthesized by cannabis. Instead, it is produced due to the breakdown of compounds like THCA. With time and exposure to oxygen, THCA gradually degrades, first into THC and then into CBN. This is why higher quantities are found in older flowers.

Known as the “sleepy-cannabinoid”, CBN has been observed to have sedative effects. It is a natural, safe method to help those who suffer from insomnia. It has also been suggested that it has additional anticonvulsant, anti-inflammatory and antibiotic properties. Though its most pronounced, characterizing attribute is sedation. 

While researchers are clamouring for more scientific investigation, CBN’s studied benefits include: pain relief, anti-insomnia, bone cell growth, antibacterial, anti-inflammatory, anticonvulsant and appetite-stimulant.

Tetrahydrocannabinolic Acid (THCA)

In live plants and raw flowers, or “buds”, THC exists in its acidic, precursor form called THCA. While these two compounds are nearly identical in terms of chemical structure, they have a few molecular differences that account for the radical difference in how they affect the brain. THCA is non-psychoactive and, while research on this cannabinoid is still in its infancy, studies have concluded that it has great therapeutic potential.

THCA has a significant impact on the endocannabinoid system. Reports indicate that it can deliver anti-spasmodic, anticonvulsant and anti-insomnia effects, while also being immune supportive. Other medicinal benefits include serving as an anti-inflammatory for the treatment of arthritis and lupus, neuroprotective agent for treating of neurodegenerative conditions, anti-emetic for the treatment of nausea and appetite loss, anti-proliferative for treating prostate cancer as well as treating gastrointestinal conditions like IBS and IBD.

While scientific research and clinical studies are still advancing, THCA is showing great promise as a therapeutic aid. It can even replace the use of THC for those who suffer from anxiety and wish to avoid psychoactive effects.

The Entourage Effect

When researching medical cannabis, one will often come across the term “the entourage effect”. The simple explanation is that plant compounds are believed to work better in unison, when extracted in “whole-plant” form, than they do in isolation.

Evidence suggests that the presence of plant compounds, called terpenes, plays an important role in the beneficial effects of medical cannabis. They have been shown to block some cannabinoid receptor sites in the brain and promote binding to others. These aromatic compounds and others, known as flavonoids, are believed to affect many aspects of how the brain and body interact with cannabinoids like THC or CBD, while also offering various therapeutic benefits of their own. 

The synergistic entourage effect and the intriguing endocannabinoid system are explained in more detail in Cannabis Science.

The entourage effect of medical cannabis compounds

Terpenes

Ever wondered why cannabis has a distinct aroma? Until recently, research has mostly centred around cannabinoids. However, terpenes are now being placed under the spotlight, as it is believed that they are the next frontier in medical marijuana. These pungent oils give cannabis varieties their distinctive flavours, such as berry, mint, pine and orange. They have been proven to affect the mind and body.

Alpha- and Beta-Pinene

Aroma: Pine.
Effects: Alertness, memory retention, counteracts some of THC’s effects.
Medicinal Value: Asthma, antiseptic.

Myrcene

Aroma: Musky, cloves, earthy, herbal with notes of citrus and tropical fruit.
Effect: Sedating, relaxing, “couch-lock” effect.
Medicinal Value: Antioxidant, anti-carcinogenic, relieves muscle tension, sleeplessness, pain, inflammation and depression.

Limonene

Aroma: Citrus.
Effects: Elevated mood, stress relief.
Medicinal Value: Antifungal, antibacterial, anti-carcinogenic, dissolves gallstones, mood enhancer, may treat gastrointestinal complications, heartburn and depression.

Caryophyllene

Aroma: Pepper, spicy, woody, cloves.
Effect: No detectable physical effects.
Medicinal Value: Gastroprotective, anti-inflammatory, good for arthritis, ulcers, autoimmune disorders and other gastrointestinal complications.

Linalool

Aroma: Floral, citrus, candy.
Effects: Anxiety relief and sedation.
Medicinal Value: Anti-anxiety, anti-convulsant, anti-depressant, anti-acne.

This is simply a brief explanation of a few of the most common terpenes, although over 100 have been identified in marijuana.

Flavonoids

These complete the trifecta of cannabis plant compounds most commonly attributed with therapeutic benefits. They are abundant throughout the plant kingdom and serve functions like giving plants their appealing flavours and aromas, providing colouration to attract pollinators, repelling insects and fungi, and protection from solar UV radiation. Though much about them remains unknown.

Flavonoids work in conjunction with cannabinoids and terpenes, potentially aiding or inhibiting their effects. More than 20 have been found in cannabis, but cannaflavins are unique to this plant species. Some of the most common (along with their attributed benefits) include:

Cannaflavin A

Powerful anti-inflammatory: according to one study, 30 times more potent than aspirin. The effects of cannaflavins B and C are still being uncovered.

Quercetin

Antifungal, anti-viral and antioxidant medicinal qualities. Also known to work as an anti-histamine and mast cell stabilizer.

Luteolin

Potential to fight cancer, infection, inflammation and oxidative stress. Silymarin, orientin and kaempferol also share these therapeutic properties.

Cannabis contains a vast amount of restorative compounds, including terpenes, cannabinoids as well as lesser-known flavonoids. These are designed, as if by some form of divine nature, to interact with the human body’s endocannabinoid system.

Many compounds are present in small quantities (less than 1%) in the plant, but have large therapeutic value. Making use of products extracted from whole-plant material is vital because marijuana requires the synergy of all of its compounds to render it effective as a medicine. Anything less will reduce the effectiveness or potentially even render the therapeutic properties entirely void.

Sourcing full-extract cannabis oil (FECO) is very important. Find out how to source a reliable product in Cannabis Oil.

Visit our Product Guide or contact us below and we will recommend medicinal products of the highest-quality.

Disclaimer
All information on this page is subject to MCDSA’s disclaimer.

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