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A Beginner's Guide to Medical Cannabis

In Canada over 350,000 people use cannabis for medical purposes, and that number continues to grow.

Why is it so popular, how safe is it, and how do you get started?

Chapters

  1. A brief history
  2. What it's used for
  3. How it works
  4. Safety
  5. Active compounds
  6. Cannabis products
  7. Retail products
  8. Travelling with cannabis

A brief history

Cannabis (often called marijuana) has been used both medicinally and recreationally in different cultures around the world for thousands of years.

antique-pharmacy-bottles-cannabis-extractIn the late 1800s to early 1900s, cannabis tinctures were readily available at pharmacies.

During the 1920s cannabis was caught up in a wave of prohibition that saw many other substances made illegal, including opium and cocaine.

Cannabis was first legalized for medical use in Canada in 2001. Since that time, the regulations have evolved to improve patient access and provide greater choice in products and suppliers (called licensed producers). In 2018, cannabis was legalized for adult recreational use as well.

What it's used for

Cannabis is being used to relieve the symptoms of a wide variety of conditions, including:

  • Arthritis
  • Acute/chronic pain
  • Nausea from cancer treatment
  • Digestive problems (Crohn’s, IBS, etc.)
  • Fibromyalgia
  • Migraines
  • Hepatitis C
  • HIV/AIDS
  • Insomnia and other sleep disorders
  • Anxiety, stress, depression
  • Multiple Sclerosis
  • Epilepsy
  • Parkinson’s
  • Low appetite

(this list is not exhaustive)

From Health Canada: "Your health care practitioner may have authorized the use of cannabis (marihuana, marijuana) for the relief of one or more of the following symptoms associated with a variety of disorders which have not responded to conventional medical treatments. These symptoms (or conditions) may include: severe refractory nausea and vomiting associated with cancer chemotherapy; loss of appetite and body weight in cancer patients and patients with HIV/AIDS; pain and muscle spasms associated with multiple sclerosis; chronic non-cancer pain (mainly neuropathic); severe refractory cancer-associated pain; insomnia and depressed mood associated with chronic diseases (HIV/AIDS, chronic non-cancer pain); and symptoms encountered in the palliative/end-of-life care setting. This is not an exhaustive list of symptoms or conditions for which cannabis may be authorized for use by your health care practitioner."

It is most commonly used to treat pain, insomnia and anxiety.  More studies are being done as prohibition is lifted around the world.

How it works

The endocannabinoid system (ECS) was discovered in 1992, and is a cell-signalling system that plays a role in regulating functions such as pain, immune responses, sleep, mood, appetite and others. two-brain-cell-receptors-delta-opioid-receptor-and-cannabinoid-picture-id950028170Endocannabinoids naturally occur in our bodies, whereas phytocannabinoids are found in plants (such as cannabis) and mimic the ones found in our bodies. It is believed the primary role of the ECS is to maintain the stability of the body’s internal environment, and that the introduction of external cannabinoids helps when the body’s own cannabinoid production is deficient.

Because of its role in regulating so many different functions, the ECS is a significant focus of research today.

Safety

Compared with many pharmaceuticals and illegal narcotics, cannabis has an extremely good safety profile. There has not been a single death attributed to the direct effects of cannabis ingestion. Unlike opioids cannabis does not act on the central nervous system, which regulates breathing.

Cannabis is not without risk, however. For example, it does interact with some medications, and can cause an elevated heart rate. It is important to have medicalsupervision when using cannabis to treat a health condition.

Active compounds

There are over 100 cannabinoids present in the cannabis plant, however the two most prevalent and well-known are THC (tetrahydrocannabinol) and CBD (cannabidiol). THC is the compound that causes intoxication, however it does have medicinal benefits such as pain relief, and these benefits can be achieved at doses well below intoxicating levels. CBD is non-intoxicating and has anti-inflammatory and anti-anxiety properties. Most patients benefit from a combination of the two, however the amounts and ratios can differ widely from condition-to-condition and patient-to-patient.

Cannabis also contains terpenoids (which give it its aroma) and flavonoids (which give it its colour). These are also thought to provide therapeutic benefit, however there is not much research available at present.

raphael-mechulam-father-cannabis-discover-thc-body-image-1455891830-size_1000Dr. Raphael Mechoulam, pictured here, is widely considered the godfather of cannabis research.(Image credit: Elior Rave)

CBD is receiving a lot of attention due to its apparent ability to provide benefit without the intoxicating effect of THC, and there are unregulated products appearing on the market and sold on the internet. Many of these do not actually contain CBD, or only in very small amounts.

Read our beginner's guide to CBD

Again, clinical experience is that positive outcomes require a combination of THC and CBD, and that the most reliable source is a licensed producer via a medical prescription.

Cannabis products

Cannabis comes in dried leaves or flowers, as an oil (dropper, spray or gel capsule), and also edible products such as chocolates and drinks. Most patients are using cannabis in an oil form. Smoking is discouraged, however vaporization is an option if immediate effect is required (oil forms can take 15min to 2 hrs to take effect). Home-made edibles are not recommended due to imprecise dosing.

Read about the pros and cons of different cannabis and CBD product formats

Retail products

With the recent legalization of cannabis for recreational use, many retail outlets have opened, providing convenient access. If you are contemplating cannabis to treat a medical condition, we recommend doctor’s supervision, medical prescription, and ordering directly from a licensed producer. This will ensure your safety and that you are using the right product, in the right amount.

Retail products can cost 30% more, are not tax-deductible or able to be claimed on insurance, and product selection and availability is not as consistent.

Read more about the benefits of buying medical vs. retail

Travelling with cannabis

You are legally allowed to bring your medical cannabis with you while travelling within Canada. If you plan to carry or pack more than 30g (the recreational limit), keep your product in its original packaging, as it will have your name on it which will be proof of legal possession above the recreational limit.

Read more about travelling with cannabis