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THC as Medicine: What It Does and How to Use It

Most of us can name a handful of ways that CBD can support our health and wellness. But did you know that it’s euphoric partner, THC, is also a powerhouse in the medicine cabinet? Find out when doctors prescribe THC over CBD or conventional treatments.

Medical cannabis refers to the use of cannabis (either the whole plant or its extracts) as a doctor-prescribed therapy to treat a disease or its symptoms. In recent years, it has become increasingly available to patients in many countries. The scientific evidence of the therapeutic activities of these products, however, is still emerging. We’re becoming familiar with the medical uses of one trendy cannabis compound called CBD, but many of us consider its intoxicating partner, THC, to be purely recreational. However, THC is also prescribed as a medicine and is being researched to unlock its therapeutic potential, as well.

The discovery of CBD, or cannabidiol, got the medical community excited because it is non-intoxicating, meaning it does not produce the “high” caused by THC. With very few side effects, CBD shows promise as a treatment option for anxiety, inflammation and some diseases of the nervous system, including Multiple Sclerosis and Parkinson’s disease. The pharmaceutical formulation of CBD, Epidiolex, has also been approved in several countries for the treatment of epileptic seizures.

 

Read More: A Medical Introduction to CBD

 

Unlike CBD, THC causes a range of intoxicating side-effects that can increase with higher doses. It affects things like concentration, memory, movement and coordination, as well as a person’s time perception1.

This is the main reason why some patients and doctors are hesitant to work with THC. However, clinicians who are comfortable using it compare it to conventional treatments for pain, nausea and sleep, such as opioids, anti-emetics or barbiturates. They find THC has gentler side-effects than these treatments and appears to treat some symptoms and conditions better than conventional meds or CBD.

Like CBD, THC mimics a natural chemical in our body. THC’s natural cousin is called anandamide, or AEA, and is found in our tissues and nervous system in a network that stabilizes many of our body processes. The system is called the endocannabinoid system (ECS).  

 

Learn More: A Medical Introduction to the Endocannabinoid System

 

Through its work in the endocannabinoid system, THC exerts its effects on our brain and body. Not only is THC responsible for the characteristic euphoric feeling or “high” from cannabis, but it also has other properties which physicians are harnessing to heal and help their patients. Some of these famous traits include appetite stimulation (i.e., “the munchies”), deep relaxation and changes to sensory perception that can reduce the intensity of pain.

 

THC as Medicine
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The Medicinal Benefits of THC 

Several reviews of scientific studies have concluded that there is high-quality evidence for the use of THC and its derivatives to treat pain, spasticity due to Multiple Sclerosis, nausea and vomiting in patients undergoing chemotherapy, and to stimulate appetite in AIDS patients2 3 4 5 6.

Dronabinol and nabilone are both pharmaceutical formulations of THC that can be prescribed in several countries to treat nausea and vomiting in chemotherapy patients or to stimulate appetite in AIDS patients (dronabinol only).

There is also moderate- to low-quality evidence (for example, animal studies and anecdotal reports from people, but no controlled human trials yet) that THC and its derivatives can be used to treat sleep disorders, reduce the severity of tics in Tourette syndrome, and reduce symptoms of post-traumatic stress disorder (PTSD)7 8 9.

Choosing a Strain

Cannabis indica and Cannabis sativa are the two main varieties of the cannabis plant that are used as medicine. Within each of these varieties, there are a huge number of individual strains as well as hybrid varieties produced by cross-breeding between the two. Each strain has its own unique cannabinoid profile and medicinal effect. When choosing a strain, most patients focus on THC content rather than plant classification, like indica, sativa or hybrid.

The main goal when choosing a strain for medicinal purposes is to select a level of THC that will minimize the risks of unwanted side effects while still providing a health benefit. Because of this, finding a strain that’s the right fit might involve some trial and error. Just like in the recreational space, medicinal cannabis follows the “start low, go slow” rule. Doctors help their patients start with a low dose of THC and gradually increase (or “titrate”) until they reach a place where their symptoms are controlled and their side-effects are minimized.

Most patients who use THC therapeutically also carefully choose the timing of their dose. THC tends to cause drowsiness and intoxication, so many who suffer from pain or sleep disturbance find that the right dose at nighttime can provide relief, help them get restorative sleep and wears off by morning. They often use a different strategy to maintain control of their issues in the daytime, such as using CBD-only products.

Dose Considerations

While dosing guidelines have been estimated for certain conditions, dosing with cannabis compounds is highly individualized. The way a person absorbs THC and is affected by it can be influenced by a large number of factors, so the exact dosage varies from person to person, and sometimes from day to day.

It is recommended by Health Canada that people with no prior experience with cannabis should begin with very low doses10, for example, 2 mg of THC. Doses should then be increased slowly over time (for example, an increase of 0.5 mg every 2 to 3 days) until the desired symptom relief occurs. This process allows a patient to more accurately gauge the effects of each level of dosage and stop immediately if any undesirable side effects occur.

In general, inhalation of cannabis from smoking or vaporization will result in almost immediate effects (within minutes), while ingestion by the oral route is slow and erratic, with the onset of effects being delayed (sometimes being felt 30 to 60 min after ingestion) and lasting much longer (up to several hours after ingestion) compared to inhalation11.

Ultimately, the factors that determine which strain and product will best meet a person’s needs are determined by the symptoms they are experiencing and the unique characteristics of the strain or product. If you have questions about the right strain or dose of THC for you, get in touch with a cannabis clinic or a physician who is experienced in managing cannabis prescriptions. With expert guidance and systematic exploration, you can find the right products and routines to make the benefits of THC work for you.

 

References

[1] Cohen K, Weizman A, Weinstein A. Positive and Negative Effects of Cannabis and Cannabinoids on Health. Clinical Pharmacology & Therapeutics. 2019;0(0).

[2] Abrams DI. The therapeutic effects of Cannabis and cannabinoids: An update from the National Academies of Sciences, Engineering and Medicine report. Eur J Intern Med. 2018;49:7-11.

[3] Fraguas-Sánchez AI, Torres-Suárez AI. Medical Use of Cannabinoids. Drugs. 2018;78(16):1665-1703.

[4] Whiting PF, Wolff RF, Deshpande S, et al. Cannabinoids for medical use: A systematic review and meta-analysis. JAMA. 2015;313(24):2456-2473.

[5] Nielsen S, Germanos R, Weier M, et al. The Use of Cannabis and Cannabinoids in Treating Symptoms of Multiple Sclerosis: a Systematic Review of Reviews. Current Neurology and Neuroscience Reports. 2018;18(2):8.

[6] Mucke M, Phillips T, Radbruch L, Petzke F, Hauser W. Cannabis-based medicines for chronic neuropathic pain in adults. Cochrane Database Systematic Reviews. 2018;3:CD012182.

[7] Abrams DI. The therapeutic effects of Cannabis and cannabinoids: An update from the National Academies of Sciences, Engineering and Medicine report. Eur J Intern Med. 2018;49:7-11.

[8] Fraguas-Sánchez AI, Torres-Suárez AI. Medical Use of Cannabinoids. Drugs. 2018;78(16):1665-1703.

[9] Whiting PF, Wolff RF, Deshpande S, et al. Cannabinoids for medical use: A systematic review and meta-analysis. JAMA. 2015;313(24):2456-2473.

[10] Health Canada. Information for Health Care Professionals: Cannabis (marihuana, marijuana) and the cannabinoids. In:2013.

[11] Health Canada. Information for Health Care Professionals: Cannabis (marihuana, marijuana) and the cannabinoids. In:2013.