The rocky vista of medicinal cannabis that research is bringing into view
- February 29, 2024
- Posted by: OptimizeIAS Team
- Category: DPN Topics
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The rocky vista of medicinal cannabis that research is bringing into view
Subject: Science and tech
Section: Health
Context:
- The cannabis plant, Cannabis sativa, is being explored for its potential effects on mood and cognition, with a particular interest in its use for managing conditions like schizophrenia, cannabis-use disorders, and heroin-use disorders.
Details:
- In a notable development, the University of British Columbia in Canada is conducting a clinical trial to investigate the use of cannabidiol (CBD) for treating bipolar depression, a condition currently lacking effective treatment options for its depressive episodes.
- Cannabidiol (CBD) is a phytocannabinoid and one of 113 identified cannabinoids in cannabis plants, along with tetrahydrocannabinol, and accounts for up to 40% of the plant’s extract.
- Delta-9-tetrahydrocannabinol (THC) is identified as the primary psychoactive component in cannabis, whereas CBD is attracting attention for its possible antipsychotic, anti-inflammatory, and neuroprotective benefits.
- The potency of cannabis is higher in the flowering parts compared to the leaves.
- Marijuana, composed of the buds and leaves of pollinated female plants, is typically grown outdoors.
The cannabinoid system:
- The human cannabinoid system consists of two main receptors: CB1 and CB2.
- CB1 receptors, predominantly located in the central nervous system (CNS), play a significant role in modulating neurotransmitter release, affecting dopamine, noradrenaline, and serotonin levels.
- This receptor is crucial for the psychoactive effects of drugs.
- CB2 receptors are primarily found in the spleen and testes, with lesser presence in the CNS. The natural substrate for CB1 is anandamide, named after the Sanskrit word for bliss, ‘ananda’.
- The endocannabinoid system (ECS), which includes these receptors and endogenous cannabinoids (endocannabinoids), is involved in regulating various bodily functions like pain, memory, motor control, sleep, and appetite.
- THC, a compound in cannabis, is known for its effects on motor control and memory and has potential implications for treating conditions like PTSD by possibly aiding in the extinction of traumatic memories.
The rimonabant debacle:
- The involvement of the endocannabinoid system (ECS) in regulating hunger led to the hypothesis that blocking the CB1 receptor could facilitate weight loss, inspired by the known effect of THC in inducing cravings for high-calorie foods.
- Based on this, Sanofi-Aventis launched rimonabant, a CB1 receptor blocker, in Europe in 2006 as an anti-obesity medication.
- Although the drug was effective in reducing weight, it was associated with severe side effects, including depression and suicidal tendencies, leading to its withdrawal from the market.
- Despite the rimonabant setback, THC and synthetic cannabinoids have found applications in stimulating appetite among patients with HIV-AIDS and cancer, and in alleviating chemotherapy-induced nausea.
- They are also used in treating various pain syndromes, with nabilone helping in chronic neuropathic pain, headache, and fibromyalgia, and Sativex (combining THC and CBD) being utilized for pain management in multiple sclerosis.
- The question of THC’s addictive potential remains debated among psychiatrists.
- While animal studies indicate addictive responses, human data are more mixed, with many users not escalating their THC consumption after reaching a certain level.
- This plateau effect might be due to THC’s fat solubility, allowing it to stay in the brain for extended periods and be excreted slowly.
- Consequently, THC withdrawal, unlike nicotine or alcohol withdrawal, lacks rapid and severe symptoms, typically manifesting as sleep issues, appetite loss, weight loss, restlessness, irritability, and anger.
Effects on anxiety and mood:
- The mood effects of cannabis are complex and not fully supported by rigorous studies for conditions like treatment-resistant depression.
- Cannabis has been linked to depression in many studies. For bipolar disorder, there is limited scientific investigation, but some research indicates that cannabis use in individuals with bipolar disorder may lead to more manic relapses, less adherence to medication, and poorer psychosocial outcomes.
- Additionally, cannabis use may increase the risk of developing bipolar disorder or trigger its onset in some individuals.
- Cannabis can have psychotic effects, with the risk varying based on the individual’s experience with the drug, context of use, and predisposition to psychosis.
- Cannabis use, especially in youth, can hasten the onset of schizophrenia in genetically predisposed individuals.
- On the policy front, Cannabis sativa is the most widely used illicit drug globally, with its use and potency increasing significantly.
- This has led to debates about decriminalizing cannabis, particularly given the interest in its medical applications.
- Jurisdictions worldwide are legalizing medical and, in some cases, recreational cannabis use.
- Policymakers are urged to consider regulations that prevent commercialization and protect vulnerable populations, such as children, adolescents, and individuals with mental illnesses, from the harmful effects of cannabis.
Source: TH