According to experts, the medical cannabis market had an estimated value of $13.4 billion in 2020. What’s more, they forecast this to grow by a whopping 22.9% to reach $44.4 billion in 2025. Experts associate this massive growth with the legalization of the cannabis plant.
One reason many are pushing for cannabis legalization is the plant’s purported benefits. Cannabinoids, in turn, appear to be responsible for most of these health effects.
What are cannabinoids, though, and how do they work? What exactly can they do to help (or at least, supposed to help with)? Are there legal cannabinoids in the US, or are they “illicit” substances?
We’ll answer all these questions in this guide, so be sure to keep reading!
Table of Contents
What Are Cannabinoids?
Cannabinoids are a group of natural substances found in the cannabis plant. There are more than a hundred different types of cannabinoids. They exert different effects by interacting with the endocannabinoid system (ECS).
What Is the Endocannabinoid System?
The endocannabinoid system is a cell-signalling system found in all mammals, including humans. Its name comes from none other than the cannabinoids found in the cannabis plant itself. Researchers identified the ECS in the early 1990s while they were exploring cannabinoids.
The Role of ECS
As a biochemical communication system, the ECS seems to play a role in physiology. So far, researchers associate it with appetite, memory, metabolism, mood, pain, and sleep. It also appears to affect immune system responses, cardiovascular system functions, and stress.
All those processes affect homeostasis, the body’s ability to keep itself in “balance.” It’s the process in which the body maintains internal equilibrium for stability.
How the ECS Works
To do its job, the ECS utilizes endocannabinoids and endocannabinoid receptors. Endocannabinoids are similar to cannabinoids, except that the body makes them. These molecules then bind to endocannabinoid receptors found throughout the body.
Researchers have identified two primary endocannabinoid receptors so far. The first group consists of the CB1 receptors, most of which are in the central nervous system. CB2 receptors make up the second group, and most of them are in the peripheral nervous system.
Endocannabinoids can attach themselves to either CB1 or CB2 receptors. It’s from there wherein they affect the body’s physiological processes.
For example, some endocannabinoids may attach to CB1 receptors to relieve pain. Others may bind to CB2 receptors to “tell” the body that it’s experiencing inflammation.
What Is the Link Between Cannabinoids and the ECS?
Cannabinoids function much like endocannabinoids; they also bind to CB receptors. In doing so, they also act as signalling molecules that trigger the ECS to take action. Like endocannabinoids, cannabinoids affect the ECS based on which receptor they bind to.
What Are the Primary Types of Cannabinoids?
Delta-9-tetrahydrocannabinol (Δ9-THC) is one of the main cannabinoids. It’s the primary cannabis substance with a psychoactive effect.
Cannabidiol (CBD) is another cannabinoid that has gained popularity over the years. Unlike THC, it’s a non-psychoactive substance.
Besides CBD and THC, other known cannabinoid groups include the following:
- Cannabichromene (CBC)
- Cannabielsoin (CBE)
- Cannabinodiol (CBDL)
- Cannabigerol (CBG)
- Cannabicyclol (CBL)
- Cannabinol (CBN)
- Cannabitriol (CBT)
Scientists are also studying these seven other cannabinoids for their potential health effects.
However, CBD and THC are the focus of most existing and ongoing research. For starters, CBD comprises up to 40% of the cannabis plant extract.
THC’s popularity, in turn, is mainly due to it being one of the first cannabinoids discovered. There’s also the fact that it seems to be the most potent psychoactive compound in the cannabis plant.
How Does THC Affect the Body?
Upon ingesting THC, the cannabinoid gets into the bloodstream. The blood then carries THC to the brain and various other organs. Once THC reaches the brain, it can bind with CB1 receptors found in the brain.
As a psychoactive compound, THC produces a sense of euphoria, AKA “high.” It also causes overactive senses, such as seeing colors in brighter hues or more vivid tones. It can also impair body movement, memory, mood, and thinking.
Despite all those side effects, THC is one of the most often used cannabinoids for pain. Some patients say that medical cannabis helps ease multiple sclerosis and nerve pain. It may also be helpful for conditions like muscle spasms, nausea, insomnia, and anxiety.
Note that THC can also exist as Delta 8 THC, an isomer of both CBD and Delta 9 THC. According to this source, Delta 8 doesn’t seem to have psychoactive effects, unlike Delta 9 THC. However, it still produces pretty much the same medicinal effects as Delta 9 THC.
What About Cannabidiol?
Medical experts aren’t sure yet how exactly CBD affects the ECS.
What they do know is that CBD doesn’t interact with CB receptors the way THC does. CBD can also bind with CB1 receptors, but instead of activating signals, it seems to restrain them. That restraining effect may explain why CBD doesn’t cause psychoactive effects.
Other researchers also believe that CBD prevents the breakdown of endocannabinoids.
Since there’s a lot not yet known about them, studies on the medical use of cannabinoids like CBD are ongoing. However, previous research suggests that CBD may help with pain and nausea. It may also be helpful for patients with anxiety or inflammatory conditions.
What Are the Approved Medical Uses of Cannabinoids?
The Food and Drug Administration (FDA) hasn’t approved the use of cannabis for any medical use. However, the agency has approved a few prescription medications that contain cannabinoids.
Here’s a quick overview of these FDA-approved cannabinoid-containing drugs.
Marinol (dronabinol) is an oral capsule that contains THC mixed in sesame oil. The FDA approved it back in 1985 for use in treating nausea and vomiting due to cancer chemotherapy.
Fast forward to 1992, and the FDA approved dronabinol as a treatment for anorexia. Doctors also prescribe it to help treat appetite loss and weight loss in patients with HIV/AIDS.
Syndros is another branded drug that contains dronabinol. The FDA approved this drug on July 01, 2016. It’s the first and only liquid THC medication that has received FDA approval.
Like Marinol, Syndros also helps ease nausea and vomiting caused by chemotherapy. Doctors prescribe it to patients whose symptoms haven’t improved with other anti-nausea drugs. It can also help treat anorexia and weight loss in people with AIDS.
In May 2006, the FDA approved Cesamet, which contains nabilone. Nabilone, in turn, is a synthetic cannabinoid that mimics the actions of THC. It’s a controlled Schedule II drug under the Controlled Substances Act.
Cesamet’s primary use is to help treat nausea and vomiting in chemotherapy patients. However, nabilone only gets prescribed to patients who don’t respond to other drugs.
Epidiolex became the first and only FDA-approved oral drug that contains CBD in June 2018. It uses a purified form of cannabidiol mixed in a strawberry-flavoured liquid.
Epidiolex used to be a Class II substance like all other cannabinoid-based drugs. However, the FDA lifted this ruling in 2020. A primary reason behind this change is that CBD doesn’t have the same psychoactive effects as THC.
Epidiolex’s primary use is to help treat seizures that occur with three types of epilepsy. These include Lennox-Gastaut syndrome, Dravet syndrome, and tuberous sclerosis complex. Studies have found the drug to be effective in reducing the frequency of seizures.
The exact working mechanism of Epidiolex is still unknown, though.
However, some researchers believe that the drug interacts with abnormal brain signals. These are erratic signals sent and processed by the drain during a seizure. The CBD in the drug may work by preventing these signals from getting sent in the first place.
What Are Other Purported Health Benefits of Cannabinoids?
Researchers are still trying to unlock the other potential health benefits of cannabinoids. However, several studies found evidence that it may be helpful for pain-related conditions. It may also help ease some of the symptoms of multiple sclerosis.
Let’s take a look at some of the most commonly-cited positive effects of cannabinoids.
Chronic pain is pain that doesn’t disappear even after 12 weeks. The sensation may be sharp, dull, burning, aching, stinging, or stabbing. It can affect only one area of the body, or it can be widespread, such as from the neck to the lower back.
Most cases of chronic pain occur due to a musculoskeletal injury, such as sprains or strains. It appears that chronic pain results from nerve damage caused by these injuries. The damage may make the nerves even more sensitive to pain than they already are.
According to the FDA, cannabinoids may be helpful for chronic pain. As such, the agency allowed the publication of studies done on Sativex, a drug containing CBD and THC. However, the FDA hasn’t approved this medication in the US yet, as it’s still undergoing trials.
Multiple sclerosis (MS) is a condition that can affect the brain and spinal column. In this way, it can cause problems with the eyes, arms, legs, sensations, and even balance. MS is a lifelong condition that, if left untreated, can be debilitating or even disabling.
Pain, numbness, tingling sensations, and loose bladder are some of the common signs of MS. It can also cause muscle stiffness or spasms. These painful signs can then result in tiredness, fatigue, and difficulty walking.
Cannabinoids may help reduce some of these symptoms.
A review looked at the findings of 17 studies on cannabinoids and multiple sclerosis. The analysis found that cannabinoid preparations may help improve MS symptoms. These include pain, patient-assessed muscle spasticity, and bladder issues.
Anxiety is so common that experts say almost a third of adults will experience it at some point. Moreover, an estimated 264 million people around the world already have this condition. Nearly two in three of those with anxiety disorders are women.
Anxiety causes a person to experience extreme fears or worries that don’t dissipate. It makes people develop a severe apprehension of something that may occur in the future. These long-term fears or worries can get so bad that they may trigger panic attacks.
Some evidence suggests that cannabinoids may be helpful in people with anxiety. For example, CBD may help make them less fearful or worried. In this way, it may help them reduce their risks of anxiety or panic attacks.
Sleep problems often co-occur in people who have conditions like chronic pain or MS. Experts even believe that 50% to 80% of people with chronic pain also have sleeping issues! After all, it can be hard to fall and stay asleep if you feel achy and sore.
In light of this, researchers looked at how cannabinoids affect pain-caused sleep issues. Some findings suggest that they may be helpful in easing the symptoms of both pain and sleep woes.
However, scientists are still trying to figure out how they work on sleep problems. They’re not sure yet if cannabinoids directly affect sleep. They’re also trying to ascertain if people sleep better because they feel less pain.
Acne is the most common of all skin conditions, affecting up to 50 million people in the US. Psoriasis, although less common, still affects about 7.5 million folks in the US each year. Many other skin diseases cause itchiness and redness.
Some researchers suggest that cannabinoids like CBD may help improve these conditions. For example, one study found that CBD appears to help reduce skin oil (sebum) production. Excessive sebum, in turn, can clog skin pores and contribute to acne development.
Another study looked at how CBD may help in the treatment of psoriasis. The researchers believe that it may help improve the symptoms of this condition.
Cannabinoids May Be Helpful if Used Correctly
There you have it, the detailed guide answering your question, “what are cannabinoids?” Now, you know that they are the active compounds found in all cannabis plants. These substances hold a lot of promise, but more research is necessary to prove just how helpful they are.
In any case, if you plan to use cannabinoid-based products, be sure to follow the directions! This way, you can reap their potential benefits instead of developing side effects.
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