The importance of being specific when discussing the therapeutic potential of cannabis and cannabinoids

When it comes to discussing the therapeutic potential of cannabis, it’s really important to differentiate between the artisanal preparations that are not regulated, the pharmaceutical-grade botanical drug substances that are regulated and the isolated cannabinoids that have been purified (ie. not synthetic). Being able to easily understand and differentiate between all three (and assume that others can too) is something I take for granted.

Some people are quick to dismiss all claims that cannabis can have any therapeutic potential whatsoever. They assume that these are the proclamations of a bunch of stoners seeking validation. They ignore the hype because they believe that there can be no real science behind it all. Seriously, how can smoking a herbal preparation grown in someone’s backyard benefit anyone’s health? Thing is, I used to be one those sceptics until I realised there’s so much more to it than just smoking weed.

What I’m trying to say is that there is real science being conducted using cannabis. However, it may not resemble what you would usually associate with the plant or drug. In order to accurately study it, scientists need to know exactly what they’re dealing with. For the vast majority of research, this means breaking down the entire cannabis plant into its individual constitutive components (of which there are more than 500!); the most obvious ones being the cannabinoids (of which there are more than 100). Each cannabinoid is rigorously studied in isolation in order to have its pharmacological effects properly characterised.

Sometimes cannabinoids work very well in combination with other cannabinoids. Research like this requires the pharmacological characterisation of each cannabinoid in isolation and then further characterisation when they are combined. As this can get quite complicated, most combined preparations usually contain 2 cannabinoids at a specific ratio.

This is a slightly different story when it comes to studying botanical drug substances, which are well-defined whole-plant extracts. The main cannabinoids (usually just 2) are present at a specific ratio, but there are tiny amounts of other cannabinoids present (less than 1%) in addition to non-cannabinoid compounds too (at low concentrations). These preparations are pharmaceutical grade because they are highly reproducible. This means that these types of cannabis preparations can be used in randomised clinical trials and the results can be taken seriously by the scientific community and clinicians. I should also point out here that isolated cannabinoids can (and have been) used in randomised clinical trials too.

The sad truth is that people’s misconceptions about cannabinoids has massively delayed the research and development of pharmaceutical agents that can be used to treat billions of people worldwide.