Cannabis 101

By Dr. Rachel Knox, MD, MBA, MCBA Medical Chair

Pot. Weed. Marijuana. Reefer. Herb. Mary Jane. Grass. Ganga. Dope.

Cannabis by any other name would smell as sweet. It’s as though William Shakespeare, himself, wrote Romeo & Juliet with cannabis in mind.

Despite its many names, cannabis is widely known for one thing: being an “illegal drug” in the United States. But as states continue to legalize the medicinal and recreational use of the plant, the truth about this sensational herb is causing quite the stir, and one filled with hope. This is because cannabis, better known by its pejorative name — Marijuana — has proven to be a scientific and medicinal phenom. What millions of users have known for over millennia without knowing exactly why — that cannabis works as a healing and relaxing agent — is now backed by (decades of) science that shows how. Here we will review some of the basics.

Understanding the scientific nature of cannabis is paramount to the industry. First things first, know that “hemp” (Cannabis sativa L.) is distinct from what we refer to as “cannabis” (Cannabis sativa L. ssp. indica and sativa), which people consume both medicinally and recreationally. Hemp is one of the most versatile textile products worldwide, used to make rope, paper, clothing, jewelry, shoes, fuel, and buildings to name a few of its manufactured uses. Although it was a staple crop for the first two centuries of American colonization, hemp is illegal to grow in the US today. It has very low levels of the cannabinoids THC and CBD, making it an ineffective psychoactive agent or medicine. Industrial hemp has been intentionally bred to contain trace amounts of active cannabinoids.

Cannabis, on the other hand, has been used as medicine, for recreation, for spiritual purposes and religious ceremonies for thousands of years. The earliest records of its use have been found in texts dating back to 2737 BC in China. By the turn of the 20th century AD cannabis made up 50% of American medicines because of its anecdotal effectiveness in healing a myriad of human maladies.

The entire Cannabis sativa plant is useful for a variety of purposes, from root to flower. The flowers — and to a much lesser extent the leaves (followed by the stem, roots and seeds) — are what contain the highest concentration of the plant’s chemically active compounds: the cannabinoids. The two most familiar cannabinoids are delta-9 tetrahydrocannabinol or THC (the most psychotropic cannabinoid), and cannabidiol or CBD which bears no psychoactive effects. There are over 100 more known cannabinoids, and even more terpenes and flavonoids that give each and every strain of cannabis its distinct psychoactive and medicinal effect, smell, flavor and antioxidative potentials.

Cannabis sativa is a dioecious plant, meaning it is made of separate male and female plants. The female plants carry the seeds and are pollinated by the male plant, after which the male plant dies. The flowers of pollinated female plants are those from which all recreational and medicinal preparations are derived. Because genetic and environmental factors determine sexual expression of germinating seeds, the process of “cloning” has become popular for cultivators so that they can grow genetically identical female plants without any need for pollination or seeds, essentially eliminating the chance of bearing any male plants.

There are considered three subspecies of Cannabis sativa: Cannabis sativa ssp sativa, Cannabis Sativa ssp indica, and Cannabis Sativa ssp ruderalis. Cannabis sativa and indica are the most commonly used cannabis types. While the ruderalis subspecies can be used medicinally, its effect is thought to pale in comparison to its sister strains, and is not widely cultivated for this reason. For our purposes, we will focus on the two most common subspecies cultivated in the US: Cannabis sativa and Cannabis indica.

Cannabis sativa and indica strains differ in more ways than one. In appearance, sativa plants are typically taller, with long, narrow and loosely branched leaves. Indica plants are typically short and have broad, dense leaves. In effect, sativa plants have been historically considered more activating, uplifting and energizing, creating a cerebral or “head high” that makes the plants more suitable for daytime use; whereas indica plants are described as deactivating, relaxing, and calming, creating a “body high,” making it a suitable choice for nighttime consumption, or for use just before bed. Genetically speaking, sativas boast a higher THC:CBD ratio while indicas are thought to contain a higher CBD:THC ratio. Due to heavy cross-breeding, however, many indicas and sativas today contain varying degrees or completely opposite chemical compositions than what has been traditionally described, leading to mass confusion — even reputable thought leaders in the cannabis industry report sativas as having higher CBD:THC ratios and indicas the reverse.

Despite this confusion, what remains most important to know is the chemical profile of any given strain. When it comes to the specific uses for which a person chooses to use cannabis, the concentration of THC, CBD and hundreds of other cannabinoids, terpenes and flavonoids are what the consumer will come to rely on. These compounds work synergistically to confer their effects, and therefore the composition of these, as opposed to whether a strain is an indica or sativa, is going to become increasingly important to consumers. Take THC and CBD for example. At equal concentrations, a user will feel the psychotropic effects of THC, while at ratios of approximately 4:1 CBD:THC (that is, 4 parts CBD to 1 part THC), CBD effectively counteracts the psychotropic effects of THC preventing a psychoactive experience, although CBD is noted to also enhance the medicinal effects THC will have on the body. This dynamic is why recreational grade strains have been bred to contain exceptionally high concentrations of THC and low amounts of CBD. Depending on one’s desired “high,” being able to anticipate just how high a strain might take the consumer is valuable. For growers, manufacturers, dispensaries and consumers alike, testing cannabis strains and products is now the best way to predict how the science of cannabis will affect the end-user.

The science of cannabis extends even beyond the plant into methods of use and onset of action. For fast activation one may choose inhalation (think smoking a joint or pipe, or vaporizing) or mucosal absorption (think dripping a tincture underneath the tongue). For longer lasting effects one may choose any variety of edible which slowly releases cannabinoids into the bloodstream upon digestion and absorption in the gut. Delving even further into the varied methods of medicinal cannabis applications, one may use topical formulations for musculoskeletal pain, spasm or neuropathy, or might try encapsulated extracts that can be taken orally or used as suppositories. Juicing raw cannabis has also been reported to be considerably beneficial.

From horticulture to paraphernalia, from consulting firms to medical consultation, and from rolling a joint to the culinary arts, understanding the scientific nature of cannabis is paramount to the industry. Despite cannabis’ ancient and sordid history, revolutionary scientific findings are demystifying the plant and finally providing the empirical evidence upon which mainstream acceptance and industry viability can firmly stand.