Medical Cannabis Overview
Over the past decade, most US states and several of its territories have legalized medical cannabis. Additional US states are slowly passing medical cannabis legislation. Yet many people, including patients and healthcare professionals, remain unfamiliar with the health benefits of medical cannabis and how it can significantly impact lives. This is particularly evident in Texas, where less than 1% of physicians are certified by the state to enter qualified patients into the Compassionate Use Registry of Texas.
At Floweret MD, we endeavor to provide non-biased, legitimate information about THC and CBD to patients and caregivers unfamiliar with the potential medical benefits of cannabis. In this section, we cover the following:
- Important cannabis compounds
- The endocannabinoid system (ECS)
- The medical benefits of THC and CBD
- How to access medical marijuana
- The legality of medical marijuana in Texas
The prized chemical compounds found in cannabis are known as cannabinoids. These compounds are similar in structure to the endocannabinoids naturally produced in our bodies. There are over 140 different cannabinoids in the cannabis plant.
We will stick to the most notable, THC and CBD. Still, it is essential to understand that cannabis flowers contain a plethora of cannabinoids, such as CBG, CBN, CBC, THCA, and THCV, each with unique properties. While we have much to learn about the ‘minor cannabinoids,’ their future medical applications look promising.
The other essential compounds found in cannabis are terpenes. Like cannabinoids, these plant oils are located in the plant’s resin glands on the buds, flowers, leaves, and even to a lesser extent on the stems. Terpenes are found in all plants and are typically used to protect the plant or attract pollinators. They are vital to the plant’s survival and evolution.
Terpenes have been used in folk medicine for thousands of years, each providing a unique assortment of benefits. While over 20,000 terpenes have been identified, there are about a dozen produced in cannabis. These plant oils assist the cannabinoids in delivering flavor, color, and therapeutic remedies. They also alter the user experience. Types of cannabis with high concentrations of sedating terpenes like myrcene are believed to be responsible for the tranquil effects of Indica-dominant cannabis strains. Conversely, terpenes like pinene deliver uplifting effects and are commonly found in Sativa-dominant strains.
The Endocannabinoid System (ECS)
Our body contains a complex cell-signaling network that works to maintain balance through the body. This network is known as the endocannabinoid system. The endocannabinoid system consists of the following main components:
Endocannabinoids – Compounds very similar in structure to plant-based cannabinoids. Endocannabinoids are neurotransmitters, sending complex messages throughout the ECS.
Endocannabinoid Receptors – Located throughout the body, primarily found in the brain, central nervous system, and spleen; Responsible for regulating several bodily functions such as mood, appetite, memory, inflammation, anxiety, and the sleep-wake cycle.
Enzymes – Proteins that can increase or decrease the production of endocannabinoids.
The endocannabinoid system functions to maintain balance within the body despite fluctuations in the external environment. The endocannabinoid system was discovered in 1988 when scientists at the St. Louis University School of Medicine were studying cannabis’s effects on the body. They found that the brain of mammals contained receptors that respond to compounds from cannabis. These receptors were referred to as CB1 receptors and, remarkably, found to be the most abundant neurotransmitter receptors in the brain. In addition, another cannabinoid receptor (CB2) was identified during the study. With the discovery of the CB2 receptors in the immune system and peripheral nervous system, scientists were able to isolate compounds in our body structurally similar to cannabis-based cannabinoids. Therefore, they named them endocannabinoids from the root word “endo,” meaning internal or inside.
The ECS produces endocannabinoids when there is an imbalance in our body. These endocannabinoids interact with the cannabinoid receptors to perform tasks such as minimizing the stress response, reducing inflammation, decreasing pain, relaxing tense muscles, stimulating appetite, modifying the sleep cycle, producing relaxation, and elevating mood.
Hemp vs. Marijuana
Medical Benefits of THC
THC (tetrahydrocannabinol) is notorious for its psychoactive effects, but it also has medical applications that can be life-changing. THC is similar in structure to our body’s endocannabinoids. This similarity allows THC to attach to cannabinoid receptors throughout the body, activating the same responses as our internal endocannabinoid system. As a result, people suffering from a wide range of medical conditions, including but not limited to pain, muscle spasticity, glaucoma, insomnia, low appetite, nausea, seizures, myoclonus, Crohn’s disease, neuropathy, ALS, Lupus, interstitial cystitis, anxiety, PTSD, and cancer, have reported relief while using medical cannabis.
THC increases effectiveness and minimizes side effects when used alongside other traditional drugs. For instance, cancer patients use medical cannabis to combat the adverse effects of chemotherapy. THC can increase the appetite, reduce pain, and help the patient sleep while undergoing treatments.
A few pharmaceutical drugs feature THC as the active ingredient; the most notable is called Sativex. The Sativex spray contains a full array of cannabinoids with varying amounts of THC. Many countries have approved the drug to treat Multiple Sclerosis (MS); in the USA, Sativex is currently in clinical trials in the US.
One of the most exciting aspects of medical marijuana is its potential to reduce pain without life-threatening side effects. The US is faced with an increasing number of opioid overdoses, partly due to the addictive properties of drugs that treat pain. Data shows that access to cannabis directly translates to lowing overdoses in specific areas.
Hemp vs. Medical Marijuana
Hemp products are readily available through a retailer or online. THC levels in hemp are usually too low to provide additional benefits or don't contain the advertised amount. In addition, the industrial hemp industry is under-regulated, and companies don't have the oversight of medical marijuana programs. Texas' medical marijuana may not be as expansive as other states, but the additional regulations guarantee the quality and safety of the products.
CBD (cannabidiol), the second most prevalent plant-based cannabinoid, is derived from hemp. CBD gained notoriety for its therapeutic benefit on rare childhood seizure conditions, such as Dravet syndrome and Lennox-Gastaut syndrome (LGS). These conditions usually do not respond to antiseizure medications. Yet, CBD was decreasing the frequency of those seizures and, for some, eliminating seizures. In 2018, Epidiolex became the first plant-derived cannabinoid prescription medicine and the only FDA-approved form of CBD for use in these conditions.
CBD doesn’t have the affinity to bind with receptors in the brain, making an intoxicating reaction impossible. Evidence suggests that CBD also reducing THC’s ability to bind to receptors in the brain, thereby reducing the psychoactive effects of THC while allowing the therapeutic effects to remain. Benefits of CBD cross over with THC, though the responses may differ. For instance, CBD has milder pain relief properties than THC, while CBD tends to have more anti-inflammatory action. Still, CBD has been used to treat the following:
- Psychosis or mental disorders
- Inflammatory bowel disease
Medical Marijuana in Texas
Texas established the Compassionate Use Program in 2015 for patients with specific qualifying conditions. In 2019, the 86th Texas Legislature expanded the program to include more qualifying conditions. On June 15, 2021, Governor Abbot signed House Bill 1535, expanding the program further to include PTSD and all cancer beginning September 1, 2021, and doubling the percent by weight of THC allowed in medical cannabis products from 0.5% to 1%.
To qualify, Texas residents must have a qualifying condition and receive a prescription from a doctor. If you are under the age of 18, you need a legal guardian or caregiver.
Outside of Texas?
*Our network of licensed physicians can also provide prescriptions to patients in the following states: California, Florida, Georgia, Iowa, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Missouri, New Hampshire, New York, Ohio, Oklahoma, Pennsylvania, and Rhode Island. Qualifying conditions vary by state. Use the chatbox or register through the patient login to be connected to your state’s specialist.
Qualifying Conditions in Texas
- Alzheimer’s Disease,
- Cerebral Palsy,
- Chronic Traumatic Brain Encephalopathy,
- Epilepsy and other Seizure disorders,
- Huntington’s Disease,
- Multiple Sclerosis,
- Muscular Dystrophy,
- Parkinson’s Disease,
- Peripheral Neuropathies,
- PTSD (new law begins 9/1/2021)
- Muscle Spasms,
- Spinal Muscular Atrophy,
- Terminal Cancer (all cancers-new law begins 9/1/2021)
- or Incurable Neurodegenerative Diseases.