Cannabis research has led to the development of synthetic cannabinoids.
These lab-based alternatives to the naturally occurring cannabinoids
found in marijuana have been shown to help patients cope with pain,
improve appetite and reduce the effects of cancer treatment. But despite
their chemical similarities, plant-based cannabinoids and synthetic
cannabinoids are not the same.
Natural Cannabinoids
When research into the effects of cannabis began, scientists identified
and isolated the plant’s compounds to find those that may be beneficial.
They found that marijuana contains about 85 active
cannabinoids.
Two of these, tetrahydrocannabinol (THC) and cannabidiol (CBD), have
been widely studied. They have been shown to:
- Increase appetite
- Decrease pain
- Reduce swelling and inflammation
- Control muscle spasms
- Reduce anxiety and depression
Synthetic Cannabinoids
As a result of studies into the medical efficacy of cannabis, synthetic
forms of these compounds were developed. The idea was to eliminate the
negative effects of the naturally occurring cannabinoids — the high and
addiction potential — while improving the health benefits through
dosage control and the removal of impurities.
The Federal Drug Administration has approved two synthetic THC
medications,
dronabinol
(Marinolยฎ) and
[nabilone](https://pubchem.ncbi.nlm.nih.gov/compound/Nabilone# section=Top)
(Cesametยฎ) for medical use. Dronabinol is approved for nausea and
vomiting related to chemotherapy and as an appetite stimulant in AIDS
patients. Nabilone is used to treat nausea and vomiting.
One is Not Like the Other
Isolating one single compound, however, eliminates any collaborative
effects of the naturally occurring compounds. For example,
researchers have
reported that the antiemetic effects of THC are enhanced, and side
effects are reduced, when taken with CBD. Another
study found that the
combination of THC and CBD improved results of radiation treatment for
glioma, a type of brain cancer. Similarly, Sativex, a cannabis
plant-derived medication containing both THC and CBD, has been approved
in Canada and other countries for treating pain and spasticity in
multiple
sclerosis
patients.
Another problem with synthetic cannabinoids is delivery method. For
example, dronabinol, a gelatin capsule, is ingested. For those suffering
from nausea or wasting, it may be difficult to keep pills down or to
swallow them. Inhaled cannabinoids may offer an alternative.
Delivery method also influences drug effects. With an ingested
cannabinoid, onset of action is about 30 to 60 minutes after it is
taken. With inhaled medication, effects can be felt in minutes.
More research is needed into the symbiotic relationship of the naturally
occurring cannabinoids and how they compare to the synthetic
medications. The most important goal is providing access to patients who
could benefit from medical marijuana because they are not getting relief
from current medications.
