Accurate Education – Marijuana (Cannabis): Delta-9 THC (∆-9 THC)

Δ-9 THC (Tetrahydrocannabinol) – Overview

THC has analgesic, anti-spasmodic, anti-tremor, anti-inflammatory, appetite stimulant and anti-emetic properties, while CBD is non-euphoric but has anti-anxiety, anti-depressant, anti-inflammatory, anti-convulsant, anti-psychotic, anti-oxidant, neuroprotective and immunomodulatory effects. CBD is a versatile anti-inflammatory analgesic through numerous distinct mechanisms.

The clinical benefits from marijuana are derived from the many constituents found in the plant, including more than 80 pharmacologically active cannabinoids. The two best understood and most common of these cannabinoids are THC (tetrahydrocannabinol) and CBD (cannabidiol). There is very limited scientific information on the pharmacology and toxicology of the other cannabinoids and pharmacologially active constituents found in cannabis. THC acts as a CB1 receptor partial agonist, while CBD is a negative allosteric modulator of the CB1 receptor.

See: THC (tetrahydrocannabinol pharmacokinetics)  

Δ-9 THC: Inhaling vs Sublingual vs Oral

Δ-9 THC: Clinical Benefits

Δ-9 THC – Euphoria and the “High” of Marijuana

The elephant in the room when discussing the benefits of marijuana is the “feel good” or euphoria associated with its use. The medical community focuses on the “medical benefits” of marijuana by emphasizing its effects on pain, anxiety, nausea and other pathologic signs or symptoms of various medical conditions. However, historically the most common motivation for using marijuana is to achieve the benefit of a “feel good” state of mind or euphoric mood.

A euphoric mood is characterized by positive feelings of strong happiness, excitement, and well-being. It is an amplified sense of pleasure that can offer therapeutic benefit by off-setting any negative feelings or mood one may be experiencing. While euphoria is one of the most pleasant mental states, when extreme it can become problematic and drive someone to repeatedly continue efforts to experience the feelings of euphoria again and again. This is the pathway that leads to “abuse” and addiction. Where is the line between therapeutic benefit and the evolution into a substance use disorder?

When use of THC or other drugs that stimulate a sense of heightened well-being or euphoria becomes problematic it appears to be related to dysregulation of the reward system in the brain. This dysregulation may be founded in underlying genetic variations of the reward system based on dopamine and serotonin levels involved in various reward pathways in the central nervous system. Or the dysregulation may be based on environmental conditions of increased stress, emotional imbalance or other non-genetic variables.

The vulnerability to developing an abusive or addictive relationship to THC, the basis of a Reward Deficiency Syndrome, is explored elsewhere on this website: Reward Deficiency Syndrome. What should be emphasized when recommending THC for therapeutic benefit is its potential for problematic use and how to recognize when the therapeutic use of THC may be leading to problematic use.

It is important to understand and appreciate the beneficial impact of the “feel good” of THC use, and it is naive to ignore this benefit whether it is used for chronic pain, anxiety or other conditions. The “feel good” effect of THC is likely the basis of of one of the primary effects of THC use: relaxation, defined as “the state of being free from tension and anxiety with a reduced sense of stress.”

Reducing stress has enormous health benefits both directly and indirectly, for example, by improving the experience of chronic pain through its impact on the emotional and cognitive factors associated with pain. As a result of this effect of THC, one is able to cope better with their pain which perhaps should be considered the ultimate goal in pain management. Stress is a fundamental contributor to neuroinflammation, one of the driving forces behind chronic pain, and to systemic inflammation, one of the driving forces behind the non-infectious diseases of aging including cardiovascular diseases and diabetes.

Δ-9 THC – Pain

Δ-9 THC – Appetite Stimulation

THC: Mechanisms of Action

THC: Activity at the CB1 and CB2 Receptors

THC is a partial agonist at both the CB1 and the CB2 receptors, leading to a plethora of effects.

THC activity at the CB2 receptor

CB2 receptor activation is associated with anti-inflammatory activity. Activation of the CB2 receptor inhibits the inflammatory response in lymphocytes and microglia.