Marijuana (Cannabis)

THC-O

THC-O (or THC acetate) is a cannabinoid that does not occur naturally in cannabis plants. As a synthetic variant of conventional Δ-9 THC, it has been around for years but has recently been gaining interest in the recreational marijuana culture. It is much more potent than Δ-9 THC and is considered “extremely psychoactive,” with the potential for severe side effects. As such it is not recommended at this time to take THC-O. in any form.

 

 

Links to other Pertinent Educational Pages:

Links to ALL Marijuana Educational Pages

 

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The medical information on this site is provided as a resource for information only, and is not to be used or relied upon for any diagnostic or treatment purposes and is not intended to create any patient-physician relationship.  Readers are advised to seek professional guidance regarding the diagnosis and treatment of their medical concerns.

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Definitions and Terms Related to Pain

 

THC-O (THC-Acetate)

THC-O is an “extremely psychoactive, marginally hallucinogenic” synthetic form of THC that is 3x or more stronger than Δ-9 THC. At higher doses it has been compared to mescaline while other users describe feeling extremely “heavy” and unable to move.
Some side effects of THC-O-acetate include:
  • Extreme lethargy/sedation
  • Nausea or vomiting
  • Dizziness
  • Seizures
  • Incapacitation and/or incoherence

 

Because of these effects, THC-O is not advised for medicinal use and no therapeutic benefits are generally attributed to its use.

 

Chemistry of THC-O

Unlike Δ-9 THC, THC-O is not extracted from hemp but is derived from synthetically altered THCA, the raw form of THC found in the cannabis plant. THCA is processed with sulfuric acid and acetic anhydride, a high-inflammable and colorless liquid used to make fibers, plastics, pharmaceuticals, dyes, and explosives. It is then heated in  an extremely volatile chemical process to change its chemical structure.

 

THC-O is most commonly available in vape cartridges, tinctures, and gummies. Because it is a pro-drug that requires breakdown in the liver before becoming active, its effects take about 20-30 minutes or more after consumption to begin. 

 

Safety of THC-O

Like other synthetic cannabinoids, the safety of THC-O use has not been established nor has the safety of vape blends. THC-O may be marketed in edible forms, as cartridges of vape blends or sprayed onto hemp flowers which are then smoked or vaped. These products are not regulated and have no oversight in their manufacturing and therefore are susceptible to dosing irregularities and toxic by-products.

 

Caution is strongly advised regarding the use of THC-O products.

 

Legality

Like delta-8 THC and other minor cannabinoids, THC-O occupies a grey area of legality. According to the Federal Analog Act, some experts say it should be illegal. This section of the Controlled Substances Act enacted in 1986 treats any chemical “substantially similar” (also known as designer drugs) as a controlled substance, but only if intended for human consumption.

Because there is a provision in the US to classify it as a Schedule 1 drug, it is likely that it will become federally banned in the future.  But for now there are 18 states that have legalized Δ-9 THC so THC-O may get by in those states and be legalized by default.

 

Resources:

National Academy of Sciences

The Health Effects of Cannabis and Cannabinoids: The Current State of Evidence and Recommendations for Research

 

www.Healer.com

This website appears to be good resource for exploring medical marijuana.

 

References:

   

Delta-8 THC – Overviews

  1. Delta-8-THC – Delta-9-THC’s nicer younger sibling? – 2022
  2. Consumer Experiences with Delta-8-THC Medical Use, Pharmaceutical Substitution, and Comparisons with Delta-9-THC – PubMed 2022
  3. Human skin permeation of Delta8-tetrahydrocannabinol, cannabidiol and cannabinol – PubMed – 2004

 

 

Cannabinoids – Pain

  1. Association of Cannabinoid Administration With Experimental Pain in Healthy Adults – 2018
  2. Effects of Cannabinoid Administration for Pain – A Meta-Analysis and Meta-Regression – 2019
  3. Cannabis-based medicines and the perioperative physician – 2019
  4. Cannabis‐based medicines for chronic neuropathic pain in adults – 2018
  5. Cannabinoids in the Descending Pain Modulatory Circuit- Role in Inflammation – 2020
  6. Current Evidence of Cannabinoid-Based Analgesia Obtained in Preclinical and Human Experimental Settings – PubMed – 2018
  7. Role of Cannabinoids and Terpenes in Cannabis-Mediated Analgesia in Rats – PubMed – 2019
  8. Medicinal Properties of Cannabinoids, Terpenes, and Flavonoids in Cannabis, and Benefits in Migraine, Headache, and Pain – An Update on Current Evidence and Cannabis Science – 2018
  9. The Molecular Mechanisms That Underpin the Biological Benefits of Full-Spectrum Cannabis Extract in the Treatment of Neuropathic Pain and Inflammation – PubMed – 2020
  10. Cannabis sativa L. an
    d Nonpsychoactive Cannabinoids – Their Chemistry and Role against Oxidative Stress, Inflammation, and Cancer – 2018
  11. Cannabinoid Delivery Systems for Pain and Inflammation Treatment – 2018
  12. Cannabinoid Formulations and Delivery Systems – Current and Future Options to Treat Pain – 2021

 

CBD – Interaction with THC

  1. Cannabidiol: a promising drug for neurodegenerative disorders? – PubMed – NCBI
  2. Oral Cannabidiol does not Alter the Subjective, Reinforcing or Cardiovascular Effects of Smoked Cannabis – 2015
  3. Taming THC – potential cannabis synergy and phytocannabinoid-terpenoid entourage effects – 2011
  4. A tale of two cannabinoids: the therapeutic rationale for combining tetrahydrocannabinol and cannabidiol. – PubMed – NCBI

 

 

Cannabinoids: Tetrahydrocannabivarin (THCV):

  1. The phytocannabinoid, Δ9-tetrahydrocannabivarin, can act through 5-HT1A receptors to produce antipsychotic effects – 2015

 

Medical Marijuana –Misc

  1. A tale of two cannabinoids: the therapeutic rationale for combining tetrahydrocannabinol and cannabidiol. – PubMed – NCBI
  2. Cannabis and cannabis extracts – greater than the sum of their parts? – 2001
  3. Medical cannabis and mental health: A guided systematic review. 2016 – PubMed – NCBI
  4. Epidemiological characteristics, safety and efficacy of medical cannabis in the elderly. – PubMed – NCBI
  5. Cannabis-conclusions – 2017 National Academy of Sciences
  6. Cannabis-chapter-highlights – 2017 National Academy of Sciences
  7. Cannabis-report-highlights – 2017 National Academy of Sciences
  8. Clinical Endocannabinoid Deficiency (CECD): Can this Concept Explain Therapeutic Bene ts of Cannabis in Migraine, Fibromyalgia, Irritable Bowel Syndrome and other Treatment-Resistant Conditions?-2004
  9. Marijuana use and the risk of lung and upper aerodigestive tract cancers: results of a population-based case-control study. – PubMed – NCBI
  10. Cannabis use and cognitive function: 8-year trajectory in a young adult cohort. – PubMed – NCBI
  11. Cannabinoids for Medical Use: A Systematic Review and Meta-analysis. – PubMed – NCBI
  12. Cannabinoids and Cytochrome P450 Interactions. – PubMed – NCBI Pharmacogenetics of Cannabinoids – 2018
  13. Systematic review of systematic reviews for medical cannabinoids – 2018
  14. Adverse effects of medical cannabinoids – a systematic review – 2008
  15. Cannabimimetic effects modulated by cholinergic compounds. – PubMed – NCBI
  16. Antagonism of marihuana effects by indomethacin in humans. – PubMed – NCBI
  17. Pharmacokinetics and pharmacodynamics of cannabinoids. – PubMed – NCBI
  18. Clinical Pharmacodynamics of Cannabinoids – 2004
  19. Affinity and Efficacy Studies of Tetrahydrocannabinolic Acid A at Cannabinoid Receptor Types One and Two. – 2017
  20. Quality Control of Traditional Cannabis Tinctures – Pattern, Markers, and Stability – 2016
  21. Exogenous cannabinoids as substrates, inhibitors, and inducers of human drug metabolizing enzymes: a systematic review. – PubMed – NCBI
  22. Pharmacology of Cannabinoids
  23. Current-status-and-future-of-cannabis-research-Clin-Researcher-2015
  24. Medical Marijuana for Treatment of Chronic Pain and Other Medical and Psychiatric Problems – A Clinical Review – 2015
  25. Cannabis Use in Patients with Fibromyalgia – Effect on Symptoms Relief and Health-Related Quality of Life – 2011
  26. Weighing the Benefits and Risks of Medical Marijuana Use – A Brief Review – 2018
  27. A Marijuana-Drug Interaction Primer – Precipitants, Pharmacology, and Pharmacokinetics – 2019
  28. Myorelaxant Effect of Transdermal Cannabidiol Application in Patients with TMD – A Randomized, Double-Blind Trial – 2019
  29. Drug interactions with cannabinoids – 2020
  30. The effects of acute and sustained cannabidiol dosing for seven days on the haemodynamics in healthy men – A randomised controlled trial – 2019
  31. Novel approaches and current challenges with targeting the endocannabinoid system – 2020
  32. Herbal Preparations of Medical Cannabis – A Vademecum for Prescribing Doctors – 2020
  33. Cannabis is associated with clinical but not endoscopic remission in ulcerative colitis – A randomized controlled trial – 2020
  34. Practical Strategies Using Medical Cannabis to Reduce Harms Associated With Long Term Opioid Use in Chronic Pain – 2021
  35. Endocannabinoid Levels in Ulcerative Colitis Patients Correlate With Clinical Parameters and Are Affected by Cannabis Consumption – 2021
  36. The pharmacokinetics and the pharmacodynamics of cannabinoids – 2018

 

Medical Marijuana – Product Evaluation

  1. Recommended methods for the identification and analysis of cannabis and cannabis products – 2009
  2. The Cannabinoid Content of Legal Cannabis in Washington State Varies Systematically Across Testing Facilities and Popular Consumer Products – 2018
  3. Quality Control of Traditional Cannabis Tinctures – Pattern, Markers, and Stability – 2016
  4. Cannabinoid, Terpene, and Heavy Metal Analysis of 29 Over-the-Counter Commercial Veterinary Hemp Supplements – 2020

Emphasis on Education

 

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