Written by: Sam Tyhonas
Edited by: Jacinda Taggett, Samira Rodrigues Dantas
Introduction
Recently, I took an online class at my institution about medical marijuana. I took this course as a way to properly educate myself on how it can work as a medicine, since I was considering getting my own medical marijuana card at the time. After taking the course, I became hooked on what kind of impact it could have on those who struggle with neurodivergent or neurological disorders. Although medical marijuana is becoming popular throughout the United States, there is still a lack of research on this subject to prove just how helpful it can be. To understand how marijuana can be used as a medicine for neurological disorders, we need a general understanding of both of these topics.
History of marijuana
Throughout history, cannabis was treated as any other plant. In early human societies, it was used to craft clothing, accessories, textiles, and more. Some cultures even include it in beverages such as bhang, which is a milkshake-like drink containing cannabis stems. According to research professional Meng Ren, wild cannabis plants have been discovered growing in areas around Central Asia, including countries such as China, Pakistan, and Afghanistan. This area is known as the Pamir Plateau, which is where the Jirzankal Cemetery is located. This cemetery has been shown to have biomarkers of cannabis on wooden braziers after gas chromatography was conducted. (Ren et al., 2019) Despite cannabis having a reputation for being used recreationally, there are records from India discussing medicinal usage prior to domestication in China. From the Sushruta Samhita (an ancient Sanskrit text written in 6th century BCE), it is claimed that cannabis was recommended for phlegm, catarrh and diarrhea. It has also been observed that the fumes of Cannabis Indica were used as an anesthetic prior to western medicine. (Russo, 2005). Although humanity’s relationship with cannabis has lasted thousands of years, within the last hundred of those years, the United States has turned this plant into an area of political discussion (Hudaks, 2016, p. 1).
In the late 1920’s to 1930’s, many different political events occurred which eventually led to the illegalization of cannabis, such as the Marijuana Tax Act of 1937. The controversy started around the time Harry Anslinger (the first commissioner of the Federal Bureau of Narcotics) was elected into office and thrusted the illegalization of cocaine and heroin into action. He knew that attacking such a small demographic would not benefit his department, so he instilled a fear of cannabis in the general public by stating, “Marijuana is the most violence-causing drug in the history of mankind", and used his confirmation bias to only showcase researchers that agreed with his point of view. The other tactic Anslinger used to criminalize cannabis was inherently racist. Although the term ‘cannabis’ was used frequently in the early 1900’s, he sensationalized the term ‘marijuana’ to associate the drug with Mexican immigrants. He claimed the use of marijuana would lead to interracial marriage or sexual relations, as this would strike fear into the hearts of white Americans. Despite this, there were a few influential figures who attempted to speak out in support of cannabis. Fiorello LaGuardia released the LaGuardia Report, and using scientific reasoning, the report concluded that marijuana did not cause any of the issues Anslinger claimed it was causing, including violence, mental illness, or sexual deviancy. Unfortunately, nothing much came of this report when it was released in 1944. Now, almost 100 years later, cannabis is classified a Schedule 1 drug. Within the drug scheduling guide in the United States, there are five distinct categories, where the number gets lower on a one through five scale if it is at higher risk for abuse and there is no accepted medicinal use. Recently, government officials attempted to change cannabis’ status as Schedule 1 due to the rise in medicinal use within the U.S., but these changes were nullified. Present day, scientists are conducting proper research studies on cannabis to disprove the racist agenda of corrupt politicians.
THC and CBD
One type of cannabis, known more formally as Cannabis sativa or hemp, is very low in THC, which is the psychoactive substance within cannabis. Cannabis indica is the type of cannabis we use today either recreationally or medicinally, as it has higher levels of THC. This molecule is what gives users the feeling of being “high”, but it has many other benefits than simply recreational use. Many of those who use THC medicinally report chronic pain significantly decreased, as well as more sleep and an increased appetite. If used improperly—such as using it too frequently, using unregulated cannabis, or using cannabis with high levels of THC without the advice of a medical professional—it can cause undesired effects, usually including deficiencies in areas such as working memory, decision making, and controlling impulses. (Petker et al., 2020) CBD is not known to cause any undesirable effects, but rather is used frequently to treat anxiety, stress, insomnia, and various symptoms associated with cancer and chemotherapy. Due to the limited research that has been performed on CBD alone, there is not much conclusive evidence supporting what the chemical can do on its own. Valuing THC as the more important compound or interesting research topic may lead to more users underestimating the effects CBD can have depending on your endocannabinoid system, as well as researchers failing to perform proper studies on cannabis.
When we inhale or ingest cannabis, both of these compounds attach to endocannabinoid receptors (referred to as CB1 and CB2 receptors in the diagram below), which are part of our natural endocannabinoid system. An endocannabinoid is a type of neurotransmitter throughout all vertebrates that assists in regulation regarding immune responses, inflammation, and many other physiological processes. If a patient uses a strain of cannabis that has higher levels of THC than CBD, more receptors will pick up on THC. For someone with a chronic pain disorder, this would be beneficial to help ease their pain; however, for someone with a mood disorder like bipolar 1, it may lead to their symptoms worsening. CBD (cannabidiol) is the other compound within marijuana, which is also known to help with pain relief. CBD is not psychoactive, but works as an antipsychotic, which means it can help treat conditions like schizophrenia, anxiety disorders, or depression by crossing the blood-brain barrier and binding to endocannabinoid receptors without binding to these receptors directly like THC would. When THC binds to these receptors, it allows for the complete activation of the receptor, which gives THC the term of an agonist. The alternative, antagonist, is used for chemicals that block a receptor. The issue comes in when someone uses too much THC than their endocannabinoid system is made for, which can result in more serious effects if used long-term as discussed previously. Since CBD does not function the same way, it is a partial agonist. Although current research regarding how THC and CBD function on their own, it is thought that CBD is able to reduce the strong binding of THC to alleviate negative side effects while using cannabis due to its biphasic nature (Seeman, 2016).
Medical professionals worldwide advocate for both compounds, but many treat THC as if it is unsafe to use due to the psychoactive effects it has. Although both compounds do different things, they have shown that they work better together than separate; this theory is referred to as the entourage effect. This theory may need some more testing, but there are other studies that may allude to this theory having some truth to it. For example, in a study testing how cannabis can be used to treat bipolar, there were some conflicting results. When studying CBD, scientists found that it has a similar pharmacological profile to other antipsychotics, but there were patients that reported worsening symptoms after using cannabis. This is likely due to the impact of high levels of THC. (Sagar et al., 2016) To make sense of why this could be, we need an understanding of what is happening internally.
There still needs to be further research done on how it can work with mood disorders, since there are also some studies that claim it helps, but that may be due to a more equal amount of THC and CBD content in the strain a patient is given. Cannabis is a very complex substance, but this does not mean it is entirely unreliable. For example, an article by Alejandra Delgado-Sequera was written to determine the molecular and cellular effects cannabis can have on Bipolar disorder type-I (BD), including alterations such as inflammation, apoptosis (more commonly known as cell death), lipid metabolism, and much more. This study presents another article that indicates BD and Cannabis Use Disorder (CUD) share some of the highest comorbidities within psychiatric disorders (Lalli et al,. 2021). Despite this claim, the Delgado-Sequera later states that apoptosis significantly decreased in BD patients that use cannabis (Delgado-Sequera et al., 2021). This finding is incredibly exciting to pharmacological research, as patients with BD are shown to experience apoptosis more frequently when unmedicated. While those with BD may be more likely to use cannabis as a way to cope, there is always a risk of addiction when using it in an unregulated way. Such as any other drug, cannabis has risks, but it can be extremely helpful when treated like a pharmaceutical.
What does this mean?
In the neuroscience field, many professionals are still skeptical of the benefits of cannabis. In order to change the perception of it, more quality research needs to be performed to prove how useful cannabis can work as a medicine. Many individuals use cannabis as a way to ease their daily chronic pain, and others use it to ease the negative symptoms of mood disorders. Despite the fact that this plant has been used for thousands of years while avoiding government regulation, Harry Anslinger and other politicians corrupted the way Americans view drugs and drug addicts, which has influenced the opinions other countries have as well.
Humans are incredibly complicated organisms, and the way individuals react to certain drugs can have hundreds of possibilities, but we need to continue working to grow our current body of knowledge. While it is important to discuss the positives and negatives, it is equally as important to realize that allowing cannabis to remain federally illegal deprives thousands of people from access to life changing medicine. We must continue to evolve as a society and move on from this traditional way of thinking and become pioneers in the field of neurology. By reducing negative perceptions of cannabis and performing many large-scale studies, we can create a healthier and happier society, ensuring those with uncontrollable illnesses a more fruitful and extensive life.
References
Alejandra Delgado-Sequera, Clara Garcia-Mompo, Ana Gonzalez-Pinto, Maria Hidalgo-Figueroa, Esther Berrocoso, A Systematic Review of the Molecular and Cellular Alterations Induced by Cannabis That May Serve as Risk Factors for Bipolar Disorder, International Journal of Neuropsychopharmacology, Volume 27, Issue 2, February 2024, pyae002, https://doi.org/10.1093/ijnp/pyae002
Hudak, J. (2016). Marijuana: A Short History. The Brookings Institution.
Lalli M, Brouillette K, Kapczinski F, de Azevedo Cardoso T (2021) Substance use as a risk factor for bipolar disorder: a systematic review. J Psychiatr Res 144:285–295.
Petker, T., DeJesus, J., Lee, A., Gillard, J., Owens, M. M., Balodis, I., Amlung, M., George, T., Oshri, A., Hall, G., Schmidt, L., & MacKillop, J. (2020). Cannabis use, cognitive performance, and symptoms of attention deficit/hyperactivity disorder in community adults. Experimental and Clinical Psychopharmacology, 28(6), 638–648. https://doi.org/10.1037/pha0000354
Ren, M. (2019, June 12). The origins of Cannabis Smoking: Chemical Residue Evidence from the first millennium BCE in the pamirs. Science. https://www.science.org/doi/10.1126/sciadv.aaw1391
Russo, E. (2005). Cannabis in India: ancient lore and modern medicine. In: Mechoulam, R. (eds) Cannabinoids as Therapeutics. Milestones in Drug Therapy MDT. Birkhäuser Basel. https://doi.org/10.1007/3-7643-7358-X_1
Sagar KA, Dahlgren MK, Racine MT, Dreman MW, Olson DP, Gruber SA (2016) Joint Effects: A Pilot Investigation of the Impact of Bipolar Disorder and Marijuana Use on Cognitive Function and Mood. PLoS ONE 11(6): e0157060. https://doi.org/10.1371/journal.pone.0157060
Seeman, P. (2016). Cannabidiol is a partial agonist at dopamine D2High receptors, predicting its antipsychotic clinical dose. Transl Psychiatry 6, e920. https://doi.org/10.1038/tp.2016.195
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