Cannabinoids: Introduction – Drugs of Abuse

by Pravin Shukle, MD

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    00:01 Welcome to Pharmacology by Lecturio.

    00:04 Today’s topic are the cannabinoids in our section in toxicology.

    00:09 Now, discussion about the cannabinoids is highly politicized.

    00:12 I’m gonna try and stay away from the politics of cannabinoids and legalization and just focus on the pharmacology.

    00:19 Remember that most of the information that patients are getting and by extension some doctors is poor research that is very easily available on the internet.

    00:30 The good research that is being done is far and few between.

    00:33 Much of the research that is being done now is actually sponsored by companies that sell cannabinoids so it is particularly suspect.

    00:42 Most of us are very suspicious of research that is positive for cures or claims of cures - cures for cancer, cures for depression, cures for AIDS, cures for all kinds of diseases are being put out by those people who are proponents of cannabinoids.

    00:59 Peer reviewed studies are expensive and often attacked in the public sphere so one has to be very careful about the information that you’re using when you're talking about cannabis and cannabinoids.

    01:12 Now, before we go on and talk about the cannabinoids and the medical aspects of it, let’s define what we’re talking about.

    01:20 Hemp is a plant, we often confuse it with cannabis.

    01:24 Cannabis is also a plant that is derived from hemp but it is a special kind of hemp plant.

    01:30 Now we have different strains of cannabis out there there’s cannabis sativa, cannabis indica, cannabis ruderalis and cannabis Americana.

    01:39 There are those proponents who will tell you that there are significant differences in pharmacological makeup and effect when smoked of these different types of cannabis but I don’t believe that personally and recent research that has come out of Britain is also supporting that point of view, that there’s not really a lot of science behind distinguishing between the different plants.

    02:02 Now, hemp is the plant from which all cannabinoids originate.

    02:07 It is a good source of fiber, it’s a good source oil including cooking oil.

    02:12 It is used as a mop crop, it is used for biodiesel, it’s used for cordage, it’s used for paper, and it can even be used for plastic.

    02:20 Burning hemp is not a dangerous thing.

    02:24 You can’t get high from burning hemp. In terms of the seeds of hemp, you get over 5,000 almost 6,000 calories per kilogram from the hulled seeds so it’s a great source of energy for either nutrition or for animal feed.

    02:42 The amino acid profile is very similar to milk and soy so it can be used to produce milk.

    02:48 It has a very low THC concentrations in the hemp plant so with respect to industrial hemp, you’re not going to get high from industrial hemp and the danger that hemp poses to society is often over stated by certain elements.

    03:04 Now, cannabinoids are a little bit different so let’s compare them.

    03:08 Hemp is applied to varieties of cannabis that is used for non-drug use.

    03:15 It has very low levels of THC, cannabis is applying to those varieties that have been breed specifically to produce some maximum amount of THC and CBD most cannabis has been genetically modified.

    03:30 Marijuana is a term used to refer to the unrefined dried plant that is rolled into joints or blunts or used for a smoking purpose by some people in the social justice area who are warriors for certain causes, that term is now being deemed as racist.

    03:50 I don’t know if that is going to stick or not, I don’t know if marijuana is gonna fall off as a term that we use commonly - just be aware that there is some elements of society who are suggesting the use of the term marijuana may be racist, I personally don’t buy that as a visible minority.

    04:07 Decarboxylation, so what is decarboxylation? We know from chemistry class the decarboxylation is the process of taking off a carboxyl group.

    04:15 Now the terpenes, found in a cannabinoids have a carboxyl group on them.

    04:22 The carboxyl group prevents binding THC or CBD to the cannabinoids receptor inside the human body, therefore, a carboxylated terpene does not cause you to get high.

    04:37 When you decarboxylate that agent, you end up with decarboxylated product that can get you high.

    04:45 Now, as I said before carboxylated cannabinoids are referred to as terpenes, so these are the different types of terpenes that are available.

    04:52 Now the terpenes themselves are rumored to have anti-inflammatory properties, that’s more claims than it is science so we don’t really know how seriously to take that.

    05:02 In terms of where you see the most terpenes, you’ll tend to see it in freshly picked plants less than three days of refrigeration.

    05:14 How does one decarboxylate cannabinoids? In the oven, you can put it at a 150° for 40 minutes, in a microwave for three minutes.

    05:23 You can do a sous-vide process for 90-100 minutes.

    05:26 The advantage of this process being there’s no odors and finally you can use a chemical decarboxylator and that would take about two hours.

    05:37 I also wanted to find what the entourage effect is.

    05:40 An entourage effects is kind of like a drug interaction but not quite.

    05:45 Compounds in cannabis that are non-psychoactive on their own might modulate the psychoactive properties of other products within the cannabinoids so an example is this, take a look at CBD, it can modulate the TCH effects in the cannabinoid.

    06:03 It may reduce the negative effects of TCH on memory so there may be an entourage effect of CBD on TCH.

    06:15 Myrcene is another product that’s found in many cannabinoids.

    06:18 It enhances the sedative effects of cannabinoids.

    06:23 Now you may hear some patients talk about coach lock when they smoke weed that is seen often when people are combining beer and cannabis or sometimes the myrcene itself is in very high concentrations and that particular brand of cannabis or marijuana is causing the coach lock.

    06:42 The treatment of it in terms of what people will do at home is sugary caffeinated type of drinks seem to help.

    06:50 You tend to used strings with more CBD to prevent yourself from getting coach lock.

    06:57 Now in terms of the treatment with the sugary drinks that’s just anecdotal, there’s not really a lot of science behind it.

    07:03 In fact the whole idea behind the entourage effect, there’s really not a lot of scientist more just sort of stories told to us by our patients.

    07:13 Linalool is a particularly interesting phenomenon.

    07:16 So linalool is an asymmetric alcohol.

    07:19 Most alcohols clinically structured early speaking are symmetric alcohols, this is an asymmetric alcohol.

    07:27 You can see that there’s half of a benzene ring on one side of the chain and a double bonded methyl group on the other.

    07:34 Now, these - because they’re asymmetric you could have two enantiomers of that particular alcohol and the alcohol is actually considered a terpene.

    07:44 Now we sometimes see these terpenes in spices and flowers and it’s often used as a scent in perfume.

    07:51 Now this product modulates glutamate and GABA neurotransmitter symptoms to enhance the sedative and anti-anxiety effects of THC.

    08:04 It also may worsen confusion; I would say almost guaranteed to worsen confusion.

    08:10 There’s something that’s an absolutely fascinating phenomenon called the ghost effect which has been clinically documented.

    08:17 The ghost effect is the reactivation of THC sedation and confusion as well, when linalool is inhaled in perfumes.

    08:27 So this is without further THC consumptions so it’s an interesting concept, it’s kind of fun for pharmacology types but what is happening here is that people have ingested THC.

    08:39 They’ve already had their high from the THC and they go down to the grocery store or to the local department store and they smell a perfume with linalool and all of a sudden, they get high again, this is the kind of process that’s happening and it’s because the terpene linalool in the perfume is reactivating the THC.

    09:01 Now, I talked about this as being clinically documented, I talked about it kind of as an interesting phenomenon but it’s probably an overestimated effect so those people who talk about being allergic to perfumes may actually be concerned about a THC reactivating syndrome more so than they are actually allergic to the perfume so you have to be particularly alert and aware to what your patients are saying at any given time.

    About the Lecture

    The lecture Cannabinoids: Introduction – Drugs of Abuse by Pravin Shukle, MD is from the course Toxicology.

    Included Quiz Questions

    1. Hemp
    2. Cannabis
    3. Marijuana
    4. Heroin
    5. Clonazepam
    1. It may reduce the negative effect of THC.
    2. It enhances the psychotic effects of THC.
    3. It causes couch lock.
    4. It increases the craving for sugary drinks.
    5. It decreases the sedative effect of THC.
    1. By modulating glutamate and GABA neurotransmitter systems
    2. By modulating the acetylcholine neurotransmitter system
    3. By modulating the dopamine neurotransmitter system
    4. By modulating the serotonin neurotransmitter system
    5. By modulating the endorphin neurotransmitter system
    1. Improved lung function
    2. Improved cognitive skills
    3. Improved memory
    4. Improved sleep
    5. Decreased risk of depression

    Author of lecture Cannabinoids: Introduction – Drugs of Abuse

     Pravin Shukle, MD

    Pravin Shukle, MD

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