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Abstract
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Legislative changes in Australia and around the world have facilitated access to medical cannabis. This has occurred in the context of societal shifts in attitudes towards cannabis as both a recreational and therapeutic drug. There is support and enthusiasm for the use of medical cannabis both among general practitioners (GPs),1 and within broader society. Many GPs will have patients who have either used medicinal cannabis or are considering its use, and who have questions about its effectiveness and side effects.
A basic understanding of the physiology of the endocannabinoid system (ECS) can help clarify the rationale for prescribing cannabis, as well as the enthusiasm for further research. The ECS is composed of endocannabinoids, cannabinoid receptors and associated enzymes.2 Two key endocannabinoids that have been identified are anandamide and 2-arachidonoylglycerol, and the two key receptors are CB1 and CB2.
The cannabis plant contains hundreds of biologically active compounds, with the most prominent and well understood phytocannabinoids being Δ9-tetrahydrocannabinol (THC) and cannabidiol (CBD). These molecules interact with the ECS, resulting in their pharmacological effects. THC and CBD have different mechanisms of action,3 and these differences are associated with particular therapeutic and side-effect profiles. For example, THC is associated with the psychoactive and euphoric effects of cannabis, whereas CBD is not intoxicating and has minimal side effects. As a result, low-dose CBD products have recently been down-regulated to Schedule 3 medications, but as yet no products have received Therapeutic Goods Administration approval...
Keywords: Cannabis impaired driving
Language: en |