More than 70 of the 400 ingredients of cannabis make up a group of cannabinoids, biologically active substances of a special structure found exclusively in the cannabis plant. The main component responsible for the psychoactive properties of cannabis is trans-delta-9-tetrahydro-cannabinol (THC). But the total effect of cannabis is determined by all active cannabinoids. Delta-8-THC, the content of which is much lower than THC (according to some data, there is no delta-8-THC in the freshly collected material at all, has the same activity as THC. Cannabinol (CBN) is ten times less active than THC, Cannabidiol (CBD) does not have psychoactive properties. The content of THC, like other cannabinoids, depends on the type of plant. In the Indian variety of cannabis, in addition to trans-delta-9-THC, there are noticeable amounts of: a THC analog with a propyl side chain delta-9-tetrahydrocannabivarin (THB) and cannabidiol, in smaller amounts – cannabidivarin, cannabichromine, cis-delta-9-THC, cannabivarin and cannabinol. In trace amounts-cannabigerol, cannabicyclol and butyl analogues of THC, CBN and CBD. Like THC, cannabinol and cannabidiol have a five-membered hydrocarbon chain as a substituent in the aromatic core. Propyl homologues of CNB and CBD: cannabivarin and cannabidivarin make up from 0 to 20% of their total content. Homologues with a butyl substituent account for less than 1% of the amount of CBN and CBD. In addition to neutral cannabinoids, various cannabinolic acids are present, especially in the forms of resin and oil.
In addition to cannabinoids, cannabis contains many substances of other classes: terpenes, steroids, carbohydrates, phenols, carboxylic acids, nitrogen-containing compounds, alkaloids.
According to some data, there is no delta-8-THC in fresh plant material, but the isomerization of D-9-THC in D-8-THC is very easy.
In 2003, the journal Nature Medicine noted that the endocannabinoid system of the brain is involved in various processes of pain, memory, neurodegeneration and inflammation, and that cannabinoids have significant clinical potential.
According to The Guardian newspaper, scientists from one of the leading research centers in Madrid have found evidence that cannabis can prevent memory loss in patients suffering from Alzheimer’s disease. Their study showed that tetrahydrocannabinol – the main psychoactive component of cannabis-inhibits the activity of cells that cause damage to brain neurons.
Cannabis and its preparations are successfully used to improve the conditions of patients with cancer and AIDS. THC is successfully used in the fight against nausea caused by the use of anti-cancer drugs; this substance is approved by the American Food and Drug Administration for the above purpose. In some countries (for example, the Netherlands and Canada), cannabis is used as a medicine for cancer patients, as an antiemetic used in chemotherapy. At the same time, pharmacological studies do not show the advantages of cannabis over other, more traditional antiemetics and analgesics. As a result, the appointment of cannabis preparations is an exception, with individual intolerance to traditional drugs.
Meanwhile, in the United States, legislation prevents the conduct of full-fledged studies of the clinical effectiveness of cannabinoids. At the same time, in the UK, the government allowed a pharmaceutical company to grow various varieties of cannabis for the purpose of clinical trials of the cannabinoids obtained from it.
The main physiological manifestations of the effects of cannabinoids on the human body, depending on the dose, are:
1. injection of the conjunctiva of the eyeballs (redness)
2. tachycardia (increased heart rate), and as a result-an increase in blood pressure.
3. dry mouth.
People who use cannabis may also experience short-term acute states of anxiety, sometimes accompanied by paranoid ideas. Anxiety can be so strong that it reaches the severity characteristic of the so-called panic reactions. Panic reactions (in the slang of those who consume marijuana/hashish – ‘treason’), although not very typical, are still the most common form of inverse reactions to moderate use of cannabis products, and are more likely to manifest themselves, among other things, because the use of cannabis is prosecuted by the legislation of most countries. A person sometimes believes that a violation of the body scheme is a disease and, perhaps, it will cause death, or he believes that the psychological disorders caused by the substance are the result of insanity. These panic reactions rarely permanently disable the patient, as they are usually short-lived. Some researchers believe that panic attacks are the result of stimulating the areas of the brain responsible for imagination and creativity, thus leaving room for self-control.
The best way to help a person at this moment is to give him a drink of hot sweet tea and calm him down. The probability of occurrence of reversible reactions is proportional to the dose used and inversely proportional to the consumer’s experience in using the drug. Thus, the most susceptible to these reactions are inexperienced people who, having no experience with the drug, take too large a dose that causes perceptual and somatic disorders.
Another rather rare reaction to cannabis is the so-called flashback, or flashback scene, which is a spontaneous return of symptoms caused by drug use when the subject is out of a state of intoxication. There is evidence that this effect can also be observed in people who abuse cannabis products, who have not previously used any other drugs. In general, however, recurrent outbreaks are characteristic only for people who use more powerful hallucinogens or psychovudelics, who smoke marijuana after these substances. When these recurrent scenes are observed after the consumption of hallucinogens, they are classified as a post-hallucinogenic perception disorder.
With regular use of cannabis, there is some tolerance associated with a decrease in the effect of the drug, while in order to achieve the desired effect, the smoker has to use large doses of cannabis, with frequent use of large doses of the desired strength, the effect may not occur at all. Tolerance is often weakened when switching to another variety of cannabis, smokers suggest that this is due to the fact that delta-9-THC is not the only one of the psychoactive cannabioids, and each variety contains its own set of cannabioids.
Psychoses caused by the use of cannabis mainly occur in India, Egypt and Morocco; they were more often observed in the late XIX – early XX centuries than now. These are prolonged psychoses caused mainly by the chronic consumption of high doses of the substance. They are not described in people who chronically smoke marijuana in the United States. In a number of studies conducted on a large number of cannabis users, it was found that psychoses do not occur in people without special disorders, with a stable psyche.
A number of other studies conducted at a high methodological level have shown that the use of cannabis can “trigger” the development of severe mental illnesses, such as schizophrenia and similar diseases. It is assumed that this effect is more likely in those who have a genetic predisposition to the development of these mental illnesses. In addition, there is evidence that in people with schizophrenia or other mental illnesses that occur with periodic psychoses, the use of cannabis provokes an exacerbation of psychotic disorders even with careful intake of antipsychotic drugs.
With frequent use of high doses, sometimes there is a slight withdrawal. However, there are no clinical withdrawal syndromes, and the person also does not feel a serious need to increase the dose of the substance in connection with withdrawal. A passionate desire to take the drug or a difficulty to refuse it may take place, being part of a pathological complex. There may be such rare manifestations of withdrawal syndrome as sleep disorders, irritability, nausea, vomiting, tremor and sweating.