Cannabis has been a friend of humankind since before the written word. It has provided fiber from its stalk, nutrition from its seed and its roots and from the flower we’ve gotten medicine. And cannabis has a very rich history as a medicine, in many different cultures going back thousands of years including in the united states. In the second half of the 19th century, cannabis tinctures were an important essential part of the american medicine cabinet. But we’ve lost the connection with the plants in terms of its therapeutic possibilities because of prohibition. A prohibition imposed federally in 1937 and it has continued federally until this very day. And because of the illegal status of marihuana and cannabis we have lost an understanding that our forefathers and foremothers have had about how to use this plant therapeutically.
And there’s other reasons that are crucial that really underscore the need to re-establish a relationship with this plant. Because today it’s not just a matter of lighting up a joint and smoking it. It’s not that simple anymore. And while that can confer a lot of benefits for many people and has. These days we also have very potent cannabis oils with different mixtures of THC (tetrahydrocannabinol) the high causer, and CBD the part of the plant that doesn’t make you feel high. These are available in many different forms and that’s confusing to people. People who don’t really necessarily know how to use these different formulas. When someone walks into a dispensary, they look at different product options and they don’t necessarily know what to choose. They don’t have the guidance from a physician. They’re not necessarily even getting the guidance they need from the dispensary staff.
The basics of CBD
What we would like to do in this article is focus very pragmatically on how we can best use these cannabis oils with different ratios of CBD and THC. How we can use them for maximum therapeutic benefit. So let’s start by just going back and and looking at some of the basic facts about CBD otherwise known as cannabidiol.
CBD is a plant cannabinoid. It’s a molecule and a compound in the cannabis plant. And so is THC. They’re both cannabinoids. CBD is not psychoactive like THC. It doesn’t make you feel high when you ingest it.
The discovery of cannabinoids CBD and THC
CBD was discovered in 1940 by Roger Adams an american scientist. He first identified CBD as part of the cannabis plant but its molecular structure was not elucidated until 1963 by dr. Raphael Mechoulam, the israeli scientist who did the same for THC the following year. CBD has astonishing therapeutic potential and that’s what we want to focus on. Not just as a single molecule but the whole plant.
When CBD was first identified molecularly and understood how it was configured, that didn’t necessarily trigger a lot of research right away into the therapeutic potential of CBD. The focus was more on THC because that was understood to the part that get a person high or stoned. So that’s where more the research money (to the extent that was any available in 60s) was focusing on.
But there was a scattering of a few different clinical studies in israel and brazil, mainly those two countries. And in 1980, there was a study involving about a dozen people, mainly children, which showed that CBD had a dramatic effect in terms of reducing seizures. So there was a hit a long time ago for CBD seizure control properties, it’s anticonvulsant properties.
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Cannabinoids as very effective neuro protectants & antioxidant
Fast forward a little bit to 1988. That was a year a research study was published, it was funded by the national institute of health, and it identified the plant cannabinoids both THC and CBD as very potent neuro protectants and antioxidants. And that these compounds had an ability to neutralize the damaging effect of free radicals in the body. And so it would protect neurons. Protect brain cells from degeneration as a result of this antioxidant activity.
That formed the basis of actually a patent that the federal government took out at night. It was in 2003 the patent was filed and it’s misconstrued today to be a patent about CBD. It was a patent not just about CBD, but CBD and THC and plant cannabinoids in general based largely on research into both THC and CBD.
The scientifically identified properties of CBD and THC
Both CBD and THC scientifically have been shown to produce or to trigger neurogenesis. Meaning the creation of new brain cells in adult mammals. And while back, maybe 30 years ago or so, that was thought to be impossible. It was thought once the brain cell was damaged that was it, they can never regenerate.
Well now we have a new paradigm in terms of brain science, that’s reaffirmed by the research into cannabinoids. In terms of CBD’s properties it’s been studied as a single molecule fairly extensively by scientists around the world now.
It’s been shown to have:
- Antitumoral properties
- Antispasmodic properties
- Anticonvulsant properties
- Antidepressant properties
- Antipsychotic properties
- Anti-addictive properties
Furthermore it’s assumed to be an anxiolytic meaning anxiety reducing agent and it’s shown to have antibiotic properties and also to be an analgesic (painkiller). And that’s just single molecule CBD what has been shown in laboratory experiments.
The interaction of cannabinoids as opposed to isolated cannabinoids
But we’re gonna focus on whole plant CBD. And we’ll look at the difference between the single molecule and the whole plant CBD. First thing that is really important to emphasize in terms of cannabis therapeutics is, that CBD and THC work best together. They have a synergistic relationship. If you want to get a maximum therapeutic benefit in terms of working with these compounds, they should be seen as working together.
One can access single-molecule THC, it’s available by prescription today, available in all 50 states legally by prescription. You can also access single molecule CBD on the internet. But we’re going to look at the synergistic interplay between them and how they enhance each other’s effects.
It’s known that CBD can actually potentiate, make stronger THC’s pain-killing effects. This has been shown in a sense of actually clinical research in addition to preclinical studies. It’s known that CBD can enhance cannabis efficiency or efficacy for dealing with neuropathic pain for treating autoimmune diseases, cancer and other conditions.
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CBD broaden the range of conditions that are treatable with cannabis
When CBD and THC are together they work better for those conditions. Also, once CBD is now part of the picture, it’s part of the grassroots mix again, after have been say ignored within the grassroots scene because the emphasis was on getting high.
Once CBD reappeared as part of the grassroots mix starting in 2009 in northern california and people began to use it as part of CBD rich cannabis preparations, we saw very clearly that CBD can actually broaden the range of conditions that are treatable with cannabis that aren’t necessarily so responsive to the THC dominant remedies.
We are talking about liver conditions, cardiovascular conditions and metabolic disorders.
Here is an example of that synergy with CBD and THC from a scientific study conducted at the California Pacific Medical Center published in 2010. And this is about how CBD will magnify THC’s inhibitory effect on brain cancer. And the actual abstract reads:
CBD enhances the inhibitory effects of delta 9 THC on human glioblastoma cell proliferation and survival. The study showed that THC alone had anti-cancer / antitumoral properties. CBD alone as well with respect to these brain cancer experiments. But when combined together that was a stronger effect than either had alone.
The psychoactivity of cannabinoids
Important to keep in mind that CBD is not psychoactive like THC. Now many people enjoy the cannabis high. Others find THC to be unpleasant. It makes them anxious, paranoid, of whatever reason they don’t like that experience.
The good news is that, with CBD it can lessen or neutralize the THC high depending on how much of each compound is in a given strain or product. And what it means is that a greater ratio of CBD to THC will mean less of a high.
Now you have a situation in states with robust medical marijuana programs, where you have cannabis oil concentrates with varying ratios of CBD to THC. So patients can use them and adjust the ratio between THC and CBD and adjust the dosage.
If they want that can actually eliminate the psychoactivity entirely. They can eliminate the high effects if that’s not what they’re comfortable with. They can find the right degree of psychoactivity that suits their needs and sensitivities. So patients have options.
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CBD to THC ratio – is there an ideall ratio?
The important here is, that there’s no single one ratio of CBD and THC that’s right for everybody. There’s no single dosage or product that’s right for everybody. Cannabis patients do have the option today of healing without the high. But a low THC remedy might not necessarily be been the most effective remedy.
A combination of CBD and THC together will have a greater effect than either of compound will have alone. So it’s really all about personalized medicine. Cannabis therapeutics is personalized medicine.
The challenge at least in terms of dealing with the cannabinoid component of cannabis medicine is for a person to find that ratio of THC to CBD, so that it’s comfortable for them. A person sensitivity to THC is a key factor in terms of determining of the ratio and dosage of a particular CBD rich medicine.
CBD rich medicine with at least some THC is preferable
When we say CBD rich medicine we don’t mean to suggest that it’s a medicine without THC. It always should have some THC in there to be most effective. So patients can adjust the psychoactive effects by adjusting ratio and dosage.
And for cannabis naive patients, for people who are coming into the medical marijuana world, you know sort of fresh and new and there might be senior citizens or younger people, best generally to start with low doses of a low THC remedy. That won’t be psychoactive.
It’s a comfortable way of sort of easing into the use of cannabis. Won’t get a person high or stoned. Not that’s necessarily a bad thing. We don’t think that’s a bad thing at all but for some people it’s very uncomfortable.
So in essence, the goal of cannabis therapeutics at least for starters is to for a person to administer consistent measurable doses of a CBD rich remedy that has as much THC included in the remedy as a person is comfortable with.
The dosage is everything even with a treatment with cannabinoids
Dosage is everything. That’s the same from paracelsus going back several centuries.
When we talk about personalized medicine, we think that the emphasis should be on the person rather than on the condition per se.
Remember we’re treating a person, we’re not treating a condition.
And it’s not so much a matter of finding the perfect ratio or dosage for the specific condition.
As if you can line them all up and say this is what works best for cancer, this what’s works best for neurological disease or whatever. No, it’s more about finding what’s comfortable and appropriate for the individual. And for some people they might do best with a balanced ratio of THC and CBD in there and they’ll do well with that.
Other people might not be able to handle that personally, because it might be too psychoactive. So they’ll use something that has more CBD and less THC and they could also do very well with that.
So the point is not so much to to gear it toward a condition as toward where a person is coming from, what their history of cannabis use is, how comfortable they are with cannabis and so forth.
There are some patterns in ratio and dosage
Having said that, we do see patterns at “the hemp oil benefits” now for a number of years. People have been using these potent oils with mixtures of THC and CBD. It’s possible now to measure these dosage and the ratios very precisely.
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High CBD – low THC Ratio
And we do see patterns and we could see that when people are presented with anxiety as a principal issue they tend to do better with a CBD dominant remedy with little THC. Also for people dealing with depression or spasms and pediatric seizure disorders, it tends to be the same thing. The patients initially at least do well with a low THC high CBD cannabis oil product.
One to one ratio of CBD to THC
However, for other conditions like cancer, neurological disease, gut issues and other conditions, we hear from patients that they do better with a one to one ratio with THC and CBD. A balanced ratio. And again it’s a matter for a person to find what’s comfortable for them.
There’s been extensive clinical trials conducted by GW-Pharmaceuticals, a british based company, they showing that a one to one ratio, a balanced ratio between CBD and THC is best for pain management.
There’s been extensive clinical trials in europe and in other countries but not so much in the united states on this. And there’s a one to one CBD rich sublingual spray called Sativex, produced by GW-Pharmaceuticals that’s actually approved for use in over two dozen countries including canada and many in the european union.
So we know, that if a person is dealing with chronic pain, and it’s neuropathic pain, the kind of pain that opiates don’t really address very well, we know this extensive clinical research showing that a balanced ratio between CBD and THC could be helpful for a person struggling with that issue. If they’re comfortable with that kind of psychoactivity which a 1:1 ratio may confer.
Cannabis and autoimmune diseases
When we’re talking about cannabis, almost any strain of product will have a significant potential in terms of dealing with autoimmune diseases.
Because autoimmune diseases involve situations when your immune system kind of overreacts to a problem that’s not there.
And there’s too much of you immune activity, too much inflammation and many different diseases are autoimmune diseases.
Well, it’s known that cannabinoids binds to a receptor, a cannabinoid receptor, it’s called the CB2 receptor that are found generally in the peripheral nervous system and metabolic tissue and to immune cells as well.
Because cannabis has compounds in it, particular THC that binds to this receptors. It can regulate immune function, it can dial back an overactive immune system. We would go so far as to say, pretty much any cannabis strain potentially could be helpful for an autoimmune disease.
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Products and administration of CBD
Now in terms of the products that are out there today there’s all kinds of CBD rich products. Pretty much the same ways you’d get your THC dominant products.
You can smoke CBD rich cannabis, you can inhale it using a vaporizer, it can be made into edibles lozenges, beverages, gel caps, sublingual sprays and tinctures, suppositories, topicals, ointments, transdermales and just simple oil concentrates that can apply with an applicator.
So all those different forms of administration are possible for CBD rich products and the same way would be for your THC dominant products.
What do you look for when you’re seeking a CBD rich product
There’s certain things that are essential for any cannabis product at this point. It’s important that these products be labeled very clearly. There should be clear labels that specify what is the quantity and ratio of CBD and THC per dose in the product.
There are products out there in dispensaries that have that information. And we think that’s a standard that all product makers should aspire to. Products that have been lab tested to assure that it’s free from mold, pesticides, solvent residues and other contaminants.
There is equipment today available to measure these things and a product should be verified as being clean.
We want products with quality ingredients. There shouldn’t be any corn syrup in any cannabis product but certainly in a CBD rich product that’s clearly a medicinal oriented product.
There should be no trans fats, no preservatives, no propylene glycol that’s used as a thinning agent sometimes in these oils or other artificial additives. These should not be present in a cannabis product that you want to use medicinally.
You want to look for products made from sustainably grown high-resin cannabis rather than from low resin industrial hemp that’s something we can discuss a little bit more.
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Avoid CBD products made with toxic solvents
Also important to avoid products that are extracted with toxic solvents like butane or hexane or other hydrocarbons. You can make a very good product using those solvents to extract the cannabinoids from the plant.
However, it’s not that easy to and unfortunately there’s a lot of bathtub chemistry going on in the cannabis world still underground in part. And it’s very easy that the resulting product could have residues of very harmful substances that one shouldn’t be exposed to.
Try to avoid products extracted with those kinds of solvents. Better to reach for a product that’s oil is extracted using supercritical co2 or a very high grade food quality ethanol product.
The disappearance and reappearance of CBD
As the story goes CBD and THC we’re both parts of the cannabis plant and relatively equal amounts for most of history. But as things played out in the united states in the emerald triangle region of northern california, which is really the cannabis bread basket, the breeders and the grower starting in the late 60s early 70s and when they began to create new hybrids combining the different plants, they were looking for the plant that would give you the perfect high. Something that they felt would do better in terms of the marketplace.
But in so doing, the breeders inadvertently bred out of the gene pool or almost completely but certainly made it recessive the CBD. And the CBD rich plants were accidentally really discovered in northern california in 2009 as a result of analytical labs emerging to service the cannabis industry. They began to test these different strains and a few strains with high in CBD popped up. And that was a very exciting development.
The source of CBD (high and low resin plants)
CBD is present only in very small amounts in most cannabis strains and also in most industrial hemp varietals. Low resin industrial hemp has about 1-5 % CBD by dry weight maximum in terms of its foliage. Compared to high resin CBD rich cannabis strains (there aren’t many of them) but a few of them will go as high as 10-20 % CBD.
So in terms of you have to compare one to the other, the CBD rich cannabis is a better source for CBD than industrial hemp. Which is not to say one can’t get a decent quality product from industrial hemp. You can get a decent CBD rich product. But there are some problems which we’ll go into.
For starters, low resin industrial hemp contains less CBD than the high resin CBD rich cannabis. And what it means that you need more of industrial hemp to extract CBD. And that raises the risk of contaminants because cannabis is a bio accumulator. It can suck up toxins from the soil. That’s one of the great virtues of the plant. It can be used actually to clean up a poisoned environment. But it’s not something that you want if you’re talking about making a medicine out of the plant.
You want a plant that’s not grown in soil with heavy metals and things like that. You want a CBD product from an organically grown cannabis or hemp plant grown for medicinal purposes.
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Hemp – Cannabis strains with the legal amount of THC
Right now industrial hemp is defined as a cannabis plant with 0.3% THC or less in it. That is an arbitrary definition. That definition exists for one purpose at this point and that’s the perpetuate marijuana prohibition.
And what it means is that, if you have a plant that is very rich in CBD but it has slightly more than 0,3 percent THC it’s illegal to grow under federal law in the united states.
But these plants are being grown out in states with medical marijuana laws and also they’re being grown out in states just with the CBD only laws. But it’s under the pretext that they are hemp not cannabis.
What about the legality of CBD?
Right now you have internet storefronts that are selling CBD for anybody wants to buy, at all 50 states or all around the world for that matter. This is an unregulated commerce. CBD is not an FDA approved dietary supplement. We believe it should be but it is not.
The FDA has done some tests on the CBD products that are being hooked on the internet. And they found some problems with that. And then there was a resultant and letters being sent to some of the storefronts that retailers of CBD products. The problems were twofold.
They found that some of the retailers were making unproven medical claims. Meaning they were claiming medical benefits for CBD on the basis of preclinical work research done on animals rather than on clinical trials conducted on human beings. And you can’t do that in terms of federal law.
The other things they found that in several products claiming to have CBD in them but the FDA found that there was no CBD or is just a tiny tiny amount in it. And that really does a disservice to the whole industry.
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No quality control on the CBD market
One of the big problems with the whole CBD market is, quality control is lacking. You have for example a situation where CBD which vape oil extracted from industrial hemp is again available on many internet sites.
And typically the this oil is is thinned using a propylene glycol which is approved as safe by the FDA for ingestion. But it has not been approved as safe for inhaling it.
There’s been some studies, including one published in the new england journal of medicine that has shown that when overheated propylene glycol breaks down into a carcinogen. So when you have people using vape pens with CBD oil in them mixed with propylene glycol there’s a chance they could be exposing themselves to harmful substances.
Considering that the only folks who are going to reach for a CBD vape oil cartridge are people who are serious medical patients. Otherwise, why would you be doing that if you wanted to get high you’d be using a vape oil cartridge with with THC dominant strain in that.
There’s other problems with what’s mixed with the CBD oils with the vape pens. A lot of these things are flavored. The problem here again, while the flavors are as proved as a food supplement they’ve never been tested before when you heat them and inhale them.
Few things that have been tested turn out to be really gnarly and dangerous. We would suggest steer clear of vape oil pens that are flavored. Unless you can be sure those flavoring agents have been tested for inhalation. And it’s not likely that they have.
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What about pharmaceutical CBD?
This is a factor right now. Actually, you can get a via the internet what people claim is like 98 – 99 % pure CBD powder or a products made from them. And those are generally made from industrial hemp and and refined to the last degree.
And we’re at a point where prescription pharmaceutical CBD is legally available. GW-Pharmaceuticals, we mentioned them before, they have a product called epidiolex that has been clinically tested on a children with severe cases of epilepsy. So now CBD is legal as an isolate, as well as THC is already legal as an isolate by prescription.
But there’s problems here. Because when you compare the effectiveness of CBD as an isolate to CBD rich oil as a whole plant configuration you get very different results. One of these studies was done in israel that have compared single molecule CBD to whole plant CBD. We should say there’s one done in israel in 2015. We don’t know when everybody will be seeing this presentation. But what they found was essentially this:
- CBD as an isolate or single molecule CBD which you can synthesize in a laboratory or extract from a plant and then refine it or extract out just the CBD itself, it did have therapeutic merit which stands to reason, but you need very high doses of the CBD single molecule and a very precise dose.
- In other words it has a narrow therapeutic window. And if you don’t get an exact dose, if you have a little too much or a little too low dose, it is not that effective or may even have no effect at all.
- Whereas with a whole plant CBD rich oil you need much less of a dose for it to be effective. And it has a much broader therapeutic window. So that you don’t have to get an exact dose and it should confer benefits and we’re seeing tremendous benefits.
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Drug Interaction of single molecule compared to full spectrum CBD
The other thing is, that CBD can interact with many other drugs. Actually over 60% of pharmaceutical medicines actually do interact with CBD. And we’re not hearing problems with that CBD interactions with other drugs when it’s part of a whole plant remedy.
But we do know that there’s cases when you have a single molecule CBD, a very high amounts of it being used, such as in some of the clinical trials on the children with epilepsy, that’s where you can get some very problematic drug interactions.
Isolated CBD makes the other drugs stay in the body longer because it delays the metabolism. And some of these other drugs are very toxic and you don’t want to mess around with that. So that’s something to keep in mind.
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A tip for using CBD and drug interactions
And if people are concerned about that, if you’re going to be utilizing CBD therapeutically even if it’s a whole plant CBD and you’re concerned about drug interactions. Consider this as an option a very practical thing. You may recall that.
Sometimes a doctor will tell you when he gives you a prescription, make sure you don’t drink in a grape juice before you take that, because the grape juice has something in it which will alter the metabolism of that pharmaceutical.
Well, CBD acts in the same way, except it’s much more potent than the grapefruit component. So you might want to ask your doctor whether he’s friendly to cannabis or not. You know doc, does these other drugs that i’m taking react in any way with grapefruit. Well, if they do, that’s a red flag.
You might want to make sure that the blood levels of these other drugs legislates a blood thinner for example and CBD is known to react or interact and delay the metabolism of blood thinners. Meaning they stay in the body longer.
So one should have their levels checked typical if you’re on something like warfarin. You check it every month. Maybe you want to check it a couple of weeks straight. One should take these medicines seriously. They’re very potent, this is not kid stuff.
But it’s very very promising this whole area of cannabis therapeutics. So many different people with so many different conditions are benefiting.
Final message
The take-home message is to keep in mind, cannabis therapeutics is personalized medicine. At least initially it’s about the person more than the condition. You’re treating a person. There’s no single ratio dosage, strain or product that’s right for everybody.
CBD and THC they’re the power couple of cannabinoid medicine and they work best together. And that whole plant CBD rich cannabis is safer and more effective than single molecule CBD.