Cannabis and Cannabinoids
Dilip Ghosh, Pulok K. Mukherjee in Natural Medicines, 2019
In 1937, the United States criminalised the use of cannabis and as a result its consumption decreased rapidly. In recent decades, there has been growing interest in the wide range of medical uses of cannabis and its constituents; however, the laws and regulations are substantially different between countries (Table 29.5). Laws differentiate between raw herbal cannabis, cannabis extracts and cannabinoid-based medicines. Both the European Medicines Agency (EMA) and the US Food and Drug Administration (FDA) do not approve the use of herbal cannabis or its extracts. The FDA approved several cannabinoid-based medicines, as did 23 European countries, Australia and Canada. In Australia, cannabis possession and use are currently illegal, but in several states and territories (South Australia, ACT and Northern Territory) a small amount for personal use is decriminalised. That means that it is illegal, but not a criminal offence. Very recently, the Canadian Senate voted to legalise recreational marijuana.
Drug Legalization and Public Health
Hanna Pickard, Serge H. Ahmed in The Routledge Handbook of Philosophy and Science of Addiction, 2019
Cannabis may be less inherently harmful than alcohol (Lachenmeier and Rehm 2015; Nutt et al. 2010), but it is far from harmless (Hall and Weier 2015; Room et al. 2010). There are differences in types and degrees of potential harm between different potencies, cannabinoid composition, and modes of use, as well as issues of potential contamination in the supply chain, and regulatory regimes provide the opportunity for public health-oriented controls and incentives favouring less harmful products that are not available to the state when a market is illegal. The new legal cannabis systems in Colorado, Washington and Uruguay are all strongly committed to regulating these aspects of the market (Pardo 2014). A substantial part of the harm from cannabis is from traffic injuries caused by driving while intoxicated; along with the legalization of cannabis, the new regimes have been updating their legislation and enforcement to deter such driving.
Medications
R. Andrew Chambers in The 2 × 4 Model, 2017
Cases involving patients who are using cocaine/amphetamines: As with cannabinoids, patients with multiple addictions will also often present with addictions to cocaine, methamphetamines, amphetamines, or other stimulants including a variety of STIMs indicated for ADD, narcolepsy, restless leg syndrome, etc. Again, these patients may be presenting a strong self-medication like rationalization for using these drugs, but the 2 × 4 Model clinician should avoid ‘pouring gas on the fire’ of dual diagnosis (exacerbating mood and psychotic syndromes and addiction) by prescribing these drugs, and they should interdict other doctors who may be doing so. At the same time, these drug are not known to greatly increase the risk of lethal overdoses on OPs (or buprenorphine), nor does buprenorphine treat addiction to these stimulant drugs. Therefore, as with comorbid cannabinoid use disorders, addictive patterns of psychostimulant use are not necessarily deal breakers for prescribing opioid replacement therapies for concurrent opioid addiction. Efforts should be made to treat all the addictions a patient has, and to monitor long-term progress with respect to each drug; if strategies are not working then change them.
Synthetic cannabinoid receptor agonists: classification and nomenclature
Published in Clinical Toxicology, 2020
A. J. Potts, C. Cano, S. H. L. Thomas, S. L. Hill
The synthetic cannabinoid receptor agonists are a heterogenous group of compounds with complex chemical structures and a diverse and occasionally bewildering array of names. Consistent nomenclature for these compounds is important to ensure correct and consistent communication between professional groups, including academics, analytical toxicologists and regulatory authorities. This is particularly important given that new derivatives continue to emerge on the market and similar rules are being applied even in the recreational vendor field. In this review we have described the most commonly available structures and the nomenclatures used for these compounds. Given the issues discussed here, we highlight the need for an international consensus on the nomenclature used for synthetic cannabinoid receptor agonists within the literature to describe this diverse set of compounds. This is probably best achieved by use and further development of the systematised code-letter system implemented by the EMCDDA.
Effects of synthetic (JWH-018) cannabinoids treatment on spermatogenesis and sperm function
Published in Drug and Chemical Toxicology, 2022
Duygu Mutluay, Şükrü Güngör, Gözde Yücel Tenekeci, Serkan Köksoy, Cennet Sinem Çoban
There are similarities between SCBs and Δ9-THC, the primary psychoactive constituent in marijuana. SCBs are chemically heterogeneous and structurally differ from Δ9-THC; however, they all have a common mechanism of action, being agonists of the endocannabinoid system (ECS) receptors CB1 and CB2 (Martinotti et al.2015, 2017). While Δ9-THC exhibits partial agonist efficacy at cannabinoid receptors CB1 and CB2 in vitro, SCBs can be fully or even super agonists at both CBRs in vitro and in vivo studies (Pertwee 2008, De Luca et al.2016). Partial or full agonist cannabinoid ligands modulate receptor activity by binding and activating the receptors to increase activity with partial to maximal efficacy (Brents and Prather 2014). In addition, SCBs metabolites often demonstrate greater CBR affinity than Δ9-THC. This can be high enough to reveal severe pharmacological and toxicological effects distinct from those induced by Δ9-THC. All these factors may explain the increased morbidity and mortality with SCB exposure, when compared with marijuana (Martinotti et al.2017). It has also been reported that SCBs products are not safe and have severely increased toxicological effects such as elevated blood pressure, vomiting, hypertension, convulsions (McQuade et al.2013), hallucinations, psychosis (Every-Palmer 2011, Hermanns-Clausen et al.2013) than marijuana.
Cannabinoids and bone regeneration
Published in Drug Metabolism Reviews, 2019
Dragos Apostu, Ondine Lucaciu, Alexandru Mester, Horea Benea, Daniel Oltean-Dan, Florin Onisor, Mihaela Baciut, Simion Bran
Cannabis had been used since ancient times for treatment of pain, but its use was forbidden due to the associated psychotropic effects (Bab et al. 2009). These negative effects are due to a compound called Δ9-tetrahydrocannabinol (THC), which acts on two distinct G-protein coupled receptors, CB-1 and CB-2, called cannabinoid receptors (Bab et al. 2009; Giacoppo et al. 2014). CB-1 receptor is found predominantly in central and peripheral nervous system, while CB-2 receptors are mainly located in the immune system (Sela and Bab 2012). Cannabis also contains other phytocannabinoids, which do not have the adverse reactions on the central nervous system, but otherwise poses important benefits as shown in current literature. Apart from phytocannabinoids, the human body has its own agonists for the cannabinoid receptors, called endocannabinoids. Moreover, synthetic cannabinoids have been produced for the treatment of different pathologies.