Monthly Archives: January 2020

The Effects of Cannabis on the Body

The effects of cannabis on the body

With both the proliferation of CBD across the globe and the increasing adoption of medical cannabis programmes worldwide, the range of possible benefits from cannabis-based products are being recognised more and more.

At the same time, as these medical cannabis products and CBD concoctions are becoming more commonplace, people are understandably questioning why this sudden rise in popularity is occurring.

In this blog, we discuss the effects of cannabis and cannabis-based products on the body – perhaps explaining this surge in popularity.

But before we get into this, you have to understand the endocannabinoid system first.    

The endocannabinoid system

If you had to sum up the role of the endocannabinoid system in a few words, while acknowledging that research around the endocannabinoid system is ongoing, you’d say that this system is one naturally present in the body that involves the activity of endocannabinoids, their receptors and enzymes. 

This system also seemingly acts like a fine-tuner of the release of other neurotransmitters within the body and is believed to have a crucial impact upon homeostasis.

As there are many cannabinoid receptors distributed widely throughout the body, with this distribution not simply being limited to the central and peripheral nervous systems, the ECS is believed to have very far-reaching effects, particularly when cannabinoids and cannabis-based products are introduced into the mix. 

The effects of cannabis and cannabis-based products on the body

Pain modulation

Pain modulation is affected by the endocannabinoid system through the modulation of the effects of the other neurotransmitters involved in the pain response. For example, the GABA Ergic and noradrenaline system may be impacted.

In practical terms, this means that cannabis-based products may be useful in helping patients suffering from chronic pain or generally painful conditions. Cannabis has a fairly well investigated value for treating chronic pain, with inflammatory conditions being particularly positively impacted by cannabis use. CBD alone has also been touted as a good remedy for inflammation.

Memory

Cannabis has well known effects upon memory. This is believed to be because the THC in cannabis affects the hippocampus, which plays a crucial role in spatial, short-term and long-term memory processes. It’s thought that the consumption of cannabis or products containing THC leads to memory problems and issues forming memories whilst intoxicated.  

The effects of THC may also impair judgement to an extent, with it often being advised that those on cannabis-based medications should not drive or carry out activities that require the user’s full attention for safety purposes. 

Sleep

Feeling sleepy after consuming cannabis is well known side effect of the drug. This is likely due to increased endocannabinoid signalling within the central nervous system, which can also induce sleep more generally.

Appetite stimulation

The endocannabinoid system also has an obvious effect on the stimulation of appetite.

In animal studies with mice, when the mice have their CB1 receptor knocked out they are leaner and less hungry than the mice that still have that receptor.

In practice, medical cannabis has been used to stimulate appetite when in the form of Dronabinol, a medicine used to treat the weight loss and loss of appetite in those who have developed acquired immune deficiency syndrome (AIDS).

Furthermore, although typically used in trials to help patients with the psychological impacts of the disorder, cannabis-based products may also be useful in stimulating appetite in patients with anorexia. This topic requires much more in-depth research however. 

Homeostatic effect

The endocannabinoid system also plays a role in the control of many metabolic functions like nutrient transport and energy storage. 

Additionally, there are reports that the endocannabinoid system may be involved in modulating insulin sensitivity and therefore might have a role to play in treating clinical conditions like diabetes and obesity (or even atherosclerosis).

Stress response

We know that the endocannabinoid system plays a role in the modulation of the stress response, with research currently being carried out around medical cannabis’ effectiveness in treating mental health and psychiatric conditions like anxiety, depression, PTSD and OCD amongst others. 

Reproductive systems

It might surprise you to learn that there are even endocannabinoid receptors found in the bladder and throughout the reproductive systems of both sexes.

In women, the operation of the endocannabinoid system to regulate the timing of embryonic implantation, with the likelihood of miscarriage perhaps being affected by whether anandamide levels are too high or too low.

We only recommend taking cannabis-based products following a consultation with a medical professional, and cannot and do not advise patients on the recreational use of any cannabis-based products. 

At The Medical Cannabis Clinics, our GMC registered specialists will identify the appropriate cannabis medicine care plan and products for patients following a comprehensive assessment which includes an in-depth evaluation of the main symptoms being targeted, current medications, pattern of symptoms and lifestyle factors such as safety-sensitive occupations. 

They will also monitor and adjust the medication on a regular basis to ensure the best effect with fewest side effects. There is also a carefully designed process in place to monitor patients’ well-being, with follow-up appointments after a week and then every month, for three months after receiving a prescription.

To book an appointment with one of specialists click here

The Basics of Cannabis Plant

Cannabis plant basics

If you’re looking to understand medical cannabis treatment, it wouldn’t hurt to understand more about where it comes from too. 

In this article, we lay out the absolute basics of the cannabis plant.

The species

Although some taxonomists believe that there may be just one species of cannabis plant (due to the plant’s ability to interbreed), cannabis as a plant is generally believed to have three distinct species: Indica, Sativa and Ruderalis.

But there’s still more debate around this. Afghanica (or kafiristanica) is often cited by some taxonomists as a fourth cannabis species. Regardless of the debates surrounding this issue, It’s likely that you won’t hear much about Afghanica and Ruderalis though, as most cannabis medicines label only Sativa or Indica.

So what’s the difference?

Although the differences between the plants might not be immediately discernible, with modern seed cultivation and interbreeding meaning the different species now look relatively similar, there are still some remaining differences between the species that you might be able to notice.

While sativa can grow as high as 15 feet tall, Indica is typically much smaller at around 4 feet. The leaves of these varieties also differ, with Sativa often having long, pointed leaves while the leaves on an Indica plant are shorter and rounder.

When looking at the effects supposedly exhibited by each species, it’s commonly believed that pure Indica strains garner a more sedating and relaxing effect whilst Sativa strains create a more stimulating effect. Again though, modern interbreeding has meant that these once distinct effects of the strains have become blurred with time.

The plant itself

Did you know that a typical cannabis greenhouse only contains female plants? Although cannabis plants can be female, male or even hermaphrodite, it is the female plants that are considered most vital for medicinal use because the female unfertilised flower head, known as the sinsemilla, contains the highest concentration of cannabinoids in the plant. Tiny mushroom shaped glands on the sinsemilla, called trichomes, contain the cannabinoids that cultivators are after. 

The female flower head can be used in a variety of different ways. 

One way the female flower head can be used, is when it’s ground up into ‘kief’, a sticky and powdery crystal-like substance that comes from the plant’s leaves and the resin glands of the flower trichomes. This substance can then be compressed into a block called hashish.

The flower head can also be smoked or vaped in a vaporising unit. However, for medicinal purposes it’s mainly cannabis oils that are prescribed. Indeed, in many jurisdictions, it’s only oil and capsules forms of cannabis than can be prescribed legally.

While the leaves and other parts of the plant often contain cannabinoids too, the amount of cannabinoids present here is negligible. For instance, the leaves contain only 2-3% THC. The stalks, roots and seeds also contain practically no phytocannabinoids, although the roots may be rich in many non-psychoactive compounds like terpenoids and sterols. More research is certainly needed to understand if and how this part of the plant could be of modern clinical use though.

At The Medical Cannabis Clinics, our GMC registered specialists will identify the appropriate cannabis medicine care plan and products for patients following a comprehensive assessment which includes an in-depth evaluation of the main symptoms being targeted, current medications, pattern of symptoms and lifestyle factors such as safety-sensitive occupations. 

They will also monitor and adjust the medication on a regular basis to ensure the best effect with fewest side effects. There is also a carefully designed process in place to monitor patients’ well-being, with follow-up appointments after a week and then every month, for three months after receiving a prescription.

To book an appointment with one of our specialists click here

CBD Oil vs Hemp Seed Oil

CBD oil vs hemp seed oil

CBD oil and hemp seed oil – two trending skincare and health products in their own right. As they come from the same plant species, cannabis sativa, these two oils are often thought to be the same thing. In fact, some companies may purposefully market products as either CBD or hemp oil incorrectly to either get around regulations or to capitalise upon CBD’s modern ubiquity. However, these oils are certainly distinct. 

In this article, we discuss the differences between CBD oil and hemp oil and why these products are deemed useful.

Hemp seed oil

Often listed on packaging as cannabis sativa seed oil, hemp seed oil, as the name suggests, is obtained from hemp seeds only, meaning that hemp seed oil contains negligible amounts of CBD, if any at all.

Hemp oil is significantly cheaper than CBD oil as there are no discernible medical benefits to the substance, although this doesn’t mean hemp oil is useless. In fact, hemp seed oil has been used for years as an ingredient in skincare products due to its moisturising properties. These moisturising properties are likely due to hemp seed oil’s fatty acid make-up, with omega-3 and -6 contributing to this effect. With these properties, many consider hemp seed oil an effective treatment for skin conditions like eczema and consider it beneficial generally in skincare due to its comedogenic rating of zero (meaning moisturisation can occur without clogging the pores or leading to excess oil production). 

Additionally, hemp seed oil is believed to be anti-inflammatory due to the GLA (gamma linoleic acid) within it, leading to many suggesting that the substance can help with inflammation that occurs during menopause. This usefulness in aiding inflammatory conditions is something hemp oil shares with CBD oil. 

CBD oil

The rise of CBD oil in recent years has been inescapable. And it seems to be in everything. But what actually is CBD oil?

CBD oil is an oil obtained from the stalks, flowers and leaves of the hemp plant. This is where the cannabidiol in the plant is found. 

Much like hemp oil, CBD oil has strong anti-inflammatory properties, meaning it is viewed as a useful treatment for skin conditions like psoriasis, eczema and rashes. CBD also has a large number of antioxidants in its make-up, perhaps suggesting why it has been adopted in a huge number of skincare products as of late.

How to tell which oil you’re actually getting

While there is a problem in the current market whereby companies are trying to market products as hemp or CBD oil interchangeably despite the differences between the two, there is a way to tell which oil you’re actually getting in your product. Simply look at the packaging of your product and see which of these ingredient names is listed. 

  • Hemp seed oil may be listed as: cannabis sativa seed oil. 
  • CBD oil may be listed as: cannabidiol, PCR hemp extract (phytocannabinoid rich hemp extract) or full-spectrum hemp.            

Have you got any more questions about CBD oil or hemp seed oil? Let us know in the comments below or on our social media and we’ll get back to you with some answers. 

We only recommend taking CBD or hemp oil following a consultation with a medical professional, and cannot and do not advise patients on the recreational use of any cannabis-based products. 

At The Medical Cannabis Clinics, our GMC registered specialists will identify the appropriate cannabis medicine care plan and products for patients following a comprehensive assessment which includes an in-depth evaluation of the main symptoms being targeted, current medications, pattern of symptoms and lifestyle factors such as safety-sensitive occupations. 

They will also monitor and adjust the medication on a regular basis to ensure the best effect with fewest side effects. There is also a carefully designed process in place to monitor patients’ well-being, with follow-up appointments after a week and then every month, for three months after receiving a prescription.

To book an appointment with on of our specialists click here.

Bioavailability & Cannabis

Bioavailability & medical cannabis

What is bioavailability?

Bioavailability is a term that is crucial to the understanding of pharmacology, which refers to the degree and rate at which an administered drug is absorbed by the body’s circulatory system, the systemic circulation.” 

When trying to understand how any drug, and medical cannabis specifically, is absorbed and metabolised by the body, understanding bioavailability is key. Essentially, bioavailability determines the efficacy of drugs by giving us an idea of the extent to which and how quickly the medical cannabis taken becomes active at the intended site of physiological activity. 

The baseline of bioavailability for any substance is intravenous injection. Any drug that is taken in this way is 100% bioavailable as the substance is immediately absorbed into the bloodstream. However, there are currently no intravenous formulations of medical cannabis, so instead, the medical cannabis being taken by patients has to bypass various biological hurdles depending upon the route of administration used. 

So, to understand the effectiveness or bioavailability of cannabis-based medicines, we need to consider various routes of administration and how this affects the absorption of the medicine. 

Routes of administration

Cannabis medicines can be taken in a number of ways, with cannabis inhalation, consumption and topical application all being possible. Respectively, this generally means smoking or vaping, eating edible products or pure oils, and rubbing salves or balms into the skin.

The relative bioavailability of all these different options is quite variable.

Smoking

Inhaling cannabis has a relatively high degree of bioavailability when compared to other administration options. In a study from 2005 called ‘Pharmacokinetics of cannabinoids’, it was found that smoked THC had about 30% average bioavailability, however it should be noted that it’s much harder to control the dosage when dealing with a smoked substance than it is when vaping, as vapes tend to have temperature controls that can help with this process. And while smoking may exhibit a high degree of bioavailability, smoking is not typically clinically recommended due to the potential for respiratory harms linked with this administration method.

Vaping

Aside from smoking cannabis in a joint, vaping also exhibits a high degree of bioavailability. Indeed, a 2016 study, ‘Medicinal Cannabis: In Vitro Validation of Vaporizers for the Smoke-Free Inhalation of Cannabis’, identified that with the right choice of vaporizer, the bioavailability of THC and CBD can reach percentages as high as 50 to 80%. However, again caution should be advised when seeking out vaping administration methods, as with the ‘vaping crisis’ experienced in the US last year, the safety of vaping has somewhat been thrown into question.

We recommend, as we recommend with all cannabis administration methods, that consultations with trained medical professionals are carried out so that medical administration can be monitored and controlled following a full medical assessment.  

Edibles

Cannabis edibles can be hugely variable in terms of bioavailability. This is because cannabinoids are lipophilic, so if they aren’t combined with a fatty substance when consumed, bioavailability will be significantly limited. Additionally, the ‘first-pass effect’ means that often when consuming edibles, the liver will inhibit the absorption of the cannabinoids.  

With all this considered, the common consensus amongst a number of studies on edibles is that their typical bioavailability falls between 4 and 20%. This clearly makes edibles much less efficient than inhaled routes of administration. 

Topical

Topical applications tend to have little impact with any internal medical conditions as the skin itself acts as a barrier to absorption.

To get medical cannabis treatment that is safely monitored by medical specialists to ensure effectiveness and results dependent upon your condition and symptoms, book an appointment with one of our specialists.      

Network of Medical Cannabis Clinics

UK’s first national network of medical cannabis clinics

UK’s first national network of medical cannabis clinics ignites a step change in patient numbers

Doctors working for The Medical Cannabis Clinics are now breaking the mould to allow qualifying patients access to cannabis across the country.

The Medical Cannabis Clinics, recently CQC registered, is the UK’s largest and fastest growing chain of private cannabis clinics, with doctors now operating from seven locations across the country and more openings planned over the coming months to meet patient demand. 

Through working in collaboration with the global leaders in medical cannabis education and training, The Academy of Medical Cannabis, the clinic chain has amassed a team of skilled clinicians who have been trained to prescribe cannabis-based medicine.

The demand for cannabinoid medicine has never been more evident after this week’s release of a YouGov poll suggesting a staggering 1.4 million British citizens are resorting to using cannabis illegally in an attempt to treat a range of conditions and symptoms.

According to Jonathan Nadler, Group MD at LYPHE Group: “Patients should be able to access legal medical cannabis but both advocates and doctors have been thoroughly dissatisfied with the lack of progress since cannabis was rescheduled in 2018. Many were outraged when NICE issued their latest recommendations a couple of months ago in which only two cannabis-based drugs, Epidyolex and Sativex, were recommended for use by those suffering from either rare forms of childhood-onset epilepsy or spasticity related to multiple sclerosis. This update left many, including patients suffering from other conditions like fibromyalgia and chronic pain, feeling snubbed by the healthcare institute and the medical community as a whole. NICE’s guidance is often taken as gospel by healthcare professionals who won’t prescribe without its explicit authorisation.”

However the NICE guidance does not override the responsibility of healthcare professionals to carefully assess and assign the appropriate line of treatment in their patients’ best interests. So, through asserting the right to their own clinical discretion around their patient’s treatment and care, specialists are now taking back their power to prescribe, providing high quality and effective medical cannabis care in the process. 

The guidelines specifically state: ‘Once NICE guidance is published, health professionals are expected to take it fully into account when exercising their clinical judgement. However, NICE guidance does not override the individual responsibility of health professionals to make appropriate decisions according to the circumstances of the individual patient in consultation with the patient and / or their guardian or carer.’

Jonathan Nadler added: “Doctors operating with The Medical Cannabis Clinics are not afraid to exercise their knowledge and expertise to write medical cannabis prescriptions for patients who need it. With clinics in London (Harley Street), Birmingham (Solihull), Manchester, Nottingham, Leeds, Newcastle and Bristol, we are proud to be assisting patients across the country.”

What is a Cannabis Strain?

All about cannabis strains

Although cannabis has been used for thousands of years, with the original plant being thought to have originated in Central Asia, the majority of our current hybrid varieties of cannabis are extremely different to this ancient ancestor.    

The multitudinous different varieties of cannabis, known as strains, have developed over time due to selective breeding and the different environments in which the seeds of the original plant variety were grown in.  

Indeed, despite originating in Central Asia, cannabis seeds were transported and planted all across the world by travellers from years ago, with these seeds then ending up in practically every continent. Once planted and grown in these different environmental conditions, the plants adapted and mutated to their new growing conditions, resulting in a number of different strains. 

These strains, which are indigenous to their particular environment and developed their difference from the original plant types naturally, are known as landrace strains and still exist today. These landrace strains have different compound constitutions due to the environment’s impact on the original plant varieties, with these strains therefore having differing terpene and cannabinoid make-ups.  

Additionally, different cannabis strains have developed as horticulturists have specifically interbred different varieties of the plant to garner specific effects. This crossbreeding takes place as growers use pollen from one strain of cannabis to pollinate another strain. The seeds of the pollinated plant then become a new variety – meaning when growers selectively breed two plants with specific desired traits, it is hoped that the resultant plant will then exhibit these combined qualities.

In years past, breeders typically bred cannabis strains to have a higher THC content, to elicit the psychotropic and euphoric effects of the plant when taken recreationally. Indeed, as stated in the National Geographic‘s ‘Marijuana Medicine’ edition: ‘In 1993, the average THC content of marijuana was 3 percent by dry weight. By 2008, savvy growers had managed to triple that figure. Today, there are ultrahigh THC breeds that top out at 37 percent‘.

However, more recently, with the popularisation of CBD’s many positive effects and the rise of medical cannabis use, high CBD content strains have been increasingly cultivated and used too.

At The Medical Cannabis Clinics, we acknowledge the growing medical consensus that a balanced ratio between THC and CBD delivers the best therapeutic benefits. Through using medicines with a balanced ratio like this, we are able to address issues like insomnia, pain and muscle spasms through our clinic. 

High CBD strains can be used for many medical conditions including treatment-resistant epilepsy and anxiety, Crohn’s disease, multiple sclerosis, diabetes and colitis. Often, treatments with us will start with a CBD dominant strain, as many patients look to avoid the “high” that may come from a more THC dominant strain.

Nonetheless, THC can still act as a beneficial medicine for conditions including chronic pain and post-chemotherapy treatment, as it increases appetite and reduces nausea. It can also reduce inflammation and improve muscle control and coordination. The effects of THC dominant strains can include euphoria, positive mood and relaxation. However, we find that it’s still best to use THC along with CBD to counteract any anxiety, which sometimes results from THC dominant treatments.

Treatment with us:

Our GMC registered specialists are some of the most experienced and respected medical cannabis practitioners in the UK. 

When you book an appointment with us at one of our clinics, these specialists will identify the appropriate cannabis medicine care plan and products for you after a comprehensive assessment has been carried out to determine the main symptoms that need to be targeted, what current medications you’re taking, the typical pattern of your symptoms and various lifestyle factors that we’ll need to consider like safety-sensitive occupations. 

You can also be assured that we’ll monitor and adjust your medication on a regular basis to ensure that the best effects are seen with the fewest side effects possible.

To book an appointment with one of our specialists, complete our form here.