It is also true that the legalisation of cannabis worldwide
is increasing at a dizzying rate. In the USA, there is a strong interest in medical cannabis, which is reflected in many neighbouring countries (including Canada, Germany and Spain), and 33 states have legalised medical marijuana.
However, one of the major drawbacks today is the lack of information and education about the benefits of medical cannabis, CBD (cannabidiol) and its derivatives. Although this may change in the short to medium term, more and more new generations of university students around the world are choosing to do more information and research during their undergraduate studies in order to “advance global pharmacy”. What public health officials, doctors and pharmacists don’t know is causing distrust and caution among patients alike. Perhaps the debate has gone too fast? There are still many important questions to be discovered. How exactly does cannabis affect brain development, for example? And how exactly does CBD help to combat schizophrenia? To find answers to important questions about cannabis, a “conducive political climate” is needed to develop this research. The socio-political climate worldwide was anything but static. Although today there are countries like the United States or Canada that are taking energetic steps to legalise any form of cannabis (recreational or medicinal), so that more and more people are using it for medical purposes, it must also be said that the use of cannabis for medical purposes is anything but new. In several countries, including the United States, cannabis preparations were widely used from the 19th to the 20th century Cannabis was entered into the US Pharmacopoeia in 1850 and was used for diseases such as chronic cough, childbirth and gonorrhoea. Despite rigorous and limited studies on its use, medical cannabis is used for a variety of conditions including Alzheimer’s disease, Human Immunodeficiency Virus / Syndrome, legally and increasingly important Acquired Immunodeficiency Syndrome (AIDS), Amyotrophic Lateral Sclerosis, Cancer, Inflammatory Bowel Disease (z. Crohn’s disease and ulcerative colitis), glaucoma, autoimmune diseases, Parkinson’s disease, post-traumatic stress disorder, Tourette’s syndrome, autism, cachexia, chronic pain, migraine headaches, nausea/vomiting, seizure disorders and muscle spasticity. Cannabis advocates argue that there is evidence to support the use of cannabis or its ingredients for a long list of conditions, and that it is relatively safe because of its self-assessment capacity and the few reported deaths. Opponents of medicinal cannabis argue that there is a lack of randomised trials to assess safety and efficacy, lack of standardisation of product quality and efficacy, harmful side effects and the potential for dependence due to its benefits against many diseases. Of the more than 100 cannabinoids in the cannabis plant, delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) are the most promising and most studied compounds so far. THC is the primary psychoactive component of the cannabis plant. It produces its effects by partial agonism of cannabinoid receptors of type 1 and 2 in the endocannabinoid system. The exact mechanism of CBD is unknown, although we know many of the benefits it can bring and that, unlike THC, it lacks the psychoactive component. CBDs include the serotonergic 5HT1A receptor agonism, G-protein coupled receptor 55 antagonism, a new receptor that plays a regulatory role in the central nervous system and may play a very important role in anxiety, inflammation and disease Inhibition of fatty acid amide hydrolase, resulting in reduced hydrolysis of anandamide, an endogenous endocannabinoid. There are already many approved CBD-containing products available today in formats such as capsules, oral solutions, edible products, tinctures, oral sprays, lozenges, inhalation or vaporisation. Inhalation has proven to be the most effective method of applying effects faster (between 5 and 10 minutes), although it is also the method with the shortest duration (between 2 and 4 hours). Oral administration is the slowest (between 30 minutes and 2 hours) but has a much longer duration (between 4 and 12 hours). However, pharmacokinetic research on these compounds is a challenge because of the low concentration of the analyte, the rapid and extensive metabolism and the difficulty of separating the compounds of interest from each other and from biological matrices. safety considerations Medical cannabis users should exercise caution when using certain drugs and medicines in combination. Much of what is known about adverse events in cannabis comes from recreational use studies, which are restrictive due to lack of standardisation of content, possible misreporting of consumption and use of polysubstances. Cognitive impairment and intoxication such as memory loss, thought disorders, paranoia and psychosis are the most important potential adverse effects, although they relate to THC and not CBD. Common but unlikely side effects of CBD are drowsiness, reduced appetite, diarrhoea and fatigue. Although there are several side effects, cannabidiol has a very low dependence potential and a very broad therapeutic index. Dronabinol, a synthetic form of THC, is also approved by the US Food and Drug Administration for the treatment of nausea and vomiting caused by chemotherapy or to relieve weight loss in AIDS patients. Epidiolex, possibly one of the best known CBD products, is indicated for the treatment of seizures associated with Lennox-Gastaut and Dravet syndrome.