The Spanish Agency for Medicines and Health Products is studying ways to regulate medical cannabis, something that the vast majority of European countries have already done
There are hardly any large cities in Spain left without their cannabidiol (CBD) establishment. Anyone who is a regular walker in their town has been able to notice the rise of these stores that, for some time now —especially since the pandemic—, sell (also online) a wide group of products rich in cannabidiol, the component of cannabis without psychotropic effects. Below we will tell you more about this compound, another very prominent cannabinoid, and the situation in Spain regarding medical cannabis.
The Court of Justice of the European Union (CJEU) endorsed in 2020 the commercialization of oils, creams, aromatic flowers, bath salts, or vapers that include CBD in their composition and that, supposedly, will help combat wrinkles, redness, anxiety, acne, menstrual pain, insomnia or muscle and joint ailments, among many other discomforts. Some almost miraculous properties collide head-on with what science says, which practically classifies them as a placebo.
Although CBD does have proven medicinal properties to treat the symptoms of some diseases, its effectiveness depends on the concentration and dose. These health products have almost nothing to do with what is hidden behind the research of cannabis with medical uses, something that does have a lot of potential and that is hopeful for many people who live with chronic pain.
The Most Prominent Compounds Of The Cannabis
Cannabis, like any other plant, is a very complex mixture of compounds (there are more than 500 of them, including some 113 cannabinoids). Of all of them, THC (tetrahydrocannabinol) and CBD (cannabidiol) stand out. They are the two most relevant in terms of their pharmacological action, but due to their abundance and potency of action, the most important is, without a doubt, THC.
Tetrahydrocannabinol (THC)
“The vast majority of the possessions of cannabis, both in recreational and therapeutic use, and both in conscious and unintentional results are due to THC action. It is, so that everyone understands it, the cannabinoid that ‘places’ in its recreational use and the one that has pharmacological properties in therapeutic use ”, explains Manuel Guzmán, professor of Biochemistry at the Complutense University of Madrid (UCM) and one of the experts who have advised the Government on the imminent law for the use of medicinal cannabis.
Tetrahydrocannabinol is, to draw an analogy, like caffeine in the coffee bean, morphine in the opium plant, or theophylline in the tea plant. “THC is the most suitable active component in cannabis, which attaches to distinct receptors that live in the body called cannabinoid receptors (CB1 and CB2, among others) and, through them, exerts a large number of actions, both those that are sought in recreational use (relaxation, greater mood, less stress, and greater sensitivity) and in medicinal use, ”says Guzmán.
With respect to the latter, the antiemetic properties of THC must be highlighted when it comes to relieving vomiting and nausea in patients who are undergoing chemotherapy treatment and who do not respond to traditional medication. “Its effects as an appetite stimulant and metabolism improvement in cancer patients, whose desire to eat has been affected after chemotherapy, or its analgesic or anti-inflammatory effect, especially when it comes to reducing muscle stiffness in the muscles, have also been scientifically proven. patients with numerous sclerosis ”, details the expert.
Cannabidiol (CBD)
But THC is not the only cannabinoid with pharmacological actions. Yes, it is true that it is the most important, but CBD also has properties that deserve to be highlighted. “Compared to THC, CBD is like drinking decaffeinated coffee ”, sums up the scientist. Manuel Guzmán refers to the fact that it has fewer actions than THC, but some of them are very interesting. “It has been shown to be effective in inhibiting seizures in pediatric epilepsies (also in adults, although less) that do not respond to first-line anticonvulsants”, the professor tells us.
THC and CBD go together well in medicine. This researcher believes that, when recommending cannabis for medicinal use, it is always better to use a balanced preparation between THC and CBD. The reason is that the patient tolerates it much better since CBD acts as a modulator of the unwanted effects of THC. “There are some psychoactive results of THC that are aspired by patients. We talk about being in a better mood or sleeping better. But there are other side effects that are not the desired ones; such as panic attacks, anxiety, lack of coordination, excessive fatigue … In this sense, CBD can temper that unwanted part that comes with THC”, says the biochemist.
There are other properties in CBD that, although they are less scientifically proven than the inhibition of nausea in patients with epilepsy, do work in certain patients and with certain doses. “Cannabidiol has a specific anesthetic effect in regular pain disorders. Its anxiolytic effect is mild. For example, if you compare it with diazepam, it is much lower, but in reasonably high doses (several hundred milligrams a day) some effect has been shown,” says Guzmán.
Cannabis And Its Medicinal Use
The Spanish Agency for Medicines and Health Products (AEMPS) has only approved two drugs with cannabinoids in their composition:
Sativex is made with a mixture of THC and CBD and is used to combat muscle spasms in patients with multiple sclerosis.
Epidiolex, which only has CBD and is used in children with epilepsy who do not respond well to other anticonvulsants.
For now, they are only dispensed with a medical prescription in hospital care and have a very high cost. The first has a price of around 500 euros for three 10 ml containers and the second exceeds 1,100 euros per 100 ml, an amount that only certain private insurers cover.
In addition to these medications, in Spain, there are many people who use crude cannabis preparations for other indications that are not officially approved, especially in cases of cancer patients and diseases with chronic pain. These preparations are not approved as medicine, but medical cannabis programs have already been implemented in many countries to improve the quality of life of patients with chronic and highly debilitating diseases (most of the states of the European Union, a large part of America, Israel, Australia, and Morocco).
Ways To Take Cannabis
There are many ways to take it, but from a pharmacological point of view, there are two routes of administration: fast and slow.
For immediate relief there is vaporization, not to be confused with smoking and vaping, since in this case the plant is heated (not burned) and that heat activates its components, which are released in a cloud of vapor. It is used especially when you want to get an effect in one or two minutes when a patient has a flare-up of pain, a convulsion, or a spasm.
For pictures of chronic pain or sleep disorders, the slow, oral route is used —such as crude cannabis preparations or cannabis oil—, which acts in the body after one or two hours. “These techniques improve the quality of life for many people: improving mood, improving sleep diseases, nutrition information, interfering anxiety, and, above all, improving emotive pain management,” says the biochemist.
In Spain, the AEMPS is currently studying ways to regulate medical cannabis, something that the vast majority of our European neighbors have already done. “This will open a door for patients to resume doing what they are accomplishing now, but with lawful and health protection: they know what they are taking, they do not have to resort to the black market and they can be monitored by the national health system. In addition, this regularization will improve clinical research and open the door to new studies on the therapeutic application of cannabinoids that will benefit the next generations”, says Guzmán.
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