Researchers are interested in discovering more about cannabis and the medicinal properties it has. So far, science indicates that any medicinal effects are the result of compounds called cannabinoids acting on a specially designed system in the human body.
There are more than 100 known cannabinoids currently, and more may be discovered. Most of them occur in cannabis in relatively low concentrations. THC and CBD are two that often occur in higher concentrations, and they’re responsible for many of the medicinal effects cannabis appears to have.
Both THC and CBD are the subject of intensive research right now, but researchers are beginning to investigate other cannabinoids as well. In the future, it may be discovered that many cannabinoids have different effects on human health.
One thing medical researchers have investigated is how to control the concentration of these substances to make their medicinal application easier. Often, this means separating the substance from the cannabis plant, isolating it in what’s known as prescription cannabinoids.
What Are Prescription Cannabinoids?
Many medical cannabis patients use the cannabis plant itself, or a part of it. Cannabinoids such as THC and CBD occur naturally in the plant. Different strains have different concentrations of multiple cannabinoids. The most commonly used parts of the plant are the buds. Oil can also be extracted from the plant.
The most challenging aspect of using cannabis medicinally is the concentration of cannabinoids. As mentioned, different strains have different cannabinoids in varying levels. The plant matter must also be stored and handled correctly. Incorrect storage can cause THC and other compounds to break down, reducing their potency.
Prescription cannabinoids seek to avoid these issues by isolating the active ingredients, such as THC. Patients who use prescription cannabinoids can be more sure of their dosage each and every time. They also don’t need to deal with the issue of inhaling their medicine.
Two Approved Prescription Cannabinoids
There are several different prescription cannabinoids on the general market, but to date, there are only two available in Canada. Nabiximols, or Sativex, is a THC-CBD mixture, designed to mimic the effects of the cannabis plant itself. It’s sometimes suggested by medical practitioners as an alternative to other pain treatments.
The other approved prescription cannabinoid is nabilone, which is often sold under the trade name Cesamet. Its medical uses are a little more widespread. While it also treats pain, just like Sativex, it also acts as an antiemetic. For this reason, it’s often given to patients who are undergoing chemotherapy as part of cancer treatment. It helps reduce the nausea and vomiting these patients often experience.
Limited Approvals and Discontinuations
Prescription cannabinoids have come a long way from their initial form. The earliest prescription cannabinoids contained only synthetic THC. Over time, it was discovered taking THC by itself had poor results for patients. Pharmaceuticals companies have since included CBD in their THC formulations to reduce negative outcomes and to better imitate the beneficial effects of the cannabis plant.
Health Canada has been cautious in approving cannabinoid products for the medical market. Nabiximols, for example, was initially available only in cases where it was being used to treat spasticity in adult patients with multiple sclerosis, in addition to other treatment options. Limited authorization also allowed it to be given to patients with advanced cancer or difficult-to-treat nerve pain.
Health Canada had approved a third prescription cannabinoid for use, but the manufacturer discontinued the approved formulation. Health Canada has not approved another prescription cannabinoid or another formulation.
The fact that there are only two Health Canada-approved prescription cannabinoids available in Canada currently should speak to the need for ongoing research in this area. As new research shows how cannabinoids achieve their effects, researchers will be able to develop more effective prescription cannabinoids, increasing potential treatment options for patients.