NUR 0086 Nursing Informatics

How Cannabis Works

Marijuana works through an endocannabinoid (EC) system. The system is named after marijuana plant Cannabis sativa alongside its ingredient delta-9-tetrahydrocannabinol (THC). EC system remains a distinct communication system in body and brain which affects such functions as how an individual feels, reacts and moves. The body yields cannabinoids, natural chemicals that interact within the EC system (Schlosser et al., 2017). Like THC, cannabinoids interact with receptors in the brain for the regulation of such functions. Cannabinoids work distinguished from other neurotransmitters. The EC system will communicate its messages uniquely since it functions “backward.” The EC system’s cannabinoids are made “on demand” when a postsynaptic neuron becomes activated from lipid precursors in the neuron (Zamberletti, Gabaglio & Parolaro, 2017). They are released and travel backward to presynaptic neuron hence attaching to cannabinoid receptors.   

When a patient is administered marijuana, EC system becomes overwhelmed by THC and rapidly attaching to cannabinoids receptors in the entire body and brain. This disrupts the natural cannabinoid’s ability to fine-tune communication between neurons thereby throwing the whole system off-balance (Hietala, 2018).   Since these cannabinoid receptors are throughout the body and brain, THC’s effects are far-reaching. THC affects brain parts which make an individual feel good which leads to a “high” feeling is.  

Endocannabinoid deficiency syndrome is a condition whereby a person yields a lower cannabinoids amount regarded as necessary in health, well-being and vitality promotion. The body fails to generate adequate endocannabinoids or sufficient receptors for EC system to properly function (Vázquez et al., 2015). Thus, the various function is never properly regulated making the body to be unbalanced permitting illness to emerge. This deficiency can trigger migraines since anandamide control receptors linked to migraines, and endocannabinoid firmly dictates periaqueductal gray matter which is the brain area which generates a migraine. Raising cannabinoid amount might decrease the endocannabinoid deficiency syndrome. Cannabinoids inhibit FAAH thereby boosting levels of anandamide in our body. The Cannabinoid oil can be used to deal with this deficiency (Woodhams, Sagar, Burston & Chapman, 2015). The medical marijuana will help supply cannabinoids into the body and brain which essential nutrient is thereby assisting in the minimization of some illness by helping the endocannabinoid system and making sure that EC system properly functions.  

Administration Routes

Inhalation/Lungs:

The intake form include vaporization or smoking as seen below:

Smoking:

This involves inhaling combusted and dried cannabis plant’s flowers. It remains of the fastest means of feeling medical marijuana effects and most intake form. The onset remains rapid, instant, and with short period/duration. The pros are the “peak effect’ which results from high cannabinoids’ bioavailability in smoke and fast cannabinoids in vivo metabolizing.  Joints, pipes alongside water pipes can be used for smoking medical marijuana. Nonetheless, the cons are that habitually smoking might result in lung damage and “high” habituation triggered by fast onset alongside dose-response diminishing.  Dose accuracy is low, and variability in quality and consistency effects are of high degree.

Vaporization:

It is the process via which dried flowers, extract or concentrate of cannabis is gradually subjected to heat at lower, and the increasingly precise temperature is permitting cannabis therapeutic ingredient (cannabinoids like THC) to phase-alter into a vapor or gas and extract from cannabis plant without necessarily burning this plant. A vapor result from this process in place of smoke. The onset is rapid and instant within seconds. The pros are that vaporization decreases cannabis use long-term harm and a safer than smoking while allowing a patient to control his dose better (Cranford, Bohnert, Perron, Bourque & Ilgen, 2016). The cons are that vaporization doesn’t alter cannabis absorption in our bodies. Like smoking, cannabis will still be taking via the alveoli. Bioavailability remains high with fair dose accuracy relying on vaporizers’ quality.

Oral Administration:

This route uses such intake forms as capsules and edibles as seen below:

Capsules and Edibles:

The cannabis is infused into cooking oil or butter or other edible fat or sugar alcohol to yield edible cannabis in capsule or food form. The pros are that edible intake is sometimes recommended for patients experiencing severe chronic pain since its effects are displayed in more of “body high” as compared to “head high.” It has since been described as a heavier or deeper feeling. The onset is not immediate at hours. It is recommended that only a small share of edible cannabis be taken at ago and wait for one hour or more for effect to be realized. The bioavailability remains extremely low alongside low dose accuracy (Jensen, Chen, Furnish & Wallace, 2015). It has a high variability degree regarding effect quality and consistency and works as psychoactive.  A cons is that a substantial share of administered dose gets destroyed because of high stomach acid pH.   

Administration via Skin:

The transdermal delivery/administration describes a self-contained, form of discrete dosage that which is applied to intact skin hence delivering drug via skin at a rate controlled into systemic circulation (Hill, 2015). A patch/gel form is directly applied to the skin. The onset is not instant and takes between 1.25 hours to five hours. The bioavailability remains medium with extremely high dose accuracy and with a high consistency degree in term of effect consistency and quality. The pros of transdermal are that dose remained pre-loaded and concealed from view thus no smell, easy to use and no ritual. The administration of the dose rate remains reliable and consistent taking place slowly over a set timeframe. The cons is that time to onset is longer.

Sublingual Administration

This is delivered under a patient’s tongue (sublingual) or in the oral cavity (oromucosal) as a method of tincture or oil. The onset is rapid since the medication is absorbed into the patient’s blood system (Bruce, Brady, Foster & Shattell, 2018). The pros are that effect consistency, and quality is high and with high dose accuracy. It is also comfortable for patients who never smoke cigarettes. The cons are that tinctures must first be prepared in oil, glycerol or oil base.  

References

Bruce, D., Brady, J. P., Foster, E., & Shattell, M. (2018). Preferences for Medical Marijuana over Prescription Medications Among Persons Living with Chronic Conditions: Alternative, Complementary, and Tapering Uses. The Journal of Alternative and Complementary Medicine, 24(2), 146-153.

Cranford, J. A., Bohnert, K. M., Perron, B. E., Bourque, C., & Ilgen, M. (2016). Prevalence and correlates of “Vaping” as a route of cannabis administration in medical cannabis patients. Drug and alcohol dependence, 169, 41-47.

Hietala, J. (2018). 42.4 The Endocannabinoid System In First-Episode Psychosis. Schizophrenia Bulletin, 44(suppl_1), S69-S69.

Hill, K. P. (2015). Medical marijuana for treatment of chronic pain and other medical and psychiatric problems: a clinical review. Jama, 313(24), 2474-2483.

Jensen, B., Chen, J., Furnish, T., & Wallace, M. (2015). Medical marijuana and chronic pain: a review of basic science and clinical evidence. Current pain and headache reports, 19(10), 50.

Schlosser, M., Löser, H., Siegmund, S. V., Montesinos-Rongen, M., Bindila, L., Lutz, B., … & von Brandenstein, M. (2017). The endocannabinoid, anandamide, induces cannabinoid receptor-independent cell death in renal proximal tubule cells. CellBio, 6(04), 35-55.

Vázquez, C., Tolón, R. M., Pazos, M. R., Moreno, M., Koester, E. C., Cravatt, B. F., … & Romero, J. (2015). Endocannabinoids regulate the activity of astrocytic hemichannels and the microglial response against an injury: in vivo studies. Neurobiology of disease, 79, 41-50.

Woodhams, S. G., Sagar, D. R., Burston, J. J., & Chapman, V. (2015). The role of the endocannabinoid system in pain. In Pain control (pp. 119-143). Springer, Berlin, Heidelberg.

Zamberletti, E., Gabaglio, M., & Parolaro, D. (2017). The endocannabinoid system and autism spectrum disorders: insights from animal models. International journal of molecular sciences, 18(9), 1916.