Basics
Cannabinoids are a heterogeneous group of substances consisting of ingredients of Cannabis sativa or indica (hemp plant). This plant is one of the oldest in the world and was already used by the ancient Egyptians as a household remedy. Even then, its beneficial as well as healing properties were discovered and researched.
It produces more than 100 different cannabinoids as resin. These ingredients are primarily used to defend against predators and protect the plant from microorganisms such as bacteria and viruses.
Probably the best known cannabinoids are THC (tetrahydrocannabinol) and CBD (cannabidiol). These are structurally different from each other and also have different effects. THC is a psychoactive ingredient of the hemp plant and thus influences mood, perception and consciousness. Thus, it is often abused as an intoxicant. CBD, on the other hand, has no effect on the central nervous system and is thus considered non-psychoactive. It is considered safe as an active ingredient compared to THC and is now used in many different preparations.
In addition, there are synthetic cannabinoids. These do not occur naturally in the plant, but are produced artificially.
Endocannabinoids are produced by the body itself and are also called endogenous cannabinoids. These are substances produced by the body, more precisely arachidonic acid analogs, which dock onto certain receptors in the endocannabinoid system to provide balance in the body as well as influence a variety of physiological functions. The system protects people and calms them in stress or anxiety situations, inhibits pain or regulates appetite.
Nowadays, these effects are used, for example, in pain therapy to relieve pain or to regulate appetite in patients suffering from obesity. At this point it must be emphasized that the use of such preparations is still being researched and their use is only in specific cases.
Applications and indications
Sativex® is considered to be the first drug based on cannabinoids. It was brought to the market by GW Pharmaceuticals. It is an oral spray that contains THC and CBD in a 1:1 ratio. It is used to relieve symptoms in patients suffering from multiple sclerosis.
Multiple sclerosis is a chronic inflammatory disease that affects the central nervous system - which surrounds the brain and spinal cord - and is always progressing. It is an autoimmune disease in which the nerve cells are attacked and damaged by the patient's own immune system. Those affected suffer from muscle spasms (cramps) and paralysis, among other symptoms.
With Sativex®, a drug has been developed that counteracts these muscle spasms and alleviates the symptoms of those affected.
However, the drug is prescribed under strict medical observation and instruction and, as an addictive drug, is subject to prescription. It is prescribed when other drugs are not sufficiently effective in improving muscle stiffness in multiple sclerosis.
Initially, Sativex® is tested on patients for four weeks under medical observation to assess its effectiveness. Only if there is an improvement after this period of time, the treatment with Sativex® is continued.
It is used as an oral spray. It is sprayed either under the tongue or on the inside of the cheek.
How much is sprayed is individual and depends on the person treating. An attempt is made to adjust the dose to achieve the greatest possible relief with the fewest side effects.
When using Sativex®, it is important to create the same conditions each time in terms of meals, i.e. it should either always be taken with food or always taken sober in order to achieve the same effect.
Cannabinoids can be abused as intoxicants mainly because of THC, also known as hashish or marijuana.
Hashish comes from the Arabic language and translates to grass. This refers to the dried resin of the cannabis plant, making it more potent than marijuana, which are the dried flowers or leaves of the hemp plant. They are usually smoked or processed in the form of cookies/cakes and taken orally. They induce intoxicating effects such as euphoria.
In many countries, cannabis is considered the most commonly used illicit intoxicant drug.
In recent years, cannabinoids have been increasingly used for the treatment of many diseases and have thus gained popularity. However, this use is highly controversial worldwide, as the positive effects of cannabinoids also raise concerns, such as the risk of addiction.
In Germany, for example, the prescription of cannabis-containing medications to patients who are seriously ill is only permitted under strict conditions.
History
The cannabis plant is one of the oldest medicinal plants in the world and has been used for therapeutic purposes by different peoples for thousands of years. The oldest documented writings date back to ancient Egypt, where evidence of the medicinal use of this medicinal plant can be found on Papyrus Ebers.
In Europe, the first written therapeutic uses date back to 1840 and can be attributed to the Irish physician William O'Shaughnessy.
At the end of the 19th century, research on cannabinoids resumed after a long hiatus, and Israeli scientists Yehiel Gaoni and Raphael Mechoulam succeeded in identifying the structure of delta-9-tetrahydrocannabinol (THC) in 1964. Thus, Mechoulam said of his discovery, "Cannabis is a medical treasure chest whose contents we don't really know yet."
From the time of the discovery until today, there has been a heated debate about the medical use of the ingredients of Cannabis sativa, which is currently only used in very seriously ill patients and under strict observation. However, much research and more detailed knowledge of the active ingredients and their dosages is needed before they can be released as medicines.
The processing of CBD as a drug additive or in cosmetics is legal in Austria and Germany, although the THC content must not exceed a limit of 0.2% in Germany and 0.3% in Austria. In Switzerland, the processing of CBD in a wide variety of products is legal due to its non-euphoric effects, as long as they contain less than 1% THC.
Sativex® was first officially launched in 2010 and revolutionized the pharmaceutical market as the first cannabinoid-containing medicine. It was approved in Germany and Austria in 2011, and in Switzerland in 2013. Today, it is used worldwide for MS patients, including in countries such as Canada and the United Kingdom. In the U.S., the drug is still in Phase III trials for approval.
