The Best Ways to Select Medical Cannabis Product

April 17, 2019

The Best Ways to Select Medical Cannabis Product

 

There can be a lot of decisions involved with taking medical cannabis. Choosing a medical cannabis product can be challenging for those who may not know where to start.

As more research has taken place and the scientific community’s understanding of medical cannabis has grown and evolved, so has the approach to product selection. There are 3 main factors that patients and their healthcare practitioners are encouraged to consider when selecting a medical cannabis product:

1. Cannabinoid Content
2. Product Format
3. Terpene Content
Aphria Product Family

Cannabinoid Content

Cannabis has a number of active compounds in it, called cannabinoids. Although there are over 100 different cannabinoids in cannabis, THC (delta-9-tetrahydrocannabinol) and CBD (cannabidiol) are the two cannabinoids most often studied in cannabis. Cannabis strains can be high in THC, high in CBD, or contain a balanced ratio of CBD to THC and are associated with different health effects as a result1,2.

THC is the best known cannabinoid found in cannabis, responsible for the intoxicating effects or “high” often associated with cannabis 1,2,3. Evidence suggest that it may be useful for treating:
– Pain4,5
– Inflammation2,6
– Chemotherapy-induced nausea and vomiting2,7
– Having anti-oxidant/neuro-protective properties3,4,8.

CBD, unlike THC, doesn’t cause feelings of intoxication1,2,9. Evidence suggests that CBD may be helpful for treating:
– Anxiety 2,10
– Inflammation 11,12
– Epilepsy 2,12
– Having anti-oxidant and neuro-protective properties 3,8,10,13

Aphria offers products that come with different cannabinoid profiles; some products are higher in THC, some are higher in CBD, and some contain a more balanced ratio of CBD to THC. Patients should work with their healthcare practitioner to select a product based on the cannabinoid content that best suits their needs.

Product Format

The format of a product will have an impact on the expected effects. Aphria’s medical cannabis products are available in two main categories: dried flower and oil products.

Dried flower that is smoked or vapourized can be felt within 0-30 minutes and generally lasts 2-4 hours. Generally, when seeking fast relief from symptoms, a patient will use an inhaled format (a vaporizer is recommended) because of the rapid onset.

Products that are ingested, such as cannabis oil, have a gradual onset of 1-3 hours, its effects last much longer, approximately 6-8 hours14. Someone that experiences chronic pain or anxiety, may benefit more from oil products, which will deliver a more gradual and sustained therapeutic benefit2. Aphria’s cannabis oils are available in bottles with graduated droppers, softgel capsules, or oral spray formats, some offering greater control over dosing, others convenience.

Terpene Profile

Terpenes are aromatic compounds that give the cannabis plant its distinct smell and flavour. Emerging research shows that they may also provide their own therapeutic benefit 8,15. Terpenes are thought to contribute to the individual effects patients can feel. For example, some terpenes when taken with cannabinoids can promote relaxation and stress-relief, while others can yield energizing and uplifting effects 15,16.

The terpene profiles of each Aphria product can be found on their product page, as well as on the Patient Portal. Learn more about terpenes, and which are present in Aphria’s products, on the Learning Center (link to article).

When a patient and their healthcare practitioner have selected the appropriate a) cannabinoid content and b) product format to meet a patient’s needs, they can then consider the c) terpene content to further differentiate and select between product options.

Sativa/Indica Classifications
Recent research has indicated that the Indica/Sativa classifications for a given strain tell you very little about how it will affect you 16,17. Cannabis growers use Indica or Sativa to describe the physical traits of a plant (its height, leaf structure, flower production, and smell) and over the years have tried to use these traits to predict the therapeutic effects of a specific strain.

Evidence indicates that this traditional system is no longer an effective way to select a product for medical use as the associations with each category (Sativa – uplifting, Indica – sedating) have not been found to be scientifically valid 16,17.

While the Indica, Sativa, or Hybrid designations of strains are available on Aphria’s website, patients and health care practitioners are encouraged to first consider the factors mentioned above (i.e., cannabinoid content and product format, followed by terpene content).

If you have any questions about these changes, please contact our Patient Care Team at 1 (844) 427-4742 or info@aphria.com.

References:

  1. National Academies of Sciences, Engineering, and Medicine. (2017). The health effects of cannabis and cannabinoids: The current state of evidence and recommendations for research. National Academies Press.
  2. MacCallum & Russo (2018). Practical considerations in medical cannabis administration and dosing. European Journal of Internal Medicine, 49, 12-19.
  3. Russo (2008). Cannabinoids in the management of difficult to treat pain. Therapeutics and Clinical Risk Management, 4(1), 245.
  4. Russo (2018). Cannabis Therapeutics and the Future of Neurology. Frontiers in Integrative Neuroscience, 12, 51.
  5. Starowicz & Finn (2017). Cannabinoids and pain: sites and mechanisms of action. In Advances in Pharmacology (Vol. 80, pp. 437-475). Academic Press.
  6. Zurier & Burstein (2016). Cannabinoids, inflammation, and fibrosis. The FASEB Journal, 30(11), 3682-3689.
  7. Rock & Parker (2016). Cannabinoids as potential treatment for chemotherapy-induced nausea and vomiting. Frontiers in Pharmacology, 7, 221.
  8. Yoo & Park (2012). Terpenoids as potential anti-Alzheimer’s disease therapeutics. Molecules, 17(3), 3524-3538.
  9. Zurier & Burstein (2016). Cannabinoids, inflammation, and fibrosis. The FASEB Journal, 30(11), 3682-3689.
  10. Mechoulam (2005). Cannabinoids as therapeutics. Birkhäuser Verlag.
  11. Klein (2005). Cannabinoid-based drugs as anti-inflammatory therapeutics. Nature Reviews Immunology, 5(5), 400.
  12. Lattanzi et al. (2018). Efficacy and Safety of Cannabidiol in Epilepsy: A Systematic Review and Meta-Analysis. Drugs, 1-14.
  13. García-Arencibia et al. (2007). Evaluation of the neuroprotective effect of cannabinoids in a rat model of Parkinson’s disease: importance of antioxidant and cannabinoid receptor-independent properties. Brain Research, 1134, 162-170.
  14. Health Canada (2016). Access to cannabis for medical purposes regulation – daily amount fact sheet (dosage). [online] available at: https://www.canada.ca/en/health-canada/services/drugs-medication/cannabis/information-medical-practitioners/cannabis-medical-purposes-regulations-daily-amount-fact-sheet-dosage.html
  15. Russo (2011). Taming THC: potential cannabis synergy and phytocannabinoid‐terpenoid entourage effects. British Journal of Pharmacology, 163(7), 1344-1364.
  16. Lewis, MA et al. (2018) Pharmacological foundations of cannabis chemovars. Planta Medica 84(4):225-233
  17. McPartland (2018). Cannabis systematics at the levels of family, genus, and species. Cannabis and Cannabinoid Research, 3(1), 203-212.