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Clinical Use of Cannabis



All vertebrates have an endocannabinoid regulating system within them. This system was discovered within the last three decades. It is important to understand that this is a regulatory system. It is also important to understand that when this system is not being well regulated, there are clinical consequences that occur. The endocannabinoid system we have is called endogenous. Endogenous means it originates within us. This system influences multiple physiologic processes that include pain regulation and modulation, seizure threshold, appetite, digestion, mood, possible immune regulation, tumor surveillance, fertility, bone physiology and more.


Therefore, this system when properly functioning is essential for good health, and, when not functioning properly may result in certain types of diseases and corresponding symptoms. Modulating our endocannabinoid system can hold therapeutic promise in a wide range of diseases and pathological conditions, ranging from mood and anxiety disorders, movement disorders such as Parkinson’s and Huntington’s disease, neuropathic (nerve) pain, multiple sclerosis and spinal cord injury, cancer, athereosclerosis, hypertension, glaucoma and others.


Marijuana, or cannabis, is a flowering plant that includes the species Cannabis sativa. There are various strains of cannabis and each strain has its own unique properties. Scientists have discovered numerous compounds produced by this plant with over 80 of them being unique to this plant. These compounds are called cannabinoids. Because they originate from a plant, they are more specifically called, phytocannabinoids (the cannabinoids produced within us are called endocannabinoids). The most well know phytocannabinoid is delta-9-tetrahydrocannabinol, or commonly called THC. There are other phytocannabinoids besides THC. All the phytocannabinoids have pharmacologic activity within us, due to us having an endocannabinoid system that has various cannabinoid receptors. The effects we obtain depends upon what cannabinoid we take in to our body. We all are familiar with the effect that the cannabinoid THC can have on our body, but that is just one compound.


As with any system in our body, the endocannabinoid system also encompasses regulation and attempts to keep the system in a normal state that is associated with good health and wellbeing. In 2001 the concept of clinical endocannabinoid deficiency was introduced in two publications and expanded upon in 2004. I was based on the concept that many neurological diseases have their basis in neurotransmitter deficiencies, such as Alzheimer’s disease, Parkinson’s disease and depression. The hypothesis was that if deficiencies caused these diseases, then deficiencies in the endocannabinoid system must also result and manifest in certain clinical features as well.


As humans, we have an underlying endocannabinoid tone. This tone reflects our normal baseline. If the tone moves too high or too low, then there would be corresponding clinical symptoms. Too low may manifest in a lowered pain threshold or disturbances in digestion, sleep or mood.





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