Cannabis and Cannabinoids (PDQ®)–Patient Version
Questions and Answers About Cannabis
- What is Cannabis?
Cannabis , also known as marijuana, is a plant from Central Asia that is grown in many parts of the world today. The Cannabis plant produces a resin containing compounds called cannabinoids. Some cannabinoids are psychoactive (acting on the brain and changing mood or consciousness). In the United States, Cannabis is a controlled substance and has been classified as a Schedule I agent (a drug with a high potential for abuse and no currently accepted medical use).
Clinical trials that study medicinal Cannabis in cancer are limited. To do research with Cannabis in the United States, researchers must file an Investigational New Drug (IND) application with the Food and Drug Administration (FDA), receive a Schedule I license from the Drug Enforcement Administration (DEA), and gain approval from the National Institute on Drug Abuse (NIDA).
By federal law, the possession of Cannabis (marijuana) is illegal in the United States outside of approved research settings. However, a growing number of states, territories, and the District of Columbia have enacted laws to legalize medical marijuana. (See Question 4).
2. What are cannabinoids?
Cannabinoids are active chemicals in Cannabis that cause drug-like effects throughout the body, including the central nervous system and the immune system. They are also known as phytocannabinoids. The main active cannabinoid in Cannabis is delta-9-THC. Another active cannabinoid is cannabidiol (CBD), which may relieve pain and lower inflammation without causing the "high" of delta-9-THC.
Other possible effects of cannabinoids include:
- Anti-inflammatory activity.
- Blocking cell growth.
- Preventing the growth of blood vessels that supply tumors.
- Antiviral activity.
- Relieving muscle spasms caused by multiple sclerosis.
3. What is the history of the medical use of Cannabis?
The use of Cannabis for medicinal purposes dates back at least 3,000 years. It came into use in Western medicine in the 19th century and was said to relieve pain, inflammation, spasms, and convulsions.
In 1937, the U.S. Treasury began taxing Cannabis under the Marijuana Tax Act at one dollar per ounce for medicinal use and one hundred dollars per ounce for non-medical use. The American Medical Association (AMA) opposed this regulation of Cannabis and did not want studies of its potential medicinal benefits to be limited. In 1942, Cannabis was removed from the U.S. Pharmacopoeia because of continuing concerns about its safety. In 1951, Congress passed the Boggs Act, which included Cannabis with narcotic drugs for the first time.
Under the Controlled Substances Act passed by Congress in 1970, marijuana was classified as a Schedule I drug. Other Schedule I drugs include heroin, LSD, mescaline, methaqualone, and gamma-hydroxybutyrate (GHB).
Although Cannabis was not believed to have any medicinal use, the U.S. government distributed it to patients on a case-by-case basis under the Compassionate Use Investigational New Drug (IND) program started in 1978. This program was closed to new patients in 1992.
Researchers have studied how cannabinoids act on the brain and other parts of the body. Cannabinoid receptors (molecules that bind cannabinoids) have been discovered in brain cells and nerve cells in other parts of the body. The presence of cannabinoid receptors on immune system cells suggests that cannabinoids may have a role in immunity.
Nabiximols (Sativex) is a Cannabis extract that contains delta-9-THC and cannabidiol (CBD). Nabiximols is approved in Canada (under the Notice of Compliance with Conditions) for relief of pain in patients with advanced cancer or multiple sclerosis.
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