DESCRIPTION

• “Cannabis” refers to the genus which has two main subspecies, Cannabis sativa and Cannabis indica. “Marijuana” refers to the pharmacologic products that originate from cannabis plants.
• Cannabis interacts with the endocannabinoid system (ECS) in our bodies.
  • The ECS has two main receptors:
    • CB 1—expressed in the central nervous system
    • CB 2—expressed in the periphery including the immune system
• Chemical components of cannabis are referred to as cannabinoids. There are three categories of cannabinoids
  • Endogenous cannabinoids, created by the body
  • Synthetic cannabinoids, typically produced pharmaceutically
  • Phytocannabinoids, derived from the Cannabis sativa plant
    • The best studied cannabinoids are δ-9-tetrahydrocannabinol (THC) and cannabidiol (CBD). Most of the psychoactive properties come from THC acting on CB1 and CB2 receptors and is the source of medical marijuana. CBD activates serotonin and initiates more anxiolytic and sedative properties (1).

EPIDEMIOLOGY

As of February 2024, 38 states, 3 territories (Guam, Puerto Rico, U.S. Virgin Islands), and the District of Columbia have legalized the use of cannabis for medical purposes.

• At the federal level, cannabis continues to be a Schedule 1 substance.

PREVALENCE

• Prevalence of medical cannabis use is about 2.5% of the U.S. population.
• The most common indications for medical cannabis use were surveyed to be anxiety, insomnia, and chronic pain.