A Microscopic View of Medical Cannabis: A Handbook for Clinicians, Medical Professionals, Dispensary Staff, and Patients

By Cathie Hiegel

This groundbreaking and informative book examines the compounds of the cannabis plant as it relates to 26 diseases, symptoms, and 19 cancers, along with corresponding cannabis protocols to provide a specific treatment plan. Each protocol sheet has a description plus the pros and cons of using cannabis for that disease or symptom. An invaluable r

• Language: English
• Publisher: Hiegel Publishing
• Release date: Sep 23, 2022
• ISBN: 9798885909747

Book preview

Chapter 1

Book Introduction

and History of Cannabis

Figure 1.1

Where did Cannabis Originate?

Cannabis is one of the oldest plants utilized by humans for its’ value as fiber, medicine, and religious rites and ceremonies. Cannabis was first cultivated in Japan dating back 12,000 years ago (8,000 B.C.) where it was grown for fiber, food, and possible psychoactive material [1]. Hemp was found near the Altai Mountains in Central Asia or present-day Taiwan dating back to the Stone Age (5,000 B.C.). It was also discovered in China around the same time being woven into rope for carrying clay pots like the picture below [1].

Yangshao hemp cord-marked amphora, 4800 BC, Shaanxi ( Wikimedia )

Figure 1.2

Ancient Assyrian people in Mesopotamia found cannabis worked as an aromatic, here it was called Ganga and probably smoked but that issue is still being debated. Cannabis traveled from the Persian world to the Arab world around 1230 A.D. and was introduced as hashish (cannabis resin). The Arabs introduced this to the Egyptians and referred to it as Indian hemp [1].

The Chinese implemented hemp into clothing, ropes, shoes, an early form of paper, and the seeds for food and oil [1]. In nomadic life, hemp was found to be useful in making rope for hunting, cultivation, and mechanical uses such as pulling, carrying, lifting, attaching objects, fastening, and climbing. These techniques were continued into the shipbuilding world. Ships needed more rope for riggings to hoist the sails (also made from hemp canvas), the lines, and caulking for the wooden hull [2]. In 1545 industrial hemp spread to South America where Spaniards imported it to Chile for fiber [1].

French and British colonists at Jamestown, VA. discovered hempe among the plants being grown near the Powhattan village, now known as Richmond, VA. [1]. Hemp was required to be grown in England by Henry VII in 1533 and 1619 both English and Indian (India) hemp became mandated to be grown in the colonies [3]. This was because the king wanted more hemp for industrial purposes. It was grown on many plantations, such as George Washington’s and Thomas Jefferson’s, for making rope, clothing, and paper [3].

Where did Medical Cannabis Originate?

Cannabis spread around the world for medical use as well. Medicinal cannabis dates back at least 5,000 years. It was medically introduced into China as early as 2737 B.C. Emperor Shen Neng of China in his book The Herbal recommended prescribing cannabis tea to treat gout, rheumatism, malaria, and even poor memory. Chinese Emperor Fu Hsi called cannabis a popular medicine in 2,900 BC, and the Chinese had identified more than 100 medicinal uses for cannabis by 1 A.D. The Ancient Egyptians introduced cannabis in suppositories to treat hemorrhoids, glaucoma, and general inflammation [3].

In India, Bhang (a beverage containing cannabis) was utilized for religious rituals, and medically to treat insomnia, headaches, gastrointestinal disorders, pain, and childbirth. Cannabis was said to have been an ingredient in a holy anointing oil referenced in the original Hebrew version of Exodus around 800 A.D. During the Middle Ages in Islamic countries, cannabis was a treatment for headaches, analgesics, and syphilis from 800-900 A.D. People were nomadic and traveled throughout the world, taking cannabis as a crop and medicine for many years [3].

Cannabis as a Medicine Begins to Flourish Once Again

An Irish man named William Brooke O’Shaughnessy studied medicine at the University of Edinburg. In 1833 O’Shaughnessy took a job with the East India Company to work in Calcutta as an assistant surgeon. In 1839 he published the results of his observations on cannabis. One thing he noted was the intoxicating effect of cannabis when being used for religious, social, and medical purposes. These euphoric effects were then unknown in Europe, except for a few young soldiers experimenting with hasheesh in Marseilles during Napoleon’s Egyptian campaign [1798]. He noted that the effects of cannabis depended on a resinous secretion that was present in the Indian hemp but seemed absent in the European hemp. He felt this because of the differences in climate since the plants looked identical. He described some of the various preparations traditionally prepared and medically implemented in India [4].

Cannabis, which was used as a medicine in ancient times, was now being implemented into O’Shaughnessy’s medical studies. In 1878 a British physician, J. Russel Reynolds, became the physician-in-ordinary to Queen Victoria and her household giving the Queen cannabis for painful menses. Empress Elisabeth (Sissi) of Austria took cannabis for cough and to stimulate her appetite [4].

During Reynold’s studies, he encountered the same problem as O’Shaughnessy, the composition of the plants was not uniform. They both felt that the climate had a significant impact on the explanation of these changes. Reynolds felt that the different growing conditions affected the hemp plants’ chemical composition. The differences in chemical composition determine the effects produced; a consistent medication composition was required to prevent overtreatment minimize side effects and maximize effectiveness.

Reynolds always tried to obtain cannabis from the same source and use the cannabis to prepare a liquid extract of the plant, called a tincture, to standardize the medication. He would dose the tincture with sugar or bread. His practice was to start with a low cannabis dose, observe the patient’s response, and incrementally increase the dosage based on the patient’s response [4]. This is how most medications are administered today. Start with a low dose, and incrementally increase the dose based on the patient’s response: start low- go slow.

Figure 1.3

When Was it Used as a Medicine

in the United States?

The United States Pharmacopeia was an official public standards-setting authority for all prescription and over-the-counter medicines in 1850. It listed cannabis as a treatment for numerous afflictions such as neuralgia, tetanus, typhus, cholera, rabies, dysentery, alcoholism, opiate addiction, anthrax, leprosy, gout, convulsive disorders, tonsillitis, insanity, excessive menstrual bleeding, and uterine bleeding, among others. [3, 5] During the Civil War, the military physicians on both sides were using laudanum (a blend of opium and alcohol), opium pills, and morphine injections. Many soldiers were addicted to these after the war ended and in 1889, cannabis was used and listed in a medical journal as a treatment plan for withdrawal symptoms [3].

The Opinions on Marihuana Begin to Change:

During early 1900, the early prejudices against cannabis began to emerge. These early prejudices against cannabis (marihuana) were believed to be racist fears of its users. Mexican-Spanish people first used the word marihuana and at this time the practice of smoking marihuana leaves in cigarettes or pipes was unknown in the United States. In the late 1800s and early 1900s, Mexicans were fleeing their country because of war at home in Mexico and came to the United States. After their arrival, Mexicans were blamed for many things: smoking weed, murder, stealing property, and seducing children. Former Spanish-American War hero Richmond P. Hobson began warning of a dire threat posed by marihuana and other drugs to our survival and character as a nation. It is an interesting theory and would help explain how, after thousands of years as a therapeutic plant, cannabis/marihuana suddenly became classified as a harmful and dangerous drug [5]. Harry J. Anslinger began to make his racist attack on marihuana in America against the Mexicans and Black people. He claimed that Mexicans and Black people were the main users and that jazz musicians were creating Satanic music because of marihuana [5].

Hemp was also under attack by three families of businessmen who were threatened by the growing use of hemp: the Du Pont family, Andrew Mellon, and William Randolph Hearst. The Du Pont family’s chemical company had just invented nylon and saw hemp fiber as a cheap competitor. Andrew Mellon, Secretary of the Treasury and a significant investor in Du Pont also opposed marijuana. William Randolph Hearst found hemp a threat to his newspaper industry and his timber companies. The hemp industry was becoming a challenge because of the ability of the plant to grow faster and less costly to produce newspapers. William Randolph Heart owned a journalism empire and began writing in his newspapers to spread untruths about the harms of marijuana. His motivation was racism and money rather than truths about cannabis, one paper said that marihuana would lead you to an insane asylum [5].

The former Spanish-American War hero Richmond P. Hobson (the Anti-Saloon League’s best-paid public speaker during alcohol prohibition), William Randolph Hearst (newspaper and timber stockholder), and Harry J. Anslinger (who would later become the first to head the Federal Bureau of Narcotics (FBN) would stoke the fire and begin their racist and ethical scare attacks on marihuana. This is the beginning of the crusade and war against marihuana in the United States [3, 5].

The War on Marihuana Begins:

Prohibition on medical marihuana was made in 1937 when the U.S. passed the first federal law against cannabis. The last witness to be heard was Dr. William C. Woodward, legislative counsel of the American Medical Association (AMA). "He announced his opposition to the bill and said that the Act would curtail the medicinal uses of marihuana and the passing of the Bill would deprive US citizens of the benefits of a drug of substantial value." Anslinger and the government could not outlaw it, so the Marihuana Tax Act was passed on Oct. 1, 1937, and marihuana was then considered a controlled substance to be taxed by the government. Doctors, dentists, and other medical practitioners were required to purchase a $1 stamp for the year and display it at their place of business. Others such as producers paid $1, laboratories paid $1, dealers paid $3, and import manufacturers and compounders paid $24. For each ounce of marihuana sold, an additional $1 was charged to each registered individual. Those who could not meet these strict requirements were charged $100 an ounce. Failure to pay resulted in a $2,000 fine and five years in prison. Most people could not pay these taxes, use decreased, and by 1941 Marihuana was removed from U.S. Pharmacopoeia [3, 6].

The debates relating to the passing of the Boggs Act, 1951 created a notion that Marihuana led to the use of harder drugs. Penalties for Marihuana were increased with the Narcotic Control Act, of 1956. The Controlled Substances Act, of 1970 classified drugs into five schedules. Schedule I substances are said to have the highest potential for abuse, have no medical value, and are considered not to be safe for use even under medical supervision. Marihuana is classified as a Schedule I drug [3, 6].

Figure 1.6

Why is Marijuana still a Schedule I Drug Today?

Marihuana was spelled with an h rather than a j in the Controlled Substances Act of 1970, even though it had been spelled with a j since the 1960"s. No matter how you spell it why is it still considered a Schedule I Drug in 2022? Considering the current number of deaths from drug overdoses occurring from opioids (natural), synthetic opioids other than methadone (primarily fentanyl), heroin, cocaine, benzodiazepines, and anti-depressants, why is cannabis (both marijuana and hemp) not being used to help with addiction as it was after the Civil War? The CDC stated that there were an estimated 100,306 drug overdose deaths in the U.S. during the 12 months ending 2021(they stated these may be under-documented). This was an increase of 28% from the previous time the year before. Cannabis is a safe alternative to our opioid and drug overdose situation [7].

Cannabis is an extremely safe medication. There has never been fatal cannabis poisoning documented in a human being. That is not to say there are no harmful effects from cannabis, but some may occur, as the result of high increased levels of ∆-9-THC in some chemovars or strains or underlying conditions of some patients. These rare complications can include chronic bronchitis and respiratory problems from heavy, long-term smoking cannabis use, elevated risk of cardiovascular diseases such as Afib or tachycardia, ischemic strokes (Reversible Cerebral Vasoconstriction Syndrome), cannabis hyperemesis syndrome (CHS), the decline in cognitive function from heavy users (road traffic and work-related injuries), and risk of psychotic symptoms or illness [8]. These are rare and THC has an unparalleled safety profile making cannabis and cannabinoid treatments far less risky than most modern drugs [7].

Bibliography:

https://en.wikipedia.org/wiki/History_of_cannabis

History of Hemp - Hemp Information - National Hemp Association

https://medicalmarijuana.procon.org/historical-timeline

Crocq MA. History of cannabis and the endocannabinoid system . Dialogues Clin Neurosci. 2020 Sep;22(3):223-228. doi: 10.31887/DCNS.2020.22.3.

Solomon R. Racism and Its Effect on Cannabis Research. Cannabis Cannabinoid Res. 2020;5(1):2-5. Published 2020 Feb 27. doi:10.1089/can.2019.0063.

The Marijuana Tax Act of 1937 | Study.com

Overdose Death Rates | National Institute on Drug Abuse (NIDA)

Matheson J, Le Foll B. Cannabis Legalization and Acute Harm From High Potency Cannabis Products: A Narrative Review and Recommendations for Public Health. Front Psychiatry. 2020;11:591979. Published 2020 Sep 23. doi:10.3389/fpsyt.2020.591979.

Photos and Pictures:

Figure 1.1 Warf, B. 2014. High points: An historical geography of Cannabis. Geographical Review 104 (4):414-430.

Figure 1.2 Info from https://en.wikipedia.org/wiki/History_of_cannabis

Figure 1.3 Kurt Jones Photography, Russellville AR.

Figure 1.4 Introduction - Marihuana: Topics in Chronicling America - Research Guides at Library of Congress (loc.gov) The Ogden standard. [volume], September 25, 1915, 4 P.M. CITY EDITION, MAGAZINE SECTION, Image 13

Figure 1.5 ID 166119426 © Michelle Bridges | Dreamstime.com

Figure 1.6 Controlled Substances Act of 1970 - The Reefer Report (weebly.com)

Chapter 2

The Endocannabinoid System

Figure 2.1

The Endocannabinoid System and How It Was Discovered?

Although cannabis has been around for at least 6,000 years and used medically, it was not until the late 1890s that its pharmacological properties were studied. The first studies of cannabinoids were discovered in 1896 by researchers T. Barlow Wood, W. T. Newton Spivey, and Thomas Hill Easterfield. They were able to isolate and identify the very first plant cannabinoid, cannabinol (CBN). They called their material red oil Later during an experiment with the red oil, Spivey died in a laboratory accident [1]. His death ended research on cannabinoids in Cambridge and Easterfield moved to New Zealand to continue his studies, while Wood continued his studies in England. There was some confusion about red oil being a narcotic but later it was realized as a mixture and was associated with the name cannabinol [1]. They had thought that CBN was the main intoxicating product of cannabis. It was eventually studied by Roger Adams when the U.S. government asked him to resolve and identify CBN [1]. This was 2 years after the Marihuana Tax Act made cannabis illegal. By the 1940s, Adams had isolated and established the structure of CBN and the partial structure of CBD [1].

Figure 2.2

Research continued in the 1960s when Israeli researcher Dr. Raphael Mechoulam and his associates first identified THC as the intoxicating agent of cannabis and discovery the endocannabinoids, their endogenous analogs. These and other studies by others are the base of the research we continue working on today [1].

ln 1988 the cannabinoid 1 receptor (CB1) was discovered and later cloned in 1990 (Matsuda et al, 1990) [2]. In 1993 a second cannabinoid receptor (CB2) was cloned in Sean Munro’s lab in Cambridge [2]. DeVane and his colleagues (1992), Mechoulam and his colleagues (1995), and Sujiura and his colleagues (1995) located and identified two of the body’s naturally produced endocannabinoids: anandamide and 2-arachidonoylglycerol, or 2-AG [2]. Each of these endocannabinoids can activate the CB1 and CB2 receptors on demand in response to elevations of intracellular calcium discovered by Howlett (2002) and DiMarzo (2005) [2]. These studies along with the work of Pertwee (2005) finding additional endocannabinoids come together to constitute what we know today as the endocannabinoid system [2]. The endocannabinoid system (ECS) is one of the important physiological systems of your body. Your ECS is responsible for making sure your entire body is working at optimal mode. That is because of its’ involvement in building and maintaining a healthy body for your survival [2].

Figure 2.3

What is the Endocannabinoid System and How Does it Work?

The endocannabinoid system is made up of three basic components: endocannabinoids, cannabinoid receptors, and enzymes that break down the endocannabinoids [3]. When our bodies are in balance and the body functions are optimized, it is known as homeostasis which is how the body keeps everything constant. Everything inside and outside your body needs to be just right for you to be healthy and your body to work at its most optimum efficiency, with or without cannabis. The endocannabinoid system works to maintain homeostasis by utilizing endocannabinoids and cannabinoid receptors found throughout the immune system and central and peripheral nervous systems [3]. The endocannabinoid system helps manage physiological processes that are both physical and chemical functions of your body. These functions include reproduction, cancer, inflammation, cardiovascular disease, memory, digestion, motor functions, appetite, pain, blood pressure, bone growth, brain functions, neurogenesis [3], and skin [4].

Figure 2.4

What Are Endocannabinoids and What Do They Do?

Endocannabinoids, also called endogenous cannabinoids, are molecules made by your body. They are like cannabis cannabinoids, or phytocannabinoids such as THC or CBD, which are produced by plants. Endocannabinoids are lipid proteins produced within an organ or cell within your body that interact with the cannabinoid receptors [5]. The primary endocannabinoids include anandamide (AEA) and 2-arachidonoylglycerol (2-AG). Endocannabinoids are produced from lipid membranes in one or two rapid enzyme steps and then released into the synapse. AEA is a high-affinity, partial agonist of CB1 receptors. This means that the AEA has a high desire to bond to the CB1 receptor, but it will activate a weak response. The endocannabinoid, 2-AG acts as an agonist at both the CB1 and CB2 receptors with moderate to low affinity [4]. This means 2-AG does not have a high desire to bond and activate to both but when it does it will activate a strong response. The cannabinoid receptors then activate the physiological processes necessary for homeostasis. You need both endocannabinoids for this process to work [5].

Endogenous cannabinoids function as homeostatic regulators of energy balance for intake of body temperature, glucose metabolism, lipid metabolism, muscle tone, movement, the immune system, inflammation, modulates pain pathways, hormones, and sleep. Essentially every function that goes on within the body [6].

Endocannabinoids are synthesized from omega-3 and omega-6 fatty acids. Omega-3 fatty acids are found in foods such as flaxseeds, fish, walnuts, tofu, olive oil, shellfish, canola oil, or navy beans [6]. Omega-6 fatty acids are found in foods such as processed snacks, fast foods, cakes, fatty meats, cured meats, vegetable oil, corn oil, or similar oils [7]. These are not as healthy as some of the other omega-6 fatty acids choices such as tofu, walnuts, and peanut butter [7]. Try to balance your intake of food with omega-3 fatty acids and omega-6 fatty acids that are healthy. This should help your gastrointestinal tract and adipose tissue in your body break down fats [7].

Figure 2.5

The Cannabinoid Receptors:

Cannabinoid receptors are G-protein coupled receptors embedded in the cellular membranes of cells found throughout the body [5]. They are activated by cannabinoids, transmit signals to the inside of the cells, and create cellular responses. There are two types of cannabinoid receptors found throughout the body, these are CB1 receptors and CB2 receptors [5]. The CB1 receptors are located and most abundant in the central nervous system primarily the brain, peripheral nerves, and spinal cord, Lower CB1 receptor expression may be found in the reproductive organs, adipose tissue, skeletal and smooth muscle, liver, lungs, kidney, adrenal glands, and heart.

The CB2 receptors are highly expressed throughout the immune system and associated organs such as the tonsils, thymus, bone marrow, skin, lymph nodes, reproductive organs, GI tract, and the spleen. Activation of the CB2 receptors produces anti-inflammatory responses throughout your whole body since they are mostly located in the immune system [3, 4, 5].

The GPR55, or orphan receptor, also a G-protein receptor is expressed throughout the body but primarily found in the brain and gut. It showed binding with some cannabinoids and non-cannabinoid ligands but lacks the classical cannabinoid binding pocket of CB1 and CB2. GRP55 is sometimes called the CB3 receptor, but this has yet to be made clear [5].

Figure 2.6

Figure 2.7

The Enzymes:

After the endocannabinoids have served their function in receptor activation, they must be removed from the synaptic cleft to prevent continued receptor activity. This is done by enzymes monoacylglycerol lipase (MAGL) and fatty acid amide hydrolase (FAAH). The enzymes FAAH and MAGL are in the cleft and break down AEA and 2-AG respectively into inactive forms. The activity of these enzymes can be affected by cannabinoids like CBD which decrease FAAH’s effectiveness and increases the amount of AEA present [6, 7].

Figure 2.8

So Why Are These Three Components of the ECS so Important?

Cannabinoids have many effects by activating the endocannabinoid system. This system plays a role in maintaining homeostasis, the normal functioning of the body. Multiple studies suggest that the endocannabinoid system is involved in neurodegenerative diseases such as multiple sclerosis, Huntington’s, Parkinson’s and Alzheimer’s diseases, and amyotrophic lateral sclerosis. These affect cognition and motor functions. These diseases involve alterations in the CB1 and CB2 receptors as well as the endocannabinoid levels [8]. ECS active ligands have also proven useful in the treatment of epilepsy, anxiety, depression, schizophrenia, neuropathic pain, chronic post-traumatic stress disorder, phobias, or sclerosis multiplex [9].

Other studies have shown that alterations of ECS receptor expression were found in many different disease conditions such as cancer and neurological disorders, The levels of endocannabinoids, especially AEA and 2-AG, are abnormal in some tumors, compared with normal tissues. These receptors have also been related to cancer prognosis. The altered expression is correlated with positive and negative survival indicators, depending on the origin of the cancer type. Multiple studies evaluated levels of FAAH and MAGL in cancer patients and revealed an even higher expression of these endocannabinoid-degrading enzymes in cancer vs healthy tissue [4, 10].

How Does Inflammation Work With the

Endocannabinoid System?

The immune system attacks pathogens that invade the body systems and cause disease. It also reacts to injuries, allergens, and toxins as the body attempts to heal. The immune system is made up of cells, tissue, and organs that try to keep these pathogens and germs from invading your body and remove the infections. When immune cells such as white blood cells (leukocytes) are activated, the body produces endocannabinoids. Types of leukocytes would include monocytes, B-cell and T-cell lymphocytes, macrophages, neutrophils, eosinophils, and basophils. The endocannabinoid system controls the immune response keeping active to fight infections and prevent them from becoming overactivated and causing the immune system to attack normal tissues [11].

Bibliography:

Appendino, G. The early history of cannabinoid research. Rend. Fis. Acc. Lincei 31, 919–929 (2020). https://doi.org/10.1007/s12210-020-00956-0.

Pertwee RG. The diverse CB1 and CB2 receptor pharmacology of three plant cannabinoids: delta9-tetrahydrocannabinol, cannabidiol and delta9-tetrahydrocannabivarin. Br J Pharmacol. 2008;153(2):199-215. doi:10.1038/sj.bjp.0707442.

Alger BE. Getting high on the endocannabinoid system. Cerebrum. 2013;2013:14. Published 2013 Nov 1.

Lu HC, Mackie K. An Introduction to the Endogenous Cannabinoid System. Biol Psychiatry. 2016;79(7):516-525. doi:10.1016/j.biopsych.2015.07.028.

Borowska M, Czarnywojtek A, Guntaj N, Woliński K, Płazińska MT, Mikołajczak P, Ruchała M. The effects of cannabinoids on the endocrine system. Endokrynol Pol. 2018;69(6):705-719. doi: 10.5603/EP.a2018.0072. 

Bisogno T, Hanus L, De Petrocellis L, et al. Molecular targets for cannabidiol and its synthetic analogues: effect on vanilloid VR1 receptors and on the cellular uptake and enzymatic hydrolysis of anandamide. Br J Pharmacol. 2001;134(4):845-852. doi:10.1038/sj.bjp.0704327.

Gertsch J. Cannabimimetic phytochemicals in the diet - an evolutionary link to food selection and metabolic stress adaptation? Br J Pharmacol. 2017 Jun;174(11):1464-1483. doi: 10.1111/bph.13676.

Zou S, Kumar U. Cannabinoid Receptors and the Endocannabinoid System: Signaling and Function in the Central Nervous System. Int J Mol Sci. 2018;19(3):833. Published 2018 Mar 13. doi:10.3390/ijms19030833.

Fraguas-Sánchez AI, Martín-Sabroso C, Torres-Suárez AI. Insights into the effects of the endocannabinoid system in cancer: a review. Br J Pharmacol. 2018 Jul;175(13):2566-2580. doi: 10.1111/bph.14331.

Barrie N, Manolios N. The endocannabinoid system in pain and inflammation: Its relevance to rheumatic disease. Eur J Rheumatol. 2017;4(3):210-218. doi:10.5152/eurjrheum.2017.17025.

Photos and Drawings:

Figure 2.1 Photo 67755249 / System © Chrischrisw | Dreamstime.com

Figure 2.2 Used Powerpoint

Figure 2.3 Photo 10318767 © Kts | Dreamstime.com

Figure 2.4 National Center for Biotechnology Information. PubChem Compound Summary for CID 5281969, Anandamide. https://pubchem.ncbi.nlm.nih.gov/compound/Anandamide.

National Center for Biotechnology Information. PubChem Compound Summary for CID 5282280, 2-Arachidonoylglycerol. https://pubchem.ncbi.nlm.nih.gov/compound/2-Arachidonoylglycerol.

Figure 2.5 Photo 168773662 © Andrii Kucher | Dreamstime.com

Figure 2.6 Shutterstock.com 1477548024

Figure 2.7 Images created using Mol* should cite the PDB ID, the corresponding structure publication, Mol* (D. Sehnal, S. Bittrich, M. Deshpande, R. Svobodová, K. Berka, V. Bazgier, S. Velankar, S.K. Burley, J. Koča, A.S. Rose (2021) Mol* Viewer: modern web app for 3D visualization and analysis of large biomolecular structures. Nucleic Acids Research. doi: 10.1093/nar/gkab314), and RCSB PDB.

Images created using Mol* should cite the PDB ID, the corresponding structure publication, Mol* (D. Sehnal, S. Bittrich, M. Deshpande, R. Svobodová, K. Berka, V. Bazgier, S. Velankar, S.K. Burley, J. Koča, A.S. Rose (2021) Mol* Viewer: modern web app for 3D visualization and analysis of large biomolecular structures. Nucleic Acids Research. doi: 10.1093/nar/gkab314), and RCSB PDB.

Figure 2.8 Shutterstock.com 1239933898

Chapter 3

The Cannabinoids

Figure 3.1

What are Cannabinoids?

There are three types of cannabinoids: endogenous, exogenous(phytocannabinoids), and synthetic [1]. Endogenous cannabinoids or endocannabinoids occur naturally and are made inside of your body, examples such as Anandamide (AEA) and 2-Arachidonylglycerol (2-AG) [1]. Exogenous cannabinoids or phytocannabinoids are found in certain plants, the main two being THC and CBD. The third type is known as synthetic pharmaceutical cannabinoids [1]. Phytocannabinoid and synthetic are both exogenous cannabinoids meaning they are made outside of the body.

Phytocannabinoids are found in liverworts, fungi, and some flowering plants such as cannabis. Trichomes are resin glands that appear as shiny and sticky crystals found on the leaves and buds of the cannabis plant with the highest density in the female plants. Trichomes provide protection helping with temperature, photosynthesis, and ultra-violet light to more complex functions such as deterring pests or attracting pollinators. These tiny, microscopic glands contain the cannabinoids, terpenes, and flavonoids that make up medical cannabis produced at different yields based on genetics and environmental conditions [2].

Figure 3.2

There are over 500 [3] or 548 [8] chemical entities found in the cannabis plant (information changes as we learn