What are Cannabinoids?

Cannabinoids are natural compounds found in the Cannabis sativa plant with over 400 chemical substances. More than 100 of them are cannabinoid compounds. The most well known among these cannabinoids are tetrahydrocannabinol (Δ9-THC) and Cannabidiol (CBD). The main difference between the two is that THC has strong psychoactive effects and causes a person to feel high, whereas CBD is non-psychoactive and moderates or controls the “high” feeling caused by THC. 

Cannabinoids that are developed and taken from hemp plants are legal and can be easily found in stores and online. However,  some cannabinoids are only legal in some places due to their effects.

The Endocannabinoid system

The endocannabinoid system (ECS) is a neuromodulatory system that plays an important role in regulating sleep, mood, memory, appetite, and reproduction. Even if you don’t use cannabis, the ECS is still active in the body. The endocannabinoid system consists of cannabinoid receptors, endocannabinoids, and the enzymes responsible for the synthesis and degradation of the endocannabinoids.

Endocannabinoids are similar to cannabinoids, but they are molecules made by your body. Endocannabinoid receptors are found in the body, these are called CB1 and CB2 receptors. CB1 receptors are mostly found in the nervous system while CB2 receptors are mostly found in the peripheral nervous system. 

Endocannabinoids bind to either of these receptors to signal that the ECS needs to take action. Enzymes are responsible for breaking down the endocannabinoids.

Types of Cannabinoids

Most people are familiar with the two most common cannabinoids: THC and CBD. But cannabis plants can actually produce more than 100 cannabinoids. 

• Cannabinol (CBN). This cannabinoid is mildly psychoactive, but not as nearly as potent as THC.
• Cannabichromene (CBC). This compound s mostly found on juvenile plants. It is mostly known to provide pain relief and act as an anti-inflammatory. It is also effective in promoting healthy bones.
• Cannabigerol (CBG). CBG rarely exceeds 1.5% in optimally-grown cannabis. It is not a psychoactive compound and is effective in treating inflammation and pain.
• Tetrahydrocannabinolic acid (THCA). This is an acidic form of THC. It is present in cannabis that has not been dried or decarboxylated to convert the acidic forms of cannabinoids like THC or CBDA. It does not produce the same effects as THC and is not psychoactive.
• Tetrahydrocannabivarin (THCV). THCV amplifies the psychoactive properties of THC but reduces the longevity of intoxication. It’s being studied as a possible treatment for diabetes.
• Cannabidivarin (CBDV). It’s being studied as a potential treatment for autism spectrum disorder.
• HU-210. This is a synthetic analogue of THC first synthesised in 1988 and is considered to be 100 times more potent than THC.
• UR-144. This is a synthetic cannabinoid invented by Abbott Laboratories. It has similar effects with THC but is slightly less potent.
• JWH. This is a series of synthetic cannabinoids invented in 1994 by Dr John W Huffman for studies of cannabinoid receptors. 
• 5F-ADB. This is also a synthetic cannabinoid that was invented in late 2014 from samples taken from an individual who died after using a product containing this substance.
• CUMYL-PEGACLONE. This synthetic cannabinoid emerged in late 2016 in Germany. Some reports suggest that some behavioural effects are associated with this synthetic cannabinoid. 

What do cannabinoids do?

The two main cannabinoids, THC and CBD, are chemically similar to the body’s endocannabinoids. This allows them to interact with the cannabinoid receptors. This interaction affects the release of neurotransmitters in the brain that transmit messages between the cells and have roles in immune function, pain, stress, and sleep, among others. 

According to a study by the Journal of Experimental Medicine, cannabinoids are anti-inflammatory and are ideal therapeutic agents in the treatment of neuropathic pain.

THC binds with the CB1 receptors in the brain and produces a high feeling. Although CBD binds with the CB1 receptors as well, CBD still needs THC for it to be able to bind to the receptor. This results in some of the unwanted psychoactive effects of THC. 

Effects of cannabinoids

Doctors are prescribing some medicinal cannabinoids for their health benefits such as relieving pain, reducing anxiety, stimulating the appetite, and controlling nausea and vomiting. Cannabinoids have both positive and negative effects on the body, which is why they use of cannabis is controlled in many countries. However, CBD is a reliable cannabinoid and is very popular for its health benefits as it is usually tolerated by the body very well. 

There are more than 100 cannabinoids in medical cannabis but the most known cannabinoids are THC and CBD. Depending on the country's rules and regulations around the use of cannabis, THC may not be permitted even for medical use.

A study published in Cannabis and Cannabinoid Research suggested that some side effects have been reported for CBD focused on animal studies including alteration of cell viability, reduced fertilization capacity.

CBD and THC may have similar medical benefits as they provide relief from the same conditions. However, CBD does not cause the “high” effects that happen with THC. Some people prefer using CBD due to its lesser side effects and non-psychoactive properties. THC and CBD do have some drawbacks and side effects which are listed below. 

THC causes temporary physiological effects including:

• Increased heart rate
• Dry mouth
• Coordination problems
• Anxiety
• Memory loss

CBD side effects may include:

• Fatigue
• Diarrhoea
• Weight loss
• Fatigue
• Appetite changes

Do cannabinoids make you feel high?

Yes, some cannabinoids will make you feel high. Unlike CBD, the main psychoactive ingredient found in cannabis plants, THC, stimulates the part of your brain that responds to pleasure. It responds to a chemical called dopamine which gives you a relaxed and euphoric feeling. 

THC could get into your bloodstream and make you feel high in a few minutes. Not everyone’s experience with cannabis is pleasant. Taking high doses of cannabis can sometimes cause anxiety and paranoia.

What cannabinoids show up on a drug test?

Products containing marijuana’s main active ingredient, THC, show up on drug tests. When cannabis is used, the drug remains in a person’s system beyond the time you feel its effects. The amount of THC or dose a person uses can also alter the time the drug remains in the system.

Depending on the type of test used, THC may be detectable the day a person uses it or up to three months. Each type of drug test has a different cannabinoid detection window. In most cases, tests don’t look for THC. Instead, they look for its metabolites or compound that THC is broken into. Cannabis use may be detected by urine, hair, blood, saliva, or sweat tests.

What are synthetic cannabinoids?

Synthetic cannabinoids are designed to mimic the effects of THC. They are similar to natural cannabis. However, these synthetic cannabinoid drugs are made to be more potent and have been associated with adverse effects including breathing difficulties, heart palpitations, and extreme anxiety. Like THC, these synthetic cannabinoids target the CB1 receptor in the brain.

Synthetic cannabinoids are much more potent than THC but are toxic. They are often mixed with other chemicals including opioids, blood thinners, and stimulants among others, making synthetic cannabinoids dangerous. These products are also often marketed as safe but even in small amounts, exposure to synthetic cannabinoids can be addictive.

Spice is one of the earliest and most popular brands of synthetic cannabinoids in the UK. However, it has become a generic term to describe any synthetic cannabinoid. Spice belongs to Class B Schedule 1 substances and is illegal to possess, supply, or produce. Currently, the only legal cannabinoid product in the UK is Epidiolex, a CBD drug that helps with two forms of epilepsy.

What is Cannabinoid Hyperemesis Syndrome?

Cannabinoid hyperemesis syndrome (CHS) is a condition that leads to severe and repeated bouts of vomiting. Other people with CHS also experience nausea, dehydration and abdominal pain. It is a rare condition and only occurs in the daily long-term use of marijuana. 

Marijuana has active substances like THC that bind to molecules in the brain, and THC is a known compound that causes the “high” and other effects that users feel. Marijuana also affects the digestive tract as some of the molecules also bind to THC. Long-term marijuana use can change the way the affected molecules respond and can lead to the symptoms of CHS.

Marijuana often has the opposite effect of CHS and helps prevent nausea and vomiting. But in the digestive tract, marijuana makes you more likely to have nausea and vomiting. Health care providers usually do blood tests for anaemia and infection, tests for electrolytes, pancreas and liver enzymes, among others, to rule out other possible causes of the vomiting.

Currently, it’s still not clear why some marijuana users get this syndrome, while others have a high tolerance to cannabinoids. According to an article by the Cleveland Clinic, genetics may play a role. They also believe that CHS may occur due to overstimulation of your endocannabinoid system.

If you use marijuana and feel abdominal pain, severe and repeated nausea and vomiting, you may have cannabinoid hyperemesis syndrome.

How is cannabinoid hyperemesis syndrome treated?

The known treatment to permanently get rid of CHS is to stop the use of this cannabis completely. You may have symptoms and side effects of CHS for a few weeks after quitting but it will disappear over time.

If you have severe vomiting and might need to stay in the hospital, doctors will give you IV fluid to help with the dehydration. They will also provide medicines to help decrease vomiting, pain medicine, and frequent hot showers as hot showers can relieve nausea.