ADHD. Cancer. Chronic pain. Epilepsy. Fibromyalgia. HIV/AIDS. Migraines. Rheumatoid arthritis. Parkinson's. These are all medical conditions that medical cannabis can help with... and this list is not even close to being all-inclusive. So how can one plant help with so many different diseases? We didn’t learn the answer to this question until the late 1980s. Keep reading to find it!
THE ECS
What is it?
The endocannabinoid system, or ECS, is a homeostatic regulatory system that is present throughout the body. The ECS is made up of endocannabinoids, or basically, a bunch of receptors in the body that control functions such as sleep, memory, mood, appetite, and pain-the main reason that people use cannabis.
The ECS is a very complex system that has receptors dated back to around, brace yourself, 600 MILLION years ago. No lie. Starting with the sea squirt and evolving from fish to mice to monkeys to humans. It obviously has an incredibly major role to be around for that long.
The Star Players
There are two predominant subtypes of cannabinoid receptors in the ECS: CB1 and CB2. CB1 receptors are primarily located in the central nervous system and CB2 receptors and more limited to the immune system but can be found in other tissues. The interesting thing about CB2 receptors is that tissues that don’t normally express CB2 may begin to do so after becoming injured or inflamed as an adaptive response. Cool, huh? The physiological effects experienced by the cannabis plant are caused by the phytocannabinoids interacting with these receptors in various areas of the body.
With more research coming about, it is now known that cannabinoid interactions expand far beyond the CB1 and CB2 receptors. Other endocannabinoid targets include GPR55 which helps with pain, inflammation, and energy homeostasis, TRPV1 aka the capsaicin receptor which also helps with pain and inflammation, PPARs which regulate important metabolic functions such as glucose metabolism and fatty acid storage. So as you can see, the ECS is not to be put into a box, it is extremely complex and unique.
When Is it Formed?
We start developing our ECS pretty early on. The complex system is said to be in development from 14-19 weeks’ gestation which is just after the first trimester. The ECS is vital in various developmental areas such as metabolic support, nervous system development, food intake and survival in the newborn period, neuroprotection, axonal elongation, synaptogenesis, and neurotransmitter synthesis, like dopamine. There is a gradual rise of CB1 receptors from infancy to adulthood and this reflects the response to the intoxicating effects of the plant. Basically, kids can tolerate the effects of THC better than their adult counterparts due to fewer CB1 receptors-we will get to why kids use THC later.
Issues
For reasons that are not yet clearly stated, some people have dysfunctions with their ECS which can lead to things such as schizophrenia, central obesity, ADHD, and autism. In one study, endocannabinoid levels were measured in 93 children and it was concluded that children with autism spectrum disorder had lower levels of endocannabinoids.
On the other hand, a 66-year-old female who had a microdeletion in the FAAH gene (which is an enzyme that degrades a naturally occurring endocannabinoid) had an insanely high level of pain insensitivity. This lady required NO analgesia after hand surgery and further exploration showed that she had a lifelong history of painless injuries AND they healed quickly! So because this lady had higher levels of endocannabinoids due to the lack of enzyme degrading said endocannabinoids, she virtually felt no pain! Interesting isn’t it?!
The Future
So as you can see, the ECS is critical not only for cannabis medicine but also for the basic homeostatic functions of the body. It is incredibly complex as well as sensitive. We start developing this system for our survival very early on and development continues well into adolescence. Unfortunately, some people experience dysfunctions of the ECS which can cause problems with basic functions and the nervous system. More research is needed in order to understand this complicated system but we have made significant progress and continue to do so! I can’t wait to see what additional research yields in the future.
References:
Backes, Michael. Cannabis Pharmacy: the Practical Guide to Medical Marijuana. Black Dog & Leventhal Publishers, 2017.
Aran, A., Eylon, M., Harel, M. et al. Lower circulating endocannabinoid levels in children with autism spectrum disorder. Molecular Autism10, 2 (2019). https://doi.org/10.1186/s13229-019-0256-6
Habib AM, Okorokov AL, Hill MN, et al. Microdeletion in a FAAH pseudogene identified in a patient with high anandamide concentrations and pain insensitivity. Br J Anaesth. 2019;123(2):e249-e253. doi:10.1016/j.bja.2019.02.019
Neurotox Res. 2000;23:14-20. Psychopharmacology. 2011;214:5-15