Dr. Emmanuel Onaivi’s presentation at the latest GCI Summit is a comprehensive, evidence-rich roundup of some of the latest research on the plant of the hour. With cannabis finally kicking its sordid reputation as a harmful substance, Dr. Onaivi invites us to consider recent breakthroughs which open up worlds of new and exciting possibilities for its therapeutic applications.
Healers and medical practitioners all over the world habitually used cannabis to treat a variety of ailments until the early 1900s, when it became shrouded in controversy at the hands of deliberately prejudiced drug policies, fuelled by ulterior economic and political motives. Alongside devastating social injustices, the illegality of cannabis had a crippling effect on medical research exploring its multitudinous medicinal uses. Nevertheless, the stigma with which cannabis became entangled — though pervasive — originated only in the 20th century Western perception.
“Cannabis is Encoded in the Human Genome”
“Marijuana is not really modern medicine,” states Dr. Onaivi, Biology professor and cannabis researcher at William Paterson University. In fact, cannabis is ancient medicine. It is “encoded into the human genome.” Cannabis is made up of over 140 cannabinoids, terpenes and flavonoids, the most well-known of which is THC, the plant’s main psychoactive constituent. Cannabis interacts with the body by binding to receptors in the endocannabinoid system, which produces its own “marijuana-like” substances. The endocannabinoid system is crucial to human functioning and is involved in “almost all physiological processes,” explains Dr. Onaivi, including the immune system and reproduction. Endocannabinoids are present “in the brain, in breast milk, in testes and in the uterus.”
Breakthrough research on cannabinoid CB2 receptors in the brain (Onaivi et al., 2006) has opened the door to drug development for a variety of neurological conditions. The neuroprotective and anti-inflammatory properties of cannabis could be useful for treating ALS, Parkinson’s, Alzheimer’s and multiple sclerosis. Cannabis treatments have also been used as an adjunctive therapy against HIV-AIDS “for many years now.” Dr. Onaivi explains that cannabinoids can be used in conjunction with antiretroviral medication to reduce and manage cachexia and other symptoms associated with the disease. Moreover, Dr. Onaivi reveals that “cannabinoid adjunctive therapy may reduce the cytokine storm (a severe immune reaction) that is induced by Covid-19.”
Specifically, the presence of CB2 receptors in neurons indicates that these cannabinoid receptors are involved in motor-function. The discovery of neuro-immuno-cannabinoid communication reveals CB2 receptors as targets of investigation for therapeutic development in neuropsychiatric disorders. This expanded understanding of the endocannabinoid system is referred to as the “endocannabinoid dome,” which opens the door of cannabis’ therapeutic potential for conditions such as: post-traumatic stress disorder (PTSD); attention deficit hyperactivity disorder (ADHD); autism spectrum disorders; addiction; and epilepsy, as well as disorders, like fibromyalgia, which cause chronic pain.
The Future of Cannabis Medicine
In light of the monumental potential for therapeutic applications of cannabis across a wide range of medical conditions, Dr. Onaivi stresses that “marijuana use as medicine is not the panacea.” He continues to explain that “there is no medicine without side effects, and marijuana has its own side effects.” Referring to the numerous hazards associated with smoking, he asserts that a “smoke free delivery system for marijuana and cannabinoids is very important,” suggesting that future therapies utilize other similarly rapid onset delivery systems such as sublinguals or suppositories. Dr. Onaivi adds that there are “challenges” in cannabinoid delivery, and that the future of cannabis medicine may require the development of nanoformulations in order to effectively target neural cannabinoid receptors with nanotherapeutics.
As social and political institutions are beginning to course-correct globally through decriminalisation and legalisation, the irony of the war against cannabis lingers in the air. With medical research set back decades by the ban, restricted access to this vital plant medicine has had colossal impacts on patient access and treatment development. Arguably, the consequences to public health amount to social injustice of comparable severity to the harms which the criminalisation of cannabis claimed to be justified upon. Irrespective of legality, cannabis remains “one of the world’s most widely used drugs,” says Dr. Onaivi. Further, this “explosion of new knowledge about the cannabinoid system” highlights the powerful role this plant could play in the treatment of life-threatening conditions and human wellbeing.
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