Cannabis products are becoming increasingly popular, with the acceptance of their treatment in clinical settings. Positive clinical evidence and reformed laws have supported this much-needed change.

However, there is a lot of prevalent misinformation and a lack of knowledge about the usage of medical cannabis. This article is designed to be a simple yet thorough guide to understand the incredible potential of cannabis medicines.

WHAT IS CANNABIS ?

Cannabis is a genus of flowering plants in the family Cannabaceae with fragrant buds. Broadly there are three species or strains within the genus, Cannabis Sativa and Cannabis Indica. Both of them have similar characteristics with specific and distinct differences. Cannabis rudralis is a sub-species of Cannabis sativa.

Historical evidence suggests that Indica has more sedating, relaxing, pain-relieving & calming properties, while Sativa has more uplifting, energizing, and neuroprotective traits. Some of the recent research has shown that at present, finding a pure Sativa or Indica species is very difficult due to hybridization, so the cannabinoids such as CBD & THC serve as good indicators to know the effects and properties of the various strains. The Indica traits are evidenced more in the CBD dominant varieties, whereas the Sativa traits are exhibited in the THC dominant varieties.

MEDICAL CANNABIS – HOLISTIC AYURVEDIC MEDICINE

HOLISTIC AYURVEDIC MEDICINE Medical cannabis, a potential panacea for holistic healing, is now backed by innumerable studies and research, reinforcing its therapeutic benefits. Therefore, the acceptance and consumption of medicinal cannabis in India are also progressing rapidly.

CANNABIS IN AYURVEDA

Cannabis is known as “Bhanga” in ayurveda. Atharva Veda mentions cannabis as one of the five most sacred plants on Earth and refers to it as a “Freedom for Distress” or a “joy-giver”. Therapeutic value of this plant is mentioned in many of the Ayurvedic texts like the Charaka Samhita, Sushruta Samhita, and Shargandhara Samhita.

Anandakand has a whole chapter dedicated to the herb, which describes various purification methods, formulations and antidotal therapy to counter the side effects of overdose of cannabis.

There are around 209 formulations mentioned in Ayurveda using Cannabis as single ingredient. These formulations are used in 29 disease conditions such as:

Grahani (Malabsorption syndrome)
Jvara (Fever)
Atisara (Diarrhoea)
Agnimandya (Loss of Appetite)
Ajirna (Dyspepsia)
Prameha (Urinary disorders)
Prameha (Urinary disorders)
Sangrahani (IBS)
hiroroga (Disease of head)
Kastharvata (Menstrual pain)
Kasa (Cough)
Kushtha (Diseases of skin)

Pandu (Anemia)
Jvaratisra (Diarrhoea due to fever)
Shotha ( Inflammation)
Shoola (Pain)
Abhinyasa Jvara (Meningitis)
Hikka (Hiccup)
Shvasa (Dyspnoea /Asthma)
Medoroga (Obesity)
Sheetapitta (Urticaria)
Apasmara (Epilepsy)
Vata vyadhi (Nerve disease)

WHAT ARE ENDO-CANNABINOIDS & PHYTO-CANNABINOIDS?

Endocannabinoids are produced inside our bodies, whereas Phytocannabinoids are plant-derived. The prefix “Phyto” signifies that they are plant-derived, while “Endo” reveals the endogenous nature of the latter.

Endocannabinoids

Endocannabinoids are naturally occurring endogenous lipids or fatty acids produced in our bodies that interact with cannabinoid receptors. These fatty compounds are produced in neurons of central nervous system in response to a stimulus that binds to specific membrane receptors in the brain and body. These receptors are called cannabinoid receptors. Types of endocannabinoids produced in our body are: Anandamide (N-arachidonoylethanolamine) and 2AG (2-Arachidonoyl glycerol), Noladine ether & Virodhamine. Anandamide is endogenous analog of phytocannabinoid THC.

When endocannabinoids bind with the cannabinoid receptors, they regulate almost all physiological and cognitive processes such as appetite, mood, memory, muscle movement, thermoregulation, and brain reward systems.

Phytocannabinoids

Phytocannabinoids are produced through secondary metabolite by glandular hairs of cannabis plant. These are basically a group of C21 terpenophelic compounds. There are more than 150 cannabinoids reported to be found naturally in the Cannabis plant. Yes, over 150! Some important cannabinoids are Delta 9 –tetrahydrocannabinols (Δ-9-THC), Δ8-trans-tetrahydrocannabinols (Δ8-THC), Cannabidiols (CBD), Cannabinols (CBN), Cannabigerols (CBGs), Cannabichromenes (CBCs), Cannabicyclols (CBLs), Cannabielsoins (CBEs), Cannabinodiols (CBNDs), Cannabitriols (CBTs) and many more. These compounds are

Other than phyto-cannabinoids, other medicinally important phytochemicals are terpenes and flavonoids. If your body is producing enough endocannabinoids, then it is in balance and under an ideal state. But sometimes, the body doesn’t function the way it is supposed to, due to various internal and external factors and suffers from cannabinoid deficiency. It then requires supplementation of phytocannabinoids from an external source.

ENDO-CANNABINOID SYSTEM (ECS) AND IT'S WORKING

“The endocannabinoid system is very important. Almost all illnesses we have are linked to it in some way or another. And that is very strange.” – Dr. Raphael Mechoulam, known as “the father of cannabis research.”

The ECS is identified in early 1900s and is a collection of neuromodulators (endocannabinoids), their receptors and signaling pathways in our body. It is a self-regulating biological system in the human body.

Endocannabinoids are endogenously produced compounds that bind with specific receptors throughout our bodies, including the central nervous system, peripheral nervous system, and immune system. Our bodies consist of receptors that have an affinity to bind with cannabinoids like CBD (Cannabidiol), THC (Delta-9-tetrahydrocannabinol), CBN, CBC, CBG, etc.

When a patient takes exogenous cannabinoids, they interact with our already existing ECS. The fact is that these compounds are already a part of us, and although these cannabinoids are supplemented by plants, they are quite similar to the ones that exist in our bodies.

Cannabis works in two ways, one by maintaining the ECS tone and secondly by complementing if there is a deficiency. Low Cannabinoid tone indicates an imbalance. It is believed by Dr Ethan Russo that the root cause of most of all modern ailments, there is a clinical endocannabinoid deficiency (CEBD).

ROLE OF ENDO-CANNABINOIDS

Endocannabinoid, specially anandamide (AEA) is synthesized in the brain, where levels are controlled by tightly regulated degradation pathways. It is also called as stress-induced neurotransmitter.

Anandamiide is synthesized and released on-demand in neuron cell membranes in the brain in response to a rise in intracellular calcium because of stimuli. It is needed to maintain homeostasis in the body. Anandamide has very short half-life and is degraded by the action of FAAH enzyme. Both the regulation of synthesis and degradation is important to regulate the brain functions. Anandamide plays a significant role in regulating emotions and pleasure. So it is offer called “bliss molecule”.

On binding with receptors (specifically cannabinoid receptors such as CB1 and CB2), it regulates cellular functions, appetite, reward, memory, mood and pain.

CANNABINOID RECEPTORS

Cannabinoid receptors are the most abundant GPCRs distributed throughout the body. Other than cannabinoid receptors there are some no-cannabinoid receptors are also functioning in endocannabinoid system. CB1, CB2, TRVP1, TRVP2, GPR18, GPR55 and GPR119 are considered as endocannabinoid receptors. CB1 and CB2 are the cannabinoid receptors. CB1 is known to be psychoactive, neuromodulatory, and a pain receptor found in the brain, fat, liver, skeletal, and muscular tissues. Whereas, CB2 is responsible for the anti-inflammatory functions located in cells that are responsible for immune function and may also be found in the CNS.

WHAT ARE CBD AND THC?

Cannabidiol (CBD) and Δ9-tetrahydrocannabinol (THC) are the two main phyto cannabinoid compounds which are largely explored by researchers.

THC is the main psychoactive compound in cannabis that produces the high sensation in human. According to studies¹, THC, the highly potent and abundant cannabinoid, exerts a wide variety of biological effects by mimicking endogenous cannabinoid, Anandamide – that bind to and activate receptors CB1 and CB2.

Whereas CBD is non-intoxicating and it balances some side-effects of using higher doses of THC, such as anxiety, heart palpitations, etc., and provides several therapeutic effects. Both of these compounds, along with the various other cannabinoids and other plant compounds, have their own roles to play, offering incredible holistic health benefits and relief to symptoms.

Onlike THC, it doesnot bind to CB1 or CB2 receptors. It binds to other non-cannabinoid receptor TRPV1 and on prolonged activation of TRPV1 desensitizes the receptor, and reduces pain. Also activation of receptors by CBD, regulates temperature, acidity, anadamide production.

CBD, as a negative allosteric inhibitor binds to a site on the CB1 receptor distinct from the THC binding site and inhibits THC to bind to CB1 receptor. Another mechanism is CBD inhibits CYP2C9 enzyme activity and prevents THC to metabolize which reduced the "high" effect of THC and enhances therapeutic effect of THC.

CBD suppresses the production of pro-inflammatory cytokines such as TNF-α and IL-1β, thus helps in reducing inflammation. It also inhibits oxidative and nitrosative stress and attenuated the expression of Intracellular adhesion molecule 1 (ICAM-1) and Vascular cell adhesion molecule 1 (VCAM-1) and thus acts as neuroprotective, antioxidant and anti-inflammatory agent.

All the cannabinoids together, also known as a wholesome or full-spectrum medicine, provide optimal benefits, scientifically known as the ‘entourage effect’, where CBD and THC, other phytocannabinoids and terpenes work together synergistically to provide a more holistic approach to treatment, as nature intended, providing improved results.

THERAPEUTIC BENEFITS

Cannabis in India is gaining popularity with its huge medicinal potential as ingrained in the Indian Ayurveda system. Cannabis has been known to promote overall well-being, by treating several diseases and symptoms.

Cannabis impacts all physiological and biochemical systems, including the immune, renal, endocrine, cardiopulmonary/ respiratory, reproductive, and central nervous systems, as well as genetics and general health.

Here is a list of diseases/ disorders with proven benefits from cannabis medicines –

Disease	Active compound	Receptors	Mechanism of Action
Parkinson’s	THC, CBD	Non-Cannabinoid receptors	Antioxidant activity
		CB2	Decreases proinflammatory cytokines and NFkb pathway activity
	THCV	CB2	Decreases proinflammatory cytokines & ROS. Increases anti-inflammatory cytokines
Huntington Disease	THC, CBD	Non-Cannabinoid receptors	Decreases oxidative stress and edema
	THC	CB1	Neuroprotective activity
	CBG	Cannabinoid & Non-cannabinoid receptors	Reduces mutant Htt protein aggregation. Counteract superregulation of proinflammatory markers
Alzheimer’s disease	THC	CB1	Inhibits AChE neurotransmitter
	CBD	CB2	Inhibits amyloid-β plaque formation. Modulates iNOS expression
	CBD	PPAR-y	Decreases amyloid-β production and reduces apoptosis
Multiple Sclerosis	THC	CB1	Reduces neuroinflammation. Prevents excitotoxicity by reducing glutamate release
Amyotrophic Lateral Sclerosis	THC	CB1	Reduces excitotoxicity by reducing glutamate release. Reduces oxidative cell damage.
Hypoxia-Ischemia	CBD	CB2, 5HT1A	Modulation of oxidative stress and inflammation. Modulation of glutamate and cytokine release. Modulation of COX-3 induction
Epilepsy	CBD	GPR55, TPRV-1, 5HT1A	Reduction of Ca2+ in synaptic complex of neurons
Epilepsy	THC	CB1	Modulates GABA release
Pain	THC, CBD	CB1, CB2	Inhibits the release of neurotransmitters from presynaptic nerve. Activates the descending inhibitory pain pathways.
Pain	CBD	TRPV-1	Desensitizes TRPV-1 receptor and inhibits activation of other intermediary molecules of signaling pathway.
Apptetite	THC, CBD	CB1, CB2	Upregulates ghrelin and downregulates leptin hormone
Respiratory Disorder	THC	CB1, CB2	Prevents fibrosis in lung, liver, heart, kidney, and skin cells. Reduces inflammation, oxidative/nitrosative stress.

A.PAIN (SHOOLA)

There is substantial evidence² that cannabinoid acts as adjuvant analgesic in management of all type of pain including chronic pain.

The analgesic effect of cannabinoids especially THC mediate by induction of antinociception via supraspinal mechanisms and peripheral CB2 receptors³. The consequent events are inhibition of the release of neurotransmitters and neuropeptides from presynaptic nerve endings, modulation of postsynaptic neuron excitability, activation of descending inhibitory pain pathways, and reduction of neural inflammation.

Neuropathic pain is a type of chronic pain resulting from peripheral nerve injury, toxic insults, and disease states such as diabetes, cancer, HIV, nerve disorder, MS and herpes infection. More recently, CBD is shown to be effective in well-established experimental models of neuropathic pain. It is believed that the analgesic effect of CBD is mediated, at least in part, by TRPV1 receptor⁴. CBD binds to non-cannabinoid receptor TRPV1 receptor and prolonged activation of TRPV1 receptor desensitize and inhibits activation of other intermediary molecules of signaling pathway and thus alleviates pain.

B. FIBROMYALGIA (FM)

FM is a pain syndrome with multiple etiologies, central sensitization, altered stress response, pro-inflammatory state, abnormal activity of neurotransmitters, small-fiber peripheral neuropathy, and genetic predisposition. Research⁵ suggests that cannabis can reduce these symptoms in different ways with its anti-epileptic, analgesic, anxiolytic, and sedative effects.

C. NEURODEGENERATIVE DISORDER (VATAVYADHI)

Cerebral Ischemia and Hypoxia

Cerebral ischemia is the clinical mechanism of acute brain injury that results from impaired blood flow to the brain. This causes a sequence of events such as excitotoxicity, release of neurotransmitters, inflammation, breakdown of blood-brain barrier, cytokine storm and oxidative stress etc.

Studies have shown that, CBD can exert a neuroprotective effect toward brain ischemia, by activating non-cannabinoid receptors (TRPV-1) and 5-HT1A receptor mediated pathway, causing an increase in cerebral blood flow⁶.

Multiple Sclerosis (MS)

MS is an autoimmune inflammatory neurodegenerative disease characterized by nerves demyelination in CNS. Cannabis reduces muscle stiffness, spasm, and pain in MS patients. Real-life data⁷ confirm cannabis as an effective and well-tolerated treatment option for resistant MSS in clinical practice. There is strong evidence that cannabinoid can cause reductions in tremor and spasticity, and benefit in treatment of neuropathic pain in multiple sclerosis.

Anxiety & Depression

Cannabis has the potential as an adjunct to therapies for anxiety disorders and can help treat a range of anxiety disorders, including generalized anxiety disorder (GAD), phobias, panic disorder, and social anxiety disorder.

The amygdala is the emotion-producing part of the brain, which lights up in situation like fear, trauma & anxiety and generates the psychological experience of fear. In same time the nerve cells in brainstem activates. Activation of brainstem causes blood pressure to rise, palpitation, skin to prickle etc. Endocannabinoid receptor such as CB1 is more distributed in these regions denoting that it has a significant role in managing the anxiety, mood and emotion. Glutamate and GABA are two excitatory and inhibitory neurotransmitters in the brain, which controls the psychological functions of brain. In anxiety disorder, it is found less concentration of GABA and over expression of glutamate in brain region. At low dose of THC, the dimeric form of CB1 & 5-HT2a receptor activates and binding with THC inhibits the expression of glutamate through a signaling cascade in glutamatergic neuron and helps in reducing anxiety. In higher dose it shows the reverse effect and increases the anxiety. In a recent study in which participants were exposed to a well-validated psychosocial stress task, a low dose of THC (7.5 mg) reduced the duration of negative emotional responses to the task and post task appraisals of how threatening and challenging the stressor was. In contrast, a higher dose of THC (12.5 mg) produced small but significant increases in anxiety, negative mood and subjective distress at baseline before and during the psychosocial stress task⁸. CBD appears to decrease anxiety at all doses that have been tested. CBD, on the other hand, appears to have robust anxiolytic effects without anxiogenic effects at higher doses.

Parkinson's Disease

Parkinson's disease is a chronic and progressive neurodegenerative disorder, characterized by the progressive degeneration of dopaminergic neurons in the substantia nigra pars compacta and consequent reduction in dopamine content in striatum.

Several clinical studies have demonstrated that endocannabinoid system undergo neurochemical and neurophysiological alterations after dopamine depletion. On reduction in dopaminergic signaling, endocannabinoids levels and CB1 receptor expression up-regulate in basal ganglia, which suggest that cannabis has a therapeutic role in the treatment of movement disorders associated with Parkinson's.

In short, Parkinson's is the results of a dis-inhibition of the striatal neurons and therefore a relative glutamatergic overactivity. Antiglutamatergic therapies with Cannabis, mostly via CB1 receptor, results through reduction of glutamate release, decreasing calcium influx, as well as of local inflammatory events.

Alzheimer's Disease

Alzheimer’s disease is the most frequently form of dementia, with an incidence of about 34 million people worldwide. It is characterized by lesions in CNS due to the formation of beta-amyloid (Aβ) plaques, neurofibrillary tangles and cortical atrophy. In such patients it is found that CB1 and CB2 receptor expression is significantly increased, while in basal ganglia and hippocampus neuronal CB1 receptor expression is decreased. Recent days, drugs containing acetylcholine esterase (AChE) inhibitors are used for Alzheimer’s treatment. A study⁹ from Israel in 2015 shows Cannabis extract (containing Δ9-THC) is an excellent alternate option for management of such disease. THC competitively inhibits enzyme AChE and prevents Aβ peptide aggregation in the brains of Alzheimer’s patients.

Epilepsy

Epilepsy patients using medicinal marijuana reported that the drug is very effective for their seizure control and mood disorders. According to the studies¹⁰, patients said that Cannabidiol/ CBD improved their seizure frequency and severity while fixing their mood disorders.

Huntington's Disease

Huntington's disease (HD) is a progressive neurodegenerative disorder, characterized by motor, cognitive and behavioral abnormalities. A systemic review conducted by Akinyemi et.al., 2020¹¹ clearly indicates that medical cannabis is highly effecting in alleviating the associated symptoms of HD such as motor symptoms, quality of sleep, depression, anxiety, cognitive loss etc.

D. APPETITE & GASTROINTESTINAL DISORDER

The ability of Cannabis to promote eating has been already documented in ayurveda. Cannabis has potent anti-inflammatory, antiemetic, appetite-stimulating, and antidiarrheal effects.

The ECS regulates energy intake and appetite through central and peripheral metabolic pathways. ECS affects homeostatic pathways in the hypothalamus and brainstem through supression of leptin hormone and release of ghrelin hormone. The CNS also affects energy intake occurs through behavior–reward pathways. Cannabinoids through the ECS inhibit GABAergic neurons, leading to disinhibition of dopamine and activation of the hedonic drive toward further food consumption. Researchers¹² have also found that cannabis intake can stimulate appetite.

In additional tot that ECS is also took a major role in maintaining gastrointestinal homeostasis, thus helps manage liver and pancreatic disorders, insulin secretion etc.

Cannabis has also been used to treat abdominal pain, anorexia, Crohn’s disease, ulcerative colitis, emesis, gastroenteritis, diarrhea, intestinal inflammation, and diabetic gastroparesis. A recent survey¹³ supports the traditional view that cannabis provides benefits in disturbances of the gastrointestinal tract.

E. SLEEP DISORDER

Cannabis affects the release of cortisol and acts as a sedative. Patients treated with CBD had a prompt and substantial reduction in the frequency of RBD-related events without side effects, as suggested by research¹⁴.

F. CARDIOVASCULAR DISORDER

Studies¹⁵ suggest that cannabis exerts a tissue-sparing effect during chronic myocardial ischemia and acute reperfusion (I/R).

Myocardial ischemia occurs when blood flow to the heart muscle (myocardium) is obstructed by a partial or complete blockage of coronary arteries by the build-up of plaques (atherosclerosis). CBD acts as a cardioprotective drug.

G. MUSCLE SPASM

Cannabis has been demonstrated to be effective in alleviating impaired bladder control, muscle spasms, and spasticity. Studies¹⁶found that cannabinoids such as THC bind with cannabinoid receptors of the human body to reduce the levels of inflammatory proteins and suppress the spasm response. Different THC/CBD combination therapies decrease muscle spasticity and suppress neuroinflammation.

H. RESPIRATORY DISORDER

Most common respiratory disorders are chronic obstructive pulmonary disease (COPD), asthma, acute lower respiratory tract infections, tuberculosis, and lung cancer. It has been found that cannabinoid receptors, specifically CB1 receptors are abundantly found in bronchi, pulmonary artery, lung tissues such as alveolar type II cells, respiratory epithelium, fibroblast, dendritic cell and pulmonary macrophages. Overstimulation of peripheral CB1 receptors is linked to several pathological processes such as fibrosis (lung, liver, heart, kidney, and skin), inflammation, oxidative/nitrosative stress. Likewise, activation of peripheral CB2 receptors produces anti-inflammatory, immunosuppressive, and anti-fibrotic effects.

I. DIABETES

Cannabidiol (CBD) and D9-tetrahydrocannabivarin (THCV) are non-intoxicating phyto-cannabinoids affecting lipid and glucose metabolism. Studies¹⁷suggest that THCV and CBD decreased blood glucose levels and increased insulin production in people with type 2 diabetes.

J. COVID

Coronavirus impacts the respiratory system much deeper and causes coagulation. Cannabis has anti-inflammatory properties and can act as a vasorelaxant. Clinical trials¹⁸suggest that whole-plant cannabis extracts high in CBD can reduce blood coagulation and can be used to counter SARS-CoV-2 infections by quelling the cytokine storm. In addition to the above-mentioned diseases, cannabis medicines have also been proven effective for diseases like seizures, wasting syndrome (cachexia), mood disorders, such as ADD or ADHD, allergies, immunity, psoriasis, autism, Tourette’s, PTSD disorders, and migraine.

K. CANCER

Since 1970, cannabis has been known to exert palliative effects in cancer patients. Along with its palliative effects, it has antiproliferative, antitumoral, and pro-apoptotic effects that inhibit cancer cell migration, adhesion, and invasion. Studies suggest¹⁹ that cannabinoids inhibit tumor progression at multiple levels. Their most prevalent antitumor effect is the induction of cancer cell death by apoptosis and the inhibition of cancer cell proliferation. Additionally, Cannabinoids has been shown to impair tumor angiogenesis and block invasion and metastasis.

Studies²⁰ also found the co-administration of cannabis medicines with chemotherapy drugs improved the potency of its antitumor effects. These synergistic effects can prove beneficial, especially in cancers that are refractory to chemotherapy. However, these effects depend on the cancer type, dosage of medicine, and abundance of receptor targets.

Growing evidence²¹ demonstrates cannabinoids are effective inhibitors of multiple types of cancer.

L. CINV (CHEMOTHERAPY INDUCED NAUSEA AND VOMITING)

Chemotherapy-induced nausea and vomiting (CINV) remains significant cause of morbidity in oncology patients. The mechanism of delayed nausea and vomiting is incompletely understood, but may involve non-serotonergic receptors including the cannabinoid CB1 receptor, with a potential role for cannabis products in its amelioration.

Cannabinoids exert their anti-emetic properties through interactions with the centrally located CB1 receptors and 5-HT3 receptors in the dorsal vagal complex (DVC), which mediates emesis. The activation of the 5-HT1A receptor ultimately reduces the amount of serotonin released, and thus a lower potential to trigger emesis. CBD is also thought to activate the CB1 receptors in the gastrointestinal tract through their GPCR (G-protein-coupled receptor) inhibitory effect, leading to decreased gastrointestinal motility. Phyto-cannabinoids such as THC and CBD also inhibit fatty acid amide hydrolase (FAAH), leading to an increased concentration of anandamide that could exert its anti-emetic properties at a higher intensity.

M.GLAUCOMA

Cannabis has the potential of becoming a useful treatment for glaucoma, as they seem to have neuroprotective properties and effectively reduce intraocular pressure. Cannabinoid receptors are found in the trabecular meshwork, non-pigmented ciliary epithelium, and ciliary muscle of human eyes.

Research²² suggests that Cannabis with THC can lower IOP in 60% to 65% of both normal individuals and patients with glaucoma. Intraocular pressure (IOP) is the fluid pressure inside the eye, which is an important aspect in the evaluation of patients at risk of glaucoma.

BEST PRACTICES FOR TAKING MEDICAL CANNABIS

Medical cannabis products available in India are in capsule, oil and gummy dose form. So it can be consumed orally. Best practice of taking oil is to keep for sometimes under the tongue for a better absorption.

DOSAGE

Dosage is the vital factor to reap maximum benefits with minimal side effects of cannabis medicines. HempCann Solutions, the parent company of brand Vedi, invests a lot in researching cannabis and improving awareness around it to make it a more safe, versatile, and effective drug.

It is advisable to start with a low dose, as body’s tolerance to dose varies with person to person, and there are other factors involved too, such as the state of disease, age, etc. It is best to follow a physician’s advice to find the correct dose and treatment protocol.

SIDE EFFECTS

Cannabis medicines are likely to be safe in low doses. Some reported side effects of cannabis when used for a long duration or in higher doses include:

1. l Dry mouth

2.l Decrease in blood pressure

3.l Increased heartbeat

4.l Decreased concentration levels

5.l Drowsiness

DRUG INTERACTIONS

Cannabis medicines are likely safe and can be taken with most drugs. However, it is best to consult your doctor before starting and sharing the list of all medications to learn more about drug interactions.

Cannabis can accelerate or inhibit the effects of other drugs, especially the ones that cause drowsiness, including antidepressants, antihistamines, sedatives, seizure medicines, pain relievers, anxiety medicines, muscle relaxants, and alcohol.

WHO SHOULD AVOID USING IT?

The risk/benefit ratio of cannabis should be carefully and individually evaluated, especially for people who:

Are under 18
Have hypersensitivity to any cannabinoid
Have severe cardio-pulmonary disease with hypotension/ hypertension/ syncope or tachycardia
Have a family history of schizophrenia
Have severe respiratory diseases such as chronic obstructive pulmonary disease (COPD)
Women who are planning pregnancy, or are pregnant, or breastfeeding.

HOW AND WHERE TO BUY IN INDIA?

Cannabis medicines are available in India. HempCann Solutions is the leading research and manufacturing company of cannabis in India. It opened the first medical cannabis clinic in India in Koramangala, Bengaluru. Vedi Wellness Centre provides Ayurvedic doctor consultation, nutritional counseling, ayurvedic medicines, herbal supplements, and natural body care products. They are operational online, too, @www.vediherbals.com.

We use the best quality ayurvedic herbs, including cannabis leaves to make its 100% vegetarian Ayurvedic medicines. Our range of Cannabis-Infused capsules and oils are made using full-spectrum Cannabis extract infused in coldpressed virgin coconut oil (for capsules) and high grade MCT oil (for oils), the Medium Chain Triglyceride extracted from Coconut. They are 100% natural and free from chemicals, artificial flavors or sweeteners, sugar, salt, gluten, soy, pesticides, and heavy metals.

VEDI’s cannabis brands for India includes-

Cannaflam is a natural Cannabis medicine for chronic inflammation. Available in the form of capsules and oil. This CBD dominant formulation is efficacious in -
- bringing joint pain relief
- preventing and treating bone loss
- strengthening bones
- managing cardiovascular conditions
- alleviating bowel inflammation
- fortifying the immune system

It also serves as an excellent alternative medicine for managing IBS, psoriasis, and osteoporesis.

Cannapain is a wholesome cannabis leaf extract medicine that is great for pain management and improving sleep. This balanced cannabinoid formulation is idea for –
- alleviating pain that affects mobility, like neck and backache.
- palliative care in cancer patients as it helps mitigate the side effects of chemotherapy, including cancer-induced nausea and vomiting.
- relieving a variety of pain, from chronic to neuropathic and from muscular spasms to sciatica pain.
- reducing anxiety
- improving the quality of sleep, controls seizures, and improves appetite.

Cannaron is a promising therapeutic medicine for all neurodegenerative diseases. It helps manage age-related ailments of the brain and the nervous system. This full spectrum cannabis medicine is having a higher THC and is helpful for -

bring relief from a wide spectrum of neuropathic conditions,
nourish the neural network.
treat depressions, stress, anxiety and fatigue with its uplifting effects
It is much sought after for improving mood and quality of life
stimulate, energize and uplift mood.

All the above 3 medicines are prescription based medicines and are available in both capsule and oil dose form.

Other than that VEDI has also some classical formulation based on cannabis:

Kameswar Modaka: Available in 5g sachet, helpful for increasing sexual desire, enhancing vitality and vigor.
Jatiphaladi Churna: Available in 3g sachet, efficacious for chronic diarrhea, cold, cough and nasal congestion.
Bilvadi Churna: Available in 3g sachet, an excellent remedy for IBS, abdominal discomfort, gut infection.
Sarpagandha ghanvati: Available in 500mg tablet dose form, useful for hypertension, and insomnia.
Vijayadi Vati: Available in 250mg tablet dose form, an proven medicine for menstrual pain & cramp, lower back pain.

UNDERSTANDING IMPORTANT TERMS

1. Marijuana: Pronounced as “marihuana”, it is a non-scientific slang term for cannabis, composed of the cured flowers of the female plant in the genus cannabis. The term marijuana is sometimes used interchangeably with cannabis. It is usually dried and crushed to be added to food or for smoking.

2. Medical Marijuana or Medical Cannabis: Medical cannabis, or medical marijuana (MMJ), is cannabis prescribed by physicians for their patients to treat certain conditions or disorders. It is a plant-based medicine obtained from the Cannabis Sativa or Cannabis Indica species. It comes in various forms, such as flowers, tinctures, extracts, capsules, etc.

3. Hash Oil: Hashish, often known as "hash", is a cannabis product composed of compressed or purified preparations of stalked resin glands called trichomes. It is said to be the most potent form of cannabis due to higher THC.

4. Hempseed Oil: The oil is extracted from seeds of the hemp plant through cold-pressing. The seeds have a rich profile of nutrients, fatty acids, and useful bioactive compounds such as omega-6 that can also have health benefits. Hemp oil is an important ingredient in many nutritional and skincare products.

5.CBD Oil: CBD oil available in the market may be full-spectrum or may be made just with CBD isolates. CBD oils contain a higher concentration of CBD and a very low percentage of THC. You might find many CBD oils in the market which contain just the isolated CBD in them, and do not contain any other cannabinoid or terpene, hence lacking the ‘entourage effect’.

6.Cannabis Oil: Derived from cannabis leaves and/ or flowers, these oils contain a full spectrum of cannabinoids, terpenes, flavonoids and pigments, thereby providing an ‘entourage effect’. Many manufacturers and marketers label their products CBD oil instead of "cannabis oil" to attract more customers. Therefore, there is a need to ask if they are using CBD isolates or full-spectrum oil in their products and choose reliable brand like VEDI as per an individual need.

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A Complete and Definitive Guide to Medical Cannabis: Everything you need to know about Cannabis dosing and use for various diseases and symptoms