The effects of cannabis medicines today

Today, cannabis medicines are increasingly recognised for their potential to treat specific medical conditions and symptoms. The use is primarily focused on the reduction of pain, but also on improving the quality of life across various chronic conditions.

A key hurdle, though, is ensuring medicinal cannabis products have consistent amounts of the main active ingredients THC and CBD. Consistency is crucial for research findings, which can then be applied in clinical practice, so patients receive a reliable treatment.

Studies show that in healthy people, the effects of cannabis medicines are dose-dependent. In patients, it generally has a good safety profile, with temporary side effects. The intensity of these effects and treatment dropout rates can vary based on the dose, its THC:CBD mix, use history and the length of use.

More quality clinical trials using standardised medicines is required to fully understand safety and efficacy. The focus should be on specific doses, composition, and how effects differ between ages and sexes.

The effects of cannabis medicines

A comprehensive review of 60 studies investigated the effects of Bedrocan medicinal cannabis flos and derived cannabis medicines in both healthy individuals and patients.

The clinical effects in patients

Seventeen (17) clinical studies on patients for various conditions suggest benefits of medicinal cannabis, including:

Pain relief (11 studies)

For people with long-lasting pain conditions like fibromyalgia, inhaled medicines or oral solutions containing Bedrocan® (22% THC) or Bediol® (6.3% THC, 8% CBD) may often lead to a significant reduction in pain intensity. One study also showed a decrease in opioid use among pain patients.

Epilepsy (3 studies)

In children and teenagers with severe epilepsy, high-dose oral solutions (200-550 mg of CBD) of Bedrolite® (9% CBD) reduced seizure frequency, with caregivers also reporting improvements in insomnia, cognitive ability and function, and improved behaviour.

The following three (3) studies are indicative only, the single studies provide insight to areas of potential clinical investigation and further research.

Alzheimer’s Disease (1 study)

Patients with Alzheimer’s Disease showed improvements in symptoms like agitation, apathy, irritability, and sleep/eating disturbances after 12 weeks of Bedrocan® cannabis-based oral solution.

Multiple Sclerosis (1 study)

For Multiple Sclerosis in patients not responding to standard treatments, Bedrocan® (22% THC) cannabis medicines helped reduce the impact of muscle stiffness.

PTSD (1 study)

Veterans with long-term PTSD reported significant improvements, including increased peace of mind and reduced irritability, when using Bediol® (6.3% THC, 8% CBD) to aid sleep.

The physiological and psychological effects of cannabis medicines

Thirty-eight (38) studies were conducted on healthy individuals using Bedrocan’s standardised medicinal cannabis flos and derived cannabis medicines. These studies provide valuable insights to the physiological and psychological effects, including:

How cannabis medicines work in the body

When people inhale a vapour of cannabinoids from the cannabis flower, the levels of THC and CBD in their blood quickly increase, usually peaking directly after inhalation. Higher doses generally led to higher blood levels.

How cannabis medicines make you feel

Higher doses of THC-containing cannabis medicines are euphorigenic and can quickly make people feel “high”. Stronger effects and more unwanted feelings like anxiety, confusion, and paranoia are linked to even higher THC doses. In contrast, CBD-only cannabis medicines didn’t cause these feelings.

Impact on cognition

THC-containing cannabis medicines often slow reaction times and impair attention and memory. These effects are more pronounced with higher THC doses. CBD-only cannabis medicines did not seem to have an effect on cognition.

Influence of CBD and THC combinations

While adding CBD might reduce feelings of anxiety, it generally does not lessen other effects of THC, such as the “high” feeling or the impact on learning and memory. This is even when CBD was present in a 3:1 ratio compared to THC.

The side effects of high doses

Cannabis medicines have a good safety profile. No serious adverse events are reported across the studies. The most reported side effects included:

• Coughing (especially with vapour inhalation; 10-70%)
• Light-headedness (after inhalation; 88%)
• Feeling “high” (20-80%)
• Mental confusion (25-37%)
• Sore throat and bad taste (during certain modes of inhalation; 25-35%)

These side effects are typically mild and resolved quickly. It is worth noting that the number of patients who stopped treatment due to side effects was suggested to be influenced by two main factors:

• Use history: Patients with less experience using cannabis medicines, in particular medicines containing THC, were more likely to report side effects.
• Higher THC doses: higher doses of THC often result in higher study dropout rates due to side effects such as mental confusion. For example, a study with an average of 55 mg THC per day had a 49% dropout rate, while another with 1.5 mg THC per day had only 1%.

What’s next for cannabis medicines

Conclusions from these clinical studies

Clinical studies on Bedrocan’s medicinal cannabis flos and derived cannabis medicines show dose-dependent effects in healthy people, affecting subjective experiences and cognitive function.

For patients, Bedrocan’s medicinal cannabis and derived cannabis medicines appear to reduce pain and may help with other conditions, with a dose-dependent side effect profile.

Future research, particularly well-designed clinical trials, is crucial to further understand the safety and effectiveness of specific cannabis plant varieties (chemovars), considering factors like dose, the balance of active compounds (THC and CBD), and individual patient characteristics like age and sex.

Important considerations for future research

The clinical review highlighted several areas for future research to improve our understanding of cannabis medicines, including:

Methodology

Studies often differed in how cannabis medicines were given (e.g., inhaled vs oral solution) and how effects were measured, making it hard to compare results directly. Future research needs more uniform study design.

Individual differences

Factors like a patient’s history of cannabis medicine use, sex and age can influence how patients respond to the treatment. Further clinical studies are needed to understand these differences.

Dose and composition

While the review focused on standardised Bedrocan products, there were still differences in the specific cannabis medicine types and doses used. Clear reporting of THC and CBD content, the medicine formulation and the administration route is required.