Cannabasics
Plant and Products
Cannabis refers to the plant Cannabis sativa (L) and has many forms from hash to hemp oils. There are several plant types that consumers may indicate they are accessing including sativa, indica, and hybrids, which are marketed as having different physiological effects.
The cannabis plant is comprised of a stem, leaves and buds. Cannabis has many other names including marijuana, weed, dope and pot that most often refer specifically to the buds and products created from the bud. The term cannabis is more accurate as it refers to the whole plant. Key to understanding cannabis are the primary chemical compounds, plant types and products.
CHEMICAL COMPOUNDS
The cannabis plant contains chemicals called cannabinoids that interact with the human endocannabinoid system to produce a myriad of physiological effects. The human endocannabinoid system is responsible for a variety of physiological as well as pathophysiological processes including neural development, immune function, inflammation, appetite, metabolism and energy homeostasis, cardiovascular function, digestion, bone development and bone density, synaptic plasticity and learning, pain, reproduction, psychiatric disorders, psychomotor behaviour, memory, wake/sleep cycles, and the regulation of stress and emotional state.2 Although the cannabis plant contains over 100 different cannabinoids (and possibly more), the two most studied and discussed are THC (tetrahydrocannabinol) and CBD (cannabidiol). THC produces an intoxicating effect by binding with receptors in the brain and CBD may help to manage pain and mediate the effects of THC on the endocannabinoid system. Although the intoxicating effects of cannabis are often highlighted, THC is the cannabinoid largely responsible for the “high” associated with cannabis.
PLANT TYPES
Generally known by the name Cannabis sativa (L), * the most common types of cannabis, that consumers may indicate they are accessing, are sativa or indica. Most plants today are a hybrid of these two types and each type is marketed for different physiological effects. Cannabis derivatives include marijuana, hash and hemp products. Hemp products, marijuana and hash are all derived from cannabis plants. Hemp is very low in THC (less than 0.3%), is not intoxicating, and it’s fiber is used in the production of cars, body care products, clothing, construction, food and plastic. Marijuana is the dried bud of the cannabis plant with amounts of THC that are intoxicating (5%- 30%) and is consumed for various desired effects. Hash is the pure resin of the cannabis plant, without the plant material of the dried bud and as such, has higher concentrations of THC than the whole bud (20%-60%).
Once a plant has matured, growers trim the flowers to produce what are referred to as dried flower (buds). The buds are coated with hairlike structures called trichomes which protrude from the plant material. There are many terpenes commonly found in cannabis. When terpenes are inhaled or ingested alongside cannabinoids, they may interact with the endocannabinoid system. In cannabis, this interaction has been called the entourage effect.
PRODUCTS
Although other parts of the cannabis plant can be consumed, the most common methods of consumption use the bud of the plant due to the concentration of cannabinoids. The two most common ways the plant is used are to create concentrates and to dry the bud. The dried buds are usually smoked, vaped or infused in fats to be consumed later as edibles. Examples of concentrates include hashish, shatter and tinctures. Concentrates are procured during an extraction process where the cannabis plants’ cannabinoids and terpenes are separated from the plant matter resulting in a concentrate with high levels of cannabinoids (more potent than the bud).
Cannabis concentrates are categorized as either solvent or non-solvent based.
- Non-solvent concentrates are extracted naturally (using water, scraping the resin off the bud, or drying the resin) to produce hash (cannabis resin) and kief (resin glands).
- Solvent concentrates are extracted commonly using carbon dioxide or alcohol. They produce many forms and textures known as shatter, wax, or oil.
Cannabis products must be heated (decarboxylated) to activate the THC and other cannabinoids when consumed. Eating it raw will not produce any intoxicating effects. Some oils and tinctures have already been activated, and do not need to be heated. In the case of purchased edibles, the THC has already been activated and can be consumed as prepared.
Methods of Consumption
There are four basic delivery methods: Inhalation, Oral-Mucosal, Ingestion, and Topical. Each of these methods uses different forms of cannabis as well as hardware or tools to facilitate consumption, and will produce varying physiological effects. The physiological effects will also depend on the level of THC and CBD within a particular plant, no matter which type of method is used to consume it.
INHALATION
Inhalation is the most common way people have traditionally consumed cannabis5 with many products to choose from (e.g. dried flower, concentrates). THC and other cannabinoids are absorbed into the body through inhaling vaporized or combusted cannabis into the lungs. The onset of effects is rapid with most people feeling a “high” within minutes of inhalation. Strain genetics and personal body chemistry make this a unique process for everyone. Examples of delivery methods using inhalation are: hand pipe, bong, vaporizer, joint, and hookahs.
ORAL-MUCOSAL
The product (most commonly a tincture) is applied under the tongue or sprayed into the mouth and absorbed through the oral-mucosal lining. Due to its rapid onset, this is the preferred delivery method for many serious medical conditions such as epilepsy and nervous system disorders. The most common methods are sprays or tinctures.
INGESTION
Ingesting cannabis involves consuming a food, drink or oil item containing cannabis that has been heated to ensure that cannabinoids are active when consumed. Cannabinoids are absorbed through the digestive tract and metabolized by the liver. As the digestive system takes a while to break down the compounds, the onset of effects can take up to two hours. Factors that can affect a person’s experience with edibles includes whether they have eaten recently, the amount of cannabis consumed, their comfort level with cannabis and the potency of the product ingested. While potentially safer than inhalation methods because it bypasses the respiratory system, ingesting cannabis makes it difficult to determine dosing due to its delayed effect. The term “edibles” refers to any food or drink that contains cannabis. These products most often are infused using ingredients high in fat like butter or olive oil that enable extraction of fat-soluble cannabinoids, whether the cannabinoids can be used by the body or not. If the cannabis has not been decarboxylated (heated), it will not cause intoxicating effects. If the cannabinoids have been activated with heat, edibles will produce powerful, full-body intoxicating effects; however, the onset of these effects will be slower than with inhalation. In addition to food and drink, ingestible oils can also be eaten, added to food or put into capsules to ingest with similar results as other food or drink items.
TOPICAL
Topical cannabis products are applied and absorbed through the skin using a thick oil extract that contains active cannabinoids. The effects of the cannabinoids are generally localized and use of the product is generally not to confer intoxicating effects, but to provide localized relief from pain or inflammatory conditions. Examples of products include balms, oils, rubs, personal lubricant, suppositories, salves and creams, which claim to offer relief from pain, muscle aches, soreness, and eczema.
Understanding Consumption
REASONS FOR CONSUMPTION
People consume cannabis for a variety of reasons. The primary reasons people consume cannabis are as follows:
- Feelings of well-being: In some cases, people consume cannabis to increase feelings of well-being. Many people feel that cannabis products provide feelings of relaxation, satisfaction, and happiness as well as a means for socialization or spiritual and cultural expression.
- Self-Medication: Some people choose cannabis as a way to self-medicate. People may consume cannabis to reduce social anxiety or stress, or to reduce symptoms associated with trauma or depression.
- Performance: People may consume cannabis to be more productive or perform better in certain tasks. Some people believe that cannabis consumption helps them to be more creative.
- Discovery: In some contexts, people may consume cannabis to explore and discover. Some people believe cannabis can offer new experiences, feelings or insights they could not find otherwise.
CONSUMPTION PATTERNS
People will vary in their cannabis consumption patterns, ranging from:
- Never consuming cannabis (abstinent);
- Occasional consumption with very little negative effects;
- Regular consumption with very little negative effects; and
- Regular consumption accompanied by difficulties in their lives due to consumption (around 10% of cannabis consumers). People may move along the continuum of cannabis consumption forwards and backwards, ranging from abstinence to regular consumption over time. Decreasing the potential harms associated with cannabis consumption may involve moving down the continuum and reducing consumption, or may involve changing the method of consumption.
CANNABIS USE DISORDER
For those who experience negative outcomes from frequent cannabis consumption, there are clinical characterizations for cannabis use disorder (CUD). Cannabis Use Disorder is characterized by a recurrent pattern of consumption where at least two of the following situations occur in a 12-month period:
- increased tolerance;
- withdrawal;
- consuming much more than intended;
- unsuccessful attempts to quit;
- a lot of time lost consuming or recovering;
- reduced activities;
- continued consumption despite persistent physical or psychological problems caused or made worse by cannabis consumption;
- failure to fulfill major roles at work, school or home;
- use in physically hazardous situations;
- continued consumption, despite social or interpersonal problems caused or intensified by cannabis consumption; and / or
- strong urges or cravings to consume.
Harm Reduction
While the research is still evolving concerning the potential harms associated with cannabis consumption, the likelihood of developing a problematic relationship with cannabis (Cannabis Use Disorder or CUD) depends upon four factors:
The physical harms of cannabis can be greatly reduced by practicing basic harm reduction methods, such as those included in:
- Canada’s Lower Risk Cannabis Use Guidelines
- Here to Help’s Safer Cannabis Use
- Take Care with Cannabis from Vancouver Coastal Health
- Pregnancy Info
RISKS
While the research is still evolving concerning the potential harms associated with cannabis consumption, the likelihood of developing a problematic relationship with cannabis (Cannabis Use Disorder or CUD) depends upon four factors:
- Length and intensity of consumption: longer, more intense consumption increases risk.
- Potency of the product: consuming high levels of THC is more addictive.
- Individual factors: genetic or individual vulnerabilities, such as personality or experiences of trauma, can impact whether a person experiences harms.
- Age of initiation: people who begin to consume cannabis at a young age (under 16 years old) at a high frequency are at greater risk.
Close to 1 in 10 people who use cannabis will develop an addiction to it, and this rises to about 1 in 6 for people who started using cannabis as a teenager. The path to Cannabis Use Disorder is individual. Two people who use the same method of consumption, at the same frequency, with the same potency of product, may result in one person developing a dependence and the other person experiencing minimal harms. The specific reasons for these individual elements are not yet well understood. Frequent cannabis use is associated with a variety of adverse health outcomes. Certain people are more vulnerable to the potential physiological harms of cannabis, such as children and youth under the age of 25, a fetus in-utero or a nursing child, and those with a personal or family history of psychosis. Certain behaviours can elevate risk, such as mixing cannabis with alcohol or prescription drugs, driving after consuming cannabis (which elevates the risk of motor vehicle collisions) and co-consumption with tobacco (which may increase cancer risk and respiratory problems).
POTENTIAL HARMS
Some of the harms associated with cannabis include negative outcomes due to interactions with the criminal justice system that can result in insecure housing, trauma, and job instability. People experiencing social marginalization due to structural violence or the harms caused by systems and social institutions, including racialized persons, people with low incomes, people with mental health co-morbidities, or people who have experienced trauma, may disproportionately bear the burden of harms associated with cannabis consumption.
Structural violence can compound the stress of social marginalization and result in poorer outcomes for Canadians. To reduce these harms, it is important to be sensitive to possible stigma and reframe language from “user” to “consumer”. To encourage conversation and reduce harms of cannabis consumption, the term “person who consumes cannabis” is preferred over “stoner” or “pot head”. A simple change in language can help to increase service utilization and reduce perceptions of stigma by people who consume cannabis.
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