Miller began with an overview of the therapeutic uses of cannabis and its constituents THC, CBD, CBN, CBC, and CBG. THC (Delta-9-Tetrahydrocannabinol) is the psychoactive element of cannabis and is activated by heat. THC is used to provide pain relief, to treat nausea, as an appetite stimulant, a sleep aid, and to alleviate symptoms of depression.
CBD (Cannabidiol) is not psychoactive even if heated and has been found to relieve chronic pain, muscle spasms, convulsions and epilepsy. It has been found to relieve anxiety and depression and to be anti-bacterial.
CBN (Cannabinol) is formed when THC is exposed to UV light and oxygen and has some psychoactive properties. It can cause grogginess and has been shown to reduce the heart rate.
CBC (Cannabichromene) is rare, not psychoactive and usually found at low levels. Research indicates it is ten times more effective as an anti-depressant as CBD. When mixed with THC, it improves the pain-relieving impact of THC.
CBG (Cannabigerol) is not psychoactive and is commonly found in cannabis. CBG-acid is the precursor to both THC-acid and CBG-acid. CBG reduces the intraocular pressure associated with glaucoma. It also has antibiotic properties and slows the rate of blood clotting.
These are only some of the constituents of cannabis. Two other important constituents are flavenoids and terpenoids, the constituents that give each strain its odor and taste.
Using the components of cannabis as medicine is complicated by the way the medicine interacts with the personal chemistry of the patient. Miller said that the percentage of a constituent in the marijuana is not a way to judge its impact on an individual. A patient has to experiment until they find the right strain. For patients growing their own medicine, she said the best route is to purchase clones of the right strain. That’s the only way to achieve consistency in dose and effect. If the preferred strain isn’t available, she said to look for the strain that has a similar profile. She recommended keeping a diary of what works for the patient and what doesn’t.
In terms of taking the medicine, Miller said that vapor inhalation is the most complete way of absorbing the medicine. To assess the dose one is getting, Miller used a formula of 1 gram of 15% THC being equal to .15 mg or 150 mg of medicine.
In smoking marijuana, she said that 67% of the product is “lost to the room” and she didn’t consider smoking conducive to medical uses.
Oral medication is problematic. Miller said that many producers of edibles are not familiar with the facts of activation, which require heating the medicine to 212 degrees for 90 minutes to achieve complete activation. Activation can also be achieved by long periods of heating at lower temperatures, but at most only 75% of the potential will be activated.
”It doesn’t matter if it’s fully activated,” she said. “What matters is if it’s activated enough to treat the symptoms.”
Once ingested, the medicine is quickly taken up by the body and spreads to organs like the thyroid, liver, heart and stomach. Stomach acids will degrade cannabinoids, so it is probably more effective on an empty stomach than taken with or after a meal.
Miller said that 50% to 90% of the cannabinoids are excreted within four to five days, although they can linger up to 80 days in a heavy user. About 80% is excreted in feces with only trace amounts in urine. Cannabinoids cross the placenta and can be excreted through breast milk.
Miller was peppered with questions, some dealing with edibles. She said that the plant material being used for edibles should be tested before being cooked to help gauge the dosage. Edibles can be kept in a freezer with very little degradation, she said. Green matter can be used in cooking and she said it doesn’t matter if its leaf or flower if the potency is right for the patient.
The next seminar will deal with cultivation and medical baking. It will be held at the college on April 6.