Introduction
The use of cannabis by people for both entertainment and treatment has a long history. Recently, its potential in patients’ treatment has attracted more attention. In particular, most recently, the endocannabinoid system (ECS) containing cannabinoids, substances also included in cannabis, was discovered. Although many pieces of research suggest significant beneficial properties of cannabinoids, the study of ECS and cannabis is still ongoing to provide more accurate data on their effects.
Cannabis Work in the Body
Recently discovered ECS attracts attention due to its participation in many body processes. ECS is a molecular biological and cell-signaling system that influences body functions (Lowe et al., 2021; Raypole & Carter, 2019). It affects such processes as memory, sleep, appetite, emotional behavior, pain, and many other functions. At the moment, researchers tend to assume that the essential role of ECS is to support homeostasis – the stability of the body (Raypole & Carter, 2019). ECS helps the body return to its previous state, in case of some impairments, for example, fever. The system’s involvement in many processes and its role in homeostasis suggests a significant potential for ECS manipulation for treatment.
To understand the work of cannabis on the body, the components of ECS need to be considered. These components affect “cell-signalling pathways, involved in the pathophysiology of many types of diseases” (Lowe et al., 2021, p. 2). ECS components are as follows: endocannabinoids, endocannabinoid receptors, and enzymes (Raypole & Carter, 2019). Endogenous cannabinoids are similar to cannabinoids from the plant but are produced by the human body as necessary. Two types of receptors – CB1R and CB2R are common throughout the body, and endocannabinoids bind to them if necessary, for example, to reduce pain (Raypole & Carter, 2019). Enzymes break down endocannabinoids when they have performed the necessary actions. In this way, the system maintains homeostasis in the body.
The cannabinoids Tetrahydrocannabinol (THC) and cannabidiol (CBD) contained in cannabis interact with ECS. THC can bind to all types of endocannabinoid receptors and affect the body (Rapole & Carter, 2019). Since the body does not regulate the production and binding of these cannabinoids, the effect can be both – positive, for example, improving appetite or reducing pain, and harmful, for instance, causing anxiety. CBD, in turn, has no adverse effects and does not bind to known receptors. Its effect is not explored precisely, and presumably, it prevents the breakdown of endocannabinoids, enhancing their impact, or it may bind to a still unknown receptor (Raypole & Carter, 2019). The influence of the cannabis components is not precisely predictable, and therefore scientists are engaged in the issue of how to synthesize the necessary elements and direct their action only to positive effects.
The study of ECS and its impact on the body’s processes and functions also influenced the emergence of the theory of endocannabinoid deficiency. This condition was called clinical endocannabinoid deficiency (CECD), and it suggests a lack of endocannabinoids, which leads to ECS malfunctioning (Raypole & Carter, 2019). CECD may explain irritable bowel syndrome, fibromyalgia, and migraine conditions. The exact causes of these untreatable problems, often occurring together, have not yet been detected, and ECS disorders may be their root. Further research is needed to understand ECS, CECD and develop treatments through manipulation of cannabinoids.
Delivery Routes
Some patients’ conditions require cannabis prescribing, and the preferred delivery routes influence the choice of products containing it. The prevalent administration methods are oral, inhalation, topical, and sublingual. Each of these methods has a different time of onset of exposure and its pros and cons. Although state laws significantly determine the choice of delivery routes, nurses’ knowledge of their characteristics will improve their care of patients requiring cannabis.
One of the ways to take cannabis is oral, sometimes called ingestion. It includes food, capsules, oils, tinctures, or similar products containing cannabis. The advantages of the method over the rest are that the action lasts longer (Theisen & Konieczny, 2019). This quality may be necessary for patients with chronic pain but who want to take drugs less often. The oral route’s disadvantage is that the onset of action depends on the individual’s metabolism. The patient may feel symptoms relief after 30 minutes or 2 hours (Kindynis, 2020). As a result, it is difficult to calculate the necessary dose, and also such a method is not suitable for patients with acute conditions requiring urgent action.
Inhalation is a method of delivery involving smoking or vaporizing cannabis. A critical advantage of this route is the speed of cannabis impact, for example, for patients experiencing acute pain. In particular, the action is noticeable after a few minutes or even 30 seconds (Kindynis, 2020). However, smoking carries significant risks, as toxic substances that contribute to cancer development are released during the process (Kindynis, 2020). Due to the advantage of quick action, the use of inhalers and nebulizers may be available in the future (Kindynis, 2020). However, it is still crucial to assess the patient’s condition and all risks before choosing this method today.
In some cases, internal use of cannabis is not necessary, and patients may use the topical delivery routes. This method involves gels, sprays, patches, and other forms of applying drugs to the skin. Such administration provides local symptom relief and has almost no side effects (Theisen & Konieczny, 2019). Moreover, the action begins in a couple of minutes and can last several hours, with some patches – a few days (Kindynis, 2020). The method’s weakness is the risk of allergies and the reaching bloodstream when skin is injured.
The sublingual delivery route is the application of products that can be absorbed through the mucous membranes. The benefit of the method is that the action can begin faster than with oral one – after 15 minutes and last about 3 hours (Theisen & Konieczny, 2019). However, its disadvantage is that if the product is oil-based, the onset of action can be delayed (Theisen & Konieczny, 2019). Nurses should alert patients about such features to prevent overconsumption.
Conclusion
The use of cannabis in treatment has been known for a long time, and recently the topic has attracted more researchers. One of the causes of the increased attention is the relatively recent discovery of ECS in the human body. The components of this system are similar to cannabinoids of the cannabis plant. Moreover, ECS affects many functions and processes of the body. Further study of the system and its interaction with the components of cannabis can improve the treatment of patients in many areas of healthcare. Cannabis and its products are prescribed to some patients now, and these drugs have various delivery routes. Each route has its benefits and disadvantages and a different onset and duration of action. Therefore, the choice of a particular method for the patients must be determined by their conditions’ characteristics and personal preferences.
References
Kindynis, J. (2020). Medicinal cannabis: Routes of administration. Applied Cannabis Research. Web.
Lowe, H., Toyang, N., Steele, B., Bryant, J., & Ngwa, W. (2021). The endocannabinoid system: A potential target for the treatment of various diseases. International Journal of Molecular Sciences, 22(17), 1-42. Web.
Raypole, C., & Carter, A. (2019). A simple guide to the endocannabinoid system. Health Line. Web.
Theisen, E., & Konieczny, E., (2019). Medical cannabis: What nurses need to know. American Nurse Today, 14(11), 6-11. Web.