The Medicinal Cannabis Library

Understanding the Difference Between CBD and THC

Explore the difference between CBD and THC and the impacts these compounds have on the body.

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medically reviewed by

Published

February 9, 2024

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Meet tetrahydrocannabinol and cannabidiol – most commonly referred to as THC and CBD. Despite both of these naturally occurring compounds being found in cannabis plants and sharing a similar chemical structure, their impacts on our brains and endocannabinoid systems are incredibly different.

Whether you’re familiar with cannabinoids or are completely new to the world of medicinal cannabis, it’s important to understand the vast differences, benefits, and effects associated with THC and CBD. 

Today, we’ll be exploring the similarities and differences between CBD and THC, discussing the potential therapeutic benefits of each cannabinoid, and highlighting important considerations and potential risks for anyone considering exploring medicinal cannabis and natural therapies within their treatment plan. 

What Are CBD and THC? 

CBD and THC are chemical compounds, also referred to as cannabinoids, that are found in the cannabis plant. Despite their similar origins, CBD and THC both interact with our body’s endocannabinoid system (more on the endocannabinoid system here)  in a range of different ways. Establishing the similarities and differences between CBD and THC and their unique impacts on our minds and bodies is the first step towards making more informed decisions about your personal journey with natural therapies

Let’s get started. 

What is CBD? 

While cannabidiol, also known as CBD, is commonly mislabeled as non-psychoactive, it still carries psychoactive effects – they just differ from those of THC (more on THC below). Unlike THC, CBD is non-psychotropic and does not give a euphoric feeling, or the “high” commonly associated with THC. 

Derived from the cannabis plant, CBD is prescribed to some patients for anxiety and pain relief and its anti-inflammatory properties. Research has shown that CBD may also help to boost moods and reduce depression, nausea, vomiting and seizures in some patients. 

Patients seeking to reap the therapeutic benefits of medicinal cannabis without experiencing the “high” or euphoric side effects may choose to engage in CBD-based treatments instead of THC

CBD is considered non-impairing because it does not bind with the body’s CB1 receptor, which is responsible for creating the high sensation. Instead, CBD works with the body’s dopamine, opioid, and serotonin receptors and has the potential to provide relief from depression, pain, and anxiety in some patients. 

What is THC? 

Unlike CBD, tetrahydrocannabinol, also known as THC, is an intoxicating and psychoactive compound that is responsible for producing the euphoric, high effects often associated with cannabis consumption. This is because THC does work directly with the endocannabinoid system as it binds to the brain’s CB1 receptors. 

Individuals may be prescribed medication containing THC as part of their treatment plan to assist in managing pain, relieving nausea, improving sleep quality, and stimulating appetite in some patients.

Where Do CBD and THC Come From? 

For over 6,000 years, the cannabis plant has been cultivated and used by mankind for its therapeutic and medicinal potential. Today, the cannabis plant is home to over 120 cannabinoids, including CBD and THC. 

While THC and CBD are two of the most well-known cannabinoids (aka major cannabinoids), it’s important to note that the cannabis plant contains hundreds of different cannabinoids – each carrying its own unique properties. 

How CBD and THC Affect the Body

While CBD and THC have the same molecular structure, these compounds have distinctly different chemical properties. Both CBD and THC interact with the body’s endocannabinoid system, but in very different ways, resulting in very different impacts, benefits, and side effects. 

When THC engages the body’s CB1 receptors directly, it triggers a number of various effects, most notably the psychotropic experience commonly recognised as a “high”. THC may help relieve symptoms of pain, reduce nausea and vomiting, increase appetite, improve sleep, and more in some patients. It’s important to note that because THC works so directly upon the endocannabinoid system via the CB1 receptor, using too much THC can actually flood the CB1 receptors, potentially leading to increased anxiety, impaired memory and slow reaction times. This is why it’s so valuable to undergo medicinal cannabis treatment with the support of a prescribing doctor who can tailor a cannabis treatment plan to your exact needs, symptoms and individual circumstances.

On the other hand, CBD works indirectly with the ECS to interact with our opioid, dopamine, and serotonin receptors and most commonly binds to the body’s CB2 receptors, serving as a modulator and inducing differing therapeutic effects without the associated high. 

However, the combination of THC and CBD (as well as other compounds found within the plant such as terpenes and flavonoids) can result in the entourage effect – a more profound therapeutic effect on the endocannabinoid system than either THC or CBD would induce alone. Research suggests that the entourage effect can provide greater symptom relief when compared to each component alone. The physiological impact of CBD, THC, or the combination of the two, will depend on individual factors such as: 

  • Lifestyle choices
  • Metabolism 
  • Other medications you may be taking 
  • The symptoms you have (and wish to treat)  

CBD vs. THC Therapeutic Benefits 

CBD and THC offer patients a range of potential medical and therapeutic benefits. Despite their differing impacts, since the legalisation of medicinal cannabis in Australia in 2016, both CBD and THC have been steadily gaining popularity as natural alternatives for a range of chronic conditions and symptoms.

CBD has garnered popularity in the medical community for its potential therapeutic benefits – without the intoxicating effects (such as the “high”) that are often associated with THC. CBD interacts indirectly with our endocannabinoid system to modulate our opioid, dopamine, and serotonin receptors, which may help reduce anxiety, reduce inflammation, and regulate our mood and emotions.

THC is commonly known as a psychoactive cannabinoid as it gives people a ‘high’ euphoric sensation that many people associate with cannabis use. THC modulates the ECS by binding with CB1 receptors in the brain. In addition to creating a high, THC has many therapeutic applications, including reducing pain, alleviating nausea, and boosting appetite in some patients. 

CBD vs. THC Side Effects 

According to the World Health Organization (WHO)Trusted Source, CBD is considered to be generally safe and well-tolerated with minimal side effects. Research has found that many of the negative side effects an individual may experience while consuming CBD are typically the result of chemical reactions between CBD and other medications an individual may be taking. Some of the more common side effects of CBD include tiredness, nausea, lightheadedness, and low blood pressure.  

Unlike THC, current research shows that CBD is not associated with addiction or dependency. On the other hand, research has found that THC has the potential to cause temporary psychiatric side effects and long-term side effects in some individuals who have a history of prolonged, and/or excessive use of cannabis. These psychiatric side effects are a result of THC’s psychoactive and intoxicating properties – aka, the properties responsible for creating the “high” feeling. 

Some of the most common side effects of THC include altered senses, dry mouth, red eyes, issues with coordination, increased heart rate, short-term memory impairment, anxiety, and psychoactive “high” feelings. 

Similarly to CBD, THC may interact with certain medications and has also been associated with potential addiction and dependency risks. We recommend always speaking with your prescribing doctor, or a specialist experienced in the prescription of medicinal cannabis to help mitigate any potential risks or side effects associated with the medication. 

CBD vs. THC Legality 

Despite the legalisation of medicinal cannabis in Australia in 2016, the legal status of CBD and THC varies. CBD products containing low THC levels are legal for purchase and consumption without a prescription from your doctor within Australia. Medical cannabis products containing higher levels of THC can only be accessed by obtaining a prescription for certain medical conditions. 

To determine your eligibility and the suitability of THC and CBD for your conditions, we recommend speaking with an experienced doctor.  

It is important to note that recreational use of cannabis remains illegal in most Australian states. Click here for more information on the legalities surrounding medicinal cannabis in Melbourne, Brisbane and Sydney

The Wrap Up 

CBD and THC both have potential medical and therapeutic benefits. Understanding the differences and similarities between CBD and THC is crucial for individuals who are seeking relief from their symptoms by utilising the potential benefits of cannabinoids. 

As research continues to develop, CBD and THC present promising options for individuals who are seeking natural and alternative approaches to their well-being and health. While both are considered generally safe, always speak with your doctor or a medical practitioner who specialises in the prescription of medicinal cannabis to determine whether CBD or THC is the right treatment option for you.

CBD vs. THC FAQs 

What is CBD Oil? 

CBD oil (also commonly referred to as medicinal cannabis oil or cannabis oil) is a derivative of the cannabis plant that contains high levels of CBD and varying levels of THC.  

It is made by extracting CBD from the cannabis plant, with the extraction method impacting the oil’s purity and health benefits. While there are many different CBD oil products available to medicinal cannabis patients in Australia, the three different types of CBD oil include: 

  1. CBD isolate 
  2. Full-spectrum CBD 
  3. Broad-spectrum CBD 

We recommend speaking to a doctor who specialises in the prescription of medicinal cannabis to help determine what type of CBD oil is right for you. 

You can read more about CBD oil here

Is Medicinal Cannabis Addictive? 

Despite having a significantly lower risk of dependence when compared to caffeine, alcohol, and nicotine, there is always the potential for a dependency to develop – especially among non-prescription cannabis users. While most medicinal cannabis patients are unlikely to become addicted to cannabis, it’s important to note that it can still be addictive, even when it has been prescribed by a medical professional. 

The likelihood of a medicinal cannabis addiction occurring depends on a range of external factors, including: 

  • An individual’s susceptibility to addiction 
  • The potency of the THC or CBD 
  • A genetic predisposition to addiction 

If you believe that you or a loved one may be displaying signs of cannabis addiction or dependency, we recommend booking an appointment with your prescribing doctor to discuss a treatment plan and strategies to move forward. 

You can read more on medicinal cannabis and addiction here

References

Anand U, Pacchetti B, Anand P, Sodergren MH. Cannabis-based medicines and pain: a review of potential synergistic and entourage effects. Pain Manag. 2021;11(4):395-403. doi:10.2217/pmt-2020-0110

Crean RD, Crane NA, Mason BJ. An evidence based review of acute and long-term effects of cannabis use on executive cognitive functions. J Addict Med. 2011;5(1):1-8. doi:10.1097/ADM.0b013e31820c23fa

Dei Cas M, Casagni E, Casiraghi A, et al. Phytocannabinoids Profile in Medicinal Cannabis Oils: The Impact of Plant Varieties and Preparation Methods. Front Pharmacol. 2020;11:570616. Published 2020 Nov 13. doi:10.3389/fphar.2020.570616

Golombek P, Müller M, Barthlott I, Sproll C, Lachenmeier DW. Conversion of Cannabidiol (CBD) into Psychotropic Cannabinoids Including Tetrahydrocannabinol (THC): A Controversy in the Scientific Literature. Toxics. 2020;8(2):41. Published 2020 Jun 3. doi:10.3390/toxics8020041

Groh, Carla PhD, PMHNP-BC, FAAN. The Differences between THC and CBD. Home Healthcare Now 40(2):p 116-117, March/April 2022. | DOI: 10.1097/NHH.0000000000001048

Hasbi A, Madras BK, George SR. Endocannabinoid System and Exogenous Cannabinoids in Depression and Anxiety: A Review. Brain Sci. 2023;13(2):325. Published 2023 Feb 14. doi:10.3390/brainsci13020325

Legare CA, Raup-Konsavage WM, Vrana KE. Therapeutic Potential of Cannabis, Cannabidiol, and Cannabinoid-Based Pharmaceuticals. Pharmacology. 2022;107(3-4):131-149. doi:10.1159/000521683

Marinotti O, Sarill M. Differentiating Full-Spectrum Hemp Extracts from CBD Isolates: Implications for Policy, Safety and Science. J Diet Suppl. 2020;17(5):517-526. doi:10.1080/19390211.2020.1776806

National Center for Biotechnology Information. PubChem Compound Summary for CID 644019, Cannabidiol. https://pubchem.ncbi.nlm.nih.gov/compound/Cannabidiol. Accessed Feb. 8, 2024.

Pennypacker SD, Romero-Sandoval EA. CBD and THC: Do They Complement Each Other Like Yin and Yang?. Pharmacotherapy. 2020;40(11):1152-1165. doi:10.1002/phar.2469

Pintori N, Caria F, De Luca MA, Miliano C. THC and CBD: Villain versus Hero? Insights into Adolescent Exposure. Int J Mol Sci. 2023;24(6):5251. Published 2023 Mar 9. doi:10.3390/ijms24065251

Specchio N, Pietrafusa N, Cross HJ. Source of cannabinoids: what is available, what is used, and where does it come from?. Epileptic Disord. 2020;22(S1):1-9. doi:10.1684/epd.2019.1121

Zou S, Kumar U. Cannabinoid Receptors and the Endocannabinoid System: Signaling and Function in the Central Nervous System. Int J Mol Sci. 2018;19(3):833. Published 2018 Mar 13. doi:10.3390/ijms19030833

The information on this website is provided for educational and informational purposes only and not intended for use as medical advice. Polln is not promoting the use of medicinal cannabis. Medicinal cannabis in Australia is scheduled medication and regulated by the Therapeutic Goods Administration (TGA). Details about medicinal cannabis as a scheduled drug can be found on their website. If you would like to explore medicinal cannabis for your chronic condition, please consult with a doctor.

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The Side Effects of CBD Oil, Explained

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The Side Effects of CBD Oil, Explained

Cannabidiol oil, also referred to CBD oil, is a derivative of the cannabis plant that has grown in popularity in recent years, With an array of potential therapeutic health benefits, and an ever-growing availability of CBD-infused products in Australia, understanding the effects of CBD oil is essential – whether you’re just starting your natural therapy journey, or are an existing medicinal cannabis patient.  

Let’s get started. 

What is CBD? 

CBD (or cannabidiol) is a naturally occurring cannabinoid found in the cannabis plant. Cannabinoids are the chemical compounds found in the cannabis plant among terpenes – the compounds responsible for giving cannabis its unique aroma and flavour, flavonoids, fatty acids, and more. 

Unlike THC, CBD is a non-psychotropic cannabinoid, meaning it does not provide patients with the “high” that is commonly associated with THC. Many people describe CBD as also being a non-psychoactive treatment, however, this can be misleading as  CBD has still been shown to carry some psychoactive properties, just different to THC. 

What is CBD Oil? 

CBD oil is created when cannabidiol is extracted from the cannabis or hemp plants. This results in an oil that contains high levels of CBD and varying levels of THC and other plant compounds. 

With countless CBD oil products now available on the Australian market, it’s important to identify and establish your needs with your doctor, to ensure that your prescribed medication can adequately help you manage your symptoms and condition. 

There are three different types of CBD oil, including: 

  • CBD Isolate 
  • Broad Spectrum CBD
  • Full Spectrum CBD 

CBD Isolate 

CBD Isolate does not contain any other cannabinoids that are present in the cannabis plant, such as terpenes, flavonoids, and fatty acids. Because of this, it is considered to be the purest form of CBD

Full-Spectrum CBD 

Full-spectrum CBD is created by using the entire plant extract, and as such, contains all naturally occurring cannabinoids, terpenes, and other compounds that are found in the cannabis plant. While this can include trace amounts of THC, is is unlikely to produce any psychoactive effects

Broad-Spectrum CBD 

Similar to full-spectrum CBD, broad-spectrum CBD also contains cannabinoids other than just CBD. Unlike full-spectrum CBD however, broad-spectrum CBD has all trace amounts of THC removed. This means that patients who are prescribed this type of CBD oil can reap the benefits of a range of cannabinoids and terpenes, without experiencing the psychotropic effects of THC. 

To determine which type of CBD Oil is best suited to you and your lifestyle, we recommend speaking to an expert in medicinal cannabis and natural therapies. 

What Are the Potential Therapeutic Benefits of CBD Oil? 

As a result of its many potential therapeutic benefits and its non-psychotropic properties, CBD may be beneficial for some patients who are seeking to reap the benefits of medicinal cannabis without the euphoric effects or “high” that are associated with THC-based treatments. 

CBD is considered to be non-impairing because it works with the body’s dopamine, opioid, and serotonin receptors, instead of binding with the body’s CB1 receptor – which is responsible for creating the sensation of feeling high. 

While research has shown that CBD may assist some patients in reducing depression, vomiting, and nausea, it is more commonly prescribed to patients who are seeking relief from inflammation and pain. CBD oil may also help some patients who experience difficulties with sleep, are experiencing symptoms associated with depression and anxiety, mood swings or a lack of appetite 

What Are the Side Effects of CBD Oil? 

While CBD oil is considered to be generally safe, as always, it’s important to weigh up any potential risks and side effects in consultation with your prescribing doctor. 

Some of the adverse reactions and side effects that some patients may experience when using a CBD oil treatment may include: 

One clinical trial conducted in 2017 to review the effects of CBD oil for drug-resistant seizures found that participants experienced:  

  • Nausea and vomiting 
  • Fever
  • Diarrhoea 
  • Exhaustion
  • Fatigue 
  • Abnormal results on liver-function test 

If you’re taking any other prescribed medications, it’s important to note that CBD oil has the potential to react with other medications. For this reason, we recommend speaking with your prescribing doctor, or a doctor who specialises in the prescription of medicinal cannabis, to discuss the right dosage for you and to appropriately gauge your risk-level for experiencing potential side effects. 

Is CBD Oil Legal? 

Just like any other medicinal cannabis product, as of 2016 CBD oil is legal to access in Australia with a valid prescription from a healthcare professional. 

Because of the growing popularity of CBD oil, it has quickly become one of the most sought-after medicinal cannabis products in Australia. However, as the interest in CBD oil continues to grow, unfortunately so does the rise of unregulated products. 

With the lack of clarity surrounding the laws and journeys to purchasing legal, regulated CBD oil in Australia, many individuals seeking to reap the potential therapeutic benefits of this non-psychotropic compound have turned to other avenues to access their medication. 

With an array of unregulated CBD oil products now circulating the internet and claiming to assist with and cure a plethora of illnesses and diseases, many Australians are choosing to access their medication this way. Whether you’re aware of the legal implications or not, at the time of writing, buying any product that contains CBD without a prescription is illegal in Australia.

At the time of writing, it is legal to purchase low-dose CBD products (containing less than 150 mg of CBD per day) over the counter. This is a result of the TGA down-scheduling CBD from a Schedule 4 prescription-only medication to now a Schedule 3 pharmacist-only medication. 

Despite this change, so far no products containing CBD have been approved by the Australian Register of Therapeutic Goods (ARTG) – which is required before pharmacists can sell the product. 

As with any treatment option, the only way to ensure you are receiving what you need in terms of quality and effectiveness is to speak with a medical professional who has extensive experience in natural therapies and the prescription of medicinal cannabis. 

The only legal way to purchase and consume medicinal cannabis treatment in the form of CBD oil in Australia is with a valid prescription. For more information on the legal and illegal cannabis landscape in Australia, read our article here.  

How is CBD Oil Consumed? 

How an individual consumes CBD oil will depend largely on what the medication is being used to treat, and what consumption method you’re most comfortable with. 

The most effective way to consume CBD oil is via the sublingual method. This allows the oil to absorb faster into the bloodstream via the sublingual glands found under the tongue. This method differs from purely ingesting CBD oil, where the medication travels through your gastrointestinal system, resulting in a much longer onset of effects. 

Before commencing any treatment, we recommend having a discussion with your doctor surrounding the various consumption methods to ensure that your chosen method aligns with your needs, experiences, and lifestyle. 

For more information on the various ways you can consume CBD oil, head over to our article on how medicinal cannabis can be consumed

The Wrap-Up 

CBD oil can be consumed in many different methods and may help to ease the symptoms of anxiety, pain and inflammation in some patients. Familiarising yourself with both the potential therapeutic benefits and possible side effects is crucial before beginning any medication. 

If you’re considering exploring CBD oil, we recommend always speaking to a trusted doctor who specialises in the prescription of medicinal cannabis to ensure that you receive the correct type and dosage for you and your lifestyle. 

Plant Talk

Everything You Need To Know About Cannabinoids: More Than Just CBD and THC

6
min read
Read Article
Everything You Need To Know About Cannabinoids: More Than Just CBD and THC

What are cannabinoids? 

Cannabinoids are a diverse array of ‘cannabis-like’ molecules, including phytocannabinoids, endocannabinoids and synthetic cannabinoids. Cannabinoids can be found within our bodies, within plants (especially cannabis plants) and can be synthesised in laboratory settings. The main cannabinoids you’ll hear about are likely to be CBD and THC, which are phytocannabinoids found in the cannabis plant. But, there is growing evidence to suggest that minor cannabinoids – alongside other cannabis compounds – may play an equally important part in the therapeutic benefits of your medicinal cannabis treatment.

There are 3 types of cannabinoids:

  1. Phytocannabinoids – ‘Phyto’ meaning plant-derived, these are cannabinoids found in the cannabis plant (and many other plants).
  1. Endocannabinoids – ‘Endo’ meaning internal, these are naturally occurring cannabinoids found in the human brain and bodily organs.
  1. Synthetic cannabinoids – cannabinoids synthesised by chemists to mimic the actions of phytocannabinoids or to influence the body’s endocannabinoid levels.

Let’s first look at the main two types of cannabinoids you’ll encounter, endocannabinoids and phytocannabinoids:

Endocannabinoids

Endocannabinoids (or endogenous cannabinoids) are naturally occurring cannabinoids found in the brain and body. They are lipid signalling molecules which exist to mediate our normal physiological functions. This means they bind to a protein target (in this case, a cannabinoid receptor) to create specific cellular responses in the body, such as stimulating appetite. Endocannabinoids may have evolved in the brain to maintain biological harmony while also playing a role in neuronal plasticity (how the brain adapts to change).¹

The two major endocannabinoids that have been discovered are:

  • Anandamide (AEA) (ananda is the Sanskrit word for bliss)
  • 2-arachidonoyl glycerol (2-AG)

Both of these endocannabinoids help our internal functions run smoothly, and a healthy human body produces them as needed. When there is a deficiency or imbalance in our endocannabinoid production, then we may need to look at external ways to upregulate our endocannabinoid levels.

Endocannabinoids, cannabinoid receptors (which both endocannabinoids and phytocannabinoids interact with) and enzymes are the three components which make up the endocannabinoid system (ECS). The ECS is the molecular system located throughout our brains and bodies which helps regulate our immune responses, cell communication, sleep, pain, appetite, hormone levels, metabolism, memory, and more. 

Learn more about the ECS here.

Phytocannabinoids

Phytocannabinoids are cannabinoids derived from the cannabis plant which can also be found in other plants, including cloves, carrots and broccoli, in smaller quantities. Research has found that the cannabis plant produces between 80 and 100 cannabinoids and about 300 non-cannabinoid chemicals.² Like endocannabinoids, phytocannabinoids also interact with our endocannabinoid system and cannabinoid receptors to produce certain effects within the brain and body.

The two most well-known cannabinoids are delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD). Both CBD and THC as well as numerous other cannabinoids are used in medicinal cannabis for their therapeutic potential. We’ll explore some of these cannabinoids and their properties below.

What do cannabinoids do? 

Both endocannabinoids and phytocannabinoids interact with the body’s endocannabinoid system (ECS) to produce varying effects. Each of us – whether we consume cannabis or not – has an ECS which helps regulate and balance many processes in the body.

The endocannabinoid system is made up of:

  1. Endogenous cannabinoids (endocannabinoids)
  2. Cannabinoid receptors
  3. Enzymes responsible for the synthesis and degradation of the endocannabinoids 

Unlike the nervous system or cardiovascular system, the endocannabinoid system is not an isolated structural system located in a specific region of the body. Instead, the ECS is a receptor system broadly distributed throughout the body which is acted upon by cannabinoids and enzymes. Endocannabinoids and cannabinoid receptors can be found throughout the brain, organs, connective tissues, glands, and immune cells.

Endocannabinoids and the ECS

A typical endocannabinoid system function works when the body’s naturally produced endocannabinoids (which are present in various organs and tissues) become active by binding with a cannabinoid receptor (also located all throughout the body) to regulate a bodily function, such as digestion or sleep. Essentially, when a system or function in the body is out of balance, receptors bind to cannabinoids to help correct the problem. Once the endocannabinoid system brings the body back into balance, enzymes will break down the cannabinoids to prevent overcorrecting the problem.

Phytocannabinoids and the ECS

Much like endocannabinoids, phytocannabinoids (which have a similar chemical structure to our endocannabinoids) also interact with our ECS and cannabinoid receptors to produce varying effects. When taken under the guidance of a prescribing doctor, phytocannabinoids like CBD, THC and more also have the potential to aid internal processes, mediate physiological functions and create balance within the body.

Learn more about the endocannabinoid system and how cannabinoids like THC, CBD and CBN interact with it here.

Effects of phytocannabinoids 

Different phytocannabinoids (or combinations of cannabinoids and other cannabis compounds such as terpenes) create different effects in the mind and body, depending on how they’re used and who is using them. Some cannabinoids, like THC, are psychoactive, meaning they have an effect on the mind and can cause changes in mood, awareness, feelings, thoughts and behaviour. Psychoactive cannabinoids can be impairing for a period of time after use. Other cannabinoids, like CBD, do not produce psychoactive effects, meaning they are not likely to impact cognitive abilities like driving or memory recall.

Cannabinoids have a range of studied therapeutic benefits, from nausea and pain relief³ to anti-inflammatory⁴ and anxiolytic (anxiety relieving) capabilities⁵. In Australia, cannabinoid medicines have been prescribed to treat the symptoms of a range of chronic conditions, including anxiety, chronic pain and endometriosis

Continue reading to learn more about some of the main phytocannabinoids found in cannabis.

Types of cannabinoids in cannabis

The cannabis plant contains over 400 distinct compounds, between 80 and 100 of which are cannabinoids. Each cannabinoid has its own unique properties, many of which are still being uncovered by researchers. CBD and THC are the two major cannabinoids that you’ll probably hear about the most, but there is growing evidence to support the therapeutic effects of minor cannabinoids such as CBG and CBN. In fact, many of the proposed medical benefits originally thought to arise from CBD may actually be attributed to minor cannabinoids.⁶

Let’s look at four of the main cannabinoids you might find in cannabis and cannabinoid medicines:

Tetrahydrocannabinol (THC)

Delta-9-tetrahydrocannabinol (THC) is one of the main phytocannabinoids found in the cannabis plant. THC is a psychoactive cannabinoid which gives the ‘high’ sensation commonly associated with cannabis use. THC works directly with the ECS by binding with CB1 receptors in the brain, and may help relieve symptoms of pain while reducing chemotherapy induced nausea and vomiting, increasing appetite, improving sleep and more in some patients. 

Learn more about how THC interacts with the ECS here.

Cannabidiol (CBD)

Cannabidiol (CBD) is another of the most abundant in the long list of cannabinoids found in the cannabis plant. Unlike THC, CBD is non-impairing and won't bring on a feeling of being ‘high.’ This is because CBD does not bind with the CB1 receptor which creates the high sensation. Instead, CBD  works indirectly with the endocannabinoid system to interact with our opioid, dopamine, and serotonin receptors, giving it the potential to provide pain relief, depression and anxiety while boosting the immune system and helping with addiction. 

Learn more about how CBD interacts with the ECS here.

Cannabinol (CBN) 

Cannabinol (CBN) is a cannabinoid known to have anticonvulsant, sedative, and other pharmacological activities⁷ that are still being explored. CBN is created during the breakdown of the psychoactive cannabinoid THC⁸. Like THC, CBN also binds to the CB1 receptor, but at a much lower strength than THC. This technically makes it a psychoactive compound, but it doesn’t produce much of a ‘high’ sensation. CBN has a stronger affinity towards the CB2 receptors, which are mostly associated with immune system regulation.⁹

Cannabigerol (CBG)

Cannabigerol (CBG) is an active, non-intoxicating minor cannabinoid found in cannabis. CBG can work synergistically with CBD to mitigate the ‘high’ produced by THC while also helping to compound each cannabinoid’s therapeutic effects, depending on the ratios of each cannabinoid present. Studies indicate that CBG may have therapeutic potential in treating the symptoms of some neurological disorders and inflammatory bowel disease, as well as having antibacterial activity.¹⁰

Synthetic cannabinoids

Synthetic cannabinoids are cannabinoids that have been synthesised to mimic the actions of phytocannabinoids or influence the body’s endocannabinoid levels. Like naturally occurring cannabinoids, synthetic cannabinoids act on the cannabinoid receptors in the body to produce certain effects. The more accurate term for these compounds is ‘synthetic cannabinoid receptor agonists’ (SCRAs).

While some synthetic cannabinoids (SCRAs) have been developed for medicinal use with a prescription, synthetic cannabis products obtained without a prescription are both prohibited and unregulated in Australia. These ‘synthetic cannabis’ products often have stronger and more negative effects (that are not caused by natural cannabis) and greater health risks than their prescribed or natural counterparts.¹¹

Some of the serious adverse effects seen with non-prescription synthetic cannabinoids include:

  • fast and irregular heartbeat
  • psychosis
  • aggressive and violent behaviour
  • chest pain
  • vomiting
  • raised blood pressure (hypertension)
  • breathing difficulties
  • hyperthermia (overheating)
  • breakdown of muscle tissue (rhabdomyolysis)
  • acute kidney injury
  • seizures
  • stroke
  • death.¹²,¹³

Synthetic cannabinoids are usually mixed with solvents and sprayed onto herbs to be sold in colourful, branded packets. Although the contents may be described as ‘herbal’, the actual psychoactive material in these products is synthetic, and not all ingredients or their correct amounts are likely to be listed. On top of this, chemicals usually vary significantly from batch to batch, so different packets can produce different effects, even when the packaging looks the same. All of these factors can contribute to the risk of overdosing on synthetic cannabis products.

Using cannabinoids safely 

The only way to ensure you’re getting the therapeutic benefits and cannabinoid content you need from your cannabis is to get a prescription from a licensed healthcare professional. Cannabinoids can cause unwanted side effects in some people at certain doses, particularly when consumed via illegal cannabis products which are not regulated for safety, quality or ingredients (learn more about legal v. illegal cannabis here) and which often contain high levels of the cannabinoid THC. While there have not been any reported deaths in teens and adults resulting solely from cannabis use or cannabis toxicity, synthetic cannabinoids obtained without a prescription are known to be dangerous and can even cause death. 

CBD is generally well tolerated as a cannabinoid and is non-impairing, even at high doses.¹⁴ On the other hand, THC can induce the ‘high’ feeling associated with cannabis, and can be impairing or sedating in some people at certain doses. Because of this, THC is more likely to cause unwanted side effects like anxiety, confusion, dizziness, slower reaction times and increased heart rate at high doses. In rare cases and at high doses it can also cause hallucinations, paranoia, psychosis, panic attacks, nausea and vomiting.¹⁵ There may also be a link between heavy recreational cannabis use and some psychiatric disorders –  with recent research suggesting that smoking high-potency cannabis each day could increase the chances of developing psychosis by nearly five times compared to people who have never used the drug.¹⁶

Available evidence suggests that the following guidelines may help users reduce or avoid cannabis use-related health risks:¹⁷,¹⁸

  1. Abstain from cannabis if it is not required to treat a medical condition, especially if you are in a higher risk group for cannabis related health problems
  2. Avoid using THC-containing cannabis treatments if you have angina or a history of myocardial infarction, or a personal or family history of schizophrenia or psychotic disorders
  3. Avoid early age initiation of cannabis use (particularly before the age of 16) unless benefits clearly outweigh the risks
  4. Choose low-potency or balanced THC-to-CBD ratio cannabis treatments, or CBD only treatments (if appropriate for your condition)
  5. Abstain from using synthetic cannabinoids
  6. Avoid combustion cannabis methods (instead opt for other non smoking consumption methods)
  7. Start with a low dose and slowly titrate up to your ideal dose under the guidance of your doctor
  8. Do not use cannabis if you are taking any medications which are known to interact poorly with cannabis (always check with your doctor)
  9. Carefully monitor any side effects and interactions with other prescription medications that you experience when taking cannabis
  10. Abstain from cannabis use while pregnant

It’s important to note that driving with any amount of THC in your system is currently illegal in Australia (in every state except Tasmania) due to its potential to impair cognitive functions needed for safe driving. Always follow the dosing and administration guidelines provided to you by your doctor and monitor your symptoms and any side effects when starting a new treatment or changing your dose.

For more information on cannabinoids, visit The Caregiver's Guide to Medicinal Cannabis.

Learn more about the differences between illegal and legal cannabis in Australia here.

FAQs

Are terpenes cannabinoids? 

Like cannabinoids, terpenes are one of the numerous chemical compounds found within the cannabis plant which have therapeutic potential, but they are not considered cannabinoids. Terpenes are organic, aromatic compounds found in plants in the form of oils. Essentially, they are what gives a plant its unique flavour and aroma. But beyond just influencing the cannabis plant’s unique taste and smell, terpenes also play a significant role in the therapeutic effects of cannabis by interacting with cannabinoids and other cannabis compounds to create subtle differences in our experience.

Learn more about terpenes here.

Are cannabinoids addictive? 

Cannabis is known to have a low to moderate risk of dependence that is significantly lower than alcohol, nicotine, caffeine, and prescription drugs like morphine and opioid medicines.¹⁹ But there is still some potential for a dependence to develop, particularly in non-prescription users and those taking high concentrations of THC. 

In 2018, a report from the World Health Organisation found that the cannabinoid CBD exhibits no effects indicative of any abuse or dependence potential in humans and stated that to date ‘there is no evidence of public health related problems associated with the use of pure CBD.’²⁰ In fact, evidence suggests that CBD can mitigate the unwanted effects of THC and shows potential in treating symptoms of Alzheimer's disease, cancer, psychosis, Parkinson's disease, and other serious conditions. It is therefore highly unlikely that CBD is an addictive cannabinoid.

THC, on the other hand, may have the capacity to create dependence in some users. Studies show that the risk of recreational cannabis dependence is more common with high strength THC cannabis strains with a low CBD content (which are often bred illegally for this purpose), large amounts consumed, high frequency use (heavy, daily) and with starting use early in adolescence.²¹ Currently, there is very limited research looking at whether there is an association between medicinal THC and dependence, so more research is needed. With the support of a, you should be able to find a treatment plan and dose that works for you while reducing the risk of dependence.

Taking tolerance breaks can reduce the amount of THC you need to feel the therapeutic benefits of your medicine and reduce the risk of dependence. Talk to your prescribing doctor if you believe you are experiencing any signs or symptoms of cannabis dependence.

Learn more about tolerance breaks here.

Chronic cannabis use can lead to what is known as Cannabis Use Disorder. Cannabis Use Disorder is categorised by a problematic pattern of cannabis use leading to clinically significant impairment or distress. This might look like taking larger amounts of cannabis over a longer period than intended, neglecting work, social or other obligations due to cannabis use, developing a tolerance or experiencing withdrawals to cannabis, experiencing strong cravings to use cannabis and more.²² Talk to your doctor if you are concerned about or believe you are showing signs of Cannabis Use Disorder. 

How many different cannabinoids are there? 

The cannabis plant produces between 80 and 100 phytocannabinoids. In addition to CBD and THC, some of these include:

  • THC-acid (THCA)
  • CBD-acid (CBDA)
  • Cannabigerol (CBG)
  • Cannabigerolic acid (CBGA)
  • Cannabichromene (CBC)
  • Cannabichromenolic acid (CBCA)
  • Cannabichromevarin (CBCV)
  • Cannabichromevarinolic acid (CBCVA)
  • Cannabidivarin (CBDV)
  • Cannabidivarinolic acid (CBDVA), and
  • Cannabinol (CBN)

Do all cannabinoids get you high?

No. Not all cannabinoids are intoxicating and therefore will not produce the ‘high’ sensation that is most commonly associated with THC. This is because each cannabinoid has unique properties and interacts with the endocannabinoid system in varying ways. Cannabinoids (like THC) which interact with the CB1 receptor in our ECS are more likely to produce a psychoactive or intoxicating effect, however not all cannabinoids which interact with the CB1 receptor will produce a strong ‘high’ feeling.

Learn more about the endocannabinoid system here.

Plant Talk

Sativa vs Indica vs Hybrid Cannabis: What to Expect

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Sativa vs Indica vs Hybrid Cannabis: What to Expect

It is common for cannabis (aka marijuana) products and treatments in the prescription and non-prescription market (which is currently illegal in Australia) to be broken up into three distinct groups: indica, sativa, and hybrid. Many patients and consumers still use these classifications to predict the effects their cannabis will have, but how accurate are they?

In this article, we’ll explore these three different strain types and the new ways patients, consumers and those in the medicinal cannabis industry are classifying their cannabis.

The history of indica and sativa 

Cannabis is believed to have originated in Central Asia and to have migrated to almost every continent across all reaches of the planet, adapting to various climates in the process. These adaptations coupled with the selective breeding of cannabis by cultivators led to variations in cannabis that became known as landrace strains, which are each named after their region of origin.

Many of these landrace strains were collected from their native habitats and brought to the Western world, where they were crossbred with one another in horticultural attempts to explore the plant’s potential. This process of hybridisation has given rise to the thousands of named cannabis varieties consumed across the world today.

You may have heard the terms ‘indica’ and ‘sativa’ as well as ‘hybrid’ in discussions around cannabis strains. Indicas and sativas came from the original landrace strains mentioned above and are known for their distinctive effects on the user. 

In 1753, the Swedish botanist Carl Linnaeus (known as the ‘father of modern taxonomy’) published Species Plantarum, a book listing every species of plant known at the time, classified into genera. Linnaeus classified all cannabis plants under one group, ‘Cannabis sativa L.,’ with ‘Cannabis’ as the genus, ‘sativa’ as the species, and ‘L.’ indicating Linnaeus’ system. ‘Sativa’ comes from the Latin ‘sativum,’ meaning ‘cultivated.’1 

Later, in 1785, French naturalist Jean-Baptiste Lamarck became the first person to classify the differences between two distinct species of the plant: Cannabis indica and Cannabis sativa. Lamarck’s classifications were based on the physical characteristics of the different plants, and his own experience when testing them. ‘Cannabis sativa’ was found to be a taller, slimmer, and more fibrous plant, while ‘Cannabis indica,’ was found to be shorter, wider, and possessing greater psychoactive properties. The name Indica means ‘from India,’ which is where the plant was thought to originate. 

Today, these definitions have endured. These are the three main types of 'strains' of cannabis you may have encountered:

We’ll explore each of these strains below.

What is indica?  

Typically known for their relaxing properties, Indica strains originally grew in cold, northern climates. They grew shorter and stockier because of these environments, with a shorter life cycle that allowed them to be harvested before the colder weather hit.  

Indica origin 

  • Cannabis indica is native to Afghanistan, India, Pakistan, and Turkey. 

Plant properties:

  • Indica plants are shorter and stockier than sativa plants with bushy greenery and broad, dark green leaves. Indicas grow faster than sativa plants, and also produce more flowers (buds).

Cannabinoid balance: 

  • Indica strains tend to have higher levels of CBD than sativa strains, but the THC content isn’t always less.

Most commonly associated effects 

  • Based on anecdotal feedback, Indica strains tend to be associated with a relaxing, sedating effect, which may assist with anxiety symptoms and sleep issues.

What is sativa?  

Known for their uplifting, stimulating effects, Sativa strains are found primarily in hot, dry climates.

Sativa origin:  

  • Sativa strains are indigenous to warmer parts of the world, such as Eastern Asia and Central and South America.

Plant properties:

  • Sativa plants are taller and slimmer than indicas, with thin, light green leaves. As they can exceed 3m in height, Cannabis sativa plants typically take much longer to mature than indicas.

Cannabinoid balance: 

  • Sativa strains tend to have a lower ratio of CBD to THC than Indicas.

Most commonly associated effects: 

  • Based on anecdotal feedback, cannabis sativa is known for its stimulating effects. It is often said to produce a 'mind high' that may increase creativity and focus and reduce anxiety.

How to recognise differences between indica and sativa

Nowadays, instead of indica and sativa strains, most cannabis strains are hybrid strains, a combination of both (we'll unpack this more below). Therefore it doesn't really make sense to compare indica vs sativa when it comes to therapeutic effects. Where the two different cannabis strains do differ distinctly is in appearance.

  • Sativa plant – skinny, light green leaves on a tall, slim plant
  • Indica plant – short, bushy plants with broad, dark green leaves

What is hybrid cannabis? 

Cannabis growers are constantly producing new and unique strains from different combinations of indica- and sativa-descended parent plants, and these are known as hybrid cannabis strains. Often grown to target specific medical use cases, hybrid cannabis plants can deliver a wide range of varying effects. Hybrids are typically grown on farms or in greenhouses from a combination of sativa and indica strains, each with unique ratios of THC to CBD.

Due to the long history of cross breeding cannabis, research suggests that strains with pure indica or pure sativa strains are rare today.2 This means that most 'Indica strains' and 'Sativa strains' are actually hybrid strains, with genetics inherited from both types.

What are the main effects of hybrids? 

Hybrids are typically classified as indica-dominant, sativa-dominant, or balanced. This means that the effects of a hybrid strain will depend on whether it has more indica or sativa in its lineage, and (more importantly) its cannabinoid and terpene content. Hybrids are typically grown to elicit specific medicinal and other effects, such as reducing anxiety and depression, delivering pain relief, and more.

Changes to how we describe strains: 

Today, research suggests that years of crossbreeding has likely hybridised sativa and indica strains to the point that most of the cannabis consumed today is a combination of the two species’ lineages.

But if sativa, indica and hybrid strain classifications don't matter as much anymore, what does?

Many in the industry now prefer to classify cannabis as fitting more or less within these categories, defined by the level of major cannabinoids CBD and THC, also known as chemotypes:

  • Type I: High THC (more than 0.3% THC and less than 0.5% CBD)
  • Type II: THC/CBD (high contents of both CBD and THC)
  • Type III: High CBD (less than 0.3% THC)

But even more importantly – we are increasingly seeing the value that terpenes, minor cannabinoids (such as CBG and CBN), flavonoids and other compounds have in the therapeutic potential of cannabis strains.

Early research tells us that a whole plant approach to cannabinoid therapies which takes full advantage of the cannabinoid content (beyond THC and CBD) and terpene profile of the cannabis plant may be the most effective way to meet its healing potential.3,4

Cannabinoid makeup 

  • Research has found that the cannabis plant produces between 80 and 100 cannabinoids and about 300 non-cannabinoid chemicals.5
  • Cannabinoids are naturally occurring components responsible for producing many of the effects of cannabis by interacting with our endocannabinoid systems.
  • Knowing which cannabinoids and ratios of cannabinoids like THC and CBD (and many more) are present in your cannabis treatments is one of the best ways to predict the effects it will have on you and your symptoms.
  • Learn more about some of the different types of cannabinoids and what they do here.

Terpenes 

  • Terpenes are the organic, aromatic compounds found in plants in the form of oils. Essentially, they are what gives a plant its unique flavour and aroma. 
  • Terpenes are responsible for the aromatic diversity of the wide range of strains and cultivars available.
  • Beyond just influencing the cannabis plant’s unique taste and smell, terpenes also play a significant role in the therapeutic effects of cannabis by interacting with cannabinoids and other cannabis compounds to create subtle differences in our experience.
  • Learn more about different terpenes and their effects here.

What is Cannabis ruderalis? 

Cannabis ruderalis is a third type of cannabis strain which contains low quantities of cannabinoids. It isn’t widely used because it isn’t known to produce any potent effects.

Ruderalis origin:  

  • Ruderalis plants are found in more extreme environments than other strains, such as those in Eastern Europe, Himalayan regions of India, Siberia, and Russia. Like indica plants, ruderalis grows quickly, having adapted to cold, low-sunlight environments.

Plant properties:

  • Ruderalis are small, bushy plants which rarely grow taller than 30 centimetres, but they grow rapidly and can be ready for harvest in little more than a month from the time of planting.

Cannabinoid balance: 

  • Ruderalis typically contains very little THC and somewhat higher amounts of CBD, but it does not contain enough of either cannabinoid to produce any noticeable effects.

Most commonly associated effects: 

  • Because of its low potency and cannabinoid content, ruderalis isn’t typically used for medicinal or recreational purposes on its own. It may, however, be bred with other cannabis types because it is affordable and yields large quantities.

Which strain is right for me? 

The best way to find the strain that works for you and your symptoms is to get a valid prescription from a licensed healthcare professional. A doctor who is well versed in medicinal cannabis and cannabinoid medicines will be able to find a treatment type that works for you, while taking all of your individual needs as well as available strain types, cannabinoid and terpene content, formats, and delivery methods into consideration. 

It’s important to note that cannabis grown or obtained without a prescription is illegal in all states in Australia, except the ACT. And, because non-prescription cannabis is unregulated in Australia, it is highly likely that your therapeutic needs won’t be met by the cannabis you purchase without a prescription. Learn more about illegal v. legal cannabis in Australia here. A medicinal cannabis prescription from a qualified doctor is the best way to ensure the safety, quality, efficacy and cannabinoid and terpene content of your cannabis medicines for optimum results.

FAQs 

Should I smoke indica for anxiety?

While indica strains are most commonly associated with relaxing effects, there is little evidence to suggest that this is due to their strain-type alone. In fact, research now suggests that most strains are hybrid, containing both indica and sativa lineages. The plant compounds, cannabinoids and terpenes are the best indicators for the effects your cannabis will have on symptoms like anxiety. If you are looking to reduce anxiety, an expert doctor can help you find a cannabis treatment with the right cannabinoid and terpene content for you and your symptoms.

Smoking is not supported by the TGA, and comes with a long list of health risks. Learn about some of the other methods available for consuming medicinal cannabis to get the most out of your treatments here.

What is stronger indica or sativa? 

In terms of their intoxicating or psychoactive effects, sativa strains are said to be ‘stronger’ than indica strains because of their high THC content. THC is a psychoactive, intoxicating cannabinoid which produces the ‘high’ commonly associated with cannabis use, and it can be impairing and cause adverse side effects at higher doses. Want to know how long cannabis' stay in your system? Read our 'How long does cannabis stay in your system?' article to find out more.

What happens if you mix indica and sativa strains?

If you take different strains of cannabis together at the same time, you will alter the effects of your cannabis – much like a hybridised strain. If you are prescribed two different strains or types of cannabinoid medicines, your doctor will likely have prescribed the specific strains for varying, specific uses, or to take at different times in the day. Talk to your doctor about the best time to take them and whether they are safe to be taken together or close together. 

Experimenting with or taking too much of either of your cannabis strains could result in negative effects, so it’s best to only consume your cannabinoid medicines as advised by your doctor.

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How medicinal cannabis can be consumed

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How medicinal cannabis can be consumed

Medicinal cannabis (historically also known as ‘marijuana’) can be delivered to the body in a number of ways, depending on your individual needs as a patient. 

When consuming medical cannabis, different methods and the site of absorption will impact how the compounds are absorbed, distributed, and metabolised by the body, altering your body’s response to them. This means that the medical cannabis format selected will have varying effects on the duration, strength and quality of your experience. 

Let’s look at five different ways to consume medical cannabis:

  1. Inhalation (including vaping and smoking methods)
  2. Ingestion
  3. Sublingual
  4. Topical
  5. Suppositories

Inhalation

There are two different ways to consume medicinal cannabis via inhalation — smoking and vaporising — both of which produce rapid onset and similar effects. 

In medicinal contexts, vaping is preferable to smoking cannabis because it reduces the amount of undesired hydrocarbons being absorbed into the body while also alleviating the need for tobacco, which can lead to addiction and other serious health issues. Vaping is considered the healthier alternative to smoking for medical patients as it also allows for a more precise dose to meet the therapeutic needs of a patient, given that less of the THC dose is lost in side stream/combustion. Smoking is not a recommended delivery method for medical cannabis.

Vaping

Vaping is the process of heating the medicinal cannabis plant or cannabis extracts at high heat without burning it, allowing cannabinoids and terpenes to be released in the form of a vapour, which is then inhaled. Inhalation delivery methods, like vaping, allow cannabinoids to be absorbed directly into the bloodstream through the lungs, making this the preferred method for patients who require rapid relief of symptoms.

Pros of vaping cannabis

Some of the benefits of vaping instead of smoking flower, include:

  • Rapid onset and fast relief – first effects occur within 90 seconds and reach a maximum after 15 to 30 minutes before wearing off after 2–3 hours. Useful for symptoms and conditions where immediate relief is required.1
  • Higher concentrations of active ingredients – vaporising heats the cannabis without burning it2, which maintains the concentrations and quality of the active ingredients like cannabinoids and terpenes3. This allows you to better absorb cannabinoids and other active ingredients.
  • Temperature control – patients can control the temperature of their vaporiser to achieve desired benefits based on the boiling points of their cannabis medicine’s ingredients, including cannabinoids and terpenes.
  • Potential reduction in overall consumption – enhanced cannabinoid and terpene uptake, reduced cravings due to no tobacco, and the ability to easily pick up and put down the vaporiser as needed allows patients to use less cannabis flower than they would need to use when smoking. This reduces the amount of medication needed and saves the patient money over time.
  • Less carcinogens and safer than smoking flower
  • Decreased respiratory symptoms compared with smoking4
  • Drastic reduction in pyrolytic smoke compounds compared with smoking5
  • Legal in public smoking areas with a prescription
  • It is the only inhalation method approved for medicinal cannabis consumption by the TGA
  • More discreet than smoking – vaping is easier to conceal than smoking and does not release as strong a smell due to the cannabis being safely heated rather than burnt.

Cons of vaping cannabis

Although vaping cannabis – particularly with a TGA approved dry-herb vaporiser – is known to be safer than smoking, it can still come with health risks.

The negative health risks associated with vaping are often related to the use of illegally manufactured vape products6 and vape products with chemical profiles that are closer to that of e-liquids. Some of these health risks include:

  • EVALI: Potentially Fatal Lung Injury, as well as other health issues. The risk of damage increases significantly if your vape product contains a chemical called vitamin E acetate, which is not present in medically approved vaporisers.
  • Ingestion of harmful by-products, including microbial contaminants, toxic chemicals, carcinogens, and addictive substances like dextromethorphan which are often found in black market cannabis oils, unapproved vape pens, cartridges and e-liquids. 
  • Vaporiser injuries from unapproved vapes can also range from burns to accidental liquid ingestion and a lung disease known as 'popcorn lung.' 
  • Lung injuries
  • Heart issues

Patients who have an underlying condition which affects the lungs or airways, such as asthma or chronic obstructive pulmonary disease, may be advised against using a vaporiser to consume medicinal cannabis. In these cases, the doctor may prescribe a treatment to be taken sublingually or orally.

To be safe and effective, prescribed cannabis flower should be vaporised using a TGA-approved dry-herb vaporiser within the correct temperature range as advised by your prescribing doctor. While these vaporisers can be more expensive than non-medical-grade vaporisers, they are known to have significantly less health risks.

Learn more about vaping by heading to our Ultimate Guide to Vaping Medicinal Cannabis article or browse TGA-approved medical cannabis vaporisers at Shop Polln.

Talk to your doctor before using a vaporiser with your prescribed medicinal cannabis treatments and only use your treatments and vaporiser as advised.

Smoking

Although smoking is the oldest and most common way to consume for non-medical cannabis users, it is not recommended for medical cannabis patients due to the health risks and the variability and unpredictability of each individual’s response. Some common smoking methods include use of rolling paper or smoking devices such as pipes or bongs. Other consumption methods are recommended and considered healthier alternatives for medical patients such as ingestion, sublingual or vaping methods. In fact, prescribed medicinal cannabis is consumed predominantly via oral routes, with an estimated 71% of patients opting for this method in Australia.7

Here are some things to consider when it comes to smoking methods:

  • At least 40% of the THC dose in cannabis is lost in side stream/combustion when smoking, making it difficult to estimate the amount of THC content a patient is receiving.8
  • Cannabis smoke, like tobacco smoke, is associated with increased risk of cancer, lung damage, and poor pregnancy outcomes9. It can also inflame and irritate your respiratory system due to exposure to heat, burned organic matter and carbon monoxide.
  • If you smoke cannabis in combination with tobacco, you are increasing your risk of many health conditions and diseases including cancer, heart disease and chronic respiratory conditions10.
  • Smoking cannabis is not supported by the TGA.
  • Smoking cannabis is less discreet than vaping as cannabis smoke has a distinct smell. It's also not an approved way to consume cannabis in public smoking areas – even with a valid prescription.
  • Smoking cannabis with tobacco is more likely to lead to addiction and dependence, which can cause patients to use more cannabis than required. This is primarily due to nicotine – the addictive substance found in tobacco – and not the cannabis itself. 
  • You may need to use more of your cannabis treatment to achieve the same results as you would with vaporising, due to cannabinoids and active ingredients being lost in combustion. This increases the costs of your medication over time

Ingestion

Ingestion methods of cannabis consumption include any medicinal cannabis treatment that is consumed orally – such as edibles, tinctures, oils, capsules and extracts. While the effects of cannabinoid medicines will take longer to kick in when taken orally, they will also last longer1. This makes them ideal for medical conditions or symptoms where control over longer periods of time is required, similar to other types of slow release medication. In a 2022 study of 1600 participants, oral consumption was the most common method for medicinal cannabis use (72%) in Australia7.

When ingesting medicinal cannabis, cannabinoids are absorbed through your digestive system and gastrointestinal tract before metabolising in the liver, resulting in slightly varying medicinal properties and both stronger and longer lasting effects than other methods. Oral medicinal cannabis treatments can come in the form of tinctures, oils, capsules, lozenges or sprays. Cannabis-infused edibles – such as gummies, cookies, candies, drinks, and more – are another popular ingestion method for cannabis, however, there are limited edible medicinal cannabis treatments currently available in Australia.

Pros of ingestion

  • No risk to lung health
  • Ability to manage dose in exact measurements
  • Can be consumed discreetly 
  • Effects last longer than other methods (4 to 12 hours)

Cons of ingestion

  • It may take 30 minutes to two hours1 to feel the full effects from ingested cannabis, however some patients may find this to be an advantage due to convenience and longer duration of effects.
  • When ingesting a treatment that contains THC, there is a potential for a second spike of psychoactive effects when the THC is metabolised in the liver after initial effects, which may be unwanted or unexpected. 

Sublingual

The sublingual method of medical cannabis delivery involves placing the treatment under the tongue, a consumption method which allows active ingredients to be absorbed directly into the blood vessels of your tongue, bypassing the digestive system. Treatments taken sublingually can come in the form of cannabis oil, tinctures, lozenges, tablets, sprays, wafers and more.

Patients who use this delivery method will place their sublingual cannabis medication under their tongue so that the mouth's mucus membranes – similar to those in the lungs – absorb the consumed cannabis into the bloodstream. 

Because this method allows the active ingredients in cannabis to bypass the digestive system, its bioavailability is higher than that of edibles and other ingestible cannabis treatments, allowing for faster onset and higher concentrations of cannabinoids. 

Pros of sublingual

  • Faster onset of effects than ingestion methods (typically 15 to 40 minutes)11
  • No risk to lung health
  • Ability to manage dose in exact measurements
  • Can be consumed discreetly 
  • Sublingual oils and tinctures have a longer shelf life and are easier to store than cannabis flower, edibles and other treatments (low risk of degradation of cannabinoids and other compounds when stored in correct temperature)

Cons of sublingual

  • Some patients may find sublingual administration slightly more inconvenient than ingestion or inhalation methods, due to having to hold the treatment under the tongue for approximately 1 minute or more
  • Depending on your treatment, you may not enjoy the taste of the treatment under your tongue

Topical

In this method, the medical cannabis products are applied directly to the skin, penetrating only the top layers of skin and providing localised relief from inflammation, pain, skin irritations and more. This is one of the most discreet ways of consuming cannabis.   

Medicinal cannabis topicals come in a variety of forms, including balms, lotions, creams, salves and transdermal patches. Topical CBD skin creams in particular have shown promise in treating symptoms of skin conditions like acne, psoriasis and eczema12, arthritis13, neuropathy pain14 and jaw pain15 in some patients.

For most topical application, cannabinoids react with receptors under the skin but do not reach the bloodstream. Transdermal patches however, are one method designed to slowly release cannabinoids into the bloodstream over a longer period of time, usually producing effects within 15 minutes.

There is clinical evidence suggesting the beneficial effects of topical cannabinoids (especially CBD) in treating a range of skin conditions16. However much more research is needed in this area.

Pros of topicals

  • Ideal for localised relief
  • Non-impairing – even when a topical treatment contains THC, the THC does not penetrate blood vessels meaning topical treatments are unlikely to be psychoactive (won’t get you high)
  • Minimal side effects
  • No dose limitations (can be applied multiple times a day)
  • Easy to use
  • Very discreet

Cons of topicals

  • Effects are localised to specific area
  • May require continued application if symptoms persist (more than once a day)
  • The transdermal patch may be visible depending on the area that requires treatment

Medicinal Cannabis Suppositories

Suppositories offer a targeted dose of cannabinoids to a localised area that can help facilitate higher absorption rates in the body. Suppositories are particularly useful for those suffering from ailments related to the mid-lower region of the body, including pelvic inflammatory diseases, inflammatory bowel syndrome, Crohn’s disease, endometriosis and more. In this method, medicinal cannabis is provided in a solid form to be inserted into the rectum or vagina. Medical cannabis oil suppositories have one of the greatest absorption rates of all delivery methods, producing effects within 10 to 15 minutes for rectal administration. Unfortunately, medical cannabis suppositories are currently not available in Australia, but we hope that in the near future, more and more novel cannabis products with therapeutic benefits such as this are made available to Australian patients.

Pros of cannabis suppositories

  • Provides localised relief from symptoms
  • Great alternative for those who cannot or prefer not to take ingestible, sublingual or inhaled cannabis-based medications, due to age, medical condition, chemotherapy-induced nausea and vomiting, difficulty swallowing or personal preference
  • Fast onset of effects
  • Long duration of effects (peak effects felt within 2–8 hours with overall duration of about 8 hours)18
  • Generally safe and well tolerated
  • Unlikely to produce a ‘high’ sensation

Cons of cannabis suppositories

  • Some patients may find this delivery method uncomfortable or invasive
  • Mainly provides relief to a certain area, may not be suitable for relieving generalised symptoms like anxiety
  • Patients need to be mindful of the ingredients in the solid, oil-based holder used to contain the cannabis medicine incase of allergy or sensitivity
  • Patients also need to be mindful of hygiene and sensitivity in areas where the suppository is inserted to avoid health issues like yeast infections

Medically approved ways to take cannabis in Australia

Consuming medicinal cannabis via vaporisation (with a TGA approved vaporiser), ingestion, sublingual methods and suppositories are all approved methods for consumption in Australia with a valid prescription. Always follow the advice of your prescribing doctor when selecting the way you wish to consume cannabis - as well as the dosing and administration instructions provided in your prescription or on your treatment packaging.

What is the best way for me to consume medicinal cannabis?

While there are many different ways to consume cannabis medication, it’s important to note that not everyone experiences these medicines in the same way. What works best for one patient may not necessarily be the ideal method for you. Individual endocannabinoid systems, tolerance levels and other biological factors vary from person to person, so it’s important to try and find out which consumption methods work best for you with the support of your doctor.