AHG Advanced Webinar Intensives Presents:

“Cannabis: Ancient Medicine, Modern Marvel”

Jessica Baker, LAc, RH (AHG)

Hosted by Michele Marlow

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PRESENTED BY JESSICA BAKER LICENSED ACUPUNCTURIST,

DIPL. O.M., RH (AHG)

BAKER BOTANICA

W H E N E N E R G Y F L O W S , W E L L N E S S G R O W S

Phytocannabinoids: Beyond THC

Webinar 2: Phytocannabinoids Outline

I. Cannabis throughout History II. Taxonomy III. Phytocannabinoids a. THC b. CBD c. CBG d. CBC e. CBN IV. Synergy

I. Cannabis throughout History

Cannabis Revolution

�  Late Pleistocene (11,700 years ago)- human settlements evolve along fresh water rivers as once uninhabitable areas are no longer under ice

�  Neolithic Revolution (10,000 BC)- humans become active producers of their own food supply

�  Cannabis was one of the earliest cultivated plants in some regions of Eurasia, especially Central Asia

�  Very early on cannabis was selected for desired use of farmer-fiber, food-seed, euphoria

�  Disruptive selection- plants selected for their extreme traits- example: short internodes and many branches

Spiritual Uses

Central Asia

�  Used by the Scythians in ritual to cure the sick and send the deceased to the next world

�  Pots and charcoal with remains of Cannabis leaves and seeds dated between 500-300BC

�  Massagetae, a nomadic tribe, may have used cannabis for ecstatic purposes

�  One of the Thracian tribe, Getae, were followers of Kapnobatai, interpreted as “walk in the smoke clouds”

India & Nepal

�  The Vedas- ancient Hindu scripture �  Book XI of the Atharavaveda refers to cannabis as the sacred

grass, along with four other plants that may free us from distress �  Gods sent “bhang” to Earth out of compassion for the human race

so they could have delight, lose fear, and excite their sexual desires

�  Sadhus- holy worshippers of Shiva, consume copious amounts of bhang and ganja

Ancient Egypt

�  By the time of Ramses III (1217-1155 BC), hemp was ground with celery and left in the dew overnight as a treatment for the eyes. The patient was to wash out both eyes with the mixture early in the morning.

�  During the 1st century, leaves of hemp were used in oil to treat inflammation.

�  Hemp was pounded in honey and administered to the vagina as a remedy to cool the uterus.

�  An Ancient Egyptian Herbal by Lisa Manniche

Europe/UK

�  In Culpeper’s Complete Herbal (1653) he doesn’t even bother to give a description of the hemp plant stating “it is so common a plant, and so well known by almost every resident of this kingdom, that a description of it would be altogether superfluous.

�  Seeds boiled in milk- cough remedy �  Emulsion of seed- jaundice; “opens obstructions of the gall

and causes digestion of choler” �  Also eases colic, allays the troublesome humours of the

bowels, stops bleeding of mouth, nose, etc �  Decoction of root- stops inflammations, eases pain of gout

and knots on the joints, hip pain �  Fresh juice mixed with oil and butter- cure for burns

Cannabis in Chinese Medicine

Cannabis in Chinese Medicine

�  One of the first cultivated plants in Southeast Asia

�  Known to be cultivated for at least 10,000 years

�  Shen Nong (Divine Farmer) taught the cultivation of cannabis, agriculture and animal husbandry

�   Referenced in Shen Nong Ben Cao Jing, which may have been compiled around 200 CE

�  By 2nd century physicians mixed cannabis with wine to give to patients pre-surgery to dull pain

Classical Cannabis

�  Ma Gu- “Auntie Hemp”, “Hemp Damsel,” “Hemp Lady”- rare personification of cannabis who was revered during 4th and 5th centuries by the Daoist sect of the Highest Clarity School of Mao San Mountain.

�  In that area feral hemp grows said to be the result of pilgrim tossing hemp seed while asking Ma Gu for health and longevity.

�  In Needham’s translation of the text Mingyi Bielu (5th century CE), he states that it is written that “hemp seeds are very little used in medicine, but the shamans say that if one consumes them with ginseng it will give one preternatural knowledge of events in the future.”

Ancient & Modern Uses in Chinese Medicine

�  Ma Fen (Ma Bo)- acrid and balanced (LU, ST, SP) �  Treats the 7 damages (joy, anger, anxiety, pensiveness, grief,

fear, fright), disinhibits the five viscera, precipitates the blood and cold qi.

�  Taking too much may make one behold ghosts and frenetically run about.

�  Protracted taking may enable one to communicate with the spirit light and may make the body light.

�  Huo Ma Ren- sweet and balanced (ST, SP, LI) �  supplements the center and boosts the qi. Protracted taking

may make one fat, strong and never senile. �  Modern uses: relax the spleen, moisten dryness, promote

lactation, hasten delivery, disinhibit urination and defecation

II. Taxonomy

It’s not what you think it means

The Myth of Sativa and Indica

�  Commonly Held Belief:

�  Sativa- tall with narrow leaves; invigorating, uplifting cerebral effect �  Indica- stout with broad leaves; physically sedating

�  Actual Reality:

�  Revised hypothesis- C. indica includes the vast majority of biotypes and C. sativa includes only European hemp

�  What we cultivate and consume in North America today are hybrids of NLD cannabis and BLD hashish cultivars

�  The effects elicited by cannabis are a combination of cannabinoids, terpenes, environment, and emotional, mental, physical, and spiritual state of person

Cannabis Biotypes (based on Hillig 2005)

Acronym & Biotype Binomial Early Range Uses

PA- Putative Ancestor

C. ruderalis Northern Central Asia

Possible- seed and crude fiber

PHA- Putative Hemp Ancestor

Unrecognized or Extinct Balkan peninsula Caucasus Mtns

Possible- seed and crude fiber

NLHA- Narrow leaf Hemp Ancestor

C. sativa ssp. spontanea Eastern Europe Central Asia Seed and crude fiber

NLH- Narrow leaf Hemp C. sativa ssp. sativa Europe Seed and textile fiber

PDA- Putative Drug Ancestor

Unrecognized or Extinct Hengduan Mtns Yungui Plateau

Possible ritual and medicinal

BLHA- Broad leaf Hemp Ancestor

Unrecognized or Extinct Eastern Asia Possible seed and crude fiber

BLH- Broad leaf Hemp C. indica ssp. chinensis China, Korea, Japan, Southeast Asia

Seed and textile fiber

NLDA- Narrow leaf Drug Ancestor

C. indica ssp. kafiristanica Himalayan Foothills- Kashmir to Myanmar

Euphoria- hashish, “marijuana”

NLD- Narrow leaf Drug C. indica ssp. indica South & SE Asia, Middle East

Euphoria- hashish, “marijuana,” fiber, seed

BLD- Broad leaf Drug C. indica ssp. afghanica N. Afghanistan, Pakistan Euphoria- hashish

III. Phytocannabinoids

Phytocannabinoids

�  Phytocannabinoids are cannabinoids that are present in the cannabis plant; non-nitrogen-containing terpenophenols

�  Over 100 phytocannabinoids have been identified in cannabis

�  The most researched phytocannabinoids: �  THC �  CBD �  CBG �  CBC �  CBN

Phytocannabinoid Subclasses

�  Cannabigerols (CBG) �  Cannabichromenes (CBC) �  Cannabidiols (CBD) �  Tetrahydrocannabinols (THC) �  Cannabinol (CBN) �  Cannabinodiol (CBDL) �  Cannabicyclol (CBL) �  Cannabielsoin (CBE) �  Cannabitriol (CBT) �  Cannabivarin (CBV) �  Tetrahydrocannabivarin (THCV) �  Cannabidivarin (CBDV) �  Cannabichromevarin (CBCV) �  Cannabigerovarin (CBGV) �  Cannabigerol Monoethyl Ether (CBGM)

CB1 & CB2 Receptor Sites

CB1 Receptor Sites CB2 Receptor Sites

Brain Bones

Liver Liver

Lungs Spleen

Pancreas Pancreas

GI Tract

Muscles

Reproductive Organs

Circulatory System

THC

Delta-9-Tetrahydrocannabinol

�  There are 9 THC related cannabinoids �  THCA is non-psychoactive and found in the

raw plant �  THCA converts to THC when heated �  Delta-9- tetrahydrocannabinol (THC) is the

component in cannabis that elicits the euphoric yet sometime uncomfortable “high” that occurs with the ingestion or inhalation of cannabis.

�  Stimulates CB1 receptors throughout CNS and body

THC Metabolism

�  The main organ that metabolizes THC is the liver, although the lungs, intestines and other tissues play a role in biotransformation.

�  For THC alone scientists have identified more than 100 metabolites, making the metabolic pathway of cannabinoids very complex.

Therapeutic effects of d-9-THC

�  Bronchodilation

�  Neuro-protective antioxidant for brain injuries and strokes

�  Anti-inflammatory without COX 1 or Cox 2 inhibition

�  Muscle relaxation

�  Anti-emetic

�  Reduces b-amyloid plaques that are found in Alzheimer’s

�  Antibacterial

d-9-THC Research

�  The appetite stimulating effects of THC was confirmed in a long-term study of 94 AIDS patients. Of the patients that completed the trial, 25% achieved a weight gain of 2kg or more during the 12-month period (Beal, et al., 1997)

�  Oral THC was more effective than placebo against cancer pain in doses of 15mg and 20 mg, although some participants reported intolerable side effects with these doses (Noyes, et al., 1975)

�  A clinical trial of inhaled cannabis for neuropathic pain showed that low potency (3.5% THC) and high potency (7% THC) cannabis had equivalent analgesic properties (Wilsey, et al., 2008)

�  Knowing that higher THC percentages are not necessary for pain reduction is significant since THC can induce uncomfortable feelings for some patients.

THCV

�  Tetrahydroannabinvarin

�  Low dose is not psychoactive, but higher doses are

�  Powerful antagonist at CB1 receptor (Pretwee, et al., 2004) �  Anxiolytic �  Potential treatment for metabolic syndrome- regulation of blood

glucose levels and reduction of insulin resistance �  Appetite suppressant �  Stimulates bone growth �  Anticonvulsant

CBD

Cannabidiol

�  There are 7 CBD-related cannabinoids

�  CBD is a negative allosteric modulator- decreases the affinity of the cannabinoid receptor for THC, which lessens the psychoactive effect of THC

�  Epidiolex is a CBD drug developed by GW Pharmaceuticals for the treatment of Dravet syndrome, and other severe treatment resistant childhood onset epilepsy syndromes.

Epidiolex Clinical Trials

CBD Research

�  Antibacterial- effective against MRSA (Appendino, et al., 2008) �  Anticonvulsant (Jones et al., 2010) �  Analgesic (Costa et al., 2006) �  Anti-anxiety (Russo et al., 2005) �  Cytotoxic against breast cancer (Ligresti et al., 2006) �  In studies by Jones, et al., 2010 and 2012, CBD shows anti-

seizure properties in vitro and in vivo and shows anti-convulsant effects in animal models of temporal lobe and partial seizures, respectively.

CBD & Neuroprotection

�  The neuroprotective antioxidant properties of CBD are well established and are found to be more potent than ascorbate (Vitamin C) or tocopherol (Vitamin E) (Hampson et al., 1998)

�  CBD could prove to be a protective agent against glutamate excito-toxicity associated with a head injury.

�  U.S. Health and Human Services patent on cannabinoids as antioxidants and neuroprotectants (US 6630507 B1; 2001).

More Benefits of CBD

�  The mechanism for CBD treating seizures is not fully understood but it is believed to be a combination of beneficial effects known as polypharmacology.

�  Many other properties have been attributed to CBD, including but not limited to bone stimulating properties, anti-anxiety and the reduction and prevention of the spread of pain.

�  As an auto-immune protectant, CBD antagonizes tumor necrosis factor which is present in auto immune disorders like rheumatoid arthritis.

�  Like capsaicin, CBD is a TRPV1 antagonist and contributes to pain reduction.

CBD dosage

�  What seems to be recommended is to start at the 0.1 mg/kg/day and gradually increase the dosage by small increments.

�  One clinician has observed in his patient population that an oral dose beginning as low as 0.1 mg cannabinoids/kg body weight/day is sufficient for symptom relief.

�  Others required 25 mg/kg/day for optimal benefit.

�  To date there is no standard dosage for specific conditions or age groups.

CBG

Cannabigerol

�  There are 6 CBG related cannabinoids �  CBG was the first cannabinoid identified �  CBG comes from CBGA, which is essential

for production of all other cannabinoids �  Antibacterial- MRSA �  Decreases intraocular pressure �  Inhibits uptake of GABA �  Reducing bladder contractions (THCV too)

CBC

Cannabichromene

�  There are 5 CBC related cannabinoids �  Binds poorly to cannabinoid receptors �  TRPV1 receptor activation, which can

increase levels of endocannabinoids (like anandamide) in the body

�  Useful to reduce sebum production in sebaceous glands

�  Anti-inflammatory and pain reducing �  Neurogenesis- promote growth of new

brain cells (THC and CBD)

CBN

CBN

�  Cannabinol is a very weakly psychotropic cannabinoid

�  Effect only measureable with intravenous application

�  Anti-convulsant �  Decreases heart rate without affecting

coronary blood flow �  Decreases intestinal motility �  Inhibition of platelet aggregation

.

IV. Synergy

Phytocannabinoid Synergy

� CBD decreases the psychotropic effects of THC- euphoria, paranoia, heart rate

� CBD decreases the THC actions on heart rate, respiration, and body temperature in rabbits, but enhanced THC analgesic properties in rats

� CBC has low analgesic effect in mice, but increased the analgesic action of THC

Terpenes

�  Terpenes may also play a role in the therapeutic and euphoric effects of cannabis.

�  We will discuss terpenes in depth in next weeks webinar

References

�  Cannabis, Evolution and Ethnobotany, Robert C. Clark and Mark D. Merlin

�  Cannabis and Cannabinoids, Pharmacology, Toxicology, and Therapeutic Potential, edited by Franjo Grotenhermen, MD and Ethan Russo, MD

�  Handbook of Cannabis Therapeutics, From Bench to Bedside, edited by Ethan Russo, MD and Franjo Grotenhermen, MD

�  Role of Cannabinoids in Pain Management, Russo & Hoffman, 2013

Stay in Touch

�  Website: jessicabakerlac.com or bakerbotanica.com �  Email: jessica@jadedragonacupuncture.com �  Facebook: Jessica Baker, LAc �  Instagram: baker_botanica_ �  Blog: www.jessicabaker.blog �  Podcast: The Herb Walk with Jessica Baker �  Book: Plant Songs: Reflections on Herbal Medicine

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