The Endocannabinoid System (ECS) attracts a substantial number of scientists trying to study its effects on human systems and organs and find possible treatment solutions. Modern medicine raises questions about using external cannabinoids for the purpose of pain release, cancer cure, inflammation reduction, and smoothening epilepsy symptoms (Zou & Kumar, 2018). However, it is hard to estimate the exact effect of cannabinoids as the receptors of this system are disseminated in various organs and cells. Consequently, the interrelation of external cannabinoids, as well as all participants of ECS, are not fully researched yet, and such therapy might lead to some unwanted effects. To understand the effects of external molecules on ECS, it is essential to get more data about ESC itself and study various routes via which cannabinoids can reach the receptors. In this assignment, the specialties of ECS function and its cooperation with cannabinoids will be disclosed.
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Endocannabinoid System, Endocannabinoid Deficiency Syndrome, and the Effects of Cannabis
The Endocannabinoid system is mostly perceived as the one responsible for feelings of pleasure and satisfaction. However, due to recent research, ECS is a so-called homeostasis-responsible part of the nervous system that controls metabolism, appetite, digestion, mood, sleep, learning and memory, liver function, reproductive system function, bone remodeling and growth, and mechanisms of chronic pain and inflammation. These are one of many functions of ECD as it has receptors all over the human body. Two types of receptors, CB1, which is met in the central nervous system, and CB2, are found in the peripheral nervous system, predominantly in the immune system (Lu & Mackie, 2021). Endogenous cannabinoids are molecules transferring the signal from one neuron to another; they are called anandamide and 2-arachydonoylglycerol. These proteins are produced in ECD when some system or organ needs a special amount of them. Special enzymes break down these molecules when their effect has been realized in the synapse, and such enzymes are a part of SCD.
There is a concept claiming that in the basement of well-known pathologies such as migraine fibromyalgia, irritated bowel syndrome lays the insufficiency of mechanisms responsible for the synthesis of endogenous cannabinoids. The latter can be met in the literature as endocannabinoid deficiency syndrome. Some authors also involve in it sleep disorders, headaches, depression, and anxiety. This hypothesis is supported by the fact that phytocannabinoid cannabis helps release all the previously mentioned symptoms. There has not been enough evidence to claim that lack of cannabinoid production leads to pathologies, as it is hard to prove that other factors play an irrelevant role in the processes. However, according to some investigations, patients with migraine and Tourette syndrome had an increased level of endocannabinoids in cerebral fluid (Earlenbaugh, 2019). Further research can confirm or reject the role of the hypothesis in modern medicine and develop strategies allowing broadcast treatment possibilities.
Cannabis, also known as marijuana, is an ancient plant used in medicine for many centuries. Cannabis refers to the group of phytocannabinoids, which simply means cannabinoids found in plants. Cannabis is more popular in medical treatments than other phytocannabinoids, such as tetrahydrocannabinol (THC), which have an undesirable psychoactive effect. They can stimulate the same receptors CB1 and CB2 in the human body and lead to the same effects: pain release, anxiety, and depression management simplifying the burden of migraine and epilepsy symptoms. However, these external cannabinoids contained in plants are different from endogenous ones and altogether can impact ECS in a different, possibly toxic way (Amornyotin, 2020). Reports are claimed by the constant use of cannabinoids, the number of cannabinoid receptors can reduce in response (Amornyotin, 2020). The latter means that despite the legislation of cannabis in Canada, most of Europe, and the United States, the long-term effects of phytocannabinoids are still unknown.
Cannabis Delivery Routes for the Patients
The dosing and therapeutic form of a drug are important for a treatment effect. Depending on the amount and route delivery, the drug effect can occur in various periods. Additionally, the other drugs a patient takes can impact the absorption of the medication or get involved in a reaction of neutralization. That is why considering the delivery route before prescribing the patient is essential for any treatment. Cannabis can be taken via smoking or vaping, by oral ingestion, as a spray for application in the oral mucosa, and by rectal suppositories. Smoking is one of the most used methods of delivering drug effects to the brain. It is also considered one of the most efficient and fast as the smoke reaches lung vessels and gets absorbed in the blood flow. A faster way to get cannabis into the blood flow is to increase the period of smoke contact with oral and nasal mucosae so the absorption begins in these areas. The disadvantage of the method is the dependence of drug concentration on smoking specialties: the number of puffs, their duration, inhalation time, hold time and smoking habit in general. Consequently, various patients can get far beyond or not reach the therapeutic dose of the medicament, and the smoking route is not recommended for medical purposes.
Oral intake, on the contrary, has a certain number of active drugs in one pharmaceutical form. Nevertheless, the specialties of digestion, metabolism rates, and excretion impact the concentration of drugs in blood. Stomach pH and specialties of microflora can influence of bioavailability of the drug. Capsules that have an enteric breakdown can solve this issue and increase absorption. Oil products have shown better bioavailability than capsule forms, and it is the number one prescribed pharmaceutical form in Australia (Applied Cannabis Research, 2020). Compared to other methods of delivery, oral ingestion is not a route of choice when aiming for therapeutical benefits. Patients with a positive attitude to swallowing tablets than using other forms of the drug may find this method convenient and practical.
Oral mucosa sprays are more efficient regarding blood concentration effects. Oral and nasal mucosae, in general, have a high index of absorption and can be used for the fast delivery of a drug to circulation. The same method is used during smoking; however, the other form of a drug. Patients with an absence of smoking habits can find this method most suitable, and identifying the most convenient route for medication intake is essential for patient compliance. The other advantage of the method is the avoidance of liver blood flow and, consequently, the breaking down processes in it. Longer periods of drug concentration are significant for the times of applications per day and, again, patient compliance.
as little as 3 hours
Rectal suppositories showed maximum plasma concentrations and the most efficient bioavailability due to an increased net of vessels in this anatomic area. If the aim is to receive the fastest therapeutic effect, it should be a route of choice. Still, not all patients find it comfortable, especially if they have increased daily activity, do sports, or live in warm locations. Regarding THC, the psychotropic effects of the drug are neutralized if used rectally, and the physician can use this data to avoid unwanted side effects by changing the route of absorption.
Thus, the endocannabinoid system is a complicated structure that is responsible for body homeostasis and has effects on various systems and organs of the human body. ECS has not been fully studied yet, as well as phytocannabinoids that chemically have a different structure of mediators from human ones. The delivery routes of a drug containing cannabis are also important as they lead to the various duration of effects and suit patients differently.
Amornyotin, S. (2020). Cannabis and endocannabinoid system. Journal of Addiction Medicine and Therapeutic Science, 7(1), 4-6. Web.
Applied Cannabis Research. (2020). Medicinal cannabis: Routes of administration. Web.
Earlenbaugh, E. (2019). Clinical endocannabinoid deficiency: When does it happen and why? Physiology. Web.
Lu, H.-C., & Mackie, K. (2021). Review of the endocannabinoid system. Biological Psychiatry: Cognitive Neuroscience and Neuroimaging, 6(6), 607-615. Web.
Zou, S., & Kumar, U. (2018). Cannabinoid receptors and the endocannabinoid system: Signaling and function in the central nervous system. International Journal of Molecular Sciences, 19(3), 833. Web.