Journal of Cannabis Therapeutics (ISSN: 1529-9775)

Volume: 4 Issue: 1
2004
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CONTENTS (View as Adobe Acrobat PDF, HTML, Text)

Article: EDITORIAL
Page Range: 1 - 6
DOI: 10.1300/J175v04n01_01
Ethan Russo MD
Article: Cannabis Vaporizer Combines Efficient Delivery of THC with Effective
Suppression of Pyrolytic Compounds
Page Range: 7 - 27
DOI: 10.1300/J175v04n01_02
Dale Gieringer, Joseph St. Laurent, Scott Goodrich

Cannabis vaporization is a technology designed to deliver inhaled cannabinoids

while avoiding the respiratory hazards of smoking by heating cannabis to a
temperature where therapeutically active cannabinoid vapors are produced,
but below the point of combustion where noxious pyrolytic byproducts are
formed. This study was designed to evaluate the efficacy of an herbal vaporizer
known as the Volcano®, produced by Storz & Bickel GmbH&Co. KG, Tuttlingen,
Germany (http://www.storz-bickel.com). Three 200 mg samples of standard
NIDA cannabis were vaporized at temperatures of 155°-218°C. For
comparison, smoke from combusted samples was also tested. The study
consisted of two phases: (1) a quantitative analysis of the solid phase of the
vapor using HPLC-DAD-MS (High Performance Liquid Chromatograph-Diode
Array-Mass Spectrometry) to determine the amount of cannabinoids delivered;
(2) a GC/MS (Gas Chromatograph/ Mass Spectrometer) analysis of the gas
phase to analyze the vapor for a wide range of toxins, focusing on pyrene and
other polynuculear aromatic hydrocarbons (PAHs). The HPLC analysis of the
vapor found that the Volcano delivered 36%-61% of the THC in the sample, a
delivery efficiency that compares favorably to that of marijuana cigarettes. The
GC/MS analysis showed that the gas phase of the vapor consisted
overwhelmingly of cannabinoids, with trace amounts of three other
compounds. In contrast, over 111 compounds were identified in the combusted
smoke, including several known PAHs. The results indicate that vaporization
can deliver therapeutic doses of cannabinoids with a drastic reduction in
pyrolytic smoke compounds. Vaporization therefore appears to be an attractive
alternative to smoked marijuana for future medical cannabis studies.
Keywords: Marijuana, cannabis, vaporization, smoking, harm reduction

Article: Clinical Pharmacodynamics of Cannabinoids

Page Range: 29 - 78
DOI: 10.1300/J175v04n01_03
Franjo Grotenhermen MD
 Our knowledge of the pharmacodynamics of cannabinoids, that is, “the study
of the biochemical and physiologic effects of drugs and their mechanisms of
action” (The Merck Manual), has considerably increased within the past decade
due to the detection of an endogenous cannabinoid system with specific
receptors and their endogenous ligands. THC (Δ9-tetrahydrocannabinol), the
main source of the pharmacological effects caused by the use of cannabis
including the medicinal benefits of the plant, is an agonist to both the CB1 and
the CB2 subtype of these receptors. Its acid metabolite THC-COOH (11-nor-9-
carboxy-THC), the non-psychotropic cannabidiol (CBD), analogues of these
natural compounds, antagonists at the cannabinoid receptors and modulators
of the endogenous cannabinoid system are also promising candidates for
clinical research and therapeutic uses. Cannabinoid receptors are distributed in
the central nervous system and many peripheral tissues (spleen, leukocytes;
reproductive, urinary and gastrointestinal tracts; endocrine glands, arteries
and heart, etc.). Additionally, there is evidence for non-receptor dependent
mechanisms of cannabinoids. Five endogenous cannabinoids, anandamide, 2-
arachidonylglycerol, noladine ether, virodhamine, and NADA, have been
detected. There is evidence that besides the two cannabinoid receptor
subtypes cloned so far, additional cannabinoid receptor subtypes and vanilloid
receptors are involved in the complex physiological functions of
endocannabinoids that include, for example, motor coordination, memory
procession, pain modulation and neuroprotection. Strategies to modulate their
activity include inhibition of re-uptake into cells and inhibition of their
degradation to increase concentration and duration of action. At doses
exceeding the psychotropic threshold, ingestion of exogenous CB1 receptor
agonists or cannabis, respectively, usually causes an enhanced well-being and
relaxation with an intensification of ordinary sensory experiences. The most
important potential adverse acute effects caused by overdosing are anxiety
and panic attacks, and with regard to somatic effects, increased heart rate and
changes in blood pressure. Regular use of cannabis may lead to dependency
and to a mild withdrawal syndrome. The existence and the intensity of possible
long-term damages on psyche and cognition, immune system, fertility and on
pregnancy remain controversial. They are reported to be low in humans and do
not preclude a legitimate therapeutic use of cannabis based drugs. Properties
of cannabinoids that might be of therapeutic use include analgesia, muscle
relaxation, immunosuppression, anti-inflammation, anti-allergic effects,
sedation, improvement of mood, stimulation of appetite, anti-emesis, lowering
of intraocular pressure, bronchodilation, neuroprotection and antineoplastic
effects.
Keywords: Cannabis, THC, cannabinoids, marijuanam pharmacodynamics,
cannabinoid receptors, endocannabinoids, mechanism of action, therapeutic
use, therapeutic potential, side effects, interaction

Article: Cannabis as a Substitute for Alcohol: A Harm-Reduction Approach

Page Range: 79 - 93
DOI: 10.1300/J175v04n01_04
Tod H. Mikuriya MD

Ninety-two Northern Californians who use cannabis as an alternative to alcohol

obtained letters of approval from the author. Their records were reviewed to
determine characteristics of the cohort and efficacy of the treatment, which
was defined as reduced harm to the patient. All patients reported benefit,
indicating that for at least a subset of alcoholics, cannabis use is associated
with reduced drinking. The cost of alcoholism to individual patients and society
at large warrants testing of the cannabis-substitution approach and study of
the drug-of-choice phenomenon.
Keywords: Addiction, alcohol, alcoholism, cannabis, depression, drug-of-
choice, harm reduction, marijuana, pain