The Cannabis Mode of Action

In pharmacology, the term mode of action refers to the specific biochemical interaction through which a drug substance produces its medicinal effect. So, an important question is, how can substances from the Cannabis plant help in combating different diseases; what is its mode of action? Scientific studies clearly show that endocannabinoids play an important role in keeping our bodies balanced, especially during a state of illness. One cannabinoid researcher described it in this way: the endocannabinoid system helps your body to “feel less pain, control your movement (spasms), relax, eat, forget (post traumatic stress), sleep and protect your nervous system”.

It has now been scientifically established that the cannabis plant produces substances called cannabinoids that can interfere with our endocannabinoid system. This interaction provides many opportunities for treating difficult diseases and for the development of new medicines. In other words, the endocannabinoid system presents a set of new pharmacological ‘locks’ that can be opened or closed with the help of natural or synthetic cannabinoids. This is exciting information, but it is not entirely unique; just think of the opiates (morphine, codeine etc.) that are produced by the poppy (opium) plant. These opiates interfere with our system of opioid receptors, which are part of our nervous system and are meant to help us deal with intense pain, danger and other forms of severe stress. Thanks to scientific study of the poppy plant we have access to potent painkillers and anesthetics that help us get through a surgery or severe accident. Thus, turning a narcotic plant into valuable medicine has been done before, and cannabis may follow the same way to modern medicine.

External cannabinoids, present in the cannabis plant, are able to interact with our internal endocannabinoid system and cause a variety of effects. However, cannabis is a potent medicine and may not be suitable for all patients. In some cases (depending on e.g. cannabis variety, dose and administration form), the effects may be therapeutic, while under other conditions unwanted effects may occur. When too much is consumed a state of intoxication will occur.

Although for some people this may be pleasant and even part of the therapeutic effect, concerns have been raised about the potential for long-term cannabis consumption to increase risk for schizophrenia, psychosis, bipolar disorders and major depression. In some way you could say that recreational users of cannabis are purposely overdosing a medicine, because they like the side-effects of it. By looking at the issue in this way, it may be easier to see the difference between medicinal use and the recreational use of cannabis.

The terpenes may be involved in all this in several possible ways: by helping cannabinoids to cross from the blood stream into the brain, or perhaps by changing the binding of cannabinoids to their receptors. Some terpenes also have their own effects, completely independent of the cannabinoid receptors. However, there are too many terpenes and too many different modes of action to discuss them all here. At present various studies have shown that whole plant preparations of cannabis often have a better medicinal effect than just THC alone. The way all the cannabis compounds work together to cause a medicinal effect is called synergy. More research is needed to fully understand how these interactions works.