Cannabis Sativa Extract
Also known as: Cannabis extract, hemp extract, marijuana extract, cannabinoid extract, phytocannabinoid extract, Cannabis sativa L. extract
Overview
Cannabis sativa L. extract is derived from the Cannabis plant and contains a complex mixture of cannabinoids (e.g., THC, CBD), terpenes, and flavonoids. It is primarily utilized for its medicinal properties, including pain management, anti-inflammatory effects, and symptom relief in conditions such as chemotherapy-induced nausea, multiple sclerosis-related spasticity, and chronic pain. The specific composition of the extract, particularly the ratio of psychoactive THC to non-psychoactive CBD, significantly influences its effects. While extensive research, including numerous clinical trials and systematic reviews, has been conducted, the findings can be heterogeneous due to variations in formulations, dosages, and patient populations. The overall quality of evidence ranges from moderate to low, often limited by factors such as small sample sizes, short study durations, and methodological inconsistencies.
Benefits
Cannabis sativa extract demonstrates moderate efficacy in managing chronic pain, neuropathic pain, and spasticity associated with multiple sclerosis. Meta-analyses indicate small to moderate effect sizes (SMD around 0.3 to 0.5) for pain reduction, suggesting modest but clinically significant benefits. It is also effective in reducing chemotherapy-induced nausea and vomiting, with some trials showing cannabinoids outperforming placebo. Patients with cancer-related symptoms, multiple sclerosis, and neuropathic pain conditions are most likely to benefit. Secondary benefits, though less consistently supported by evidence, include potential improvements in sleep quality and reductions in anxiety symptoms. Benefits are typically observed in the short to medium term (weeks to months), with long-term efficacy and safety data still limited.
How it works
The primary mechanism of action for Cannabis sativa extract involves its interaction with the endocannabinoid system, specifically targeting CB1 and CB2 receptors located throughout the central and peripheral nervous systems. THC acts as a partial agonist at CB1 receptors, leading to its characteristic psychoactive and analgesic effects. CBD, on the other hand, modulates receptor activity indirectly and exhibits anti-inflammatory and anxiolytic properties without inducing psychoactivity. The extract also influences other neurotransmitter systems, such as serotonin and opioid pathways, contributing to its diverse therapeutic effects. Bioavailability varies significantly by administration route; oral consumption results in low and variable absorption due to first-pass metabolism, while inhalation offers rapid onset of action.
Side effects
While generally considered safe under medical supervision, Cannabis sativa extract can cause common adverse effects, including dizziness, dry mouth, fatigue, somnolence, and cognitive impairment, reported in over 5% of users. Less common side effects (1-5%) include anxiety, paranoia, nausea, and increased heart rate. Rare but serious side effects (<1%) can include psychosis, dependence, and withdrawal symptoms with prolonged use. The extract can interact with other medications, particularly central nervous system depressants and drugs metabolized by cytochrome P450 enzymes. It is contraindicated in individuals with a history of psychotic disorders or severe cardiovascular disease. Special caution is advised for pregnant or breastfeeding women and adolescents due to potential neurodevelopmental risks.
Dosage
Recommended dosages for Cannabis sativa extract vary widely depending on the specific formulation, cannabinoid profile, and intended therapeutic use. In clinical trials, typical THC doses range from 2.5 to 20 mg per day, while CBD doses often fall between 100 and 600 mg per day. Optimal dosing requires careful titration to achieve a balance between efficacy and the management of potential side effects. Maximum safe doses are not definitively established, and higher doses generally increase the risk of adverse effects. Timing of administration depends on the indication; for instance, pre-chemotherapy dosing for nausea or daily dosing for chronic pain. The extract is available in various forms, including oils, capsules, inhaled products, and oromucosal sprays, each with distinct pharmacokinetic profiles. Absorption can be enhanced when consumed with dietary fats, and co-administration of different cannabinoids may produce synergistic effects.
FAQs
Is cannabis extract addictive?
Cannabis extract, particularly THC-rich products, has the potential for dependence, though the risk is generally lower than many other substances when used medically and under supervision.
Can it cause psychoactive effects?
Yes, extracts containing THC can cause intoxication and psychoactive effects. CBD-dominant extracts, however, are non-psychoactive and do not produce a 'high'.
How quickly do effects appear?
The onset of effects varies by administration route: inhaled forms typically act within minutes, while oral forms can take 30-90 minutes to produce noticeable effects.
Are there withdrawal symptoms?
Mild withdrawal symptoms can occur after prolonged heavy use of cannabis extract, particularly with high-THC products, if use is abruptly discontinued.
Is it legal?
The legal status of cannabis extract varies significantly by jurisdiction and depends on its cannabinoid composition, especially its THC content. Always check local regulations.
Research Sources
- https://jamanetwork.com/journals/jama/fullarticle/2338251 – This systematic review and meta-analysis by Whiting et al. (2015) analyzed 79 randomized controlled trials involving approximately 6000 patients. It found moderate evidence for the efficacy of cannabinoids in treating chronic pain, spasticity, and chemotherapy-induced nausea, while also noting common adverse events. The study utilized GRADE methodology, indicating high quality, but highlighted heterogeneity in cannabinoid types, doses, and outcomes across studies.
- https://pmc.ncbi.nlm.nih.gov/articles/PMC8216112/ – Nugent et al. (2017) conducted a systematic review and meta-analysis of 374 studies, including both animal and human data. The research identified significant antinociceptive effects with cannabinoids, reporting a standardized mean difference (SMD) of approximately 1.3 in preclinical models. While robust meta-analytic methods were used, the study acknowledged translational gaps between animal and human data, suggesting moderate quality.
- https://pmc.ncbi.nlm.nih.gov/articles/PMC7076827/ – Mücke et al. (2018) performed an evidence mapping of 44 systematic reviews across multiple conditions. Their findings suggest that cannabis and cannabinoids are probably beneficial for chronic pain and spasticity, but evidence for other indications was inconsistent. The study provided a comprehensive overview but noted overlaps of studies within the included systematic reviews and variable quality among them, indicating moderate overall quality.
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