With the popularity of novel psychoactive substances (NPS), awareness about their potentially harmful effects is also increased.
The main drawback to the medical use of cannabis and THC synthetics is the potential for side effects and the lack of regulation and standardization of dosage and potency. While cannabis and THC synthetics are effective in treating various medical conditions, they can also cause side effects such as dizziness, drowsiness, dry mouth, and impaired coordination. In addition, because the FDA does not regulate these products like other prescription medications, there is often a lack of consistency in dosage and potency from one product to another, making it difficult for doctors to prescribe and patients to use these products safely and effectively. Finally, there is still a great deal of stigma and legal restrictions surrounding the use of cannabis, which can make it difficult for patients to access and use these products, even if a doctor has prescribed them.
Medical Cannabis
Cannabis was first used medicinally by ancient civilizations such as India and China, where it was known as “bhang” or “ganja.” Its medicinal properties were described in ancient texts dating back to 1500 BC. For example, the Hindu Charaka Samhita describes the benefits of smoking dried cannabis flowers for treating ailments like epilepsy, anxiety, depression, insomnia, and pain relief.
Modern medicine began using cannabis therapeutically in the late 19th century when its anti-nauseant property was discovered. Over time, scientists identified many other beneficial uses for cannabis, including treating glaucomas, HIV/AIDS, multiple sclerosis, cancer, and chronic pain.
In the early 20th century, cannabis extracts became available through pharmacies due to advancements in extraction techniques. However, with the introduction of synthetic THC analogs, which had higher potency than naturally occurring cannabis, people started abusing cannabis recreationally, leading to bans on its production and sale.
As scientific research progressed in the 1970s, several studies showed that cannabis could alleviate nausea and vomiting from chemotherapy treatments, improve appetite in AIDS patients, reduce seizures in epileptic children, and treat muscle spasms caused by multiple sclerosis. These findings led to renewed interest in medical cannabis, resulting in its legalization for medical use in certain countries worldwide.
Currently, some 33 countries worldwide allow the legal use of cannabis for medical purposes. Canada and Uruguay are among the few countries that have completely legalized cannabis for both medical and adult recreational use.
Schedule I Controlled Substances In The U. S.
The federal government defines schedules 1–5 as “controlled substances” under the Controlled Substances Act (CSA). Schedule I includes the most dangerous drugs, such as heroin and LSD. Schedule II contains slightly less hazardous drugs, such as cocaine and methamphetamine.
Schedule III includes drugs with less severe abuse potential, such as codeine and morphine. Schedule IV contains drugs with a lower risk of dependence and abuse, such as diazepam and meprobamate. Finally, Schedule V consists of medications with the lowest risk of abuse and addiction, such as caffeine and nicotine.
Under the CSA, all Schedule I drugs are illegal for any purpose without a special permit issued by the Drug Enforcement Administration (DEA) after careful consideration of the risks involved. Schedule II drugs require only a prescription from a licensed physician and may be dispensed only at specially designated pharmacies.
Schedule III drugs need no prescriptions but must be dispensed by pharmacists who work at “dispensing facilities.” Schedule IV drugs do not require prescriptions but must still be issued by pharmacists working at dispensing facilities.
Schedule II Controlled Substances In The U. S.
Schedule II drugs include many drugs commonly prescribed for conditions such as ADHD, migraines, and anxiety disorders. Some examples include Adderall, Ativan, Valium, Xanax, and OxyContin.
Schedule II drugs are generally considered safer than Schedule I drugs because they require physicians to prescribe them based on specific diagnoses. Also, unlike Schedule I drugs, Schedule II drugs may be legally obtained through a doctor’s prescription.
Schedule III Controlled Substances In The U. S.
Schedule III drugs are usually prescribed for short-term use and produce fewer side effects than Schedule I and II drugs. Examples include codeine, morphine, and oxycodone.
Schedule IV Controlled Substances In The U. S.
These drugs are often prescribed for long-term use, especially for conditions like chronic pain. Some examples include methadone, hydrocodone, and oxymorphone.
Schedule V Controlled Substances In The U. S.
These drugs are typically prescribed for short-term use and intended to help wean patients off more addictive Schedule II or Schedule III drugs. Examples include caffeine, nicotine, and alcohol.
Schedule VI Controlled Substances In The U. S.
These drugs are highly addictive and considered unsafe even for medically supervised use. They are primarily used in prisons and psychiatric hospitals. Examples include PCP and ketamine.
Schedule VII Controlled Substances In The U. S.
These drugs are used exclusively for scientific research and are extremely difficult to obtain. Only one Schedule VII drug exists, lysergic acid diethylamide (LSD).
Schedule VIII Controlled Substances In The U. S.
These drugs are used mainly for veterinary purposes. Examples include tramadol, oxytocin, and buprenorphine.
Schedule IX Controlled Substances In The U. S.
These drugs are used for limited legitimate purposes outside of the prison setting. Examples include alprazolam, clonazepam, and nabilone.
What Are Synthetic Cannabinoids?
Synthetic cannabinoids are chemical compounds designed to mimic the effect of tetrahydrocannabinol (THC), the primary active ingredient in cannabis. Unlike natural cannabis, however, synthetic cannabinoids contain little to no CBD found in cannabis plants.
This makes them much more potent and potentially more dangerous. Furthermore, the synthetic cannabinoids sold today differ significantly from the original designer molecules and thus vary widely in terms of safety and effectiveness.
One way to classify synthetic cannabinoids is into two groups: phytocannabinoids derived from cannabis and non-cannabinoid synthetic cannabinoids. Phytocannabinoids are natural cannabinoids produced by the cannabis plant itself, while non-cannabinoid synthetic cannabinoids originate from artificial sources. Both types of synthetic cannabinoids act on CB1 receptors located throughout the body, producing the same psychedelic effects as THC does.
While most synthetic cannabinoids sold today belong to the former category, recent reports indicate that newer non-psychoactive synthetic cannabinoids belonging to the latter group may pose serious health concerns. These so-called “designer drugs” are manufactured in clandestine labs and sold online, sometimes labeled as incense, potpourri, or bath salts.
Since they are chemically distinct from traditional cannabis, these new designer drugs cannot be detected with standard drug tests. As a result, users are unaware of the dangers posed by these drugs until they experience a life-threatening reaction.
Synthetic cannabinoids are frequently referred to by their brand names, such as K2, Spice, Kush, and Black Mamba. Other common names include Spice Gold and Spice Silver. Many of these brands offer a variety of products ranging from herbal blends to concentrated oils and powders.
Although synthetic cannabinoids were initially designed to avoid detection by law enforcement, they now account for nearly half of all illicit drug overdoses in the United States. A 2014 Centers for Disease Control and Prevention study reported that over 5,000 Americans died between 2002 and 2013 due to synthetic cannabinoid exposure.
Most deaths occurred due to intentional self-poisoning rather than accidental overdose. The U. S. National Institute on Drug Abuse estimates that more than 400 million people worldwide have tried synthetic cannabinoids. However, this figure is likely underestimated since many cases go unreported due to fear of criminal prosecution.
