Introducing CBGV - should CBD and THC worry about their leadership?

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To say that the cannabis industry is growing is to say nothing. In two years, legal cannabis sales reached approximately $12.2 billion in 2018, that is almost a 50% increase of sales from 2016. This industry is growing like bamboo, breaking old rules, and changing the world around us without giving us any time to wake up and get used to such changes. The benefits of such deep penetration of cannabis in our usual life are numerous. Violent drug related crimes have seen a decline, alcohol consumption decreases and such long-awaited alternatives to opioid drugs have appeared on the horizon, causing a significant decline in opiate-related deaths. Advantages of the cannabis industry growth are impressive, and it’s not enough to just mention the health benefits provided by cannabinoids - the most promising compounds of the cannabis plant. However, each coin does have two sides, and the case with cannabis is not an exception. The first and quite severe problem is that of the legalisation of medicinal marijuana. Nowadays, marijuana, or cannabis has been legalised for recreational purposes in eleven states and the District of Columbia; also, for medical use only in twenty-two states in the USA.

However, despite the fact that during the 2016-2018 period seven states have legalised recreational marijuana usage, the federal government in the US still classifies it as a plant containing high potential for resulting in substance abuse with no accepted medical value, thus still having cannabis listed as a Schedule I substance. It significantly complicates global research, limiting the number of studies and trials catered to this issue. The lack of studies however, investigating medical cannabis health benefits, do not allow it to be a globally recognised drug and the use marijuana as a beneficial alternative to a range of medications is not permitted. Due to this, the federal government does not have enough arguments in favour of medicinal cannabis and finds nothing better than to include it to the list of prohibited substances again. Such a vicious circle prevents the global adoption of medical marijuana as a drug and delays the moment when it can be used for medicinal purposes for an incomprehensible period of time. Nevertheless, new studies, human and animal trials, and anecdotal evidence from patients using medical cannabis continue to reveal its new benefits and make scientists looking at the plant from different angles revealing new cannabis potential.

With such popularity of cannabinoids, more and more people nowadays get to know the mysterious cannabis plant. They decide to go further than just buy another THC-induced product to get high - they want to learn how it all works and why do we have these beneficial effects when taking cannabinoids. With more than enough advertising covering the cannabis industry, a lot of questions regarding this plant still remain unanswered. In the next paragraph, we decided to put all of them together and try to answer the most frequently asked question regarding medical marijuana, starting from the basic ones and to the issues at the state level.

FAQs about medical cannabis - what we need to know about this plant?

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Understanding the medicinal value and influence of cannabis within our body is vital if we are considering to consume it for therapeutic purposes.

To help you with your research, we have collected a bunch of frequently asked questions to help you learn more about cannabis:

Marijuana, hemp, and cannabis - is it the same thing?

Many of us don’t see the difference between cannabis, hemp and marijuana as they are often used interchangeably in many advertisements. However, this is an incorrect assumption to make.

The term “cannabis” always refers to the products that are derived from a type of plant known as Cannabis sativa, whereby this plant contains more than five hundred different chemicals.

As for “marijuana”, it refers to the part of the Cannabis sativa plant or its related products that contain substantial amounts of THC (tetrahydrocannabinol), which is notorious for its psychoactive properties.

However, it is also important to note that certain parts of the cannabis plant contain very low percentages of THC in their chemical composition. Under certain jurisdictions in the United States, such plants are called “industrial hemp” and are deemed to be safe for consumption.

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What are cannabinoids?

You probably would have come across the term “cannabinoid” in medical marijuana reviews and advertisements.

In essence, cannabinoids are a group of chemicals found in the cannabis plant. These chemicals are considered to have a wide range of different health benefits along with minimum side effects when consumed. In our world today, more than one hundred different cannabinoids have been identified in the cannabis plant, with research still ongoing.

The most well-studied cannabinoids are THC and CBD (cannabidiol). These two compounds are often used in a wide range of cannabis-infused products available today for the different diseases and conditions.

Does the FDA approve cannabis or cannabinoids for medical use?

Currently, the United States Food and Drug Administration (FDA) has not approved the use of cannabis and its associated chemicals for any medical use.

Nevertheless, several drugs containing individual cannabinoids have been granted the FDA’s approval, namely:

  • Epidiolex - This drug contains a purified form of CBD and received approval for the treatment of seizures associated with Dravet syndrome and Lennox-Gastaut syndrome, which rare and severe forms of epilepsy
  • Marinol and Syndros - These drugs contain Cesamet, which contains nabilone (a synthetic substance that is similar to THC), and dronabinol (a synthetic THC). Both of the drugs have received the FDA’s approval and are used for the treatment of chemotherapy-induced nausea and vomiting. In addition, Dronabinol is also known for its ability to treat weight loss and loss of appetite in patients with HIV/AIDS diagnosis
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If there is no FDA’s approval, is it legal for food products to contain CBD or THC?

Although the FDA hasn’t approved cannabis for medicinal use, they have allowed certain products containing THC and CBD to be sold as dietary supplements.

As its name suggests, a dietary supplement is a product that is intended to supplement a diet. The supplement is usually taken by mouth and contains one or several dietary ingredients such as herbs, vitamins, minerals, amino acids, or other substances that are beneficial for our health.

Even though a dietary supplement is always considered “natural”, it isn’t always safe for our body, so it is highly recommended to always read and follow the instructions carefully. Currently, foods with THC or CBD in their composition cannot be sold legally across states. However, such products can be sold legally within a state depending on state laws and regulations.

Are cannabinoids and cannabis safe for our health?

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Despite the various health benefits, there are still several concerns being raised about the safety of cannabinoid consumption.

Among the possible side effects and risks related to cannabis use are:

  • The deterioration in concentration
  • Potential substance abuse issues, which include symptoms such as withdrawal, cravings, and having a lack of control. According to statistics, adolescents using cannabinoids are up to seven times more likely to develop a cannabis-related substance abuse problem than adults
  • Orthostatic hypotension, whereby the individual would encounter symptoms like dizziness or a head rush. This may result in sustaining injuries from fainting or falling, especially amongst older people
  • The risk of developing schizophrenia or other severe mental illnesses, especially in people who are predisposed to these diseases
  • Serious lung injuries linked to cannabis vaping
  • Recurrent severe vomiting

For which people cannabinoids may be harmful?

There is evidence that CBD may be harmful to some consumers. Before Epideolex got the approval of the FDA, it was tested to evaluate its effectiveness and safety of use. During these studies, some patients had mild side effects, which included sleepiness and diarrhoea, while others had developed abnormalities of the liver function. In some cases, participants of the study even had to stop Epideolex taking due to the liver problems. Researchers have also revealed that Epideolex interacted with some of the other medications these people were taking. Nonetheless, such problems are limited today and can be managed as patients usually take Epideolex under proper medical supervision.

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In contrast to this, people using CBD oil or CBD-infused products don’t have such protection and are under the higher risk of adverse effects. In many cases, people who decided to take CBD without medical supervision may not even know the exact amount of CBD they are taking.

In 2017, 84 different CBD products were analysed to determine the percentage of cannabidiol in their composition. The results were shocking - 26% of the products contained substantially less CBD than was indicated on the label, while 43% contained significantly more.

To take on not to take - which diseases can be treated with cannabinoids?

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For many of us, the possibility of substituting the usual drugs with cannabinoids still remains controversial. Nevertheless, with the growing number of studies and research of cannabinoids in medicine, the scales are beginning to tilt in favour of cannabis and its medicinal effects within our body.

Positive results of the studies confirmed the health benefits of the cannabis compounds and revealed new effects these chemicals may have on the diseases.

In fact, scientists all over the world are actively studying medicinal cannabis to evaluate the whole spectrum of effects this plant can offer. To date, it is known that medications containing cannabinoids may be effective in the treatment of nausea and vomiting associated with chemotherapy as well as rare forms of epilepsy. In addition to this, these drugs can be helpful for such conditions as loss of appetite and weight loss associated with HIV/AIDS. Also, the growing number of studies confirms the benefits of cannabinoids for different types of pain, including chronic pain and multiple sclerosis.

Let’s consider what the research says about cannabinoids use for specific conditions.

Cannabinoids for anxiety

Today, there is a substantial amount of evidence from research and studies that cannabinoids might help to decrease anxiety. One of the studies investigated twenty-four people with a social anxiety disorder. The results of this research have shown that people who were given CBD had less anxiety in a public speaking test in comparison with participants who were given a placebo. Some studies have also confirmed that cannabinoids and CBD, in particular, may be helpful for reducing anxiety in people with chronic pain.

Cannabinoids for pain

Most of the studies held to research the effects of cannabinoids on pain were held to investigate its impact on chronic neuropathic pain. A review of sixteen studies which was held in 2018, evaluated the results of cannabis-based medications in patients with neuropathic pain. Most of the participants of the studies tested cannabinoids-infused medication called Nabiximols. Nabiximols (with a brand name of Salvatex) contains both CBD and THC in its composition and is approved in some countries. In the United States, Salvatex spray hasn’t got approval yet. The results obtained from the review demonstrated that this medication provided participants of the studies with better pain relief in comparison with placebo. However, there is an assumption that the obtained data obtained is not reliable enough as the number of people taking part in the studies is small, and thus the results can be biased.

Another review looked at 47 studies with almost 5,000 participants to eliminate possible inaccuracies in data because of the small number of people. Studies evaluated cannabinoids effects on various types of pain, excluding cancer pain. The results of the review have shown the benefits of using medical cannabis in 29% of people. This part of the participants was taking the cannabinoids and had a 30% reduction in their pain. However, the number of adverse effects among people who were taking cannabis instead of placebo was also higher.

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Cannabinoids for decreasing the use of the opioids

The problem of opioid addiction still remains a pressing issue. More than 130 people die every day from opioid-related drug overdoses all over the word. In addition to this, 10.3 million people misused prescription opioid medications in 2018. This, in comparison with 808 thousand people who used heroin in the same year, is an incredible amount.

Two million people misused prescription opioids for the first time, and the same number had an opioid use disorder in 2018. According to statistics, up to 29% of patients prescribed opioids for chronic pain misuse them. The number of opioid-related deaths all over the world continues to grow from year to year with little sign of it slowing down, and decisive action must be taken as quickly as possible.

A range of studies has shown the ability of cannabinoids to decrease opioid use by controlling pain with a smaller dose of opioid-related drugs. However, not everyone agrees that cannabinoids or cannabis, in general, should be taken seriously as a solution to the opioid crisis.

Sceptics claim that there isn’t enough evidence for the therapeutic benefits of cannabis in the treatment of chronic pain. Nevertheless, studies keep demonstrating positive results of cannabis use to relieve pain and be effectively used as an addiction to opioids.  When cannabis is taken in conjunction with opioid drugs, an “opioid-sparing effect” occurs that allows reducing pain with lower opioid doses significantly. Such an effect is achieved because of synergy between cannabinoids and opioids as both CB1 type of cannabinoid receptors, and opioid receptors are located in the same pain-signalling regions of the brain and spinal cord. One of the recent studies explored the effectiveness of medicinal cannabis for reduction of opioid doses and demonstrated favourable results. It was shown that in states with operational dispensaries, the reduction in opioids overdoses was 25%, while the reduction in treatment admissions of heroin and other opioids was 38%. As for patients, according to one review, 32% of patients taking opioids decided to substitute their prescription drugs with cannabis to manage pain. In addition to this, another study also reports that among medical cannabis patients who used opioid medications, almost 80% reduced their use.

As the global opioid crisis continues to worsen, the evidence that cannabinoids may reduce the use of the opioids due to their opioid-sparing effect inspires hope. Many cannabis researchers assume that cannabis may significantly limit opioid use by reducing the necessary doses and lowering the rates of opioid dependence.

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Cannabis for multiple sclerosis

Today, an approved medicine known as Nabiximols (trade name: Sativex) is actively used in patients with multiple sclerosis to reduce muscle spasticity. This drug is an extract of the cannabis plant and contains roughly equal amounts of CBD and THC. This medication got approval in 2010 as a botanical drug in the UK despite a lack of evidence of its effectiveness. Today, Sativex is available as a mouth spray which is intended to alleviate such conditions as spasticity, neuropathic pain, overactive bladder, and other symptoms of multiple sclerosis.

There is also some evidence suggesting that medical cannabis may be effective in alleviating the painful symptoms of multiple sclerosis, although additional studies are needed. Modern studies also differ as to whether cannabis-infused products can help to improve sleep, quality of life, bladder function, tremors, and progression of the disease. There are also no studies and trials which would compare cannabinoids effects to the most commonly used drugs prescribed for multiple sclerosis pain and spasticity.

As a result, researchers can’t say for sure whether cannabinoids can be used as an independent or primary treatment.

Cannabis for epilepsy

The ability of the cannabis plant to effectively treat epilepsy and reduce its symptoms was discovered quite a long time ago.

The main purpose of all the medication used today for epilepsy is to maximally reduce the number of seizures or ideally to stop them all. For the moment, besides numerous studies of the benefits of the cannabinoids for epilepsy treatment, there is also some evidence of medicinal cannabis effectiveness in the treatment of certain forms of epilepsy among children. The most well-known cannabis compound known as a potential agent to treat epilepsy, including its rare forms, is CBD.

However, the main part of the research held to investigate the CBD properties was aimed at studying it as an add-on compound to current treatments. Cannabidiol effectiveness was evaluated for drug-resistant epilepsy forms in children and young adults up to twenty-five years when the use of other anti-epileptic medications could not control their condition. In paediatric patients with drug-resistant forms of epilepsy, cannabidiol products reduced the frequency of seizures by more than 50% in half of the patients participating in the study. Several other studies have also reported significantly improved quality of life in both paediatric and adult groups of patients. Nevertheless, additional studies in different age groups are needed to examine the treatment features of cannabinoids therapy fully.

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Currently, there is not enough evidence to recommend this treatment for adults as there are few studies of how effective cannabidiol is in alleviating the symptoms of adult epilepsy. There is also no evidence that would support the use of medical cannabis as rescue therapy for patients with status epilepticus. Status epilepticus is a condition when a single seizure lasts more than five minutes or two or more seizures occur within a five-minute interval without the ability for a person to return to normal condition between episodes.

Cannabis for cancer

The possibility of using cannabinoids for cancer treatment sounds more than just promising - it would be life-changing for millions of people all over the globe.

According to the statistics from the World Health Organisation (WHO), cancer occupies the second position of leading causes of deaths globally. In 2018, the number of people who struggled with this disease and lost had reached 9.6 million. On a global scale, one in six deaths is due to cancer. To say that this is a problem is to say nothing. Researchers worldwide are working at the medication that would be able to change this statistic forever.

For today, cannabinoids have shown a hopeful potential not only to treat cancer-related symptoms such as nausea, vomiting, loss of appetite, and weight loss but also the growth of malignant cells in general.

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How does it work? The internal endocannabinoid system (ECS), through which cannabinoids have an ability to impact our body and mind is also responsible for cell growth and apoptosis. Apoptosis is a natural process in our body where the cells are destroyed as part of a particular organism’s growth. As cancer occurs due to the abnormal mutation of cells and their proliferation, malignant cells grow as the abnormal process in the body. The main reason for this is that cells no longer acknowledge the signals of our body that encourage or destroy cell growth. The more cells grow and divide, the more they become uncontrollable. Since cancer cells no longer respond to apoptosis, they can speed up their proliferation while ignoring the other signals from “normal cells”. As the endocannabinoid system can regulate cell growth and death, it is considered as an extremely important system in our body. THC binds to the CB1 receptors of the ECS and is responsible for mood, behaviour, and other cerebral functions. At the same time, CBD links to the CB2 receptors and signals these receptors if there are “invaders” that can be potentially dangerous to the body. The apoptotic process by the receptors of the ECS is achieved through the de novo synthesis of ceramide and sphingolipid that promote cell destruction. Once these compounds bind together, activation of the receptor occurs, which can help the endocannabinoid system to send the signal of an “antitumorigenic warning”.Working as an alarm system, the ECS can suspend cancer development by inhibiting reproduction, metastasis, and tumour angiogenesis.

Many trials and studies are still in process, although the results that have already been achieved show great promise of cannabinoids in the cancer treatment.

Cannabigerivarin as a “young” but a potent competitor to well-known cannabinoids

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New cannabis chemicals also show a great medical potential in addition to the previously well-studied cannabinoids. An example of such a compound would be CBGV (cannabigerivarin).

Currently, there aren’t a lot of studies investigating CBGV and abilities of its therapeutic use. The main reason for such attention to the almost unknown compound was due to the postulation that it may increase the overall benefits of medicinal cannabis.

CBGV refers to the group of non-intoxicating cannabinoids, which means it can’t provide any psychoactive effects when inhaled or ingested. It was shown in some studies that CBGV can increase CBD metabolism within the body, making CBD more potent when taken together. Today, CBGV is considered as one of the most beneficial new cannabinoids offered by the cannabis plant. Chemically, it is a derivative of cannabigerol (CBG), which is known as “mother of all cannabinoids” due to its role as the molecular source of all other cannabinoids, including CBD and THC.

Some researchers have also suggested that the relationship between CBGV and CBD is similar to that of THCV and THC. Like other cannabinoid acids, CBGV is activated via exposure to heat or light. This cannabinoid is found in small amounts in specific cannabis strains and apart from having a beneficial effect on the human body, also plays an essential role in the cannabis plant. The cannabis plant is quite vulnerable and requires special care to grow healthy and to produce high-quality marijuana. Similarly to other plants, cannabis contains specific elements that play the role of the plant protectors. CBGV is one of such guarding elements. It provides insecticidal benefits and can support the cannabis plant in developing resistance to diseases, which are dangerous for plant health.

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As CBGV is a little-known cannabinoid, current research on its effects is quite limited. In general, this compound is considered to be similar to CBG as they both have almost identical chemical structure (the only difference is in different carbon rings). The full spectrum of CBGV health effects hasn’t been discovered yet, although its ability to relieve pain is already known. Due to its analgesic and anti-inflammatory effects, CBGV can be effective for patients with fibromyalgia, arthritis, and rheumatic disease lupus.

Other possibilities for the therapeutic use of this compound include:

Epilepsy

Currently, there is an initial indication that CBGV can serve as an anticonvulsant agent and as a medication to relieve epileptic seizures. So far, CBD is more widely used to treat epilepsy, and the most attention of the scientists is given to its ability to deal with epilepsy in children. The first scientific trial of CBD effectiveness to treat epilepsy was held in 2014. It took place over a year and included 11 American epilepsy centres. The study has demonstrated positive results and confirmed the effectiveness of cannabidiol to treat epileptic seizures.

What is the role of CBGV in this process? If the theory about the ability of CBGV to boost the CBD metabolism is correct, it will allow taking these cannabinoids in combination, thereby increasing the effects of cannabidiol significantly.

Skin diseases

CBGV is not alone in its ability to be used for skincare and chronic and symptomatic skin diseases.

However, unlike all other cannabinoids, only CBGV can improve, soothe, and even heal dry skin. Patients suffering from dermatitis and other inflammatory skin diseases may benefit from the anti-inflammatory properties of CBGV soon. Moreover, as CBGV could potentially be used to treat dermatitis, it may also deal with dry skin which is a classic symptom of neurodermatitis. In one of the studies, researchers also found out that when working together, CBGV and CBDV can significantly suppress the expression of cytokines - the growth and differentiation proteins of cells. These proteins are responsible for the signal transmission and the message delivery among the cells. The cells of our immune system also use cytokines to act on the brain and hormone glands. By blocking excessive cytokines, CBGV together with CBDV helps the overworked immune system to return to its natural level.

Cancer

Not so long ago, CBGV was studied as a part of the research into non-hallucinogenic cannabinoids as drugs to help patients with leukaemia (one of the types of cancer). Six cannabinoids were examined individually and in combination to evaluate their potential anti-cancer effects. The results of the study were impressive - when applied together in combination, two forms of CBGV, two forms of CBG, and two forms of CBD displayed an increased influence on blood cancer cells. Moreover, CBGV showed itself to be cytostatic and caused a concurrent standstill in all phases of the cell cycle. Due to the absence of psychoactive effects, scientists and doctors see great potential from these results. In addition to this, the pain-relieving effects of CBGV make it the ideal choice for patients undergoing drug chemotherapy or radiation therapy. Of course, more research is needed, and a number of animals and human trials still have to be performed, but the results we have today are promising and may serve as a starting point for further research.

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Bladder disorders

The ability of CBGV to be effective in treating bladder dysfunctions was revealed in 2015. It was a big breakthrough for patients with overactive bladder as several studies have shown the ability of both CBG and CBGV to decrease bladder contraction. CBD, CBDV, and THCV that were tested in this study also showed effectiveness in contractility effects in hyperactive bladders.

Eye diseases

In the UK, about 480,000 people have chronic glaucoma. According to statistics, about 1 in 50 people over 40 years of age, and 1 in 10 people over 75 years of age have chronic open-angle glaucoma. One of the main causes of such widespread disease is increased intraocular pressure. Without taking the appropriate actions, glaucoma can make patients go blind. Our intraocular pressure increases because of the impaired drainage of the tear fluid at the corner of the eye chamber.

Cannabinoids like CBGV and CBG have shown the ability to drain aqueous fluid. In addition to this, CBGV has also shown positive results in dealing with eye problems, enabling painful intraocular pressure to be relieved. As CBG and CBGV have common anti-inflammatory and antibacterial methods of action, they both can potentially be used as potent medications for glaucoma treatment.

The bottom line

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Cannabinoids are slowly but surely conquering modern medicine, substituting usual prescription based medication and drug usage by showing several positive and beneficial results.

With a growing number of studies, more and more people begin to take these compounds seriously as medications that can provide them with real effects. The number of players on the medicinal cannabis playing field is growing, and this is great as each of them has unique features or can somehow improve the effects of its “siblings”.

The appearance of the new cannabinoids shouldn't be perceived as rivalry, as in this game, all the players are in one team moving forward to treat different diseases and conditions without side effects. Each new cannabinoid discovered is not a competitor but an assistant to other compounds. CBGV is showing prospective effects by boosting the impact of other cannabinoids on our organism, thereby increasing their treatment ability, which can be highly beneficial for patients. Besides this, studies show that this chemical can be used as an independent medication able to treat a comparably wide range of diseases.

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Additional studies are needed, and the work is in full swing worldwide to reveal all the potential benefits of this compound. Currently, the results of CBGV research are more than just good - they are impressive.

What will come next? We’ll probably find out soon.

Verified by a Healthcare Professional

Anastasiia Myronenko

Anastasiia Myronenko

Anastasiia Myronenko is a Medical Physicist actively practicing in one of the leading cancer centers in Kyiv, Ukraine. She received her master’s degree in Medical Physics at Karazin Kharkiv National University and completed Biological Physics internship at GSI Helmholtz Centre for Heavy Ion Research, Germany. Anastasiia Myronenko specializes in radiation therapy and is a fellow of Ukrainian Association of Medical Physicists.