In the past decade, we have seen a burgeoning interest in cannabis, particularly as medicine. Many patients consider it to be a helpful intervention for many conditions, especially acute or chronic pain, anxiety and sleeplessness. There is special interest in cannabidiol (CBD), a less psychotropic chemical compound found in many marijuana plants.
Of course, cannabis has always been used recreationally. Its popularity is such that many American states have challenged federal law and made cannabis legal, at least for medical purposes. The rush to legalization has tended to outrun the typical pharmaceutical development process, leaving patients largely on their own to determine dosages and understand contraindications and side effects – with the Internet and dispensaries offering advice that ranges from great to dubious.
Cannabis has a worldwide distribution. There are references to it in traditional Chinese medicine texts such as the Divine Farmer's Classic of Materia Medica (Shen Nong Ben Cao Jing), which extols its ability to descend blood and cool qi, but warns about how overindulgence might lead a person to see apparitions. And in the writings of the ancient emperor Shen Nung, cannabis is recommended for difficult menstrual pain or irregular periods, as well as joint pain and treating malaria.
Had the great minds of TCM had access to the marijuana of today, it is hard to imagine what they would make of it. The application of scientific growing principles has resulted in potency several folds more powerful than even the finest wild-grown cannabis of a few decades ago.
Delta-9-tetrahydrocannabinol (THC) is an active compound produced in cannabis that is primarily responsible for its psychoactive effects. In the storied 1960s, when cannabis gained popularity, the average THC percentage was about 3 percent. Potency levels were at 12 percent, on average, by 2014, and THC extraction systems have paved the way to food, oils and waxes in which the THC content may approach 75 percent. The higher the THC concentration, the higher the psychological risk of its use.
Cannabis: Significant Risk
How high is that risk? Significant. One investigation pointed to the finding that those who imbibed high-THC cannabis every day were at five times the risk of dealing with issues of psychosis than those who imbibed none at all.
Another arena for exploration of cannabis' iatrogenic mental health effects is in depression and suicide. In a study of identical twins, with one twin using cannabis frequently and the other infrequently, the more frequent user had a higher likelihood of reporting major depressive disorder and suicidality.
As for psychosis, scientists have investigated the association of cannabis use and schizophrenia-like syndromes. Out of 13 studies, 10 found a statistically significant association. To be sure, correlation is not causation, but many people do make health decisions based on logical correlations.
Meanwhile, the effect of chronic cannabis use on regular users is profound. Compared to nonusers, chronic users tend to be weaker verbal learners, have deficits in learning and memory, be poorer at paying attention, and be impaired in psychomotor function (which is why motor vehicle authorities are so concerned about "buzzed" driving).
The Saving Grace: CBD?
If there is a saving grace in cannabis, it may be in CBD. Because it is not psychotropic, the dangers of any of the negative effects discussed above are slim to none. Meanwhile, there is growing evidence that CBD can help reduce inflammation, pain, anxiety, depression, oxidants and nausea, as well as many other expressions of negative physical / mental health.
High CBD content even seems to reduce common effects of high THC concentration in any sample of cannabis – the well-known paranoia, anxiety or panic – while still permitting the user to have a pleasurable mental experience. Without the THC, the user can employ CBD simply for the purposes of health.
It worth noting that in TCM, cannabis was used principally for pain. A reference to its use as such was made 15 centuries ago in the Additional Records of Famous Physicians, pointing out that cannabis can "relieve impediments," which was the phrase used for pain at the time. Of course, in the sixth century, there was no possibility of understanding the molecular structures of either THC or CBD.
CBD Makes Cannabis Sense
A Dutch study of 2,000 users indicated that the higher the CBD content of the cannabis ingested, the lower the number of psychotic-syndrome experiences. A different investigation of users, which relied on hair analysis, found that if cannabis users had levels of CBD and THC detectable in their hair, they experienced fewer psychotic effects than those with only THC concentrations in their hair samples.
CBD is also generally legal just about everywhere. It is now being produced in oils, tinctures and creams. For pain, it can be administered topically. For psychological issues such as anxiety and depression – so common and even normal in this age of COVID-19 – it may be administered sublingually.
From the standpoint of TCM, practitioners should consider it to be a yin cooling tonic, which may help patients with pain reduction and alleviation of swelling. There is no evidence that it is addictive or has adverse side effects, unlike many traditional prescription pain medications.
The years ahead will bring us more and better research about all kinds of overlooked health resources. It may even be possible for biochemists to genetically alter CBD into an outstanding, reliable and repeatable medication. TCM practitioners should watch these developments with interest, and consider incorporating CBD into their own methods of healing.
References
Chronic pain afflicts over 20% of the adult population. Sadly, most MDs have essentially no education in treating pain, beyond offering a few toxic medications. Then they tend to steer people with pain away from those health practitioners who are trained. This puts the acupuncture community on the front lines for addressing this epidemic.
When the body is going through a stressful event, the sympathetic system is activated. This activation will help the body with a life-threatening situation. If this state is activated for prolonged periods of time, it starts to consume energy. These traumatic events that generate stressors in the autonomic nervous system (ANS) will eventually become internalized.
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One of the things that makes acupuncture so difficult to measure is that the medicine actually does contain some esoteric aspects. There have been numerous studies that demonstrate the neurochemical reasoning behind why acupuncture points stimulate the autonomic nervous system to enact change However, not all the benefits of TCM can easily be measured by randomized, controlled trials. But does that make them fundamentally and definitively untrue?
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