CANNABIS VERSUS HEMP
The distinction between cannabis and hemp is a legal one. Both cannabis and hemp are the same plant, and scientists are still working out the genetic nuances that separate one variety from another. In today’s landscape, however, hemp is defined as a plant that produces less than 0.3 percent THC. Cannabis, on the other hand, can contain any ratio of CBD, THC, and other cannabinoids.
CANNABIS NOT MARIJUANA
Over the years, the cannabis plant has collected several different nicknames. Many of which, like marijuana, are clouded by a controversial history. When working with medical cannabis patients, the most accurate term to use when discussing the plant is cannabis. Cannabis is the latin name for the plant and has been used in Western pharmacopoeia since the 1700s, when the plant received its latin nomenclature (Pollio, 2016).
In the cannabis industry, titration refers to the process of gradually increasing or decreasing a dosage of a cannabinoid or individual cannabis product over time. Titration is used to ease patients onto cannabis medicines, find their optimal dose, and reduce the potential negative side effects.
Microdosing is a term that describes consuming very small amounts of cannabinoids. A standard microdose is between one and three milligrams of THC or CBD. These microdoses are thought to help patients maintain a low tolerance to cannabis medicines while still reaping some of the health and wellness advantages of the plant. Microdoses of cannabis are typically so small that no intoxication is experienced. Over time, however, concentrations of fat-soluble cannabinoids like THC and CBD will build up in the
body. This potentially enables long-term effects from very small doses of cannabinoid medicines.
OPTIMAL THERAPEUTIC DOSE
When dosing cannabis medicines, patients often start with small dosages and titrate up until they reach their optimal therapeutic dose. At this dosage, they have reached the precise amount of cannabis medicine needed to achieve the desired effect. As a tolerance develops to the effects of cannabis over time, a patient’s optimal therapeutic dose may change.
The exact definition of biphasic is “in two phases.” In the world of cannabis medicine,
this term is used to describe the somewhat contradictory effects of THC. The beneficial effects of the cannabinoid increase until they reach a certain dosage point. After crossing a particular dosage threshold, a patient might experience a worsening of the symptoms they hope to treat. Many of the therapeutic effects of THC occur on a bell curve, with diminishing returns in high doses.
Mg/mL stands for milligrams per milliliter. Cannabis products are often dosed in milligrams of active cannabinoid infused into a milliliter of oil, solvent, topical, or another solution. In edible cannabis, the dosage of active cannabinoid is measured in milligrams per serving. In dried flower, the active cannabinoid content is measured as a percentage.
The ratios of dominant cannabinoids in cannabis flower and products provide important information regarding the overall effect that the product will have. A given ratio quantifies the parts of THC relative to parts of CBD. In some products, ratios including different cannabinoids, like CBN, may be listed.
The entourage effect refers to the synergistic relationship between cannabinoids, terpenes, and other phytochemicals in the cannabis plant. While each of these chemicals in isolation can have profound effects on human health, it is the concert of these compounds together that is thought to provide enhanced medicinal benefits. The entourage effect is also expected to contribute to the distinct experiences inspired by individual cannabis chemovars.
The terms indica, sativa, and hybrid are often used to categorize cannabis cultivars into three distinct types. In popular culture, indica varieties are thought to produce a sedative effect. In contrast, sativa varieties are often touted as energizing, while hybrids can be any combination of the two. In reality, however, the accuracy of these three general terms is contentious.
Rather than provide distinct effects, it is most accurate to say that indica/sativa terminology most accurately describe the physical characteristics of different cannabis cultivars. Indica plants tend to be shorter in stature and have broad leaves. Sativa
Cannabis plants that display particular chemical characteristics are called chemovars. Thus far, it is broadly accepted that at least three different chemovars dominant today’s cannabis market. These three chemovars are:
A THC-dominant chemovar contains mostly THC relative to other chemical constituents found in cannabis resin. Until recently, the vast majority of cannabis cultivars in illicit, recreational, and medical markets were high-THC varieties. These varieties range in psychoactive potential depending on the amount of THC present in the cannabis product.
Dried flower typically contains between 8 and 25 percent of the cannabinoid. Based on data from 2014, the average percentage of THC in high-THC varieties fell at 12 percent total (Elsohly et al, 2016). Some particularly impressive cultivars may feature beyond
30 percent of the psychoactive. These high-producing cultivars are recommended
for consumers who are comfortable with intoxicating cannabis and who have prior experience with THC.
As mentioned above, cannabis cultivars are often dominant in one cannabinoid or another. Though, some cultivars can be dominant in both. A CBD-dominant cultivar will contain more CBD than THC. While there are more THC-dominant cultivars than CBD- dominant ones, today’s CBD varieties often feature anywhere from 6 to over 20 percent CBD.
Some chemovars, however, will present more of a mixed cannabinoid ratio. These chemovars will contain equal or sizable proportions of both CBD and THC. Some mixed chemovars display a one-to-one ratio of THC to CBD. Others may feature a two-to-one, one-to-two, or another combination. These mixed chemovars will produce more wide- ranging effects, depending on the unique ratio of a given sample. The higher the THC content, the greater the likelihood that the product or flower will produce a psychoactive effect.
A phenotype is an observable genetic characteristic passed down from a parent to an offspring. In cannabis, different plants will express different phenotypes depending on their breeding. Individual plants may express different coloration, differences in leaf shape, differences in height, and other observable physical traits.
The cannabis plant traditionally breeds by exchanging genetic material between both male and female plants. In some cases, when a plant is under stress and this type of breeding becomes impossible, a plant will develop hermaphroditism. In commercial and home operations, growers have another way of reproducing plants. A clipping can be taken from a “mother” plant and this clipping will grow to be a genetic copy of the plant it was taken from. This clipping is a clone. This allows for more control over the genetic makeup of the plant and ensures that a plant will showcase the same phenotypic characteristics as the mother plant.
Top-shelf products are considered to hold some of the highest quality in a dispensary or care center. These products are typically flower that showcases a high cannabinoid and/ or terpene content, excellent manicuring, or superior appearance or flavor.
Cannabis Chemical Makeup Terms:
Cannabinoids are a unique class of chemical compounds thought to be exclusive to the cannabis plant. Though, research is currently underway to determine whether or not other plants also produce these compounds. Some cannabinoids, like THC, produce intoxicating effects. Most cannabinoids, however, are expected to have vast medicinal potential. CBD and THC are the two most dominant cannabinoids that are derived from acids by the cannabis plant. These cannabinoids, among others, engage with the human body via the endocannabinoid system (ECS).
Sub-cannabinoids are cannabinoids that are less abundant in the cannabis plant. Apart from THC and CBD, some of the most common sub cannabinoids include CBN, CBG, and THCV. None of these cannabinoids produce a psychotropic experience that is as strong as THC. These sub-cannabinoids are expected to have medicinal properties, though they have been studied far less than the more dominant cannabinoids.
Terpenes are aromatic molecules which give different cannabis chemovars their distinct aroma and flavor. These molecules are abundant in nature in plant resins, and terpenes make up one of the largest classes of chemical compounds produced by plants, most notably in citrus plants and conifers.
Flavonoids are pigment molecules in plants. Many flavonoids provide a bitter flavor to plant foods, but they may also be responsible for some of the nuance of tastes found in fruits and vegetables. Flavonoids are the molecules responsible for providing coloration to cannabis leaves and flowers. They also hold numerous medicinal and nutritional benefits.
In the raw cannabis plant, which has been unheated and uncured, cannabinoids are found in their acidic form. Instead of calling these molecules cannabinoids, they are considered cannabinoid acids. These acids are the precursors to both dominant and sub-cannabinoids. They do not produce intoxicating effects. The two most common cannabinoid acids are THCA and CBDA, which are the precursors to THC and CBD, respectively.
Cannabis Plant Terms:
Bud is the term used to describe a single sample of dried cannabis flower. A two-gram package of dried flower, for example, may contain two to four distinct buds. When growing cannabis, the term bud refers to the developing flower on the cannabis plant.
The term flower refers to the resin-dense flowers of the female cannabis plant. However, male, female, and hermaphrodite plants all produce flowers. When purchasing cannabis, the word “flower” is used to describe dried plant material sold by the gram or ounce. The term bud is sometimes used synonymously with flower.
Trim refers to the sugar leaf and other plant matter that is cut off of cannabis flowers during the manicuring process. Trim is often collected and used to make extractions, tinctures, and both culinary and topical infusions.
Shake is the slang term that refers to the small bits of plant material that have fallen off of dried cannabis flower. The more the dried flower is handled, the more shake is generated. Shake looks like trim, though trim is typically produced in a larger quantity.
Trichomes are the crystal-like resin glands that sit on the surface of cannabis leaves and flowers. There are six types of resin glands in all, though the most common are tall stalks with a bulbous head. Trichomes house the majority of medicinal and nutritious compounds produced by the cannabis plant. When extracted, these trichomes concentrate into cannabis or hemp essential oil.
Extraction refers to the separation of cannabis resin from plant material. To extract the essential oil from the cannabis plant, a solvent is needed to pull the fat-based compounds from the fiber and other substances that make up the structure of the cannabis plant. Extractions are cannabis concentrates, meaning that they are highly potent. In fact, extractions are the strongest cannabis products available in terms of total cannabinoid content.
Carbon dioxide (CO2) is one of the solvents used to extract cannabis resin. CO2 extracts tend to have a syrup-like texture and feature a golden to dark amber coloration. CO2 is considered to be among the safest solvents to use to extract cannabis resin.
Butane Hash Oil (BHO) is a cannabis concentrate made using butane as a solvent. Like all cannabis concentrates, BHO is highly potent, often featuring over 60 percent active cannabinoid. BHO comes in several different varieties, the most common are shatter, wax, and crumble. Shatter features a hard, glass-like consistency. Wax is opaque and softer
to manipulate. Crumble is opaque and features a breadcrumb-like texture. A high-quality BHO will feature a golden to dark amber coloration.
Ethanol is another common solvent used to make cannabis extractions. Like CO2, ethanol is considered to be one of the safest solvents to use during extraction. Unlike BHO and CO2, however, ethanol is more likely than other solvents to remove chlorophyll, which is the compound that gives plant their green coloration. As a result, ethanol extractions tend to feature greater color variance than other extracts. Depending on how the extract was processed, the resulting concentrate may maintain more of a green coloration or a light to dark amber hue.
ICE WATER HASH
Ice water hash is a type of solventless extraction. This extraction method uses ice water to freeze trichomes, which then become bitter enough to break off. These trichomes will then condense into a crumble-like powder and are sometimes compressed to create
a more solid hash. Compared with solvent extractions, ice water hash is less refined and less potent. This type of hash can take on a dark amber to deep green coloration, depending on the quality of the processing.
Kief is the term used to describe trichome crystals that have been removed from the plant, either via agitation or with a screen. When using a standard four-chamber herb grinder, dried trichome crystals naturally collect in the container as cannabis flower is ground. Similarly, dried cannabis flower can be rubbed onto a screen to remove trichome crystals. The fine powder that collects, as a result, is called kief. Kief is one of the simplest forms of extraction. It is also, perhaps, the least potent.
Decarboxylation refers to the process of transforming cannabinoid acids into their more active form. Decarboxylation occurs when the acid (carboxyl) group on the molecule degrades. Through this degradation, cannabinoid acids like THCA and CBDA are transformed into THC and CBD. Some decarboxylation happens naturally as the cannabis flower ages. Most decarboxylation, however, occurs when cannabis materials are exposed to heat. This happens when cannabis products are smoked, baked, or heated in another capacity. After decarboxylation, THC will exert intoxicating effects.
A concentrate is a cannabis extract. Simply stated, it is the term for the concentrated resin that accumulates after the resin has been extracted using a solvent. Concentrates are among the most potent cannabis products on the market.
Full-Extract Cannabis Oil (FECO) is a cannabis concentrate that is most commonly extracted with ethanol. It has earned the term “full-extract” because it contains cannabinoids, terpenes, and flavonoids, and other compounds found in the cannabis plant. Other solvents, like butane and CO2, remove many terpenes and flavonoids that naturally occur in the plant. FECO, in contrast, best maintains the integrity of the plant by maintaining a greater diversity of cannabis compounds in the concentrate.
Rick Simpson Oil (RSO) is similar to FECO and the terms are often used synonymously.
A traditional RSO, however, uses naphtha as a solvent. As cannabis oil continued to gain popularity over the past decade, the use of naphtha as a solvent has fallen out of favor. Now, many home extractors use a high-proof grain alcohol or ethanol to extract resin from cannabis plants and extract it into a concentrated oil. RSO was first developed by the Canadian activist Rick Simpson, who used the oil to treat his own skin cancer.
A full-plant concentrate is one that is made using whole cannabis flowers. Like FECO and RSO, the goal of full-plant extracts is to maintain the integrity of the plant. With a full- plant extract, extractors seek to maintain terpene, cannabinoid, and flavonoid profiles
of individual cannabis cultivars. Trim and sugar leaves may also be included in these extractions, though full-plant extracts are not made solely with trim.
The term whole flower is often used synonymously with full-plant. Like full-spectrum extracts, whole-flower extracts oppose cannabinoid isolates. CBD, THC, and terpenes can all be purified and sold as isolated extractions. Whole-flower and full-plant extracts are not purified and instead include as many beneficial compounds as the solvent allows.
A traditional hash is made from pressed kief, which has been removed from the plant after flower is rubbed onto a series of screens. Hash is one of the oldest forms of cannabis concentrates, and it has been consumed for centuries by many Central and South Asian societies. While other extracts can be consumed sublingually, hash is most often smoked.
Rosin is a solventless concentrate made by pressing cannabis flowers or kief in between two hot plates. The temperature and pressure melt cannabis trichomes into a playable concentrate, which can then be smoked or vaporized. Rosin typically features an amber coloration.
Live resin is a unique type of butane hash oil that is prepared using flash-frozen cannabis flowers. To make live resin, cannabis plants are frozen immediately after harvest. This freezing preserves terpenes, cannabinoids, and other phytochemicals before they have had a chance to degrade. These flash-frozen plants are then placed into extraction equipment, creating a product with a granular texture and moist appearance.
Wax, shatter, and budder are all preparations of butane hash oil. Wax features an opaque appearance and a malleable, rock-like texture. Shatter features a glass-like texture and tends to come in amber-colored sheets. Budder is a soft, whipped product, creating an opaque concentrate that is smooth and easy to manipulate.
Forms of Consumption:
Sublingual cannabis preparations are products that can be used under the tongue. Cannabinoid receptors are found on salivary glands, which allows cannabis to be uptaken into the bloodstream from inside the mouth. The activation time varies from product to product, however, results from sublingual application may appear within mere minutes or as long as a half an hour.
Topical cannabis products are intended for use on the skin. Creams, balms, massage oils, and cosmetics are all considered topicals. Topicals are used to ease pain and inflammation in a localized area. Cannabis compounds, however, cannot be absorbed through the skin and into the bloodstream. As such, cannabis topicals will not cause a psychotropic effect.
Vaporization is one of the safest ways to inhale cannabis. Unlike smoking, vaporization heats cannabis flower and concentrates at low temperatures to the point of evaporation. In contrast, smoking combusts cannabis material, creating potentially harmful carcinogens. Vaporization successfully reduces the number of carcinogens inhaled by consumers, making it a safer consumption method than smoking (Gieringer, 2001).
Live resin is a unique type of butane hash oil that is prepared using flash-frozen cannabis Cannabis’s active constituents can be infused into foods and drinks for easy consumption. Cannabis is most often infused into butter and cooking oils. However, isolates and other concentrates can also be used to infuse edibles and beverages. Infused foods can
take between 30 minutes and two full hours to take effect. Infused drinks have a faster activation time, with an average onset time closer to 30 minutes.
Dabbing refers to the process of touching a cannabis concentrate to a hot plate and inhaling the combusted smoke through a water pipe. The water pipe used for dabbing is called an oil rig. The hot plate is referred to as a nail, though no actual nails are used in the process of dabbing. Instead, a titanium, quartz, or ceramic hotplate are the most commonly used devices. Rosin, live resin, and BHO are the most common concentrates used for dabbing.
A cannabis-naive patient is a first-time consumer. This patient will have a low tolerance for cannabis medicines and will need to titrate up to their optimal therapeutic dose. This consumer is the most likely to experience negative side effects from cannabis products. When introducing a cannabis-naive patient to cannabis, that patient must slowly titrate up to their optimal therapeutic dose.
A caregiver is a person that has been designated to provide for a medical cannabis patient. Qualifications and regulations for caregivers vary by state law. In general, however, a caregiver can pick up cannabis products and/or grow cannabis plants in their homes on behalf of a patient. A caregiver is not legally allowed to consume the cannabis products that they acquire or cultivate for another.
RECOMMEND VS. PRESCRIBE
In the United States and in other regions of the world, cannabis cannot be legally prescribed as medicine. Instead, doctors can only recommend cannabis to patients that may benefit from medical cannabis. Most U.S. states have approved a handful of qualifying conditions that allow a medical professional to recommend cannabis. These fqualifying conditions are different in every region that has legalized medical cannabis. When working with patients, it is common practice to refer to cannabis products as recommendations and not prescriptions.