American medical journal points out that high concentration of THC can cause dependence

By Sofia Missiato

The study conducted in 2020 by the Lancet Psychiatry journal revealed that the use of cannabis with a high THC content, that is, above 10 milligrams per gram, can cause dependence. However, there is conflicting information when evaluating the scope of this analysis. The American research involved 196 healthy individuals and used isolated THC, and shortly after the experience, it was concluded that a single administration of a high percentage of the substance induces psychotic and negative symptoms.

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Leticia Mayer, a family physician specializing in geriatrics and palliative care, understands that episodes of psychosis can affect people who already have some predisposition: 'A common mistake is to speak about Cannabis in a generalized way, not making the proper distinction between medicinal use and adult use. Periodic and high doses of THC in recreational form can trigger psychiatric symptoms in predisposed individuals. As for dependence, this is not seen in the medicinal treatments proposed habitually, especially due to the much smaller amounts of THC used compared to adult use. In treatments with medicinal cannabis, there is a correct dose for each patient depending on their individual needs.'

The most studied components of marijuana are tetrahydrocannabinol (THC) and cannabidiol (CBD), natural compounds of the cannabis sativa plant. But a major detail sets them apart: THC is the main psychoactive ingredient of cannabis, while CBD is not.

THC stimulates the brain's visual and auditory receptors, with a mild euphoric effect for the user. The latter, on the other hand, causes a sedative effect on the body. Both CBD and THC act on cannabinoid receptors in our body, which are mainly found in the brain and in our nervous and immune systems.

Cannabis has over 500 other chemical substances, including over 100 compounds chemically linked to THC, meaning it is a much more complex plant than is usually addressed. Each chemical compound plays a different role in how it affects the mind and body. Terpenes, for example, which are also compounds found in marijuana and are responsible for flavors and odors, when acting together with cannabinoids, have a greater effectiveness in modulating the Endocannabinoid System, which can result in better absorption by the body.

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The maximum concentration of THC recommended by the World Health Organization (WHO) is 0.2% in products derived from cannabis sativa, but products with higher concentrations can be found. There is a toxicity that can be triggered in any individual when consuming an amount higher than the body can absorb, the study conducted by the Lancet Psychiatry journal does not account for individualities.

Leticia Mayer emphasizes: 'Medicinal cannabis is truly personalized medicine, so it is difficult to speak about recommended doses. Of course, there are some doses that serve as guidelines for prescriptions, however, the doctor must assess the pathologies, symptoms, and the patient's sensitivity to define the best dosage and posology. It is necessary to be attentive to the emergence of side effects, as this will likely be the limiting factor regarding the daily maximum dose, and this varies from person to person.'

Cannabis species with high THC concentration work well as a muscle relaxant, for chronic pain, and as an antispasmodic, being a psychoactive with benefits for patients with cognitive impairment, as demonstrated by the study published in the Journal of Medical Case Reports, which shows improvement in the condition of Alzheimer's patients. Scientific research has shown that treatment with medicinal cannabis improves cognitive and behavioral functions that are normally altered in this disease.

Therefore, the potential therapeutic effect of marijuana lies in individualized dosage. It is important to be attentive to understand the treated body and which combination of cannabinoids works for each individual. A topic that will continue only with research and education, the effectiveness of alternative treatment with phytocannabinoids requires proper prescription like any other medication.

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