Cannabis contains various cannabinoids that compose the Cannabis Sativa or Indica plant, such as cannabidiol (CBD) and delta-9-tetrahydrocannabinol (THC), which have been a primary clinical focus for research and clinical interests. CBD and THC both induce clinical effects through their influence on the endogenous endocannabinoid system; however, the observable impact of these pharmacological components differs significantly. The psychoactive component of cannabis involves effects produced primarily by THC’s partial agonistic effects on cannabinoid-1 receptors (CB1R’s), which generates the “high” that users feel. In contrast, CBD has been shown in early studies to exhibit potential therapeutic effects (e.g. antipsychotic, anxiolytic, anti-craving pro-cognitive and neuroprotective effects), as it appears to have differential, and somewhat opposing, pharmacological effects compared to THC [29]. Recreational cannabis, both unregulated and regulated, is prepared with various combinations of THC and CBD. Overtime, however, the most common cannabis preparations have come to consist of high THC and lower CBD potency [48]. Due to the complex pharmacological makeup of cannabis products, as well as the diffuse distribution of cannabinoid receptors throughout the brain that influence a variety of neurotransmitters, the clinical effects range from euphoria and relaxation to panic anxiety and psychosis.
