Medicinal Cannabis Substitution: Pharmacological Considerations for Healthcare Providers
The temporary unavailability of specific medicinal cannabis strains, such as Bacio Gelato, requires a careful and informed approach to substituting these products to ensure continued therapeutic efficacy and patient well-being. Understanding the active compounds and their interactions is an important first step.
Medicinal cannabis contains a complex array of cannabinoids, terpenes, and flavonoids, each contributing to its therapeutic profile. The primary cannabinoids—tetrahydrocannabinol (THC) and cannabidiol (CBD)—are well-known for their effects on the endocannabinoid system, influencing various physiological processes such as pain, mood, appetite, and inflammation.
Substituting a cannabis strain requires matching the pharmacological profile of the original strain as closely as possible. For instance, Bacio Gelato is an indica-dominant strain with 23% THC and a terpene profile dominated by caryophyllene, myrcene, and limonene.
These terpenes contribute to its sedative, anxiolytic, anti-inflammatory, and appetite-stimulating effects. Therefore, an appropriate substitute should have similar levels of THC and a comparable terpene profile to provide analogous therapeutic benefits.
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- 3 Weston-Green K, Clunas H and Jimenez Naranjo C (2021) A Review of the Potential Use of Pinene and Linalool as Terpene-Based Medicines for Brain Health: Discovering Novel Therapeutics in the Flavours and Fragrances of Cannabis. Front. Psychiatry 12:583211. doi: 10.3389/fpsyt.2021.583211
- 4 Op. cit., Francomano.
- 5 Carrie Cuttler, Amanda Stueber, Ziva D. Cooper et al. Acute Effects of Cannabigerol on Anxiety, Stress, and Mood: A Double-Blind, Placebo- Controlled, Crossover, Field Trial, 15 May 2024, PREPRINT (Version 1) available at Research Square [https://doi.org/10.21203/rs.3.rs-4213847/v1]
- 6 Tory R. Spindle, C. Austin Zamarripa, Ethan Russo, Lauren Pollak, George Bigelow, Alexandra M. Ward, Bridget Tompson, Cristina Sempio, Touraj Shokati, Jost Klawitter, Uwe Christians, Ryan Vandrey, Vaporized D-limonene selectively mitigates the acute anxiogenic effects of Δ9-tetrahydrocannabinol in healthy adults who intermittently use cannabis, Drug and Alcohol Dependence, Volume 257,2024,111267,ISSN 0376-8716, https://doi.org/10.1016/j.drugalcdep.2024.111267. (https://www.sciencedirect.com/science/article/pii/S0376871624001881)
- 7 Ibid, Spindle. 8 Debra A. Hunt, Joanne Keefe, Tammy Whitehead, Amber Littlefield, Understanding Cannabis The Journal for Nurse Practitioners, Volume 16, Issue 9,2020,Pages 645-649,ISSN 1555-4155, https://doi.org/10.1016/j.nurpra.2020.07.007. (https://www.sciencedirect.com/science/article/pii/S1555415520303871)