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Classification (Psychoactive and Non-Psychoactive Cannabis)
CLASSIFICATION
Psychoactive and Non-Psychoactive Cannabis
Under current peruvian regulations, psychoactive cannabis refers to medicinal cannabis products with a THC (Tetrahydrocannabinol) concentration greater than 1%. Products with a THC concentration below this threshold are classified as non-psychoactive cannabis.
Psychoactive cannabis products are characterized by inducing a cerebral intoxicating effect on the user, whereas non-psychoactive cannabis lacks any intoxicating properties or effects on the user.
DOSAGE
In most clinical studies that have examined the effects of cannabis consumption on various aspects of human functioning and development, dosages of cannabis preparations or products between less than one gram and no more than five grams per day of a preparation or product with approximately 10% THC have been applied. However, the wide range of commercially authorized products, with THC contents ranging from less than 1% to 25% or more, and with equally variable concentrations of CBD, makes it practically impossible to establish a precise dosage for a user or for a specific illness to treat.
It is recommended to start with a low dose and gradually increase it until the desired effect is achieved, while monitoring for any potential side effects or unwanted reactions. Although self-medication is common, it is important that it be guided beforehand or, at a minimum, based on clear information on how to adjust or titrate the dose. Regardless of the type of product, every user should have basic guidance to support safer and more informed use.
In the case of frequent users, it is important to remember that the concentration-effect curves for the actions of endocannabinoids and THC-like cannabinoids have an inverted U-shape; that is, as the concentration increases, the effect also increases until a maximum effect is reached, and if additional increases in concentration are applied, the effect begins to decrease until it might eventually be replaced by an opposite or adverse effect due to receptor desensitization. This phenomenon has been called "endocannabinoid overload" and might explain some of the toxic effects of high doses of THC.
SAFETY CONSIDERATIONS
Due to the cerebral effects noticeable from psychoactive cannabis consumption, it is advised to avoid combining it with other central nervous system depressants such as alcohol, benzodiazepines, and opioids during cannabis treatment.
The following individuals are considered unsuitable for treatments with cannabis or cannabinoids such as THC or CBD:
• Pregnant women. Cannabinoids and other components of the plant cross the placental barrier and can cause harm to the fetus.
• Women who are breastfeeding. Cannabinoids are excreted through breast milk and can intoxicate the infant.
• Children and adolescents. Cannabis derivatives (THC) have severe effects on various aspects of mental and brain development, as well as cognition. CBD does not have these adverse effects.
• Patients with a history of problematic drug use (alcohol, prescription drugs, or illicit drugs).
• Patients with a personal or family history of psychosis (THC).
• Patients with pre-existing heart and/or coronary artery disease.
SIDE EFFECTS
If the user experiences side effects or undesirable outcomes due to substance interaction or excessive consumption, symptomatic and supportive treatment is recommended. In more serious situations, consult your trusted doctor. In case of any adverse effects, discontinue cannabinoid treatment until consulting with a physician.
The most frequently observed adverse effects in various clinical trials involving cannabinoid compounds include dizziness, fatigue, dry mouth, muscle weakness, muscle pain, and palpitations. Less commonly, users have reported disorientation, intoxication sensations, memory and concentration issues, tremors, motor coordination difficulties, nausea, hypotension, constipation, blurred vision, dysphoria, anxiety, depression, paranoia, and hallucinations.
SCIENTIFIC EVIDENCE
Regarding the effectiveness of cannabis in various medical conditions, there is conclusive or substantial evidence that cannabinoids are effective for the treatment of:
• Chronic pain
• Chemotherapy-induced nausea and vomiting
• Muscle stiffness (spasticity) associated with multiple sclerosis
• Refractory epilepsy
• Appetite stimulation
Regarding the potential risks associated with inappropriate use, including substance abuse and the occurrence of discontinuation symptoms:
• It has been found that approximately one in ten users may develop dependence, characterized by the occurrence of discontinuation symptoms after stopping use. These symptoms typically peak two to three days after cessation and may last up to one week, with sleep disturbances potentially persisting for up to three weeks. Users with a history of substance abuse may be more prone to problematic cannabis use.
• Abrupt discontinuation of long-term cannabis use does not lead to a uniform pattern or timeline of symptoms. In most cases, effects are likely limited to temporary disturbances in sleep, mood, or appetite in some users.
• Regarding the potential risks of “medical cannabis use” evolving into problematic use of cannabis or other substances, available evidence indicates that the legalization and regulation of medical cannabis have not produced measurable increases in non-medical cannabis use. There is no conclusive evidence linking medical cannabis use to higher levels of recreational use in the general population. Similarly, evidence does not support a clear association between medical cannabis regulation and increased criminal behavior.
SOURCES
We have followed the guidelines provided by the National Academy of Medicine of Peru and the Canadian Centre on Substance Abuse. For more detailed analysis and scientific evidence, you can refer to the Cannabis Studies Center of Peru, a team of health professionals and related experts, whose objective is the academic study of the therapeutic/medicinal properties of cannabis.