From the Guidelines
Tetrahydrocannabinol (THC) is a specific chemical compound found within the cannabis plant, while cannabis refers to the entire plant itself, containing over 100 different cannabinoids, including THC and cannabidiol (CBD), as well as other compounds like terpenes and flavonoids. THC is the primary psychoactive component in cannabis that produces the "high" sensation when consumed 1. The concentration of THC in cannabis products can range from less than 1% in hemp varieties to over 30% in specially bred strains, which is important because different cannabis varieties and products offer varying effects based on their THC content and the presence of other compounds that work together in what's known as the "entourage effect" 1.
Some key points to consider:
- Cannabis can be consumed in various forms, including smoking dried flowers, vaporizing, edibles, tinctures, or topicals, with THC content varying widely between different strains and products 1.
- The pharmacokinetics of THC and CBD, including their bioavailability, vary according to formulation and route of administration, with oral THC onset being 30 minutes to 2 hours, lasting 5-8 hours, and inhaled THC onset occurring in seconds to minutes, lasting 2-3 hours 1.
- There is a potential for drug-drug interactions mediated through altered drug metabolism pharmacokinetics, particularly with warfarin, buprenorphine, and tacrolimus, which are classified as high-risk interactions 1.
- The paucity of available data on drug-drug interactions is a concern, as clinicians will be unable to provide informed, scientifically supported answers as to the potential for cannabis and/or cannabinoids interactions with approved anticancer therapeutics 1.
Overall, understanding the difference between THC and cannabis is crucial for healthcare professionals to provide informed guidance on the potential benefits and risks of cannabis use, particularly in the context of cancer treatment and management.
From the Research
Definition and Composition
- Tetrahydrocannabinol (THC) is the main psychoactive component in cannabis, responsible for the associated "high" or "euphoria" 2.
- Cannabis, on the other hand, refers to the plant itself, which contains various constituents, including THC and cannabidiol (CBD) 2, 3.
Effects and Interactions
- THC is known to produce psychotomimetic effects, whereas CBD does not show any psychotomimetic effect and may even counteract some of the psychotomimetic effects of THC 3.
- The presence of CBD may mitigate some of the adverse side effects of THC, such as intoxication, psychomotor impairment, anxiety, and psychotic symptoms 2.
- The combination of THC and CBD may result in lower psychotomimetic scores compared to THC alone 3.
Medical Uses and Variability
- Oral cannabinoids, including THC, are available for the treatment of chemotherapy-induced nausea and vomiting (CINV) in patients with cancer 4.
- However, oral THC has high pharmacokinetic variability, with variability in oral dronabinol peak plasma concentrations estimated between 150 and 200% 4.
- A new oral dronabinol solution has decreased intraindividual variability compared to oral dronabinol capsules 4.
Comparison with Other Substances
- Cannabis and tobacco have different psychoactive substances, with nicotine being specific to tobacco and THC being specific to cannabis 5.
- The inhalation technique of cannabis is different from that of tobacco smoking, with larger puff volumes, deeper inhalation, and longer pulmonary retention time 5.