In today's age of medical marijuana, government propaganda is all but dead. The more you know about your medicine, the more effective it can be.
The scientific evidence for the medicinal value of cannabis is so well documented in the peer-reviewed literature that the case for cannabis as medicine is now firmly established. As a result, if someone says that cannabis medicine is a joke, the proper 21st century reply is: "You are welcome to your unsupported opinion, but the scientific evidence for cannabis as medicine is overwhelming." Referring that person to Google Scholar—a database of scientific, peer-reviewed articles that constitutes the best reference for anyone ignorant on this subject—will return over 50,000 peer-reviewed articles alone. The first couple hundred scientific papers address the topic directly. All of them confirm that, yes, cannabis is a medicine. For the naysayers, it is simply game over.
These days, we are more concerned with how cannabis works as medicine and what the various treatment types and options are. Also, many medical users wish to be fully self-sufficient; this means not obtaining their medical marijuana by any other means except cultivating and preparing it themselves. For many first-time users, however, questions arise with respect to which type of cannabis they need to grow. To answer that question, we must first understand that cannabis is a genus of its own in the plant kingdom. Its taxonomic nomenclature (or scientific name) is actually Cannabis sativa L., which (confusingly enough, for newcomers) has three distinct species: Cannabis sativa, Cannabis indica and Cannabis ruderalis.
However, there are really only two types to choose from when growing cannabis for medicine, indica or sativa (ruderalis is a hardy, hempy, low-potency species not typically grown for ingestion), and both are grown quite differently and with different results. So the medical user must first decide which type is going to be more beneficial. Fortunately, they don't really have to become an expert on the ins and outs of cannabis botany or biochemistry to find the right type for them: Simply sampling both—and different varieties of each—can be enough. Many medical marijuana outlets have plenty of samples to choose from, so when the medical user finds the strain they need, they can then begin to examine their self-sufficiency options with that strain, assuming it's available in seed or clone form.
Medical Marijuana Basics
For this article, we shall focus on sativas, which are pretty much the iconic type of cannabis that we see in all those marijuana-leaf media images. For all its popularity as an icon, however, it's actually the type of cannabis that most home growers have very little experience with—especially the pure type.
You've undoubtedly heard of sativas such as Cambodian, Haze or Thai, but you may not know that these are some of the most difficult strains to grow. So if a medical user wants to be self-sufficient and needs a pure sativa, they'll be undertaking a much more specialized and complicated home grow than someone who chooses an indica. Sometimes a mostly sativa hybrid (i.e., a plant with both sativa and indica genes), may be sufficient, and this can reduce both the difficulty and the flowering times, since such hybrids are easier to grow—but the user will have to forgo some of the sativa effects for the indica influence. So, all in all, indica users are at an advantage, since indicas grow faster and are more forgiving when it comes to growroom mistakes. Sativa growers, on the other hand, really need to put the work in.
The main difference for the medical user between indicas and sativas is the plants' biochemistry, in particular the different types of active chemical compounds in cannabis, referred to as cannabinoids. There are 85 known cannabinoids in the plant, and probably many more. (The number keeps growing every year as new research discovers more of them.) It's not possible here to go through all of the cannabinoids and their effects on humans; however, we can talk about the primary ones, which appear in the plant in much greater quantities and largely explain the major variations in the medicinal differences between sativas and indicas. These include tetrahydrocannabinol (THC), cannabinol (CBN), cannabigerol (CBG), tetrahydrocannabivarin (THCV or THV) and cannabidiol (CBD).
Cannabinoids and Their Effects
The main effects from cannabis use are produced in the human body by the spe- cific, membrane-bound receptors called CB1 (found mostly in the brain) and CB2 (mostly in the immune system), to which many of these cannabinoids bind. THC, for example, is used by both the CBI, and CB2 receptors, and its neuroprotective qualities ease pain in most medical marijuana users. The medicinal value of THC is wide-ranging, with new applications being found all the time.
Cannabinol (CBN) is also psychoactive, but it's basically the result of THC as it degrades. CBN's effects have been described as very similar to THC, though weaker. Cannabigerol (CBG) binds to CBI and CB2 receptors and appears to help with glaucoma and other forms of ocular pressure that need to be released.
Tetrahydrocannabivarin (THCV or THV) is quite interesting. While it is nonpsychoactive, it appears to be very similar to THC, and it also has a large range of medical applications, from diabetes to problems relating to the human metabolism. THCV/THV is a very popular cannabinoid with pharmaceutical companies looking to market its applications, particularly because of the practical side to its non-psychoactive yet medically valuable similarity to THC.
Cannabidiol (CBD) is the compound that has created the most excitement among medical researchers in recent years. While CBD doesn't seem to interact directly with the CB1 and CB2 receptors, it does appear to interact with other receptors in the body, producing relief from inflammation, nausea, anxiety and convulsions, among other uses. As with THC, new applications for CBD are being discovered all the time.
It's important to note that cannabidiol (CBD), while not directly psychoactive, does appear to help prevent some of the unwelcome psychological effects caused by THC. Depending on the user, these effects can range from hyperactivity to paranoia, and they can get uncomfortably intense for some people. However, for others these psychoactive effects are not unwelcome at all. In fact, the very opposite is true: They are what is needed. Some people find that sativa increases awareness in a positive way, even spurring creativity. Artists and musicians who have found that cannabis enhances their vision or sound in creative ways usually derive those benefits more from a sativa influence than an indica one.
Sativas vs. Indicas
One way of understanding the distinction between indicas and sativas as medicine is by looking at the CBD-to-THC ratio. In general, indicas have a higher CBD-to-THC ratio, whereas sativas have a lower one—meaning that indicas are known for having higher percentages of CBD than sativas. For those looking to minimize the unwanted psychoactive effects of THC, that makes indicas an obvious choice. But if a medical user wants the psychoactive effects, then they would look to a pure sativa or, more likely, a sativa-dominant hybrid—while, in general, medical marijuana users looking for full-body, relaxing effects or relief from physical pain will turn to indica or indica-dominant hybrids, since experiments show it is highly likely that CBD is contributing to this pain inhibition.
As with anything in medicine, though, it's not always as black-and-white as this, so a caution is given in assuming that indicas and sativas always perform this way—meaning that indicas don't always produce a body-stone effect, and sativas don't always deliver an uplifting, cerebral high. Overall, it may very well turn out that indica strains contain a greater number of cannabinoids than sativa strains do. (I personally think this is very likely.) As a result, someone medicating with an indica strain is almost guaranteed to find the right cannabinoid that they need to help their medical problem, making it a good bet to try indicas before sativas. On the other hand, if sativas turn out to contain fewer cannabinoids that indicas, then the unwanted cannabinoids can conceivably be eliminated by choosing a sativa.
Benefits of Sativas
So what are the sativas' medical benefits? Sativas can help with psychological problems, including depression, as well as aid in encouraging activity. Sativas are better suited as a stimulating medicine, though they have been known to relieve some kinds of pain, including migraines. The uplifting effects of sativas mean that they make a good medicine to take in the mornings or during the day. However, sativa users need to consider if they're really the best option for evening and nighttime use, because the cerebral effects—somewhat analogous to caffeine—can keep the user awake. Certainly the purer varieties of sativa will do this, so if a sativa user is having trouble sleeping, then it's time to consider a more balanced sativa/indica hybrid as their medicine—or possibly even switching to indica use in the evening. This may also help reduce the amount of tolerance that the body develops toward the medicine, which is something that all medical users have to contend with—there are times when interrupting one's regular use and then restarting it later helps to combat tolerance-related problems.
The good news for medical users is that the range of sativa strains is growing, and there's no shortage of varieties to experiment with, including many new strains like Waipi'o Hapa (Centennial Seeds), Simbay Moon (Ganjah Seeds), K-13 Haze (Philosopher Seeds), Inferno Haze (Gage Green Genetics), Juanita la Lagrimosa (Reggae Seeds), Margoot (Green Devil Genetics), Jack O'Nesia (Karma Genetics), Kaligria (ASG Seeds), the Magician (De Sjamaan) and Mekong Haze (Delta-9 Labs), which are quickly gaining popularity in Europe and elsewhere.
So what does the future hold for medicinal sativas? Essentially, more of what's already happening now: medical users becoming self-sufficient and turning to specialized strains that cater to their individual needs. Selective breeding over successive generations can change cannabinoid levels, and it's not very difficult to have a strain's cannabinoid content examined and reported (though it still may be costly for individuals). Medical marijuana breeders should take note of this. Grouping medical strains by type, especially chemotype, is the current trend, and in the future we will likely see every medical marijuana strain's chemotype being identified, quantified and put on the label.
Also, let's not forget what every grower knows: that harvest times, curing times and how cannabis is stored are also supremely important. For example, harvesting earlier than usual can reduce the amount of THC that degrades, and therefore an earlier harvest can give even an indica strain more of a cerebral high than it normally has. Likewise, curing in darkness preserves THC, while exposing cured bud to light will generally degrade THC. A strain's genetics, while important, can only take us so far; the environment will also impact how a plant grows and what its cannabinoid content will be. This is why self-sufficiency is probably the most stable way for medical users to ensure that their medicine is the same time and time again. Sharing a strain with someone else does not mean they will get the exact same results, but it should be somewhat close depending on how and where they grow it.
I always like to finish articles like this by pointing out that human cannabinoid receptors such as CB1 and CB2 are extremely interesting in that they're what convert the plant's chemical compounds into a psychoactive/medicinal experience. That there is a mutual symbiosis between cannabis plants and human beings that is "binding-site-specific" is miraculous—and monumental: It strongly implies that throughout human and cannabis evolution, there has been a historic connection between our species. Archaeological finds have unearthed the remains of early Homo sapiens with cannabis plants, cannabis seeds and cannabis-related fabrics together and intact.
Cannabis use among humans is not a new phenomenon. What is new is the failed experiment of cannabis prohibition, which was undertaken without any scientific foundation and certainly without considering the consequences. Historians will look back on cannabis prohibition as one of the great failed social experiments of all time and wonder why so many had to suffer at the hands of a few people who were badly lacking in knowledge. Science has already cleared the name of every cannabis user and prisoner—past, present and future.