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This Doctor Says Marinol is NOT Medical Cannabis

By: Dr. David Bearman

For years, some law enforcement sources—many of who should know better—have referred to Marinol as prescription marijuana. Marinol® (dronabinol) is synthetic THC, it is not prescription marijuana. As you will see, that assertion is wrong by about 511 chemicals.

Marinol is THC; just one of many chemical compounds found in cannabis, synthesized and mixed in sesame seed oil. Cannabis is a plant, and like other plants, it contains hundreds of active chemical compounds. Plants are complex, a tomato contains about 380 different molecules, coffee has roughly 880 and cannabis—512. Of these 512, 80-100 are cannabinoids like THC and CBD. The rest are compounds such as terpenes and flavonoids. Both cannabinoids and terpenes are known to have medical implications.

What are Cannabinoids?

Cannabinoids are essentially 21-carbon molecules which can block or stimulate the body’s own endocannabinoid receptors. Many of these cannabinoids, including THC, have therapeutic value.

Here are some examples:

THC (Tetrahydrocannabinol) is, among other things, an analgesic (pain killer), anti-inflammatory, neuroprotectant, antiemetic and muscle relaxant. When THC is heated through cooking or burning, it is converted to delta-9 THC, the psychotropic compound responsible for the “high”, or euphoric effects. When the molecule is obtained in its acid form through juiced raw cannabis it is non-psychotropic and not intoxicating. As THC ages it degrades into cannabinol (CBN).

CBN (Cannabinol) is a mild psychotropic that may stimulate bone growth. It is anesthetic, anti-convulsive, analgesic and anti-anxiety. It often has the effect of putting patients to sleep.

CBD (Cannabidiol) is non-psychotropic and relieves anxiety, convulsions, depression, inflammation and nausea. It is also a sedative, sleep aid and muscle relaxant that is being studied for the treatment of epilepsy.

CBC (Cannabichromene) is an anti-inflammatory, analgesic, anti-anxiety, anti-depressant, neuroprotective, anti-proliferative and treats acid reflux. It has been extracted for use in various cannabis topicals for its anti-inflammatory effects.

CBG (Cannabigerol) is an analgesic, muscle relaxant, anti-erythemic (reduces redness) analgesic, anti-proliferative (stops the growth of malignant cells) and digestive aid. Researchers and patients are looking at it in the treatment of cancer.

THCV (Tetrahydrocannabivarin) is an appetite suppressant, anti-bacterial, antiviral and anti-epileptic compound that can also aid memory and calm the user. Researchers and patients are looking into it for the treatment of diabetes and weight loss.

CBDV (Cannabidivarin) is anti-inflammatory, analgesic and protects cells lining the digestive tract, which play a major role in immune function.

What are Terpenes?

Terpenes are what give different cannabis strains their unique odors. They are odor molecules found in all plants, with each cannabis strain having its own unique blend of terpenes, the terpene profile, usually found in other plants.

The terpene profile is often thought of as the strain’s “fingerprint” or unique genetic identifier. Terpenes are ubiquitous in citrus fruit. They are also found in pepper, pine trees, lavender and other plants. There are no terpenes found in MarinoI, which is just synthetic THC.

Here are some examples of cannabis terpenes’ therapeutic activity:

Pinene: is also found in pine needles and has anti-inflammatory effects in addition to being a bronchodilator, memory aid and Acetylcholinesterase inhibitor.

Myrcene is also found in hops and mangoes and is a sedative hypnotic, muscle relaxant, analgesic, anti-inflammatory, Antipsychotic and antispasmodic. Many new cannabis product formulations include added myrcene to combat the anxiety some patients feel using high-THC cannabis.

Limonene is found in abundance in many citrus fruits and treats acid reflux, anxiety and depression. It is antifungal and antimicrobial, which is why citrus terpenes are often used in cleaning products. In addition, it is anti-spasmodic, anxiolytic and gastroprotective.

Terpinolene is also found in coriander and is an analgesic and digestive aid.

Linalool is also found in lavender and is anesthetic, anti-convulsive, anti-anxiety, antineoplastic (prevents tumor development), antipsychotic and an anxiolytic sedative.

Caryophyllene is also found in black pepper and is anti-inflammatory, analgesic and protects cells lining in the digestive tract.

Why Patients Need Whole Plant Cannabis: The Entourage Effect

An important concept with cannabis is the entourage effect. This is the combined effect of all the therapeutic constituents of the plant acting in concert synergistically to address many symptoms in one.

With Marinol, there is no entourage effect because hundreds of chemicals are missing.

Just to be entirely fair, Marinol does have therapeutic value and I prescribe it. I tell my patients, however, that it is not as effective as cannabis and is more expensive. It’s only effective for conditions that require THC. Marijuana-like products may be available by prescription, but it’s not prescription marijuana.

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About the Author
David Bearman, M.D.

David Bearman, M.D.

Dr. Bearman is one of the most clinically knowledgeable physicians in the U.S. in the field of medicinal marijuana. He has spent 40 years working in substance and drug abuse treatment and prevention programs. Dr. Bearman was a pioneer in the free and community clinic movement. His career includes public health, administrative medicine, provision of primary care, pain management and cannabinology.

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