Pioneering research in the 1990’s [1-4] on cannabis led to the remarkable discovery of an internal biological system that regulates and controls many of our physiological processes.[5] This was named the endocannabinoid system (ECS). The ECS is recognised as one of the largest and most important receptor systems in the human body.[5]
A pictorial representation of the main cannabinoid receptors CB1 and CB2 and their locations in the human body. CB1 receptors are mostly found in the central nervous system, CB2 receptors are mostly found in the peripheral nervous system, especially immune cells [5].
The Endocannabinoid System
The endocannabinoid system (ECS) is a messenger and receptor system vital for human functioning, and since its discovery, has become a focus area of published medical research.[5]
An analogy that might be useful to consider when we refer to the ECS is that of an air traffic controller. It’s an internal signalling system functioning across our physiological processes and organs, acting, and reacting to stimuli (both internal and external) to regulate and balance processes in the body. So how does this relate to our health?
Cannabinoids are compounds that were originally found in the cannabis plant and can also be found in other plants. Humans naturally produce cannabinoid-like compounds, which interact with the body’s ECS through an extensive network of receptors concentrated in the brain and our organs, connective tissues, glands, and immune cells.[5]
The messenger molecules of the ECS, called endocannabinoids, bind to their receptors, and help to facilitate the balance of internal functions across our biological systems referred to as homeostasis. [6-8]
It is through this homeostatic mechanism that the ECS helps us to relax, [9] forget traumatic experiences, [10] fall asleep, [11] control pain, [12] and reduce inflammation.[13]
In essence, the ECS assists in keeping your body in balance
The ECS & Plant-Based Medicines
Phytocannabinoids, naturally occurring in plants and certain plant-based medications, possess structural similarities to our endocannabinoids, enabling them to engage with receptors within our Endocannabinoid System (ECS) as well as other receptor types.[14-15]
In line with the views of the Therapeutic Goods Administration (TGA), ANTG acknowledges that more research is needed to establish the potential of various plant-based medicines.
While the TGA has issued clinical guidance documents for certain medications, it is crucial to consult with your healthcare provider to determine the most suitable approach for managing conditions such as chronic pain.
By advocating for ongoing research and informed healthcare decisions, ANTG aims to ensure positive outcomes for individuals navigating health challenges.
Regulation Of Unapproved Therapeutic Goods
Unapproved therapeutic goods are regulated differently to conventional prescription medicines, and can be accessed through the Special Access Scheme (SAS) or Authorised Prescriber (AP) Scheme.
To find out more about these schemes and how unapproved therapeutic goods can be accessed in Australia, visit the TGA’s website.
Speak to your treating practitioner to see if they are suitable for you.
Our products are GACP and GMP certified, meaning we abide by the highest independently verified standards of quality available worldwide.
Our Australian Natural range is grown and manufactured in Australia, and our Global Selects range is grown by our global partners to GACP standards and manufactured in our Australian GMP facilities.
There are many plant-based products that are available to a patient. Your doctor will explain the benefits of each of these and decide which is most appropriate for any symptoms or clinical indications you are experiencing.
References
1. Herkenham M, Lynn AB, Little MD, Johnson MR, Melvin LS, de Costa BR, et al. Cannabinoid receptor localization in brain. Proc Natl Acad Sci U S A. 1990;87(5):1932-6. PubMed PMID: 2308954; PubMed Central PMCID: PMCPMC53598.
2. Pertwee RG. Pharmacology of cannabinoid CB1 and CB2 receptors. Pharmacol Ther. 1997;74(2):129-80. PubMed PMID: 9336020.
3. Devane W, et.al. Isolation and structure of a brain constituent that binds to the cannabinoid receptor. Science. 1992;258:1946-9.
4. Galiegue S, Mary S, Marchand J, Dussossoy D, Carriere D, Carayon P, et al. Expression of central and peripheral cannabinoid receptors in human immune tissues and leukocyte subpopulations. Eur J Biochem. 1995;232(1):54-61. PubMed PMID: 7556170.
5. Moreno E, Cavic M, Canela EI. Functional Fine-Tuning of Metabolic Pathways by the Endocannabinoid System-Implications for Health and Disease. Int J Mol Sci. 2021;22(7). Epub 20210401. doi: 10.3390/ijms22073661. PubMed PMID: 33915889; PubMed Central PMCID: PMCPMC8036872.
6. Kunos G, Osei-Hyiaman D, Liu J, Godlewski G, Batkai S. Endocannabinoids and the control of energy homeostasis. J Biol Chem. 2008;283(48):33021-5. Epub 20080811. doi: 10.1074/jbc.R800012200. PubMed PMID: 18694938; PubMed Central PMCID: PMCPMC2586261.
7. Chen C. Homeostatic regulation of brain functions by endocannabinoid signaling. Neural Regen Res. 2015;10(5):691-2. doi: 10.4103/1673-5374.156947. PubMed PMID: 26109933; PubMed Central PMCID: PMCPMC4468750.
8. Rodriguez de Fonseca F, Del Arco I, Bermudez-Silva FJ, Bilbao A, Cippitelli A, Navarro M. The endocannabinoid system: physiology and pharmacology. Alcohol Alcohol. 2005;40(1):2-14. Epub 20041118. doi: 10.1093/alcalc/agh110. PubMed PMID: 15550444.
9. Viveros MP, Marco EM, File SE. Endocannabinoid system and stress and anxiety responses. Pharmacol Biochem Behav. 2005;81(2):331-42. doi: 10.1016/j.pbb.2005.01.029. PubMed PMID: 15927244.
10. Berardi A, Schelling G, Campolongo P. The endocannabinoid system and Post Traumatic Stress Disorder (PTSD): From preclinical findings to innovative therapeutic approaches in clinical settings. Pharmacol Res. 2016;111:668-78. Epub 20160722. doi: 10.1016/j.phrs.2016.07.024. PubMed PMID: 27456243.
11. Murillo-Rodriguez E. The role of the CB1 receptor in the regulation of sleep. Prog Neuropsychopharmacol Biol Psychiatry. 2008;32(6):1420-7. Epub 20080418. doi: 10.1016/j.pnpbp.2008.04.008. PubMed PMID: 18514375.
12. Guindon J, Hohmann AG. The endocannabinoid system and pain. CNS Neurol Disord Drug Targets. 2009;8(6):403-21. doi: 10.2174/187152709789824660. PubMed PMID: 19839937; PubMed Central PMCID: PMCPMC2834283.
13. Barrie N, Manolios N. The endocannabinoid system in pain and inflammation: Its relevance to rheumatic disease. Eur J Rheumatol. 2017;4(3):210-8. Epub 20170901. doi: 10.5152/eurjrheum.2017.17025. PubMed PMID: 29164003; PubMed Central PMCID: PMCPMC5685274.
14. Morales P, Hurst DP, Reggio PH. Molecular Targets of the Phytocannabinoids: A Complex Picture. Prog Chem Org Nat Prod. 2017;103:103-31. doi: 10.1007/978-3-319-45541-9_4. PubMed PMID: 28120232; PubMed Central PMCID: PMCPMC5345356.
15. Walsh KB, McKinney AE, Holmes AE. Minor Cannabinoids: Biosynthesis, Molecular Pharmacology and Potential Therapeutic Uses. Front Pharmacol. 2021;12:777804. Epub 20211129. doi: 10.3389/fphar.2021.777804. PubMed PMID: 34916950; PubMed Central PMCID: PMCPMC8669157.
16. Medicinal cannabis Special Access Scheme Category B Data Australian Government. Department of Health and Aged Care. Therapeutic Goods Administration. Canberra, ACT, Australia. [10/09/2022]. Available from: https://www.tga.gov.au/medicinal-cannabis-special-access-scheme-category-b-data.
17. Lynch ME, Ware MA. Cannabinoids for the Treatment of Chronic Non-Cancer Pain: An Updated Systematic Review of Randomized Controlled Trials. J Neuroimmune Pharmacol. 2015;10(2):293-301. Epub 20150322. doi: 10.1007/s11481-015-9600-6. PubMed PMID: 25796592.
18. Lynch ME, Campbell F. Cannabinoids for treatment of chronic non-cancer pain; a systematic review of randomized trials. Br J Clin Pharmacol. 2011;72(5):735-44. doi: 10.1111/j.1365-2125.2011.03970.x. PubMed PMID: 21426373; PubMed Central PMCID: PMCPMC3243008.
19. Hauser W, Petzke F, Fitzcharles MA. Efficacy, tolerability and safety of cannabis-based medicines for chronic pain management – An overview of systematic reviews. Eur J Pain. 2018;22(3):455-70. Epub 20171015. doi: 10.1002/ejp.1118. PubMed PMID: 29034533.
20. Parker LA, Rock EM, Limebeer CL. Regulation of nausea and vomiting by cannabinoids. Br J Pharmacol. 2011;163(7):1411-22. doi: 10.1111/j.1476-5381.2010.01176.x. PubMed PMID: 21175589; PubMed Central PMCID: PMCPMC3165951.
21. Grimison P, Mersiades A, Kirby A, Lintzeris N, Morton R, Haber P, et al. Oral THC:CBD cannabis extract for refractory chemotherapy-induced nausea and vomiting: a randomised, placebo-controlled, phase II crossover trial. Ann Oncol. 2020;31(11):1553-60. Epub 20200813. doi: 10.1016/j.annonc.2020.07.020. PubMed PMID: 32801017.
22. Devinsky O, Cross JH, Laux L, Marsh E, Miller I, Nabbout R, et al. Trial of Cannabidiol for Drug-Resistant Seizures in the Dravet Syndrome. N Engl J Med. 2017;376(21):2011-20. doi: 10.1056/NEJMoa1611618. PubMed PMID: 28538134.
23. Devinsky O, Patel AD, Cross JH, Villanueva V, Wirrell EC, Privitera M, et al. Effect of Cannabidiol on Drop Seizures in the Lennox-Gastaut Syndrome. N Engl J Med. 2018;378(20):1888-97. doi: 10.1056/NEJMoa1714631. PubMed PMID: 29768152.
24. Thiele EA, Marsh ED, French JA, Mazurkiewicz-Beldzinska M, Benbadis SR, Joshi C, et al. Cannabidiol in patients with seizures associated with Lennox-Gastaut syndrome (GWPCARE4): a randomised, double-blind, placebo-controlled phase 3 trial. Lancet. 2018;391(10125):1085-96. Epub 20180126. doi: 10.1016/S0140-6736(18)30136-3. PubMed PMID: 29395273.
25. Devinsky O, Patel AD, Thiele EA, Wong MH, Appleton R, Harden CL, et al. Randomized, dose-ranging safety trial of cannabidiol in Dravet syndrome. Neurology. 2018;90(14):e1204-e11. Epub 20180314. doi: 10.1212/WNL.0000000000005254. PubMed PMID: 29540584; PubMed Central PMCID: PMCPMC5890607.
26. Nielsen S, Germanos R, Weier M, Pollard J, Degenhardt L, Hall W, et al. The Use of Cannabis and Cannabinoids in Treating Symptoms of Multiple Sclerosis: a Systematic Review of Reviews. Curr Neurol Neurosci Rep. 2018;18(2):8. Epub 20180213. doi: 10.1007/s11910-018-0814-x. PubMed PMID: 29442178.
27. Johnson JR, Burnell-Nugent M, Lossignol D, Ganae-Motan ED, Potts R, Fallon MT. Multicenter, double-blind, randomized, placebo-controlled, parallel-group study of the efficacy, safety, and tolerability of THC: CBD extract and THC extract in patients with intractable cancer-related pain. Journal of pain and symptom management. 2010 Feb 1;39(2):167-79.
28. Beal JE, Olson R, Laubenstein L, Morales JO, Bellman P, Yangco B, Lefkowitz L, Plasse TF, Shepard KV. Dronabinol as a treatment for anorexia associated with weight loss in patients with AIDS. Journal of pain and symptom management. 1995 Feb 1;10(2):89-97.
29. MacCallum CA, Russo EB. Practical considerations in medical cannabis administration and dosing. Eur J Intern Med. 2018;49:12-9. doi: 10.1016/j.ejim.2018.01.004. PubMed PMID: 29307505.
