Developing a Better Understanding of Cannabinoids

CBD has become a blanket descriptor for a range of chemical compounds that HME providers and DME pharmacies should more closely comprehend in order to help their clients.

As the public’s acceptance of cannabis products continue to grow, and more states are decriminalizing medical and/or recreational cannabis consumption, a growing number of consumers have been looking to CBD (cannabidiol) and hemp products in hopes of alleviating pain and inflammation, anxiety, and insomnia. 

It is important to note that “CBD” has become a blanket term for therapeutic hemp products and that CBD is just one of the currently 160+ identified potentially therapeutic cannabinoids. 

Other cannabinoids that have been identified with therapeutic benefits that are gaining in consumer popularity include CBN (cannabinol), CBG (cannabigerol), and Delta-8 THC:

  • CBN (cannabinol) – Like CBD, CBN is non-psychoactive, meaning that it does not elicit a “high.” CBN can be used effectively as a sleep aid or sedative. This cannabinoid has also been shown to help regulate the immune system and works to relieve the pain and inflammation caused by several conditions. CBN naturally occurs in both hemp and marijuana plants when THC-A oxidizes. CBN can also be synthetically manufactured.
  • CBG (cannabigerol) – CBG is known as the “mother cannabinoid” as all other known cannabinoids derive from CBG in nature. CBG works to fight inflammation, pain, nausea and may work to slow the proliferation of cancer cells. Research has shown it also significantly reduces intraocular eye pressure caused by glaucoma. CBG occurs naturally in cannabis and may also be manufactured synthetically

  • Delta-8 THC (tetrahydrocannabinol)– Delta-8 THC is a federally legal form of THC that is naturally occurring in both hemp and marijuana plants. Like other cannabinoids, Delta-8 THC can be synthesized. Consumers report that Delta-8 THC is roughly one-half to three-quarters as psychoactive as Delta-9 THC. 

The National Institutes of Health (NIH) state, Delta-8-Tetrahydrocannabinol is an analog of tetrahydrocannabinol (THC) with antiemetic, anxiolytic, appetite-stimulating, analgesic, and neuroprotective properties ... This agent exhibits a lower psychotropic potency than delta-9-tetrahydrocannabinol (delta-9-THC), the primary form of THC found in cannabis.”  

As these cannabinoids gain popularity by both recreational and medical consumers alike, there is the concern of legality and safety of cannabis and cannabinoid-based products. Both the legality and safety of these products should be of utmost importance to not only the consumer/patient and the healthcare provider recommending the product(s) but also to the practitioner or retailer selling them.

As for legality, it can be confusing, and this is where the 2018 U.S. Farm Bill comes into play. The 2018 U.S. Farm Bill states that hemp cannabis and cannabinoid products are federally legal provided that these products contain no more than 0.3 percent Delta-9 THC by weight and that these products are 100 percent industrial hemp-derived, not synthesized. Per the 2018 U.S. Farm Bill, all hemp-derived cannabinoid products and cannabinoids such as CBD, CBN, CBD, CBG, Delta-8 THC, etc., are federally legal as long as these products do not exceed 0.3 percent Delta-9 THC by weight.

This is where things get sticky. It is much cheaper and much easier to produce synthetic molecules such as CBD, CBN, CBG, and Delta-8 THC. This, in turn, leads to greater profit, and many cannabis companies offer these man-made, less-expensive, and federally illegal products. Remember, cannabinoids are molecules found in plants, similar to the ascorbic acid (Vitamin C), beta-carotene, and folic acid molecules found in an orange. 

In nature, these molecules vary from plant to plant and harvest to harvest. It is much more costly and much less efficient for a manufacturer to derive these nutrients or cannabinoids from natural plant sources than it is to synthetically manufacture them. A premium vitamin/mineral supplement will be food-derived, not synthetic. An example of this is the natural d-tocopherol form of vitamin E found in premium supplements and the less effective, synthetic dl-tocopherol form of vitamin E commonly found in less costly mass-market brands.

Unlike synthetic nutrients, synthetic cannabinoid products are currently federally illegal as these cannabinoids are not derived from industrial hemp per the 2018 U.S. Farm Bill. Reputable cannabis companies providing therapeutic products are well aware of this regulation and will always offer 100 percent hemp-derived cannabinoids. Additionally, consumers do not know what potentially toxic chemicals may be used to synthesize cannabinoids. 

This brings us to safety. Hemp cannabis products are commonly available in topical forms such as lotions and salves, oral delivery forms like tinctures and gummies, concentrates, or the hemp flower itself to consumers via-inhalation. With so many delivery systems available, it is imperative to ensure the product delivery system is as “clean” and safe as the active ingredients themselves. 

“Gummy” product delivery systems are increasing in popularity amongst adult consumers, and health-conscious consumers should be aware that many of these gummies contain artificial flavors, dyes, and sweeteners such as high fructose corn syrup (HFCS). Vegetarian and vegan consumers should be aware that many gummies are made from gelatin, which is an animal ingredient. Consumers should also ensure that therapeutic cannabis gummy products are actually infused with ingredients, not merely gummies simply sprayed with an ingredient solution. When looking for a hemp product intended for health and healing, it is important that the manufacturer provides full disclosure of all ingredients as well as transparency of all manufacturing and extraction processes.

To ensure both a safe and effective product, consumers and healthcare providers should choose hemp products from companies that proactively provide independent third party certificates of analysis (COA) from reputable labs that provide the following laboratory analysis:

  • Total Cannabinoids – This ensures the final product contains cannabinoid(s) labeled in the amounts they are labeled at. Also, this states that the product does not exceed 0.3 percent Delta-9 THC by weight.
  • Pesticides and Herbicides – This states the product does not contain potentially toxic synthetic pesticides, herbicides, and residuals.
  • Heavy Metals – States that the product does not exceed acceptable levels of lead, cadmium, arsenic, mercury, and others.
  • Residual Solvents – This states the product does not contain potentially toxic residual solvent such as butane or hexane. 
  • Microbials– This states the absence of molds, yeasts, and fungus in the product.

Additionally, truly therapeutic hemp products should be certified organic and certified free of genetically modified organisms (Non-GMO), synthetic dyes and flavors, artificial sweeteners, gluten, and gelatin. Some premium products are also certified Kosher.

In summary, to ensure choosing a safe and effective product, health-conscious consumers and healthcare providers should always choose reputable cannabis brands that proactively provide all certificates of analysis and regulatory certifications. 


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