Two of the main active compounds in cannabis, THC (tetrahydrocannabinol) and CBD (cannabidiol) — called plant or phytocannabinoids — are chemically similar to the natural endocannabinoids produced by the human body. The discovery of the ECS, coupled with the awareness of plant cannabinoids and the opportunity to make synthetic (or human-made) versions has generated a substantial amount of scientific interest in understanding how cannabinoids might be used to maintain health and alleviate symptoms of disease.

Endocannabinoids

Endocannabinoids are neurotransmitters derived from fat (lipids). The body makes endocannabinoids naturally (“endo” means originating in the body). Researchers have extensively studied two major endocannabinoids, each of which plays a distinct role within the ECS:

Arachidonoyl ethanolamide (anandamide, AEA), also known as the “bliss” molecule2-arachidonoyl glycerol (2-AG)

These endocannabinoids are synthesized on demand, meaning the body makes them when needed rather than producing them in advance.

Endocannabinoid Receptors

Endocannabinoids bind with endocannabinoid receptors, which reside on the surface of a variety of types of cells throughout the body, to trigger a physiological response. Researchers have focused on two endocannabinoid receptors in particular:

Cannabinoid 1 (CB1) Receptors Most of these are in the central nervous system, especially neurons (nerve cells) in the brain. Both anandamide and THC (the compound in cannabis that makes people feel high or stoned) bind with CD1 receptors.Cannabinoid 2 (CB2) Receptors These are located mainly on immune cells but are also found in the central nervous system.The endocannabinoid 2-AG binds with CB2 receptors.

Enzymes

Fatty acid amide hydrolase (FAAH), which breaks down anandamideMonoacylglycerol (MAG-L), which breaks down 2-AG

While scientists initially believed that the ECS only affected the brain and nerves, they now agree that it exerts an influence on almost every part of the body: skin, bone, fat tissue, liver, pancreas, skeletal muscle, heart, blood vessels, kidneys, the gastrointestinal tract, and more. Researchers are continuing to investigate the many complex ways in which the ECS interacts with the central nervous system, the peripheral nervous system, the immune system, the digestive system, the reproductive system, virtually all the major organs, and many other parts of the human body. Since their discovery, endocannabinoids have been found to play a role in:

Pain sensationThermoregulationMemoryMoodAppetiteStressSleepMetabolismImmune functionReproduction

The drug nabilone (Cesamet) has a chemical structure similar to THC and is approved to treat nausea associated with cancer chemotherapy. Synthetic cannabidiol (Epidiolex) was approved by the FDA in 2018 to treat certain rare pediatric seizure disorders, including:

Dravet syndromeInfantile spasmsLennox-Gastaut syndromeTuberous sclerosis complex

Post-traumatic stress disorder (PTSD)Tourette’s syndromeSocial anxietyTraumatic brain injury

Since the study was first published, numerous clinical trials and reviews also suggest a potential role for cannabinoids for:

Palliative careSkin disordersLupusDiabetesBacterial infectionsAutism

It also has 20 times the anti-inflammatory power of aspirin, and twice that of steroids like hydrocortisone.

In addition, THC interacts with a variety of other receptors and enzymes in the body, with research suggesting a variety of potential benefits in terms of treating addiction, and even helping to reduce complications during organ transplant surgery. The cannabis plant also contains metabolites called “terpenes” that are responsible for its color and smell and for promoting its therapeutic properties. Dark chocolate is also a food cannabinoid and one that lives up to its reputation as the food of the gods. Cacao beans possess two compounds, N-oleoyl ethanolamine and N-linoleoyl ethanolamine, that inhibit FAAH so that the blissful effects of anandamide are prolonged. But these examples are just the tip of the iceberg. Dietary intake of specific plants and vegetables that contain prebiotic dietary fiber like inulin or fructans — types of fiber that help stimulate the growth of healthy bacteria in the gut — are also believed to stimulate the ECS in beneficial ways.

1990 Scientists succeed in cloning the CB1 receptor in rats and humans. 1992 Dr. Mechoulam’s lab identifies anandamine. 1993 A researcher at Cambridge University in England becomes the first to clone the CB2 receptor. 1995 Mechoulam’s lab discovers 2-AG.

MigraineIrritable bowel syndrome (IBS)Fibromyalgia, a chronic disorder marked by pain and tenderness throughout the body as well as fatigue

Supporting the CED hypothesis are clinical data showing that, for people with the above conditions, cannabinoid treatment (medicinal cannabis, pharmaceutical cannabinoids, and their synthetic derivatives) and other changes aimed at the ECS may decrease pain and improve sleep, among other benefits. Still, familiarizing yourself with the key terms will make it easier to understand current research aimed at utilizing the power of the ECS to prevent illness, treat disease, and maximize health and well-being. Learn More About the Language of the ECS

Favorite Orgs for the Endocannabinoid System

Society of Cannabis Clinicians This educational and scientific society is composed of physicians and healthcare professionals who are dedicated to the support of cannabis for medical use. We like their research library, which lets you browse through different studies covering the use of cannabis for specific health conditions. Project CBD This nonprofit educational organization is dedicated to promoting and publicizing research about the medical use of cannabis. Additionally, their site provides in-depth information about the endocannabinoid system and its many functions. District of Columbia Department of Health The DC Department of Health’s online slide show “An Introduction to the Biochemistry & Pharmacology of Medical Cannabis” provides a wealth of information about the history of cannabis, its use in medicine, and the endocannabinoid system as a whole. ProCon.org This nonprofit offers resources for critical thinking and ways to educate the public without bias. As its name implies, the site presents both pros and cons about many controversial issues, including medical marijuana use. United Patients Group The United Patients Group is a trusted resource for medical cannabis information. The organization offers continuing medical education (CME) courses and one-on-one consulting for physicians and medical institutions. Don’t miss their Medical Directory, which provides a list of professionals that embrace the use of medical cannabis and other integrative health practices. The Medical Cannabis Institute When it comes to education, this group has got you covered. The Medical Cannabis Institute provides online, science-based continuing education for healthcare professionals. Their goal is to better prepare those who treat patients who might benefit from or are already using medical cannabis. They also aim to educate researchers seeking to gain a broader understanding of the endocannabinoid system.

Favorite Online Support and Advocacy Networks

Weed for Black Women Weed for Black Women is a new organization dedicated to destigmatizing, educating, and supporting Black women and other women of color who are interested in all things related to medicinal and recreational cannabis. Ellementa Ellementa is a global, women-centric wellness company that is well-entrenched in the cannabis, CBD, and other plant medicine space. Offerings include education, robust community engagement, and a weekly live-broadcast exploring various plant-centric topics on women’s health. Marijuana Policy Project The mission of this group is to increase public support for nonpunitive, noncoercive marijuana policies; identify and activate supporters; change state laws to reduce or eliminate penalties for use of marijuana; and gain influence in Congress. On their site, you’ll find information about newsworthy issues and policies. You can take action to support their work by visiting the Federal Policy page. Americans for Safe Access If you’re looking to become an advocate, the ASA is ready for you. The organization provides resources and training opportunities for activists. Their mission is to ensure safe and legal access to cannabis for therapeutic use and research. You’ll find resources and brochures on how to talk to your doctor about medical cannabis, ways to become a state-authorized patient, and information about your legal rights. NORML NORML’s mission is to sway public opinion to legalize the responsible use of marijuana by adults. The group also aims to serve as an advocate for consumers, so they have access to high-quality marijuana that’s safe, convenient, and affordable.

Favorite Apps

WeedMaps This app is your ultimate guide to cannabis. You can learn about different products and locate dispensaries, deliveries, deals, and doctors near you. WeedMaps also provides community reviews on thousands of cannabis products and brands. Releaf This app allows you to anonymously log real-time experiences with specific cannabis and CBD products. You can easily track the product you’re using, where you purchased it from, and what symptoms you experienced to help guide your next treatment decision.

Favorite Product Sites

Leafly

Favorite Blogs

MedicalMarijuana.com The Medical Marijuana Blog features informative entries about different medical cannabis topics. From tips on how to grow your hemp to info on legalization, you’ll find a wide range of subjects covered on this site.

Favorite Patient-Centered Annual Meetings

CannMed CannMed is the leading scientific conference covering the latest in cannabis science, medicine, cultivation, and safety. International Cannabinoid Research Society Symposium on the Cannabinoids The International Cannabinoid Research Society is a scientific association with more than 500 international members, who are researchers in the field of cannabinoids and related bioactive lipids. Their annual symposium covers the latest breakthroughs in cannabinoid science.

Favorite Retreats or Experiences

Cannabliss Retreats Looking for a cannabis-inspired getaway? Cannabliss helps educate its retreatgoers on how to strengthen the body, expand the mind, and awaken the spirit with cannabis. Guests travel to locations such as Jamaica and interact with different cultures. Cannabis Food Experiences Enthusiasts and chefs are just starting to explore the role of food cannabinoids in the ECS. Participants can partake in communal dining experiences, grab a CBD smoothie, or discover new recipes for home dinners and parties. Additional reporting by Liz Scherer.