September 29, 2020 14 min read

Cannabis is a plant with a long history of medicinal use that is currently used around the world for medicinal and recreational purposes. 

The term “cannabis,” used as a broad term, describes a group of three plants—Cannabis sativa, Cannabis indica, and Cannabis ruderalis. All three plants are similar in structure but are known for having different genetic compositions and effects, and therefore different uses.

A cannabis sativa plant

Cannabis Sativa and Cannabis Indica are the varieties most commonly used for their flower, which may contain potent levels of THC (the psychoactive component in cannabis) and is sometimes called "marijuana" or "weed." 

Cannabis Sativa L.is a specific species of the cannabis plant that is commonly called "hemp," and contains only trace amounts of THC. The flower of the hemp plant, which is often rich in CBD (a non-psychoactive cannabinoid that's recently gained attention for its therapeutic potential), can also be used in a similar manner to cannabis sativa flower. However, hemp is different from other cannabis varieties in that it is incredibly fibrous, which makes it useful for making a variety of textiles and food products.

Cannabis ruderalis is far less common and generally has low levels of both THC and CBD. It's known for its "autoflowering" capabilities, which means it can be cultivated with little to no effort from the grower. For this reason, ruderalis strains may be interbred with more potent strains to create incredibly useful cannabis plants that are easy to cultivate.

As it becomes more popular, the names used to describe these plants and their products are evolving. Although "weed" and "marijuana" have been heavily used in the past, they are beginning to phase out. The term "cannabis" is gaining popularity as the name for high-THC (psychoactive) products and "hemp" is frequently used to describe low-THC products or the cannabis material used to make textiles.

For the intents and purposes of this article, we’ll use “cannabis” to refer to high-THC Cannabis sativa plants and their products.

Table of Contents
How is Cannabis Used
Medicinal Cannabis Use
Recreational Cannabis Use
How Does Cannabis Work?
Cannabis Effects
What are the Short Term Effects of Cannabis?
What are the Long Term Effects of Cannabis?
How to Avoid Negative THC Affects
Is Cannabis Legal?
Is Cannabis Addictive?
Resources

Key Takeaways

The term “cannabis” technically refers to a group of plants in the Cannabaceae family. In modern times, however, “cannabis” is usually used to refer to high-THC cannabis products designed to induce psychoactive effects.

Cannabis products are used recreationally by many people, but also offer multiple medicinal effects. It has been approved for recreational use in some states and for medical use in over half of U.S. states.

Short term effects may include relaxation, increased appetite, a sense of calm, and euphoria, but also potentially paranoia, increased heart rate, decreased blood pressure, and other minor adverse reactions in some people.

Certain long term effects have been identified, but they may have more to do with inhalaing cannabis smoke than cannabis' effects. 

Ultimately, cannabis is a popular and potentially useful substance that is battling legality concerns throughout the country and the globe. Understanding the facts about cannabis can help break incorrect cannabis stigmas and promote responsible use where cannabis is legal.

How is Cannabis Used?

Cannabis has a lengthy history of medicinal use, and thanks to it’s relaxing psychoactive properties, it is now commonly used as a recreational substance in many parts of the world.

The way that cannabis is used varies greatly and depends on the user and the intended use. We’ll break cannabis use down into two categories to make it simple:

Medicinal Cannabis Use

In some states, cannabis has been approved for medical use for a limited number of conditions, meaning doctors may be able to recommend cannabis for ailments like chronic pain, bowel disorders, anxiety, and more.

The list of “qualifying conditions” for cannabis use varies by state, but some conditions that commonly make the list include:

  • Anorexia nervosa
  • Autism
  • Cachexia/Wasting syndrome
  • Cancer
  • Chronic pain
  • Crohn’s disease
  • Glaucoma
  • Hepatitis C
  • HIV/AIDS
  • Huntington's disease
  • Irritable bowel syndrome
  • Lupus
  • Migraines
  • Multiple sclerosis
  • Neuropathy
  • Osteoarthritis
  • Parkinson’s disease
  • Posttraumatic stress disorder (PTSD)
  • Seizures (including those characteristics of epilepsy)
  • Severe fibromyalgia
  • Ulcerative colitis
  • Tourette syndrome
  • Traumatic brain injury

In order to gain access to cannabis for medicinal use, most states require you to hold a “medical cannabis card.” The products available to medicinal users are typically no different than those available to recreational users, but medical card holders may pay less state taxes, be allowed to possess greater quantities of cannabis products, be able to shop at different hours, or be able to shop online.

Although the products available are mostly the same, medicinal users tend to prefer some cannabis products over others.

Cannabis-infused chocolate chips cookies

Smoking cannabis flower is the most common way that cannabis is used, and many people choose natural cannabis flower because it is unadulterated. However, it is hard to measure doses with cannabis flower, and some medicinal users may not respond well to inhaling smoke of any kind. Therefore, some medicinal users may need (or prefer) other dosing methods.

Cannabis edibles are an incredibly popular choice among medicinal consumers. Many come in pre-measured doses that make it easy to control the amount of THC you take. Some people argue that while THC edibles take longer to take effect, they also offer longer-lasting, more potent effects, which makes them popular for managing severe or chronic conditions.

THC concentrate, or a highly potent form of cannabis, may be recommended by physicians to those with severe conditions that respond to cannabis. Concentrates, like Rick Simpson Oil, are often chosen by people using cannabis to manage seizures or cancer-related ailments. Some concentrates may be vaporized and inhaled with a vaping device or dab rig while others are designed to be taken orally.

THC tinctures and sprays are popular for medicinal use because they offer direct, metered dosing by mouth.

THC topicals are also almost always chosen for medicinal use, because they do not offer the same psychoactive effects that recreational users seek. Even without psychoactive effects, many medicinal users choose THC topicals to manage pain or certain skin conditions that don’t respond well to other treatments.

THC suppositories are also popular for medicinal use, especially in those dealing with conditions that cause nausea or otherwise make it difficult to take cannabis by mouth. Suppositories are not always available at dispensaries, however, so medicinal patients must work with their doctor to find them when needed.

Recreational Use

Cannabis causes a psychoactive “high” that makes it a popular choice for recreational use, especially in certain social settings. When cannabis is used among groups, cannabis flower is the most common choice.

Cannabis flower rolled into a joint

Cannabis flower can be rolled into joints (with cigarette-style papers) or blunts (with cigar-style papers) or smoked in a “smoking piece” like a bong or a pipe. These types of products are easy to pass around, which is why they are usually chosen for recreational use at parties or events.

Other types of cannabis products are also popular among recreational cannabis users, though.

Cannabis vaporizers are becoming increasingly popular because they offer potent effects but are more versatile and discrete than smoking cannabis flower.

Cannabis edibles are also a popular choice because they are known for being incredibly potent. Edibles are available in a variety of forms, like gummies, candies, cookies, cakes, and more. Many people prefer to make their own THC edibles from cannabis flower, but it can be difficult to gauge the dose, so it’s not recommended for inexperienced recreational users.

Cannabis concentrates are also trending in the recreational world because of their potent effects. Concentrates are available in many forms, like wax, shatter, or oil. “Dabbing,” or vaporizing cannabis concentrates on a heated dab rig is the most popular way to use this concentrated version of THC.

How Does Cannabis Work?

Although the types of cannabis products vary greatly, the way that they work to produce effects within the body is the same whether you smoke cannabis flower, take edibles, or apply THC-infused topicals on your skin.

a human diagram from a museum exhibit on the endocannabinoid system

Cannabis interacts with the body through various modes, but the most prominent interaction is through the Endocannabinoid System. This system, which is found in all mammals, is very complex and researchers are still working to understand the full impact it has on overall health and daily life, but we do know a bit about how it functions.

To keep it simple, the endocannabinoid system is a system of neurotransmitters and neuroreceptors that spans throughout the body, including in the brain, skin, and all major organs. It plays a role in communicating a series of regulatory responses involving pain, mood, appetite, body temperature, immune responses, and more.

This “communications system” is made up of endogenous cannabinoids, or “endocannabinoids,” that are naturally produced by the body to help send these regulatory messages.

Cannabis has molecules, called “phytocannabinoids,” that are structurally similar to endocannabinoids. They are able to interact with the body’s endocannabinoid system in a similar manner to endocannabinoids.

Phytocannabinoids include THC (the main component in cannabis), CBD (the main component in hemp), and various minor cannabinoids like CBG, CBC, and CBN.

THC is considered to be structurally similar to anandamide, a chemical found naturally in the brain that helps produce feelings of euphoria. Anandamide got its name from the Sanskrit word “ananda,” which means “joy/bliss.” This explains why THC has a euphoric effect for most people.

In addition to cannabinoids, cannabis also contains various terpenes that may alter its effects.

Terpenes, the same plant-based components that make up essential oils, determine the flavor and aroma of different cannabis strains, but also have their own therapeutic potential (which you can read more about here.)

In short, cannabis contains a variety of compounds that mimic messengers in our body responsible for controlling pain, hunger, mood, immunity, and more, as well as multiple botanical compounds that have been proven to offer targeted therapeutic effects.

Cannabis Effects

The effects of cannabis vary for every person, likely because each person’s endocannabinoid system is uniquely balanced.

Cannabis’ effects are highly regarded as “relaxing” and “euphoric,” and the response from those who use cannabis is overwhelmingly positive. Many people also suggest that the cannabis experience is dose dependent, and many people who enjoy the light euphoria from small doses may experience uncomfortable side effects at high doses. However, as with all substances, some people don’t respond well to cannabis.

The effects of cannabis not only vary by person, but by strain. Each cannabis strain has a unique composition of cannabinoids and terpenes, and some people claim to respond well to some strains and poorly to others.

There is some evidence regarding the collective effect of different cannabinoids and terpenes, a phenomenon called “the entourage effect,” but research has only scratched the surface. While understanding how cannabis components like terpenes and cannabinoids work can help you find the best cannabis strain for you, most people find that a “guess and check” method is also an effective way to find the best strain.

In general, though, cannabis poses several different short-term and long term effects.

What are the Short Term Effects of Cannabis?

Many of the short-term effects of cannabis are considered desirable, and the short term effects are the reason that people seek cannabis for medical and recreational use.

The amount of time it takes for effects to kick in varies by person and by product. When smoking cannabis flower or vaping concentrate, the effects are nearly instant. Other products, like edibles, capsules, or oral oils may take longer to kick in because they need to be digested before they reach the bloodstream. In general, edible cannabis can take 1-2 hours to produce effects.

The short term effects from different dosing methods are generally the same. Positive effects of cannabis may include:

  • Relaxation
  • Improved mood
  • Increase sensation
  • Increased appetite
  • Altered perception of time and events
  • Improved focus
  • Creativity
  • Calming effect
  • Potential relief from a variety of symptoms

For some people, and especially at high doses, THC may come with negative effects, including:

  • Coordination issues
  • Fatigue or lethargy
  • Slow reaction times
  • Nausea
  • Anxiety or paranoia
  • Increased heart rate
  • Lower blood pressure

These effects are considered short term effects because they take effect and die out quickly. Generally speaking, the effects from cannabis last anywhere from 2 to 6 hours after they kick in.

What are the Long Term Effects of Cannabis?

Various long-term effects have been associated with cannabis use, but much of the research focuses on what is considered “chronic” or frequent use and not on the effects of occasional use.

It’s also important to note that much of the research regarding THC has been focused on proving the risks, but many experts note that the potential long term effects of cannabis still may be less risky than the long-term effects of some prescription drugs that cannabis could replace for some patients, like medications taken for pain.

Still, chronic use of cannabis may still pose adverse effects in the long term, and the risk of adverse effects to cannabis is substantially increased for people who start using cannabis products as a minor, before the brain is fully developed.

Long term effects of cannabis may include:

  • Immune response: A 2019 study found that heavy cannabis use may be linked to moderately increased white blood cell levels, which is in-line with the pro-inflammatory response of cigarette smoke. It is unclear whether these effects are linked to all cannabis use, or just cannabis use that involves inhaling smoke.
  • Gum disease: The American Dental Association suggests that there may be a link between cannabis use and gum disease. Again, gum disease may be linked to inhaling smoke and different cannabis delivery methods may produce different effects. More research is needed.
  • Testicular cancer: A 2018 review found that cannabis use that exceeds 50 times per lifetime may increase men’s risk of testicular cancer, but it’s unclear how cannabis has this effect. More research is needed.
  • Decreased brain development: A 2014 study found that cannabis may have a negative impact on overall brain development when used by adolescents. According to this research, people who use cannabis before adulthood may be more likely to experience learning problems and memory issues than adults, but it's unclear if these effects are permanent.
  • Respiratory problems: Research suggests that smoking cannabis may pose similar risks to smoking tobacco because combustion causes the release of carcinogens and toxins that may inflame and irritate the airways. Cannabis may be linked to some respiratory issues, like bronchitis, but more recent research has shown no apparent link between cannabis use and lung cancer.

The most significant and heavily studied long-term effect of cannabis is it’s potentially negative impact on memory and cognition, and research still disagrees on several points concerning the impact of cannabis on the brain.

Much of the research concerning adverse reactions to long-term, frequent cannabis use looks at the impact of smoking cannabis. It is unknown if other delivery methods are safer or pose less risk, but many industry experts suggest that edibles and oral products may be easier on the body by avoiding the toxic byproducts created by combustion.

Of course, chronic overuse of any substance is likely to throw the body out of balance and result in long-term adverse effects. If you plan to use cannabis everyday, like for medicinal purposes, you should discuss the potential adverse effects with your doctor first.

How to Avoid Negative THC Effects

There hasn’t been much research to explain who is at greater risk of experiencing a negative reaction to THC or how the negative side effects may be avoided. Still, there are multiple factors that are likely to affect the risk of adverse reactions in some way.

A bottle of CBD that may be used to modify negative THC effects

First, there may be a decreased risk of side effects at smaller doses. Of course, smaller doses may reduce the effects of cannabis overall, including positive effects, but it’s still a good idea to start small to stay on the safe side until you know how you will respond to THC.

Many people also report that adding CBD to their cannabis routine makes a difference. Some people seek out cannabis products with a 1:1 CBD to THC ratio for medical use because it provides more balanced effects. Others claim that CBD can help “bring down” a cannabis high, but these effects have not been studied.

Research does show that CBD may inhibit some of the negative effects of THC, like paranoia, when taken at the same time. Since CBD is non-psychoactive, it may also work by simply reducing your exposure to psychoactive material while using cannabis.

Is Cannabis Legal?

Although cannabis is one of the most heavily used psychoactive substances around the world, it’s legality is a sticky topic in most places.

Cannabis has only been legalized for recreational use in two countries, Canada and Uruguay. In the United States, cannabis is still considered an illicit substance on a federal level and it is categorized as a Schedule I substance—meaning that illegal possession can carry the same weight as heroine, LSD, or peyote.

However, many U.S. states have passed laws to legalize cannabis for medicinal use. Fewer states have legalized cannabis for recreational use, and a handful of states who have not passed laws to legalize cannabis have decriminalized it on some level.

Cannabis’ legal status has been expanding over recent years, and multiple attempts have been made to legalize it on a federal level within the U.S.

Many medical professionals and researchers have identified cannabis’ legal status as a barrier to medically-focused cannabis research. Because the plant is illegal according to the federal government, it is difficult for researchers to get grants for cannabis-based research efforts or access to legal cannabis material for their research.

Unlike high-THC cannabis, some plants in the cannabis family have gained federally legal status in recent years. In 2018, the Hemp Farming Bill legalized “industrial hemp,” a species of cannabis that has less than 0.3% THC, on a federal level. The bill’s context also legalized CBD in all 50 states, and many people who cannot access legal cannabis products have turned to CBD instead.

Is Cannabis Addictive?

Conversations about cannabis’ abuse potential generally harbor quite a bit of disagreement among cannabis users and researchers. Many people claim that THC has far less potential for addiction than substances like opioids, which are known for quickly forming physical dependencies that lead to addiction.

A person smoking a cannabis joint

In general, cannabis is most often associated with dependence, not addiction. Researchers and leading organizations agree that cannabis can be habit forming, especially after chronic use, which may lead to a condition called “marijuana use disorder.”

A 2015 study suggests that 30% of people who use high-THC cannabis may have some level of marijuana use disorder, which is characterized by a physical dependency on phytocannabinoids and low endocannabinoid levels.

Those with a physical dependency on marijuana may experience some withdrawal symptoms when discontinuing use. THC withdrawal symptoms may include irritability, sleep disruptions, appetite changes, restlessness, depressed mood, or certain physical discomforts, like stomach pain, headaches, or shakiness.

Research suggests that those who begin using cannabis before the age of 18 are four to seven times more likely to develop a cannabis dependency than a person who first uses cannabis as an adult.

Not everyone who quits using cannabis will experience withdrawal symptoms, and those who do will experience the worst withdrawal symptoms within the first week after quitting.

Even knowing the risks for dependency, cannabis is frequently considered a “soft drug” compared to other substances with a high-risk for dependency. Opioids, for instance, are known for causing violent withdrawal symptoms like nausea and vomiting and opioid addiction has an undeniable link to the risk of death.

Addiction and dependency are not the same, and while researchers agree that some people who experience cannabis dependency may also experience addiction, that is not always the case. There is very little accurate data to represent the risk of true addiction to high-THC cannabis.

Alternatively, other cannabis products have been approved by leading organizations as having no public health risks. CBD is considered to have little to no risk for dependency or addiction, and some sources suggest that it may even be useful in treating certain substance abuse disorders. One study suggests that CBD may be therapeutic for patients battling opioid, cocaine, psychostimulant, tobacco, and cannabis addiction.

Resources

  1. “Total and differential white blood cell count in cannabis users: results from the cross-sectional National Health and Nutrition Examination Survey, 2005–2016” https://jcannabisresearch.biomedcentral.com/articles/10.1186/s42238-019-0007-8
  2. “Cannabis: Oral Health Effects” https://www.ada.org/en/member-center/oral-health-topics/cannabis
  3. “Cannabis use and incidence of testicular cancer: a 42-year follow-up of Swedish men between 1970 and 2011” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5812006/
  4. “Adverse Health Effects of Marijuana Use” ncbi.nlm.nih.gov/pmc/articles/PMC4827335/
  5. “Cannabis smoking and lung cancer risk: Pooled analysis in the International Lung Cancer Consortium” https://pubmed.ncbi.nlm.nih.gov/24947688/
  6. “Cannabis Use, Lung Cancer, and Related Issues” https://www.jto.org/article/S1556-0864(18)30038-8/fulltext
  7. “Drug Scheduling” https://www.dea.gov/drug-scheduling#:~:text=Schedule%20I%20drugs%2C%20substances%2C%20or,Schedule%20II
  8. “Prevalence of Marijuana Use Disorders in the United States Between 2001-2002 and 2012-2013” https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2464591
  9. “Diagnostic Criteria for Cannabis Withdrawal Syndrome” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3311695/
  10. “Likelihood of developing an alcohol and cannabis use disorder during youth: Association with recent use and age” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2219953/
  11. “Cannabidiol as an Intervention for Addictive Behaviors: A Systematic Review of the Evidence” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4444130/

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