Cannabis. Cannabidiol. Cannabinoids. Tetrahydrocannabinol. Yeesh. Do I need a degree to medicate with cannabis?

No, you don’t! But since you are partially in control of your medication in terms of finding the right dose and strains, learning about the endocannabinoid system may help you understand the internal process.

The endocannabinoid system (ECS) is one of the most abundant neurotransmitter systems in the body. As part of this system, cannabinoid receptors are located throughout the body in our brains, organs, tissues and more. This helps to explain why cannabinoids work on a systemic level.  

How does it work? The ECS receptors bind with cannabinoids. Remarkably, the phytocannabinoids in the cannabis plant mimic our own endocannabinoids, so the receptors are able to bind with either endocannabinoids or phytocannabinoids found in the cannabis plant (endo means internally made and phyto means plant).

Our bodies’ internal pharmacy creates a neurotransmitter and cannabinoid called anandamide, taken from the Sanskrit word ‘ananda’ meaning “joy, bliss, delight”. Among other effects, anandamide helps regulate mood, temperature, and enhances pleasure.

THC (tetrahydrocannabinol) is the cannabis plant’s version of anandamide. THC will bind to cannabinoid receptors throughout the central and peripheral nervous system and also regulate mood, temperature, enhance pleasure and more. Other plant cannabinoids, including CBD, work within the endocannabinoid system as anti-inflammatory and neuroprotective agents.

If the body is deficient in producing its own cannabinoids, supplementing with medical cannabis may help to bring your system back to balance or homeostasis.  Emerging evidence suggests this deficiency can be caused by stress, age, illness and can possibly result in illness, pain and disease-like symptoms.

How do we know how much cannabis is enough? NHS doctors and educators stress that patients should keep a journal and titrate their cannabinoid doses up slowly. In some cases, patients may only need to slightly augment with phytocannabinoids to achieve symptom relief.

Titrating up slowly will help find that ‘sweet spot’ where symptoms are decreased or alleviated, and medication related side effects are minimized. Only the patient is in a position to judge the proper dose, thereby giving them control over their recovery. The doctor will suggest a starting dose, and can indicate general amounts to stay within, but patients will be in the best position to gauge and journal effects and dose appropriately.  

Health Canada regulated medicinal cannabis is safe and there are almost no dangerous side effects. However, like all medications, cannabis can have risks or side effects. Care with any new medication must be taken. Make sure you are mindful when taking your medication. This will help prevent any discomfort or intoxication resulting from overmedicating.

Our physicians advise to start doses below the expected therapeutic window, and titrating up slowly.  When your symptoms resolve, pain dissipates or nausea retreats, a therapeutic dose has been reached.

I asked our own Medical Director, Dr. Mark Kimmins, why doctor bias around the endocannabinoid system is prevalent.

“Currently, much research is being undertaken to determine the best way to use plant cannabinoids to treat human disease and associated symptoms. Despite thousands of scientific papers on the endocannabinoid system, it is not currently taught within most medical school curriculums. This is likely because the system was discovered relatively recently (1992), and is amazingly widespread and complex, and there are as many unknowns as answers currently. Surprisingly it is still possible to find medical doctors who have never heard of the endocannabinoid system. However, there are also many physicians who have witnessed overriding clinical evidence that cannabinoid therapy is safe and effective in their patients. This strong clinical evidence, combined with active ongoing research, is likely to bring the endocannabinoid system to the forefront of medicine soon.”

This is just the tip of the endocannabinoid system iceberg. Know that you know the basics of how it works in your body, you can start to understand how medicinal cannabis will help you.


— Kait Shane, Community Outreach Educator Natural Health Services. Follow Natural Health Services on Twitter @NatHealthserve.

For further insight into all things cannabis, don’t forget to check out The Cannabis Show (new episodes every Wednesday) and connect with us on Facebook, Twitter and Instagram. The Cannabis Show is also available as an audio podcast, subscribe on iTunes, Google Play, Stitcher, TuneIn, and Overcast.

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