Cannabis
(Cannabis sativa) is the most widely
used illicit drug in the world, with an estimated 192 million users
globally. The main psychoactive component of cannabis is (−)-trans-Δ9-tetrahydrocannabinol (Δ9-THC), a compound with a diverse range of pharmacological
actions. The unique and distinctive intoxication caused by Δ9-THC primarily reflects partial agonist action at central
cannabinoid type 1 (CB1) receptors. Δ9-THC is an approved therapeutic treatment for a range of conditions,
including chronic pain, chemotherapy-induced nausea and vomiting,
and multiple sclerosis, and is being investigated in indications such
as anorexia nervosa, agitation in dementia, and Tourette’s
syndrome. It is available as a regulated pharmaceutical in products
such as Marinol, Sativex, and Namisol as well as in an ever-increasing
range of unregistered medicinal and recreational cannabis products.
While cannabis is an ancient medicament, contemporary use is embroiled
in legal, scientific, and social controversy, much of which relates
to the potential hazards and benefits of Δ9-THC itself.
Robust contemporary debate surrounds the therapeutic value of Δ9-THC in different diseases, its capacity to produce psychosis
and cognitive impairment, and the addictive and “gateway”
potential of the drug. This review will provide a profile of the chemistry,
pharmacology, and therapeutic uses of Δ9-THC as well
as the historical and societal import of this unique, distinctive,
and ubiquitous psychoactive substance.