The Basic Science of Cannabinoids

Abstract

The cannabis plant has been used for centuries to manage the symptoms of various ailments including pain. Hundreds of chemical compounds have been identified and isolated from the plant and elicit a variety of physiological responses by binding to specific receptors and interacting with numerous other proteins. In addition, the body makes its own cannabinoid-like compounds that are integrally involved in modulating normal and pathophysiological processes. As the legal cannabis landscape continues to evolve within the United States and throughout the world, it is important to understand the rich science behind the effects of the plant and the implications for providers and patients. This narrative review aims to provide an overview of the basic science of the cannabinoids by describing the discovery and function of the endocannabinoid system, pharmacology of cannabinoids, and areas for future research and therapeutic development as they relate to perioperative and chronic pain medicine.

Effects of recent cannabis consumption on eye-tracking and pupillometry

“…Research reports that pupil size has a strong (Pearsons r = 0.81–0.86) correlation with blood THC level ( Shahidi Zandi et al, 2021 ). The rate at which THC is excreted from the body depends on several demographic and cannabis-related variables ( Chayasirisobhon, 2020 ; Sideris et al, 2024 ), and THC metabolites persist in blood longer than duration of euphoria ( Spindle et al, 2021 ). Although it had been several hours since the Cannabis Group had consumed any cannabis, more than half of the sample self-reported to be daily users meaning that it was highly likely that there were still elevated levels of THC in their blood.…”

The Sobering Sting: Oleoyl Serotonin Is a Novel Stephanoconus Snail Venom-Derived Antagonist of Cannabinoid Receptors That Counteracts Learning and Memory Deficits

“…Like the OS compound, rimonabant is also a CB1 receptor antagonist, indicated for the treatment of obesity and related metabolic risk factors in nondiabetic and diabetic overweight and obese patients [46,47]. However, this compound was withdrawn from the market due to psychiatric adverse effects such as depression and even suicidal ideation [11,12]. These side effects are linked to the central psychiatric adverse effects of the CB1 receptor signaling pathway [11,12].…”

“…However, this compound was withdrawn from the market due to psychiatric adverse effects such as depression and even suicidal ideation [11,12]. These side effects are linked to the central psychiatric adverse effects of the CB1 receptor signaling pathway [11,12]. At present, we cannot exclude that OS too would suffer from similar side effects as rimonabant, limiting its potential to become a drug.…”

“…Though over a hundred phytocannabinoids have been found and numerous synthetic cannabinoids have been generated over the past few decades, only a few phytocannabinoids and synthetic phytocannabinoid analogs have reached the clinical market so far [3,11,12]. For example, the approvals of nabiximols, a mixture of tetrahydrocannabinol and the nonpsychotropic cannabinoid cannabidiol, for the treatment of spasticity and neuropathic pain in multiple sclerosis, and of purified botanical cannabidiol for the treatment of otherwise untreatable forms of pediatric epilepsy, have brought the therapeutic use of cannabinoids and endocannabinoids in neurological diseases into the limelight [3].…”

The role of cannabinoids in chronic pain management: clinical insights and challenges

“…The discovery of phytocannabinoids and their effects enabled the design of a myriad of synthetic cannabimimetic compounds that served as the basis for several groundbreaking studies in the last few years. 2 , 3 …”