What is cannabis?
Cannabis (Cannabis sativa) is a plant that is used recreationally and therapeutically. Edibles (i.e. food products infused with cannabis), creams, extracts, and smokes are a few examples of cannabis products that are available in states where it is legal, such as Washington, Oregon, and California. Despite this, cannabis is still considered a Schedule I controlled substance by the Drug Enforcement Administration (DEA). The FDA supports research involving cannabis-based treatments for medical issues such as seizure disorders, chemotherapy-derived nausea, and cancer. However, due to the numerous active compounds found in cannabis and our limited knowledge of them, including tetrahydrocannabinol (THC) and cannabidiol (CBD), the FDA has not formally approved the plant and any plant-derived products “as a safe and effective drug for any indication.”
What is the focus of our research?
Cannabis consists of over 480 constituents, two of which are the main active components: THC and CBD. Cannabis-containing products can have varying amounts of both compounds, which are used for different purposes. Because of the rising popularity of cannabis products, especially as a treatment (self and prescribed) for medical conditions, it is critical to understand how cannabis constituents interact with pharmaceutical medications. A clinical study recently completed by NaPDI Center partners showed that the principal compounds in cannabis have the potential to interact both with pharmaceutical drugs and with themselves. CBD and THC, when taken concurrently, were shown to inhibit cytochrome P450 (CYP) 1A2, CYP2C9, CYP2C19, and CYP3A enzymes. When THC was taken alone with minimal CBD, only CYP2C9 was inhibited. Also, when THC was taken with minimal CBD, it was metabolized much faster than when both THC and CBD were taken concurrently, suggesting CBD may inhibit the breakdown of THC. Future research will aim to strengthen the physiologically-based pharmacokinetic (PBPK) model developed by this study and use it to predict cannabis-induced interactions, as well as predict cannabis pharmacokinetics in special populations such as young adults or people with cancer.