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2. Phytocannabinoids: Cannabis Plant, Modes of Consumption and Sinsemilla
Dr. Paul Morrison
Clinical Senior Lecturer
Institute of Psychiatry
King's College London
NHS Consultant Psychiatrist
The Maudsley Hospital, London

3. Possible origins Three subspecies Central Asia Himalayan Mountains
Cannabis sativa
Cannabis indica
Cannabis ruderalis

4. Δ9-tetrahydrocannabinol (THC)
Cannabinoids
Δ9-tetrahydrocannabinol (THC)
Δ9-tetrahydrocannabivarin (THCV)
Cannabidiol (CBD)
Cannabinol (CBN)
Cannabigerol (CBG)
Cannabichromene (CBC)
Clarke R. & Watson D. (2007) Cannabis and natural cannabis medicines, in ElSohly MA (ed.) Marijuana and the cannabinoids. Totowa, New Jersey: Humana press Inc. pp

5. Δ9-tetrahydrocannabinol (THC)
Cannabinoids
Δ9-tetrahydrocannabinol (THC)
Δ9-tetrahydrocannabivarin (THCV)
Cannabidiol (CBD)
Cannabinol (CBN)
Cannabigerol (CBG)
Cannabichromene (CBC)
Clarke R. & Watson D. (2007) Cannabis and natural cannabis medicines, in ElSohly MA (ed.) Marijuana and the cannabinoids. Totowa, New Jersey: Humana press Inc. pp

6. THC CBD CBC CBG (Cannabigerol) T allele D allele C allele
Clarke R. & Watson D. (2007) Cannabis and natural cannabis medicines, in ElSohly MA (ed.) Marijuana and the cannabinoids. Totowa, New Jersey: Humana press Inc. pp

7. THC CBD CBC CBG (Cannabigerol) T allele THC dominant plant D allele
CBD dominant plant
CBC
C allele
Clarke R. & Watson D. (2007) Cannabis and natural cannabis medicines, in ElSohly MA (ed.) Marijuana and the cannabinoids. Totowa, New Jersey: Humana press Inc. pp

8. Unpollinated plant (Sinsemilla)
Energy:
Seed production
Pollinated plant
Energy
Cannabinoid production
Sinsemilla: without seeds
T allele dominant
High THC, no CBD
Unpollinated plant (Sinsemilla)

9. Unpollinated plant (Sinsemilla)
Energy:
Seed production
Pollinated plant
Energy:
Cannabinoid production
Sinsemilla: without seeds
T allele dominant
High THC, no CBD
Unpollinated plant (Sinsemilla)

10. Unpollinated plant (Sinsemilla)
Energy:
Seed production
Pollinated plant
Energy
Cannabinoid production
Sinsemilla: without seeds
T allele dominant
High THC, no CBD
Unpollinated plant (Sinsemilla)

11. Unpollinated plant (Sinsemilla)
Energy:
Seed production
Pollinated plant
Energy
Cannabinoid production
Sinsemilla: without seeds
T allele dominant
High THC, no CBD
Unpollinated plant (Sinsemilla)

12. Modes of consumption

13. Hash oil: concentrated THC resin
Smoked:
Rolled cigarette
Hash oil: concentrated THC resin
Smoked
Vaped
Ingested orally
Food
Usually in fat

14. Hash oil: concentrated THC resin
Smoked:
Rolled cigarette
Hash oil: concentrated THC resin
Smoked
Vaped
Ingested orally
Food
Usually in fat

15. Hash oil: concentrated THC resin
Smoked:
Rolled cigarette
Hash oil: concentrated THC resin
Smoked
Vaped
Ingested orally
Food
Usually in fat

16. Sinsemilla

17. Intense cultivation methods, strains selectively bred High in THC :
Sinsemilla
Intense cultivation methods, strains selectively bred
High in THC :
No cannabidiol (CBD)
Unbalanced product
Traditional cannabis
4-5% THC
Cannabidiol (CBD)
Potter DJ. et al (2008) Potency of delta-9-THC and other cannabinoids in cannabis in England in 2005: implications for psychoactivity and pharmacology. Journal of forensic sciences. 53,

18. Intense cultivation methods, strains selectively bred
Sinsemilla
Intense cultivation methods, strains selectively bred
High in THC : > 15%
No cannabidiol (CBD)
Unbalanced product
Traditional cannabis
4-5% THC
Cannabidiol (CBD)
Potter DJ. et al (2008) Potency of delta-9-THC and other cannabinoids in cannabis in England in 2005: implications for psychoactivity and pharmacology. Journal of forensic sciences. 53,

19. Intense cultivation methods, strains selectively bred
Sinsemilla
Intense cultivation methods, strains selectively bred
High in THC : > 15%
No cannabidiol (CBD)
Unbalanced product
Traditional cannabis
4-5% THC
Cannabidiol (CBD)
Potter DJ. et al (2008) Potency of delta-9-THC and other cannabinoids in cannabis in England in 2005: implications for psychoactivity and pharmacology. Journal of forensic sciences. 53,

20. Intense cultivation methods, strains selectively bred
Sinsemilla
Intense cultivation methods, strains selectively bred
High in THC : > 15%
No cannabidiol (CBD)
Unbalanced product
Traditional cannabis
4-5% THC
Cannabidiol (CBD)
Potter DJ. et al (2008) Potency of delta-9-THC and other cannabinoids in cannabis in England in 2005: implications for psychoactivity and pharmacology. Journal of forensic sciences. 53,

21. THC
CBD
Could be inhibited by:
CB1
Animal models
Effects

22. THC CBD CB1 Effects Could be inhibited by: Sinsemilla hazards:
Animal models
Sinsemilla hazards:
Attributable to CBD absence?
Effects

23. Could CBD counteract THC at the psychological level?
Healthy volunteers
Session 1: CBD+THC
Session 2: THC+ placebo
THC could increase psychosis scores and worsen memory performance
CBD: protected against THC effects
Lower psychosis scores
Counteracted memory effects
Englund A, Morrison PD, Nottage J, Hague D, Kane F, Bonaccorso S, et al. Cannabidiol inhibits THC-elicited paranoid symptoms and hippocampal-dependent memory impairment. Journal of psychopharmacology 2013;27(1):19-27.

24. Could CBD counteract THC at the psychological level?
Healthy volunteers
Session 1: CBD+THC
Session 2: THC+ placebo
THC could increase psychosis scores and worsen memory performance
CBD: protected against THC effects
Lower psychosis scores
Counteracted memory effects
Englund A, Morrison PD, Nottage J, Hague D, Kane F, Bonaccorso S, et al. Cannabidiol inhibits THC-elicited paranoid symptoms and hippocampal-dependent memory impairment. Journal of psychopharmacology 2013;27(1):19-27.

25. Could CBD counteract THC at the psychological level?
Healthy volunteers
Session 1: CBD+THC
Session 2: THC+ placebo
THC could increase psychosis scores and worsen memory performance
CBD: protected against THC effects
Lower psychosis scores
Counteracted memory effects
Englund A, Morrison PD, Nottage J, Hague D, Kane F, Bonaccorso S, et al. Cannabidiol inhibits THC-elicited paranoid symptoms and hippocampal-dependent memory impairment. Journal of psychopharmacology 2013;27(1):19-27.

26. Could CBD counteract THC at the psychological level?
Healthy volunteers
Session 1: CBD+THC
Session 2: THC+ placebo
THC could increase psychosis scores and worsen memory performance
CBD: protected against THC effects
Lower psychosis scores
Counteracted memory effects
Englund A, Morrison PD, Nottage J, Hague D, Kane F, Bonaccorso S, et al. Cannabidiol inhibits THC-elicited paranoid symptoms and hippocampal-dependent memory impairment. Journal of psychopharmacology 2013;27(1):19-27.

27. Could CBD counteract THC at the psychological level?
Healthy volunteers
Session 1: CBD+THC
Session 2: THC+ placebo
THC could increase psychosis scores and worsen memory performance
CBD: protected against THC effects
Lower psychosis scores
CBD counteracted memory effects
Englund A, Morrison PD, Nottage J, Hague D, Kane F, Bonaccorso S, et al. Cannabidiol inhibits THC-elicited paranoid symptoms and hippocampal-dependent memory impairment. Journal of psychopharmacology 2013;27(1):19-27.

28. Appears to soften THC effects
CBD

29. First-episode psychosis patients vs healthy controls
High potency cannabis: 5x more likely to suffer a psychotic disorder
Hashish use: not related to increased risk of psychosis
Lower THC content, presence of CBD
Sinsemilla
Highest risk of psychotic disorder
South London: ¼ of new cases of psychotic illness
Di Forti, M., Marconi, A., Carra, E., Fraietta, S., Trotta, A., Bonomo, M., ... & Stilo, S. A. (2015). Proportion of patients in south London with first-episode psychosis attributable to use of high potency cannabis: a case-control study. The Lancet Psychiatry, 2(3),

30. First-episode psychosis patients vs healthy controls
High potency cannabis: 5x more likely to suffer a psychotic disorder
Hashish use: not related to increased risk of psychosis
Lower THC content, presence of CBD
Sinsemilla
Highest risk of psychotic disorder
South London: ¼ of new cases of psychotic illness
Di Forti, M., Marconi, A., Carra, E., Fraietta, S., Trotta, A., Bonomo, M., ... & Stilo, S. A. (2015). Proportion of patients in south London with first-episode psychosis attributable to use of high potency cannabis: a case-control study. The Lancet Psychiatry, 2(3),

31. First-episode psychosis patients vs healthy controls
High potency cannabis: 5x more likely to suffer a psychotic disorder
Hashish use: not related to increased risk of psychosis
Lower THC content, presence of CBD
Sinsemilla
Highest risk of psychotic disorder
South London: ¼ of new cases of psychotic illness
Di Forti, M., Marconi, A., Carra, E., Fraietta, S., Trotta, A., Bonomo, M., ... & Stilo, S. A. (2015). Proportion of patients in south London with first-episode psychosis attributable to use of high potency cannabis: a case-control study. The Lancet Psychiatry, 2(3),

32. First-episode psychosis patients vs healthy controls
High potency cannabis: 5x more likely to suffer a psychotic disorder
Hashish use: not related to increased risk of psychosis
Lower THC content, presence of CBD
Sinsemilla
Highest risk of psychotic disorder
South London: ¼ of new cases of psychotic illness
Di Forti, M., Marconi, A., Carra, E., Fraietta, S., Trotta, A., Bonomo, M., ... & Stilo, S. A. (2015). Proportion of patients in south London with first-episode psychosis attributable to use of high potency cannabis: a case-control study. The Lancet Psychiatry, 2(3),

33. First-episode psychosis patients vs healthy controls
High potency cannabis: 5x more likely to suffer a psychotic disorder
Hashish use: not related to increased risk of psychosis
Lower THC content, presence of CBD
Sinsemilla
Highest risk of psychotic disorder
South London: ¼ of new cases of psychotic illness
Di Forti, M., Marconi, A., Carra, E., Fraietta, S., Trotta, A., Bonomo, M., ... & Stilo, S. A. (2015). Proportion of patients in south London with first-episode psychosis attributable to use of high potency cannabis: a case-control study. The Lancet Psychiatry, 2(3),

34. Key Points
Cannabis is subdivided into three species: C. sativa, C. indica, C. ruderalis
Each species has differences in cannabinoid concentrations
Sinsemilla is a very potent product. It is high in THC and has no CBD
CBD appears to soften the effects of THC
Sinsemilla use is associated to higher risk of psychosis than hashish
THC

35. Key Points
Cannabis is subdivided into three species: C. sativa, C. indica, C. ruderalis
Each species has differences in cannabinoid concentrations
Sinsemilla is a very potent product. It is high in THC and has no CBD
CBD appears to soften the effects of THC
Sinsemilla use is associated to higher risk of psychosis than hashish
THC

36. Next Presentation: Cannabinoid Pharmacology and Synthetic Cannabinoids