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How Does Cannabis and THC Really Work?

Dear Nurse Susan, 

I recently read that raw cannabis does not get you high. What is that all about?!?!? If the marijuana plant doesn’t get you high then what does?

Curious Minds Want to Know

Dear Curious, 

I know what you mean. Particularly when you actually see and smell healthy, robust cannabis plants you think those plants are eager to work their magic. Depending on what magic you’re looking for, raw cannabis does have many benefits. However, having a psychoactive effect and getting you high is not one of them.  

So, let’s talk about tetrahydrocannabinol (THC)! THC is the psychoactive cannabinoid found in the cannabis plant. It is formed by the decarboxylation of THCA, a non-psychoactive cannabinoid found in the raw cannabis plant. THCA is known to be an effective anti-inflammatory and neuroprotectant. It is commonly found in topicals, oils and tinctures. So, the first thing to know is raw cannabis will not get you high!

The process of decarboxylation turns THCA into THC. So what is decarboxylation? We’ll get a little geeky for a minute and define decarboxylation. Honestmarijuana.com says: “The first term, “de-”, is a prefix that basically means removal. The second term, “carboxyl”, is a chemical term for the acid radical group COOH which is found in most organic substances. The third term, “-ation”, is a suffix that basically means an action. Put those three terms together and you get, “the action of removing the carboxyl group (COOH)”. That’s what decarboxylation means.” 

Leafly goes on to explain: “The two main catalysts for decarboxylation to occur are heat and time. Drying and curing cannabisover time will cause a partial decarboxylation to occur. This is why some cannabis flowers also test for a presence of small amounts of THC along with THCA. Smoking and vaporizing will instantaneously decarboxylate cannabinoids due to the extremely high temperatures present, making them instantly available for absorption through inhalation.

While decarboxylated cannabinoids in vapor form can be easily absorbed in our lungs, ediblesrequire these cannabinoids present in what we consume in order for our bodies to absorb them throughout digestion. Heating cannabinoids at a lower temperature over time allows us to decarboxylate the cannabinoids while preserving the integrity of the material we use so that we may infuse it into what we consume.”

There is a trend in some states to legalize CBD but not cannabis or THC. THC and CBD (and all the other cannabinoids and terpenes) work synergistically and when you isolate one compound it is much less effective. Without at least a little THC you are leaving most diseases and patients with inadequate treatment.

Most patients are concerned about being “high” and have the misunderstanding that cannabis therapy means getting high. It is very easy to modulate the THC dose to minimize or avoid the psychoactivity. Using raw cannabis is an excellent source of cannabinoids and terpenes without getting high. Stay tuned for my tutorial on THCA! 

What are the effects of THC?

THC binds with the Endocannabinoid System at the CB1 and CB2 receptor sites. Here is a basic explanation of the endocannabinoid system. .  Research, user reports and documentation have shown that THC has been effective in producing the following effects: 

  • Pain relief
  • Anti-nausea/vomiting
  • Increases appetite and reduces cachexia/wasting; good for cancer and HIV/AIDS
  • Anti-inflammatory; good for arthritis, fibromyalgia, Crohn’s, psoriasis
  • Anti-cancer properties in conjunction with CBD; super activation of CB1 and CB2 receptor sites leads to apoptosis (programed cell death)
  • Inhibits the growth of certain lung cancers
  • Kills leukemia cells
  • Antioxidant
  • Relieves stress and PTSD
  • Relieves Tourette’s
  • Relieves tremors
  • Relieves agitation in Alzheimer’s
  • Muscle relaxant
  • Bronchodilator
  • Neuroprotective; good for Parkinson’s and other neurodegenerative diseases
  • Anti-spasmodic; good for muscular dystrophy
  • Relieves fatigue (sativa)
  • Relieves itching
  • Anti-seizure
  • Relieves symptoms of opioid withdrawal
  • Antidepressant
  • Sedative; promotes sleep (Indica)
  • Relieves sleep apnea
  • Relieves heartburn; GERD; good for duodenal ulcers
  • Inhibits gastric acid secretion
  • Reduces blood pressure
  • Relieves endometriosis, cramps, menstrual pain
  • Relieves phantom limb pain
  • Relieves migraines/headaches
  • Relieves spinal injury pain
  • Relieves ADD/ADHD
  • Relieves obsessive-compulsive disorder
  • Relieves bipolar disorder
  • Reduces intraocular pressure; good for glaucoma
  • Inhibits progression of atherosclerosis

This is quite a list! In addition, and perhaps more importantly - No one has ever died of an overdose of cannabis because there are no CB1 or CB2 receptors in the brain stem, which controls respiration and heartbeat. Opioids, however, are another story. There are opioid receptors in the brain stem which is why there is an epidemic of fatal opioid overdoses. However, that does not mean that a person can consume excessive amounts of THC and have no consequences. Usually they will either fall asleep, or feel anxiety, paranoia, rapid heart rate, and a sense of perceived harm, even though they are safe.

After reading this it is clear that there are myriad uses and positive effects of THC. However, like any medicine, it is not a wonder drug.  As with any medication, it does not have the same effect and work effectively for everyone. When treating medical conditions the process is similar to many medication treatment protocols – there is a process of determining if the medicine produces the desired results, and then dosing it appropriately for maximum benefit and minimum unwanted side effects. This is why working with a medical cannabis professional is often the best way to get timely and maximum results from various medical cannabis products.

So Curious, I hope this gives you a better understanding of the cannabis plant, THC and how to effectively use cannabis for both medical and recreational purposes. 

To your health,

Nurse Susan  


(Susan Marks RN, BSN, PHN writes for CityWatch and is a medical cannabis educator and consultant based in Los Angeles. You can contact her at hello@dearnursesusan.com